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HomeMy WebLinkAboutHealth Services AgreementContract S KittCoSheriff-HSA2020-004 The Kittitas County Sheriff's Office Health Services Agreement For The Year 2O2O This Agreement is between Kittitas County through Kittitas County Sheriffls Office (hereinafter "sheriffs Office") and Central Washington Comprehensive MentalHealth (hereinafter the "providef) and shall be in effect from the date signed by both parties until December 31, 2020. The Sheriff or the provider may terminate this contract provided that at least thirty (30) days written notice is given in advance of termination. Exceptions may be made if the Sheriff deems removal is necessary. This contract shall be to provide Mental Health care within KCCC as outlined below: Definitions: A. Practitioner: presumptively a Psychiatric Advanced Registered Nurse Practitioner (p-ARNp| - a person who holds a current, valid license to practice as such in Washington State as defined in RCW 71.05.020 and who has prescriptive authority. The Provider may substitute another licensed medical professional whose license status includes prescriptive authority sufficient to implement and maintain existing prescriptions appropriate to the mental health condition of inmate patients. Contract Provisions: L' The Provider will supply a qualified Practitioner who will provide Mental Health related medical assessmentand treatmentto inmates of the Kittitas CountyCorrections Center (KCCC) according to established professional protocols and within their licensed capabilities, based on the assessment and recommendations made by the Mental Health Professionaland/or other professionals who have evaluated the inmate. The Practitioner shall work up to three (3) hours every Thursday afternoon, starting with the first Thursday after the effective date of this contract. The three hour period shall not start earlier than noon or end later than 1700 (5:00 PM). Provider and KCCC agree that variations within and deviations from the currently intended schedule that do not change the number of hours of service provided may be informally agreed upon due to the nature of KCCC operations, weather conditions, and other circumstances beyond the control of the parties. Provider may delegate appropriate authority to the Practitioner to address such necessary deviations. The KCCC on-duty supervisor shall be the designated point of contact for such communications. 2. Qualified Substitute: Provider may, with advance notice to the Sheriff's Office, if the designated Practitioner is not available for any reason, provide a substitute for the Practitioner of egual or greater qualifications. The period of notice shall be as much as reasonably possible, consistent with the circumstances that require the substitution. lt is the intent of the parties that a specific substitute be designated and utilized to the greatest extent possible so that continuity of care is maintained and the background investigation referred to in Provision Eleven (11) may be conducted in a timely manner. 3. After passage of the scheduled time previously agreed upon pursuant to Provision 1 (one), any additionaltime required for patient care shall be charged at an hourly rate described below or Page 1 portion thereof in fifteen (15) minute increments as actually provided. 4- Each inmate shall have access to sick call by providing a written Request for Medical Services, signed by the inmate requesting the service. Those Requests for Medical Service that do not require the services of the Practitioner shall be returned to the Duty Supervisor for action. lndigent inmates shall not be denied access to medical care. 5' Payment for prescription medications shall be the responsibility of the inmate receiving the medication. Medications to sustain life or to prevent life threatening medical problems shall be permitted. All medications shall be at the expense of the inmate. Those medications for conditions other than life threatening shall be provided only if the inmate has funds to pay for such medications. The final decision as to the necessity of any medication pursuant to this provision shall be made by the Practitioner or the approved substjtute. 6. The Practitioner shall be responsible for logging all patients seen and completing the Kittitas County Corrections Center Medical Services Log as well as individual patient charting. The Practitioner shall provide medical referral and obtain medical consultation as necessary. 7, The Provider shall provide telephone consultation to Corrections Staff regarding emergency inmate medical needs outside of regular sick call hours, but such telephone consultation shall be limited to the hours of 8:00am to 9:00pm daily. Such telephone calls may be billed with a five (5) minute minimum of 52.50 per telephone call as actually provided. There will not be an actual call schedule, but as available. All other calls shall be referred to the local emergency room for assistance. 8. The compensation to Provider for these services is as follows: 5125.00 per hour ln the event the Practitioner is subpoenaed to court regarding care given at the Kittitas County Corrections Center the hourly rate shall be paid for actual time spent preparing for court and testifying. The Practitioner shall be responsible for keeping an accurate and detailed time card accounting for all billable time. Time cards are turned in once a week and paid on or about the 5th of the next month. The Provider and Sheriff's Office agree that in the event that no inmates have requested to be seen by the Practitioner, the "sick call" for that day as scheduled pursuant to Provision One (1) of this Agreement may be cancelled by telephone with two (2) hours notice and that there will be no charge for that cancelled sick call. For the purposes of this Provision, the Sheriffs Office official responsible for the determination and cancellation shall be the assigned Corrections center Duty supervisor for the shift during which the sick call is scheduled. 9. Kittitas County shall indemnify and hold harmless the Provider, its agents or employees from and against all loss or expense, including but not limited to judgments, settlements, reasonable attorney's fees and costs by reason of any and all claims and demands upon the medical provider for damages because of personal or bodily injury including death at any time resulting therefrom, sustained by any person or persons and on account of damage to property including loss of use thereof, due to the negligence of Kittitas County, the Kittitas County Sheriffs Office, its elected officers, employees, volunteers, or other agents except such inJury or damage as shall have been PageZ occasioned by the sole negligence or willful misconduct of the Provider, its agents or employees. Kittitas County has insurance to cover the Provider during such times as the P-ARNp or qualified substitute is treating inmates of the Kittitas County Corrections Center pursuant to this agreement. Such insurance shall not cover patients who were not Kittitas County Corrections Center inmates and that were treated by the Provider outside of the Corrections facility. Provider shall defend, indemnify and hold harmless Kittitas County, the Sheriffs Office, its appointed and elective officers, agents and employees, from and against all loss or expense, including but not limited to judgments, settlements, reasonable attorney's fees and costs by reason of any and all claims and demands upon the County, the Sheriffs Office, its elected or appointed officials, agents or employees for damages because of personal or bodily injury including death at any time resulting therefrom, sustained by any person or persons and on account of damage to property including loss of use thereof, whether such injury to persons or damage to property is due to the negligence of the Provider, its subcontractors, its elected officers, employees or their agents, except only such injury or damage as shall have been occasioned by the sole negligence of Kittitas counry, the Sheriffs Office, appointed or elected officials, agents or employees. lt is further provided that no liability shall attach to Kittitas County by reason of entering into this contract, except as expressly provided herein. 10. The Sheriffs Office, through the Kittitas County Corrections Center, shall maintain basic medical supplies and items, which shall be used in the treatment of inmates of the facility. Such supplies shall include prescription forms, over the counter medications, first aid supplies, topical agents and such other supplies as deemed appropriate by the Provider. The Provider may delegate its role in this process to the p-ARNp. 11' The Practitioner shall be subject to a Background lnvestigation as determined by the Sheriff; this may include a polygraph test (see RCW 49.44.120). This will be conducted by whomeverthe Sheriff's Otfice deems qualified to complete. This can be done prior and anytime after the contract is signed by the Provider. The P-ARNP or qualified substitute may be subject to such background investigation or any part thereof more than once. 12. ln the event that any litigation should arise concerning the construction or interpretation of any of the terms of this Agreement, the venue of such action of litigation shall be in the Superior Court of the State of Washington in and for the County of Kittitas. This Agreement shall be governed by the law of the State of Washington. 13. All services pursuant to this Agreement shall be furnished by the provider as an independent contractor and nothing herein contained shall be construed to create a relationship of employer- employee or master-servant but all payments made hereunder and all services performed shall be made and performed pursuant to this Agreement by the Provider as an independent contractor. The Provider acknowledges that the entire compensation for this Agreement is specified in Sections 7 and 8, and that neither the Provider nor Practitioner is entitled to any Kittitas County benefits including, but not limited to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance benefits, or any other rights or privileges afforded to Kittitas County employees. Provider will defend, indemnifiT and hold harmless Kittitas County, the Kittitas County Sheriffs Page 3 office, their officers, agents or employees from any loss or expense, including but not limited to settlements, judgments, setoffs, attorneys' fees or costs incurred by reason of claims or demands because ofbreach ofthe provisions ofthis paragraph. 14. Either party may request changes in the Agreement. Any and all agreed modifications shall be in writin& signed by each of the authorized agents of the parties. 15' Except as set forth elsewhere in the Agreement, for all purposes under this Agreemen! except service of process, notice shall be given by the Provider to the Corrections Commander, Kittitas County Corrections Center, 205 W' 56 Ave. Suite #1., and to the Kittitas County Commissioners, 205 W 5th Ave, Suite 10& Ellensburg, WA 98926. Notice to the Provider for all purposes under this Agreement shall be given to the address or telephone number as the case may be reflected on the signature page. Notice may be given by delivery or by depositing in the U.S. Mail, first class, postage prepaid. 16. lf any term or condition of this Agreement or the application thereof to any person(s) or circumstances is held invatid, such invalidity shall not affect other terms, conditions or applications which can be given effect without the invalid term, condition or application. To this end, the terms and conditions of this Agreement are declared severable. 17. Waiver of any breach or condition of this Agreement shall not be deemed a waiver of any prior or subsequent breach. No terms orconditions of this Agreement shall be held to be waived, modified or deleted except by an instrumen! in writing, signed bythe parties hereto. 18. This written contract, including Exhibit "A", the federally mandated Business Associate Agreement, attached hereto and incorporated by reference into this contract, represents the entire Agreement between the parties and supersedes any prior oral statements, discussions or understandings between the parties. As to Exhibit "A", "provider/, is the ,,Business Associate,,. 19' This Agreement is subject to public disclosure laws. This contract is subject to review by any Federal or State auditor. The County or its designee shall have the right to review and monitor the financialand service components of this program by whatever means are deemed expedient by the County' Such review may occur with or without notice, and may include, but is not limited to, on- site inspection by County agents or employees, inspection of all records or other materials which the county deems pertinent to the Agreement and its performance, and any and all communicationswithorevaluationbyservicerecipientsunderthisAgreement. TheContractor shall preserve and maintain all financial records and records relating to the performance of work under this Agreement for 6 years after contracttermination, and shall make them available for such review, within Kittitas County, State of Washington, upon request. Dated this 2024 Page4 for Hea re Lw_ ,,ffierk of the Board- Julie Kjorsvik [J Deputy Clerk of the Board- Mandy Buchholz +l*lrpm Clay 202A, BOARD OF COUNTY COMMISSIONERS KITTITAS COUNW, Commissioner TO FORM: traL\'1,1, D. R. Mitchell,Prosecuting Attorney 4th Ave. Yakima WA 98902 Printed Name ADOPTED this ultl ,,ilil1 JL2 DATE Page 5 Contract # Kittcosheriff-HsAzo20-004 BUSINESS ASSOCIATE/ QUALIFIED SERVICE ORGANIZATION AGREEMENT This Business Associate/ Qualified Service Organization Agreement (,'BA,/QSO Agreement,,) is between Comprehensive Healthcare (Covered Entlty) and (Kittitas County Wash ington) (Business Associote) Recitals Covered Entitywill make availableand/or provide certain Protected Health lnformation and Records {as defined below) to Business Associate in the course of the parties' relationship. Business Associate will make avallable and/or provide certain Protected Health lnformation and Records (as defined below) to Covered Entity in the course of the parties' relationship. ln order to protect the privacy of the Protected Health lnformation and to comply with HIpAA and the HIPAA Regulations {as defined below} as well as the Confidentiality of Substance Use Disorder Patlent Records, 42 C.F.R. Part 2; Covered Entity and Business Associate desire to enter into this BA/qSO Agreement setting forth the terms and conditions of use and disclosure of protected Health lnformation. ln consideration of the mutual promises set forth below, the parties agree as follows: Article 1: Definitions 1.1 Business Associate. "Business Associate" shall mean (insert name of Business Associate). confidentiality Rule. "Confidentiality Rule" shall mean the Confidential of Substance Use Disorder Patient Records in 42 CFR Part 2. Covered Entiw. "Covered Entiqy''shall mean Comprehensive Healthcare lndividual. "lndividual" shall have the same meaning as the term "individual" in 45 cFR g 164.501 and shall include a person who qualifies as a personal representative in accordance with 4s cFR S 16a.s02(el. 1,5 HIPAA. "HIPAA" means the Health lnsurance Portability & Accountability Act of 199G, p.L. 104- 91. Page 6 t.2 1.3 1.4 1.6 Contrast # KittCoSheriff-HsA2020-004 HIPAA Reeulations. 'HIPAA Regulations" mean the regulations promulgated under HIpAA by the u.s. Department of Health and Human services, including the privacy Rule. t.7 Privacv Rule. "Privacy Rule" shall mean the Standards for Privacy of lndividually ldentifiable Health lnformation in 45 CFR Part 160 and part 184, Subparts A and E. 1.8 Protected Health lnformatlon. "Protected Health lnformation" shall have the same meaning as the term "protected health information" in 45 CFR 5 164.501, limited to the information created or received by Business Associate from or on behalf of the Covered Entity. The term protected Health lnformation shall also include "Records,'as provided herein. 1.9 Records. "Records" shall have the same meaning as the term "records,, in 42 cFR s2.11. 1.10 Reoulred Bv [aw. "Required By Lad'shall have the same meaning as the term "required by law" in 45 CFR $ 154.501. 1.11 Secretarv."Secretary"shall meantheSecretaryof theDepartmentof HealthandHuman Services or the Secretary's designee. t.t2 General Rule. Capitalized terms not otheruise defined in this BA Agreement shall have the same meaning as those terms in the privacy Rule. 1.13 Qualified Service Oreanizatlon. "Qualified Service Organization" shall have the same meaningas the term "Qualified Service Organization" in 42 C.F.R. S 2.11. 1.14 Substance Abuse Confldentiallty Regulations. 'Substance Abuse Confidentiality Regulations,, shall mean the regulations promulgated by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, including the Confidentiality Rule. Article 2: Oblieations and Astivities of gusiness Associate 2.1 Prohlbitions. Business Associate agrees to not use or disclose Protected Health lnformation other than as permitted or required by the BA/qSO Agreement or as required by applicable federal or state laws and regulations. 2.2 Qualllled Servlce Organlzation. Business fusociate acknowledges that lt may also be a eualified Service Organization as defined in 42 CFR 2.11 and as such: {i} acknowledges that, to the extent it receives, stores, processes or othenarise deals with any information, whether recorded or not, relating to a patient received or acquired by a federally assisted alcohol or drug program, it is fully bound by the regulations in 42 CFR Part 2; and (ii) if necessary will resist in Judicial proceedings any efforts to obtain access to any information, whether recorded or not, relating PageT Contract # KittCoSheriff-HsAz020{04 to a patient received or acquired by a federally assisted alcohol or drug program, except as permitted by 42 cFR Part 2. 2.2 Safeguards. Business Associate agrees to implement and use appropriate safeguards and comply with Subpart C of 45 CFR Part 164 to prevent use or disclosure of the protected Health lnformatlon other than as provided for by this BA/QSO Agreement. Agrees tha! when Business Associate uses, discloses, or requests Protected Health lnformation, it will limit the use, disclosure, or request to the minimum necessary. Susiness Associate acknowledges that in receiving, transmitting, transporting, storing, processing, or othenrrise dealing with any Protected Health lnformation or Records received from the Covered Entity identifying or otheruise relating to the patients within the Covered Entity, it is fully bound by the provisionsof the federal regulations governing the ConfidentialityofSubstance Use Disorder patient Records, 42 C.F.R. Part 2; and the Health lnsurance Portability and Accountability Act (HIPAA), 45 C.F.R. Parts 142, 160, 162, and 164. 2.3 Mltigatlon. Business Associate agrees to mitigate promptly, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of protected Health lnformation by Business Associate in violation of the BA Agreement, the privacl Rule, confidentiality Rule or other applicable federal or state law and regulations. 2.4 Rep-orts of lmproDer Use or Dlsclosure. Business Associate agrees to immediately report to Covered Entity any use or disclosure of the Protected Health lnformation not provided for by this BA Agreement of which it becomes aware. Business Assoclate also agrees to immediately report to Covered Entity about any complaint that the Business Associate receives concerning the handling of Protected Health lnformation or compliance with this BA Agreement. Busines Associate must notify Covered Entity of any Breach relating to Unsecured protected Health lnformation, which notice shall be in compliance with the requirements of the HITECH Act and shall be gaven to Covered Entity at its designated address for receiving such notices, as soon as practicable and wlthout unreasonable delay, and in no case later no later than five (5) business days after such breach is discovered by Eusiness Associate. Such notice shall include, to the extent possible, the identification of each individual whose Unsecured Protected Health lnformation has been, or is reasonably believed by Business Associate to have been breached, along with other available information that Covered Entity may be required to include in its notification to the individual. Notice to Covered Entity may be given by email, return receipt requested or certified mail, return receipt requested, lf Business Associate learns subsequent to its inltial notification to Covered Entity of any additional information that Covered Entity may need for its required notification to individuals, Business Associate shall promptly notify Covered Entity of such information in the same manner as specified above, 2.5 Disclosures to Agents and subcontractors. ln accordance with 45 cFR 164.502(eXlXii), 164.308(bX2),and42CFR Part 2 ifapplicable, ensure thatanysubcontractorsthatcreate, receive, maintain, or transmit Protected Health lnformation on behalf of the business associate page g Contract # KittCoSheriff-HsA2020-004 agree to the same restrictions, conditions, and requirements that apply to the business associate with respect to such information; 2.6 Access. To enable the Covered Entity to fulfill its obligations under the privacy Rule, Business Associate agrees to make Protected Health lnformation in Designated Record Sets that are maintained by Business Associates or its agents or subcontractors available to Covered Entity for inspection and copying within ten (10) days of a request by Covered Entity. lf an lndividual requests inspection and copying of Protected Health lnformation directly from Business Associate or its agents or subcontractors, Business Associate shall notifo the Covered Entity in writing within five (5) business days of receipt of the request, and shall defer to, and comply with, Covered Entit/s direction in a timely manner regarding the response to the lndividual regarding the request for inspection and copying. 2.7 Amendment. To enable the Covered Entity to fulfill its obligations under the privacy Rule, Business Associate agrees to make any amendment(slto Protected Health lnformation in a Designated Record set that are maintained by Business Associate or its agents or subcontractors that the Covered Entity directs or agrees to pursuant to 45 CFR 5 184 within ten (10) days ofa request by Covered Entity. lf an lndividual requests amendment of protected Health lnformation directly from Business Associate or its agents or subcontractors, Business Associate shall notify the Covered Entity in writing within five (5) business days of receipt of the reques! and shall defer to, and comply with, Covered Entity's direction in a timely manner regarding the response to the lndividual regarding the request for amendment. 2.8 Federal Government Officials. Business Associate agrees to make internal practices, books, and records, including policies and procedures and Protected Health lnformation, relatlng to the use and disclosure of Protected Health lnformation received from, or created or received by Business Associate on behalf of, Covered Entity available to the Secretary as designated by the secretary, for purposes of the Secretary determining Covered Entity's compliance with the Privacy Rule. Business Associate shall notify Covered Entity regarding any protected Health lnformation that Business Associate provides to the Secretary concurrently with providing such Protected Health lnformation to the Secretary and upon Covered Entity's request, shall provide covered Entity with a duplicate copy of such protected Health lnformation. 2.9 Documentation of Dlsclosures. Business Associate agrees to implement a process for documenting such disclosures of Protected Health lnformation and information related to such disclosures as would be required for Covered Entity to respond to a request by an lndividual for an accounting of disclosures of Protected Health lnformation in accordance with 45 CFR g 164.s28. 2.10 Accounting of Disclosures. Business Associate agrees to provide to Covered Entity the information collected in accordance with Section 2.9 of this BA Agreement within ten (10) days of the Covered Entity's request in order to permit Covered Entity to respond to a request by an withlndividual for an accounting of disclosures of Protected Health lnformation in accordance Page 9 3.1 3.2 3.3 Contract # KitrCosheriff-HSA2020-004 45 cFR I 154.528' lf an individual requests an accounting directly from Business Associate or its agents or subcontractors, Business Associate must notify Covered Entity in writing within five {5) business days of the request, and shall defer tq and comply in a timely manner with, Covered Entity's direction regarding the response to the lndividual regarding the request for an accounting. Artlcle 3: Permltted Uses and Dlsclosures bv guslness AFsociatg. Specific Purooses. Business associate may only use or disclose protected health information as required or permitted by law. tesal Responsibllltles. Except as otherwise limited in this Agreement, Business Associate may use Protected Health lnformation for the proper management and administration of the business associate orto carry out the legal responsibilities ofthe business associate. RegortlngLaw Vlolatlons. Euslness Associate may use Protected Health lnformation to report violations of law to appropriate Federal and state authorities, consistent with s 164.502(J)(1). Article 4: Oblieations of Covered EntiW Notlce of Prlvacv Practices. Covered Entity shall notifo Business Associate of any limitation{s) in its notice of privacy practices of Covered Entity in accordance with 45 CFR g 164.52O to the extent that such limitation may affect Business Associate's use or disclosure of protected Health lnformation. lndividual Permission' Covered Entity shall notify Eusiness Associate of any changes in, or revocation of, permission by lndlvidual to use or dlsclose Protected Health lnformation, to the extent that such changes may affect Business Associate's use or disclosure of protected Health lnformation. Restrlctlons. Covered Entity shall notify Business Associate of any restriction to the use or dlsclosure of Protected Health lnformation that Covered Entity has agreed to in accordance with 45 cFR I 164.522 and 42 cFR Part 2, to the extent that such restriction may affect Business Associate's use or disclosure of protected Health lnformation. Prohlbited ReEuests. Covered Entity shall not request Business Associate to use or disclose Protected Health lnformation in any manner that would not be permissible under the privacy Rule or Confidentiality Rule lf done by Covered Entity. Artlcle 5: Term and Terminatlon 4.L 4.2 4,3 4.4 Page 10 s.1 5.2 5.3 5.4 Contract # KittCoShEriff-HSA2O2O-004 Term. The Term of this BA Agreement shall be effective as of the date signed, and shall terminate when all of the Protected Health lnformation provided by Covered Entlty to Buslnes Associate, or created or received by Business Assoclate on behalfofCovered Entlty, is destroyed or returned to Covered Entity, or, if it is infeasible to return or destroy protected Health lnformation, protections are extended to such information, in accordance with the termination provisions in this Section. Termination for cause. Upon Covered Entity's knowledge of a material breach by Business Associate, Covered Entity shall either: A. Provide an opportunlty for Business Assoclate to cure the breach or end the violation, and terminate this Agreement if Buslness Associate does not cure the breach or end the violation within the time specified by Covered Entity; B' lmmediately terminate this Agreement if Business Associate has breached a material term of this Agreement and cure is not possible; or C' lf neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary. Effect of Termination. A. Except as provided in paragraph (B) of this section, upon termination of this Agreement, for any reason, Business Associate shall return or destroy all protected Health lnformation received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity. This provision shall apply to protected Heatth lnformation that is in the possession of subcontractors or agents of Business Assoclate. Business Associate shall retaln no copies of the protected Health lnformation. B. ln the event that Business Associate determines that returning or destroying the Protected Health lnformation is infeaslble, Business Associate shall provide to Covered Entity notification of the conditions that make return or destruction infeasible. gusiness Assoclate shall thereafter extend the protections of this Agreement to such protected Health lnformation and limit further uses and disclosures of such protected Health lnformation to those purposes that make the return or destruction infeasible, for so long as Eusiness Assoclate maintains such protected Health lnformation. Suwiual. The respective rights and obligations of Business Associate under this Article 5 shall survive the termination of this BA Agreement. Article 6: Mlscellaneous Page 11 6.1 6.2 5.3 6.4 6.5 Contract # KittCosheriff-HsA20z0-004 Regulatoru References. A reference in this Agreement to a section in the privacy Rule means the section as in effect or as amended. Amendment. The Parties agree to take such action as is necessary to amend this Agreement from time to time as is necessary for Covered Entity to comply with the requirements of the Privacy Rule and the Health lnsurance Portability and Accountability Act of 1994 pub. L. No. 104-191 and the Confidentiality Rule. lnteroretatlon. Any ambiguity in this Agreement shall be resolved to permit Covered Entity to complywith the Privacy Rule. State Law. ln addition to HIPAA and the HIPAA Regulations, Eusiness Associate shallcomply with all applicable state and federal privacy and security laws. Notlces. Under the terms of this BA Agreement, either party shall be deemed as being given notice, if delivered personally, or if mailed by first class United States mail, postage prepaid, and addressed as follows: lf to Covered EntiU: Comprehensive Healthcare PO Box 959 Yakima, WA 98907 ensive Healthcare The parties mutually agree as of the date above to this agreement. PresidenVCEO lf to Business Associate: Klttitas County Washington (insert Business Associate signe/s name) {insert name of Business Associate) Date: Dz-21.h?r) Date: Page12