HomeMy WebLinkAbout2004-11-16-6:00PM-RegularFILED
1004 NOV 12 P 4: 11
BRAZOS COUNTY,:. - CIIR c
bill 'y EXAS
BRYAN, TEXAS B
J#TY
NOTICE OF MEETING
AND AGENDA
BRAZOS COUNTY COMMISSIONERS COURT
THE
1
1MISSIONERS COURT OF BRAZOS COUNTY WILL MEET IN REGULAR
ON 16 NOVEMBER 2004 AT 6:00 P.M. IN ROOM 102 OF THE BRAZOS
3232 BRIARCREST DRIVE, BRYAN, TEXAS.
ion and Pledge of Allegiance - Commissioner Cauley
2. C for citizen's input and/or concerns.
Consider d take action on agenda items 3 -16:
3. Re est from Jail Administration for approval to reclassify Class 1511, Positions 71
thr gh 75 from Class 1511 (Detention Officer) to Class 1515 (Detention Officer -
Bo i g), and fund the difference in annual salary with unexpended merit funds.
4. Budget Amendment 03/04-54.1 thru 03/04-54.4
5. Budget Amendment 04/05-7.1 thru 04/05-7.8
6. Pe*nnel Change of Status.
7. Pa+inent of Claims.
8. Apication for Payment #2 from McClure & Browne Engineering/Surveying Inc. for
w 4 performed by Elliott Construction, Ltd. on the West 28a' Street Wastewater
9. Rewal of Prescription Service with Eckhard Service (EHS), effective 1/01/2005.
10. Re wal of the Dental Plan with Blue Cross Blue Shield of Texas (BCBSTX), effective
01/01/2005.
VOL C_ PAGE 1=
Commissioners Court Agenda
16 November 2004
Page 2
11. R olution #04-022 appointing Dana Zachry as Magistrate, Associate Judge and Juvenile
R eree, effective 29 November 2004.
12. Itthe est by County Court at Law #2 for approval of out of state travel for Tommy Munoz
vel to Las Vegas, Nevada to take a short court which completes his course of study
National Center for State Courts. Dates of travel are 13-15 December 2004.
13. Rooewal of Bid 2004-044R, Rental of Equipment with Operator.
14. R uest from Purchasing for permission to advertise Bid #2005-005, Oversized
L estone Aggregate
15. A and of Bid 2004-041, Road Signs and Sign Posts to the following, as recommended by
Road & Bridge and Purchasing Departments based on best value:
Primary Vendor: Rocal, Inc.
Secondary Vendor: Hall Signs
Third: Pathmark Traffic
.--16. F' r. al Plat of Harlan Hills subdivision, 10.92 acre tract (lot 10 of "unrecorded" Moon
S division), volume 4892, page 209.
17. ouncement of interest items and possible future agenda topics.
18. C 1 for citizen input and/or concerns.
19. Ancy / Board / Committee reports by Court members.
20. C vene into Executive Session pursuant to §551.076 of the Texas Government Code to
d tconnel erate the deployment, or specific occasions for implementation, of security
p or devices, in consultation with an attorney.
21.
22.
23.
24.
The Brazos ount
interpretive ice:
and possible action on the Executive Session.
e into Executive Session pursuant to §551.074 of the Texas Government Code to
personnel in the Information Technology Department.
and possible action on the Executive Session.
Courthouse is wheelchair accessible. Handicap parking spaces are available. Any request for sign
must be made two business days before the meeting. To make arrangements, call (979) 361-4102.
VOL Co f PAGE )a
COMMISSIONERS' COURT
REGULAR MEETING
NOVEMBER 16, 2004
A regular meeting of the Commissioners' Court of Brazos
nty, Texas was held at the Brazos Center, in Bryan, Brazos
nty, Texas, beginning at 6:00 p.m. on Tuesday, November 16,
4 with the following members of the Court present:
Cd
C
2
Randy Sims, County Judge, Presiding;
Eric Caldwell, Commissioner of Precinct 1;
Duane Peters, Commissioner of Precinct 2;
Kenny Mallard, Commissioner of Precinct 3;
Carey Cauley, Jr., Commissioner of Precinct 4, Absent;
Karen McQueen, County Clerk.
The attached sheet contains the names of the citizens and
officials that were in attendance.
The County Judge gave the invocation and led the pledge
ofl allegiance.
There was no citizen input/and or concerns.
The first matter for consideration was a request from the
J 1 Administrator for approval to reclassify Class 1511,
P itions 71 through 75 from Class 1511 (Detention Officer) to
C ss 1515 (Detention Officer Booking), and fund the
d :Terence in annual salary with unexpended merit funds. On
m ion by the County Judge, seconded by Commissioner Peters,
t Court voted unanimously to remove this from the agenda.
The Court next considered Budget Amendment #03/04-54.1
L tp
PAGE 1,11
C issioners Court meeting November 16, 2004 2
t ough 54.4, that would reallocate funds for Constable,
P
cinct 3 and
County Attorney;
remove remaining
funds
from
C
tificates of
Obligation 2002
and County Court
at Law
# 2
C rtroom to general fund and adjust the budget for TJPC-
S ary Supplement Grant. On motion by Commissioner Peters,
s onded by Commissioner Caldwell, the Court voted unanimously
t approve the budget amendment as submitted, a copy of which
i attached.
The Court next considered Budget Amendment #04/05-7.1
t4tough 7.8, that would reallocate funds for the County
A orney, Road and Bridge Department, Judicial Software Fund,
S Tiff's Department and Jail; transfer funds from Contingency
t the Sheriff's Department and the County Judge; and transfer
f lads from contingency to the general fund. On motion by
Cmmissioner Mallard, seconded by Commissioner Peters, the
C rt voted unanimously to approve the budget amendment with
t exception of amendment 7.8. A copy of which is attached.
The Court proceeded to consider the change of status of
loyees as submitted on the attached Personnel Action
R uests. On motion by Commissioner Peters, seconded by
C issioner Caldwell, the Court voted unanimously to approve
t changes as submitted.
L L 4 PAGE
;ioners Court meeting November 16, 2004 3
The Court next considered the following Claims as
s#mitted by the County Treasurer for payment:
7001167 through 7001412
0 motion by Commissioner Mallard, seconded by Commissioner
Peers, the Court voted unanimously to approve the Claims as
sIbmitted.
The next matter before the Court was Application for
P ment #2 from McClure & Browne Engineering/Surveying, Inc.
f work performed by Elliott Construction, Ltd. on the West
2 h Street Wastewater Improvements. On motion by Commissioner
C dwell, seconded by Commissioner Peters, the Court voted
unanimously to approve payment of $44,837.06.
The next matter before the Court was the renewal of
P#scription Service with Eckerd Service (EHS). There are no
c#nges to the plan. On motion by the County Judge, seconded
bj,lCommissioner Peters, the Court voted unanimously to approve
too renewal of the prescription service with EHS.
The Court next considered renewal of the Dental Plan with
Bj!e Cross Blue Shield of Texas (BCBSTX). There are no
nges to the plan. On motion by Commissioner Peters,
s~~onded by Commissioner Caldwell, the Court voted unanimously
ttlapprove the renewal.
On motion by the County Judge, seconded by Commissioner
L tpq PAGE 15
C issioners Court meeting November 16, 2004 4
P ers, the Court voted unanimously to adopt Resolution #04-
022 authorizing Dana Zachary to assume the duties authorized
o4ja Magistrate, an Associate Judge and Juvenile Referee under
t Texas Family Code as being in the best interest of Brazos
C nty. A copy of the resolution is attached.
The next matter for consideration by the Court was a
r uest submitted by County Court at Law # 2 Judge, Jim Locke,
s king approval for out of state travel for Tommy Munoz to
c ~plete his course of study with the National Center for State
C rts. The class runs from December 13-15, 2004 in Las Vegas.
or ~ motion by Commissioner Peters, seconded by Commissioner
C dwell, the Court voted unanimously to grant the request from
Judge Locke and approved payment of out of state travel expense
f Mr. Tommy Munoz.
The Court next considered renewal of Bid 2004-044R, Rental
o4jEquipment with Operator. Texcon is the Primary Vendor and
r ewing at the same prices. Young Contractors is the
S ondary Vendor should Texcon choose not to renew. On motion
b Commissioner Caldwell, seconded by Commissioner Peters, the
C rt voted unanimously to approve the renewal of Bid 2004-
044R.
The next matter for consideration was approval for the
chasing Agent to advertise Bid 2005-005, oversized
L 64
PAGE 1(p
14
C issioners Court meeting November 16, 2004 5
Limestone Aggregate. On motion by Commissioner Peters,
s onded by Commissioner Mallard, the Court voted unanimously
t authorize the Purchasing Agent to advertise for bids for
o rsized limestone Aggregate.
The Court next considered awarding Bid No. 2004-041, Road
Si ns and Sign Posts. Becky Stephens, Senior Buyer made the
f lowing recommendations:
Primary Vendor-Rocal, Inc.
Secondary Vendor-Hall Signs
Third- Pathmark Traffic
or. 'motion by Commissioner Caldwell, seconded by Commissioner
P ers, the Court voted unanimously to accept the
r ommendations of the Senior Buyer and award the contract as
s ted. A copy of the bid tabulation is attached.
The Court next considered approval of the Final Plat of
H 'lan Hills Subdivision, 10.92 Acre Tract (Lot 10 of
recorded" Moon Subdivision) in Precinct 1. Richard Vance,
C my Engineer, stated that he had reviewed the plat and
e rything appeared to be in order. On motion by Commissioner
C dwell, seconded by Commissioner Peters, the Court voted
u nimously to approve the final plat of Harlan Hills
S division, 10.92 Acre Tract (Lot 10 of "Unrecorded" Moon
S division) as submitted.
L 6q PAGE 1-7
issioners Court meeting November 16, 2004 6
Under announcement of interest items and possible future
a4 nda topics the following spoke:
Commissioner Mallard
a) Reminded everyone of the meeting on December 15, 2004
with Representatives Ogden and Brown. Included in the
meeting will be members of both school boards, both
cities and the Commissioners Court. You need to get
your questions into him as soon as possible.
b) There will be a High Speed Rail meeting on November
19, 2004 in Temple.
Commissioner Caldwell
a) On Monday, November 22, 2004, there will be a meeting
at the Millican Community Center beginning at 6:00 p.m.
to discuss the incorporated status of Millican.
b) On Tuesday, November 23, the Brazos Valley Council of
Governments will meet. The topic of regional projects
will be on the agenda.
There was no citizen input and/or concerns.
Under Agency/Board/Committee reports by Court members,
t# following spoke:
Commissioner Mallard
a) The Chamber of Commerce hosted the Intergovernmental
C4*imittee meeting last week. They discussed the upcoming
ting with the state representatives.
County Judge
a) He and Commissioner Mallard met with the 9-1-1 Board
where they discussed voice over internet protocol. A
lot of people and businesses are using their
computers as their telephone service. In an
emergency this makes it very difficult for 9-1-1 to
L (o9
PAGE is
C issioners Court meeting November 16, 2004 7
determine where you are calling from unless you know
the voice over internet protocol address.
At 6:28 p.m. the County Judge announced the meeting
c Used to the public so that the Court could meet in Closed
E#cutive Session to discuss the deployment, or specific
o
asions
for implementation,
of security
personnel or
d
'ices,
in consultation with
an attorney as
allowed under
S4~tion 551.076 of the Texas Government Code. He asked that
C dy Gallego, Executive Assistant, Ruth McLeod,
A inistrative Assistant, Debbie Lockledge, Administrative
A itant, Loraine Nichols, Human Resources Manager, Bill
J nes, Risk Manager, 85th District Judge, J. D. Langley and
L yd Wasserman, Commissioner, Precinct 1 elect stay for the
EU cutive Session.
At 6:43 p.m. the County Judge announced the meeting open
t the public and said no action would be taken but, he then
r cinded the statement. Then on motion by Commissioner
C dwell, seconded by Commissioner Peters, the Court voted
u nimously to engage Managed Network Solutions to take a look
a the firewalls, dial up, and internet to attempt to identify
cfLcial network services.
At 6:46 p.m. the County Judge announced the meeting
c sed to the public so that the Court could meet in Closed
E cutive Session to discuss personnel in the Information
L (4 PAGE I I
Cc 0 missioners Court meeting November 16, 2004 8
Technology Department as allowed under Section 551.074 of the
T as Government Code. He asked that Candy Gallego, Executive
A istant, Wayne Dicky, Jail Administrator, Ruth McLeod,
A inistrative Assistant, Debbie Lockledge, Administrative
A itant, Loraine Nichols, Human Resource Manager, Bill
J nes, Risk Manager, 85th District Judge, J. D. Langley and
L yd Wasserman, Commissioner, Precinct 1 elect stay for the
E cutive Session.
At 7:00 p.m. the County Judge announced the meeting open
t the public. Commissioner Mallard moved to assign
C issioners Caldwell and Cauley as Co-Directors of the
Information Technology Department. The County Judge seconded
t motion. Commissioners Peters, Mallard and the County
J ge voted "Aye". Commissioner Caldwell abstained.
There being no further business to come before the Court,
t meeting was adjourned.
L
64
PAGE -=2o
T fl
foregoing minutes of the Commissioners Court meeting held
N tember 16, 2004 have been examined and are approved in open
Court this the ,22ro_ day of Ffbn-ja 2005, in Bryan,
B zos County, Texas.
dy S' s
nt Judge
D ne Peters
C *imissioner, Precinct 2
C ey Ca~ley, Jr.
C issioner, Precin
Attest:
Keen McQueen
C ty Clerk
PAGE
Lloyd asserman
Commissioner, Precinct 1
Kenny Mall
Commissione'rj Precinct 3
1(
4
BRAZO
M E E T I N
i
COUNTY COMMISSIONERS COURT
ON . 204AT
N c-lpZp
Or nization/Department
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VOL PAGE-d-.1,
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENT(S) FOR THE 2003-2004 BUDGET YEAR
NO. 03/04-54.1 thru 03/04-54.4
following t
The
this the Wh day of November 2004 at a regular meeting of the Commissioners' Court, the
embers were present:
Randy Sims, County Judge, Presiding
Eric Caldwell, Commissioner, Precinct 1
E. Duane Peters, Commissioner, Precinct 2
G. Kenny Mallard, Commissioner, Precinct 3
Carey Cauley, Jr., Commissioner, Precinct 4
Karen McQueen, County Clerk
g proceedings were held:
T WHEREAS, on 16 November 2004 the Court heard and approved a budget amendment for the
udget year for Brazos County, Texas.
REAS, an expenditure is necessary due to the necessity to meet unusual and unforeseen
conditions hich could not be reasonably included in the original budget adopted 12 September 2003 the
following, u endment(s) to the original are hereby authorized, as described on the attached page(s).
A ~PTED AND APPROVED this the Wh day of November 2004.
THE
By:
Original:
Copies
COURT OF BRAZOS COUNTY, TEXAS.
County Judge
Clerk's Office and
l to the original budget
Auditor
Treasurer
;sioners' Court Minutes
VOL `F PAGE a 3
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 03/04-54.1
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
17
410060
CR
Fees- Alternative Dispute
1,100.00
17
110700
734000
DR
Dispute Resolution Center
1,100.00
Alternativ
Dispute Resolution - To increase the budget to recognized realized revenues in excess o
f
original b
et.
42
913000
DR
Transfer to General Fund
36,000.00
42
6342
802120
CR
Software - Finacial Accoutin
36,000.00
Certificate
~
of Obligation 2002 -To move remainin funds to general fund to be s
pent in 04-05.
43
913000
DR
Transfers to General Fund
8,700.00
43
634301
611300
CR
Contingency
7,790.00
43
634301
672810
CR
Equipment - Electronic
910.00
Count Co
t At Law #2 Courtroom - To move remaining funds to General Fund
. Original fundin
g from
General Fin
I
Prepared By:
Date:
kdc
11/4/2004
Approved By:
Date:
VOL ` PAGE
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 03/04-54.2
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
30
490280
CR
Matching Funds
570.00
30
480031
CR
Grant-TJPC
93,480.00
30
3111
517510
311104
DR
St. Su lement-TJPC-JPO
79,800.00
30
3111
517511
311104
DR
St. Su lement-TJPC-JPO
14,250.00
TJPC-Sal
Supplement Grant
To adjust b
et to approved budget for Fisca
l Year ending 8/31/04.
Prepared B :
Date:
ifj
11/5/2004
Approved By:
Date:
VOL LC `I PAGE a5
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 03/04-54.3
11/16/2004
FD DIV ACCT PROJ DR/CR ACCOUNT NAME Increase Decrease
01 303011 711190 DR Janitorial Services 277.00
01 303011 617400 CR Telephone 277.00
Constable Pct. 3 - Overrun of 'anitorial services due to quotations received after
budget preparation.
Prepared By- We Approved By.
Date. 11/4/2004 Date:
VOL &4 PAGE a(v
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 03/04-54.4
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
01
180001
i
672855
DR
Typewriters
105.00
01
180001
!
673420
DR
Furniture
77.00
01
180001
591000
CR
DDEA
182.00
ount Attorney - During review of 03-04 fiscal year it was noted tha
t the expenditures for
ese items were purchased straight from DDEA and should have been approved thru budget amendment
first. This amendment will not effect the 04-05 DDEA calculation, because the were considered
urin the calculation.
Prepared By:
Date:
H
kdc
11/4/2004
Approved By. ~
Date:
VOL 4 PAGE d 7
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENT(S) FOR THE 2004-2005 BUDGET YEAR
NO. 04/05-7.1 thru 04/05-7.8
this the 16d' day of November 2004 at a regular meeting of the Commissioners' Court, the
embers were present:
Randy Sims, County Judge, Presiding
Eric Caldwell, Commissioner, Precinct 1
E. Duane Peters, Commissioner, Precinct 2
G. Kenny Mallard, Commissioner, Precinct 3
Carey Cauley, Jr., Commissioner, Precinct 4
Karen McQueen, County Clerk
The foll41ng proceedings were held:
T WHEREAS, on 16 November 2004 the Court heard and approved a budget amendment
for the 20"-2005 budget year for Brazos County, Texas.
an expenditure is necessary due to the necessity to meet unusual and unforeseen
could not be reasonably included in the original budget adopted 25 August 2004 the
following endment(s) to the original are hereby authorized, as described on the attached page(s).
A PT ED AND APPROVED this the 16`" day of November 2004.
THE CONWISSIONERT COURT OF BRAZOS COUNTY, TEXAS.
By:
Sims, County Judge
Original: I ''I County Clerk's Office and attached to the
original budget
Copies: County Auditor
County Treasurer
Commissioners' Court Minutes
VOL PAGE a8
t~
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.1
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
4700
63470100
i
80715000
DR
Roads - Capital
279,800.00
4700
63470100
49028000
CR
Transfers from General Fund
279,800.00
0100
11001500
91110000
DR
Transfers to Capital Im rov.
279,800.00
0100
11001500
61130000
CR
Contingency
279,800.00
Infrastruct
re Certific
iates of Obli
gation 20
02 - During the budget process there was an estimate of
$90,000 ex
cted to be rolled over from the 03-04 budget. The actual amount of unspent funds is $279,837.1
To enable t
funds to be available in the 04-05 fiscal year the moneys must be moved from the General Fund
Contin enc
Section 111 of the Local Govt. Code indicates that the only way revenues (including Reserve
I
Fund Balan
can increase after the budget is adopted is if the auditor can certify that the funds are from a
new source
t anticipated during the budget process. These Certificates were in existence at budget time
but were no
.
,pent - the are not from anew source. Therefore it appears that rbudgetpurp et oses the funds
must be mo
d from Co
ntin enc .
Prepared Fly:
D4te:
We
]11/2004
Approved By: -
Date:
VOL ` PAGE a q
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
EEE
No. 04/05-7.2
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
28000100
51615000
DR
Hourly - Law Enforcement
1,747.00
0100
28000100
51615000
DR
Hourly - Law Enforcement
632.00
0100
28000100
1
53100000
DR
Social Security
182.00
0100
28000100
53200000
DR
Retirement
271.00
0100
28000100
;
53800000
DR
Worker's Compensation
58.00
0100
11001500
61130000
CR
Contingency
$ 2,890.00
S
heriff "s Department - To move moneys from Contingency fora position
at was reduced during budget but that was open waiting on someone to return from military leav,
erson returning had 2 merit steps that were not budgeted in 04-05 bud et.
ount for reimbursement of un aid earnin s in 03-04 calculated at $67.20 er a for 9.4
ays.
Prepared By:
Date.'. _
kde
1/4/2004
Approved By:
Datc: /
r
VOL PAGE 0
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.3
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
18000100
67285500
DR
Typewriters
278.00
0100
18000100
59100000
CR
DDEA
278.00
County A
me - To
move funds from DDEA to allow for the purchase of
ewriters.
]eC1 13
We
1/4/2004
Approved By: >.-1L
hate:
VOL PAGE /
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.4
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
56001000
1610000
Hourly - Staff
-
0100
Road and
id e - No than a in the departmental budget but a change in
the position budgets.
De artmen
requests to move $2,330 from position 2631-1 to position 263
1-2. Neither position
has been oc
*
ipied during the 04-05 fiscal year so the amount being moved is for the entire 2080
hours in th
iscal year Change moves 3 steps (Grow 17) from position 1 to position 2.
Prepared By:
Date.
kdc
1/4/2004
Approved By: xX
I)atc:
VOL PAGE
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.5
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
4400
63440100
'
72155000
DR
Computer Consutlin
34,000.00
4400
63440100
1
80213500
CR
TSG Enhancements
34,000.00
4
Judicial S
are Fund
-To move funds to a
llow for the en an ement of a rofessional
information
echnolo security audit firm.
Prepared By:
Date:
kdc
11/4/2004
r _
Approved By:
Date:
VOL PAGE 33
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.6
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
28000100
61750000
DR
Tele hone - Cellular
2,500.00
0100
28000100
59100000
CR
DDEA
2,500.00
Sheriffs
ice - To move funds to allow for
the payment of the October bill on previously contracted
cell hones
d to a for the cell hones that will be retained as coup cell hones versus ce
ll hone
allowance.
y•
rk: t -
dC
~1012004
APPro~ei
Date f 3 ~
VOL ~`F PAGE
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.7
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
11001500
61130000
CR
Contingency
4,000.00
0100
10000100
72590000
DR
Professional Fees - Other
4,000.00
Coun J
e
To move fi:
ds to allow
for the paym
ent of H
R-Surve .com for conducting the Juvenile Services
survey.
I
7/ 1/2004
fron,
tDate
z x h U L
BRAZOS COUNTY, TEXAS
BUDGET AMENDMENTS
No. 04/05-7.8
11/16/2004
FD
DIV
ACCT
PROJ
DR/CR
ACCOUNT NAME
Increase
Decrease
0100
28002000
151820000
CR
Merit
6,771.00
0100
28002000
51615000
DR
Law Enforcement-Hrl
6,771.00
Sheriff Of
e: Jail
To allow fu
, in for rec
lassification of class 1511 positions 71-75 (group 15 to 1515
positions 14
_14 (group 16). Pendin
g approva
l of attached co of memo.
'
d
if'
J
IIA2/2004
A lr6yed
Pl
3
R~ rya
1)11tC. 1 r, r a ;
~~6
PERSONNEL CHANGE OF STATUS
CO T DATE: November 16, 2004
DE RTMENT: Personnel
some
P OSE:m 0 . ■ ■ ■ ApIj. .e Personnel Chang ~ of Status
■ ■
TMENT NAME EMPLOYEE NAME ACTION REQ
CO Y CLERK PIVONKA, PANSY RETIREMENT
LANGE, CHARLOTTE NEW HIRE
MWENEWMENNONXI
UESTED
WERNMENEwwwwal
COURT TAYLOR, EVONNE MERIT INCREASE
EVANS, KRISTIE MERIT INCREASE
ODSTRCIL, ROBERT MERIT INCREASE
361 11 STRICT COURT NAVARRO, DOROTHY MERIT INCREASE
JAKUBIK, TIFFANY MERIT INCREASE
VOL ~4 PAGE
PERSONNEL CHANGE OF STATUS
page 2 of 2
CO T DATE: November 16, 2004
DE TMENT: Personnel
PU OSE: Am= Personnel Chan4e of Status
DEP TMENT NAME EMPLOYEE NAME ACTION REQUESTED
■ ■ ■ \ t \ t ■ .
SHE F'S OFFICE - JAIL ESPINOZA, LISA ABANDONED POSITION
BRIDGE FLOWERS, JR., LOUIS DISCHARGED
CHADWICK, KEN D. NEW HIRE
PHALLAN, SHAWN D. NEW HIRE
(This
A in Commissioners' Court: November 16, 200
Judge's or Commissioner's Signature:
py to be attached to minutes)
VOL 4-PAGE- 29
CONFIDENTIAL
TDI MANAGED CARE SERVICES, INC.
d/b/a EHS
SPONSOR AGREEMENT
behalf
THIS AGREEMENT, made as of the 15' day of January, 2004, between TDI Managed Care
Inc., d/b/a EHS, a Delaware corporation, with its principal place of business at 620
Drive, Pittsburgh, Pennsylvania 15238 ("EHS"), and Brazos County with a principal place of
at 300 East 26th Street, Suite 107, Bryan, Texas 77803 ("Sponsor", which is acting on
its Plan).
'VHEREAS, Sponsor has committed to provide a prescription drug plan for eligible covered
and
EREAS, EHS has established a nationwide network of retail and mail service
to accept Sponsor's prescription drug plan; and
VHEREAS, EHS has a remote electronic claims adjudication and processing system for
ng and processing claims made for prescription drugs and other goods and related
and
EREAS, EHS has a drug utilization review service by which the cost effectiveness,
and resulting therapeutic effect of various drugs is reviewed and monitored
y; and
HEREAS, Sponsor desires to engage EHS to adjudicate and process claims on its behalf
through the electronic claims adjudication and processing system and may request EHS to
implem t drug utilization review now or in the future, and EHS desires to furnish such services as
describ in this Agreement.
)W, THEREFORE, in consideration of the mutual promises and agreements herein
the parties hereto agree as follows:
"Ancillary Charge" means a charge in addition to the copayment or deductible,
which a Covered Person is required to pay the Member Pharmacy when a Covered
Person and/or Covered Person's physician requests that a pharmacy service be
dispensed which is not in conformance with the Formulary or the MAC List.
"Average Wholesale Price" or "AWP" means the current average wholesale price
of a prescription drug as listed in the First Databank Blue Book or other nationally
recognized price source designated by EHS.
"Benefits" mean the prescription drugs and other goods and related services
covered by the Plan.
"Covered Entity" means health plans, health care clearinghouses, and those health
care providers who conduct certain financial and administrative transactions
electronically, as defined under the Health Insurance Portability and Accountability
Act of 1996 ("HIPAA") and the regulations promulgated thereunder by the U.S.
Department of Health and Human Services (the "HIPAA Regulations").
"Covered Person" means an individual who is eligible to receive Benefits in
accordance with and under the terms of a Plan.
"Disclosure" with respect to PHI, shall mean the release, transfer, provision of
access to or divulging in any other manner of PHI outside the entity holding the
PHI.
nty-110804:57940 VOL G ~ PAGE Ocy
CONFIDENTIAL
G. "Effective Date" means the period beginning on January 1, 2004.
H. "EHS Claims System" means the electronic system used to adjudicate and process
claims made for Benefits.
"EHS DUR" means the concurrent drug utilization review program used by EHS as
further detailed in Exhibit C.
"EHS Program" means the EHS Claims System, EHS DUR and all other services
which EHS may provide to Sponsor.
K. "Exclusions" mean the prescription drugs and other goods and related services not
covered by the Plan.
L. "Formulary" means a document proprietary to EHS which (i) lists various
prescription drugs, and (ii) is provided by EHS to Member Pharmacies, physicians,
other health care providers and/or Covered Persons for the purpose of guiding and
prescribing, dispensing and reimbursement of prescription drugs. For a
prescription drug not listed on a Formulary, a Covered Person may be required to
pay a higher copayment or to pay the difference between the prescription cost of
the non-Formulary drug and a Formulary drug when the two drugs are from the
same therapeutic class. Formularies are subject to periodic review and
modification by EHS and/or the Plan.
M. "Individual" means the person who is the subject of the PHI.
"Maximum Allowable Cost" or "MAC List" means a list of certain prescription drugs
for which reimbursement will be paid by Sponsor through EHS to the Member
Pharmacy. A Covered Person may be required to pay an Ancillary Charge
depending on the Plan design. From time to time, the MAC List is subject to
periodic review and modification by EHS to reflect market conditions.
"Member Pharmacies mean a nationwide network of retail pharmacies that have
contracted with EHS and may accept Sponsor's Plan.
"Plan" means Sponsor's prescription drug plan or plans.
"Protected Health Information" ("PHI") means any information, whether oral or
recorded by a Covered Entity in any form or medium: (i) that relates to the past,
present or future physical or mental condition of an individual; the provision of
health care to an individual; or the past, present or future payment for the provision
of health care to an individual, and (ii) that identifies the individual or with respect
to which there is a reasonable basis to believe the information can be used to
identify the individual.
TIONS OF SPONSOR
Prior to the Effective Date, Sponsor shall provide EHS, in a form approved by EHS,
with information concerning the Plan, as and when needed and in sufficient detail
to allow EHS to perform its obligations hereunder, including at least the following:
The effective date and the expiration date of the Plan;
2. The classes of dependents covered, including any age limits applicable to
dependent children;
3. The estimated number of Covered Persons by geographic location;
4. The manner of distribution of EHS identification cards to Covered Persons;
110804:57940 VO J OA^c 410
CONFIDENTIAL
5. The Benefits and Exclusions under the Plan;
6. The parameters ("Parameters") for determining (i) whether and to what
extent Benefits are covered by the Plan or Exclusions apply, and (ii) the
amounts of all payments and the compensation rates to be offered for all
Benefits;
7. The amount of the Plan deductible, or copayment, if any; and
8. Electronic eligibility information, including at least the following:
(a) The names and identification numbers of all Covered Persons as
of the Effective Date;
(b) The relationship of each Covered Person to one another (e.g.,
qualified dependent) as applicable and such other information as
may be reasonably required for adjudication of claims via the EHS
Claims System;
(c) The date of birth of each Covered Person;
(d) If Sponsor's Plan includes EHS DUR, sufficient information to
prepare Covered Persons' profiles for use in providing EHS DUR
services;
(e) If Sponsor's Plan includes network planning, each Covered
Person's home address; and
(f) Updates to, additions to and deletions from eligibility information
and Covered Persons' profiles on a continuous basis as such
changes occur.
Sponsor warrants that if the Plan provides for the reimbursement to Covered
Persons of the cost of prescription drugs purchased at non-Member Pharmacies,
then the Plan shall state that such reimbursement shall be conditioned upon the
submission of a claim for direct reimbursement in a form approved by Sponsor and
EHS, together with the Covered Person's proof of payment for the prescription
drugs.
Prior to the Effective Date, Sponsor shall provide each Covered Person with
complete and accurate information describing the Plan and the EHS Program.
Sponsor represents that the Parameters and the information provided to EHS
pursuant hereto are consistent with the Plan in all respects.
Sponsor warrants that by the effective date of applicable law, its Plan shall be in
compliance with the requirements of the Health Insurance Portability and
Accountability Act of 1996 ("HIPAA"), as explained in Article XI of this Agreement
entitled "Special Provisions for Protected Health Information.
Sponsor represents that all provisions under this Agreement have been agreed to
by its Plan.
TIONS OF EHS
EHS shall enter the Plan's Parameters and eligibility information received from
Sponsor into the EHS Claims System. The information entered into the EHS
Claims System shall be deemed correct until EHS is otherwise notified by Sponsor
that corrections are required. EHS shall promptly correct any errors brought to its
attention.
ounty-110804: 57940 VOL (O T 3 PAGE
CONFIDENTIAL
EHS shall produce EHS identification cards for distribution by Sponsor to all
Covered Persons. Two EHS identification cards per eligible family, bulk shipped to
Sponsor locations, will be provided at no cost to Sponsor. The cost of additional
EHS identification cards or a more selective distribution, i.e. direct mailing, will be
borne by Sponsor.
EHS shall take all reasonable steps to maintain its contracts with an adequate
number of Member Pharmacies in the various geographic locations where Covered
Persons are resident. EHS shall furnish each Member Pharmacy with a summary
description of the Benefits under the Plan. Sponsor acknowledges and agrees that
the Member Pharmacies are chosen solely based on their willingness to provide
services to the Covered Persons for the reimbursement specified by Sponsor's
Plan and their professed willingness to abide by the Pharmacy Services Agreement
with EHS. Sponsor further acknowledges and agrees that EHS shall not be
responsible for any negligence, fraud or misconduct of any Member Pharmacy or
any affiliate, director, officer, employee, agent, or parent of Member Pharmacy.
D. EHS, or its designated agent, shall process claims received from Member
Pharmacies through the EHS Claims System and may also process paper claim
forms received from Covered Persons for direct reimbursement. EHS, or its
designated agent, shall determine eligibility and conformity to the Plan and effect
payment of eligible claims and provide notification of declined or ineligible claims. If
requested by Sponsor, EHS shall also administer an initial benefit determination
and appeals process for prescription drug benefit coverage consistent with the
reasonable procedures requirement under the Employee Retirement Income
Security Act of 1974 as amended ("ERISA"). However, Sponsor acknowledges that
requests for prescription drug benefit coverage made to EHS as a prior
authorization or to a Member Pharmacy (or a non-Member Pharmacy under the
direct reimbursement procedure) to fill a prescription are not "claims" made to the
Plan under ERISA. Sponsor further represents and warrants that the Plan
documents reflect the foregoing, and that non-EHS appeals procedures exist in
such documents for Covered Persons who do not receive prescription drug
coverage under the Plan. The parties acknowledge that EHS is not a fiduciary or
plan administrator of Sponsor or Sponsor's Plans and that, with respect to the
provision of services by EHS under this Agreement, EHS shall not assume any
obligations of Sponsor, any named or unnamed fiduciary, or the Plan administrator
under the provisions of ERISA. The parties agree that should Sponsor desire for
EHS to manage any part of the benefit determination or appeals process under
ERISA, other than as set forth in this Section, such EHS obligations shall be clearly
set forth in a separate agreement between the parties.
EHS shall invoice Sponsor for the retail and/or mail service prescription claims
amounts and applicable sales tax, if any, which have been processed by EHS, or
its ' designated agent; during the applicable period (the "Prescription Claims
Invoice"). EHS shall furnish to Sponsor a Prescription Claims Invoice no less
frequently than twice a month.
EHS shall invoice Sponsor for the administrative fees specified in Exhibit A (the
"Administrative Fees") which have become due during the applicable period (the
"Administrative Fees Invoice"). EHS shall submit to Sponsor an Administrative
Fees Invoice no less frequently than monthly. (The Prescription Claims Invoice,
the Administrative Fees Invoice, and any other invoice authorized under this
Agreement are collectively referred to as the "Invoice").
EHS warrants that it shall be in compliance with those requirements of the Health
Insurance Portability and Accountability Act of 1996 detailed in Article XI of this
Agreement entitled "Special Provisions for Protected Health Information."
SA-RMG razosCounty-110804: 57940 VOL 04PQta
CONFIDENTIAL
IV.
V.
MAIL SERVICE PHARMACY
A. The parties understand that EHS shall be obligated to arrange for retail Member
Pharmacies to provide pharmacy services for Covered Persons as set forth in this
Agreement. If requested by Sponsor, EHS shall also arrange to provide the mail
pharmacy services described in Exhibit B, which would be provided by EHS's
affiliate Thrift Drug, Inc. d/b/a Express Pharmacy Services ("EPS").
EHS RETROSPECTIVE AND CONCURRENT DRUG UTILIZATION REVIEW (DUR)
SERVICES
EHS shall provide the EHS retrospective and concurrent DUR services listed in
Exhibit C.
VI.
B. EHS may deny payment for claims to the extent the information received is not
sufficient to allow for EHS DUR services.
UTIC DRUG MANAGEMENT PROGRAM
If requested by Sponsor, EHS shall provide the therapeutic drug management
program listed in Exhibit D.
VII.
VIUNERATION AND PAYMENT
Within forty-eight (48) hours of receipt of a Prescription Claims Invoice from EHS,
Sponsor shall initiate an Automated Clearing House (ACH) transfer for the
Prescription Claims Invoice amount to a bank account designated by EHS.
Within ten (10) business days of receipt of an Administrative Fees Invoice from
EHS, Sponsor shall remit payment for the Administrative Fees Invoice amount to
EHS by Automated Clearing House (ACH) transfer as in the foregoing Section A.
Any additional charge for services other than those specified in Exhibit A shall also
be remitted by Sponsor within ten (10) business days after receipt of an Invoice
from EHS.
If at any time Sponsor shall fail to pay EHS, on or prior to the due date of the
Invoice, any amount owing EHS hereunder, EHS shall have the right to impose a
finance charge on the unpaid Invoice balance, in addition to any other remedies
available to EHS. The finance charge shall equal the prime rate reported by Mellon
Bank, N. A. plus three (3%) percent.
If at any time Sponsor shall fail to pay EHS on or prior to the due date of the
Invoice, any amount owing to EHS hereunder, EHS shall have the right, in addition
to the imposition of a finance charge and any other remedies available to EHS,
upon forty-eight (48) hours prior notice to Sponsor, to: (1) decline to issue or
reissue EHS identification cards to Covered Persons, (2) suspend eligibility of
Covered Persons or any and all other services under this Agreement immediately
until such time as Sponsor's account with EHS has been brought current, (3)
advise. Member Pharmacies immediately, as they access the EHS Claims System,
that Covered Persons' EHS identification cards are no longer valid, and (4) apply all
or any portion of Sponsor's security deposited with EHS to Sponsor's delinquent
account. Sponsor shall be responsible for all costs of collection and agrees to
reimburse EHS for such costs and expenses (including reasonable attorneys'
fees).
If at any time EHS shall determine, based on prescription claims volume, Sponsor's
payment record and/or Sponsor financial information, that there are reasonable
grounds for insecurity on the part of EHS as to the ability of Sponsor to meet its
financial commitments hereunder as they become due, EHS shall have the right to
require Sponsor to provide security in such amount and form and at such time as
EHS deems necessary. No security in the form of a reserve or deposit shall bear
interest.
110804:57940 VOL 6 V 5 PAG E Y3
CONFIDENTIAL
G. EHS may change the Administrative Fees applicable to the Plan by giving Sponsor
sixty (60) days notice prior to the expiration of the then current term. The revised
Administrative Fees will not be effective until the first day of the month following the
expiration of the then current term of the Agreement. Sponsor may object to any
increase in Administrative Fees by giving notice thereof to EHS at least thirty (30)
days prior to the expiration of the sixty (60) day period. In such event, if the parties
cannot agree on an appropriate Administrative Fee, this Agreement shall expire at
the end of the sixty (60) day period that corresponds to the expiration date of the
then current term of the Agreement, and the revised Administrative Fees will not
apply.
VIII
EHS REBATE PROGRAM
EHS has engaged WeIlPoint Pharmacy Management ("WeIlPoint") to perform
certain formulary development and rebate contracting functions for EHS. As part of
its duties, WeIlPoint will negotiate rebate payments from pharmaceutical
manufacturers for EHS and Sponsor. WeIlPoint will receive the rebate payments
and pass them on to EHS for distribution to Sponsor.
Throughout the term of this Agreement, EHS shall pay to Sponsor an amount set
forth in Exhibit A for each prescription claim processed for Sponsor by EHS during
a calendar quarter for Sponsor's Covered Persons (the "Rebate") contingent upon
Sponsor's execution of this Agreement and acceptance and distribution of EHS's
drug formulary ("Formulary"). Payment of these amounts will be contingent upon
manufacturers' payment of rebates to WellPoint, and WellPoint's passing them on
to EHS. The Rebate shall be remitted to Sponsor following the end of the calendar
quarter in which payment is received by EHS, or its designated agent, from the
drug manufacturer.
In connection with its negotiation of rebate arrangements on behalf of Sponsor,
WeIlPoint receives from the pharmaceutical manufacturers certain group
purchasing administrative fees for its services of 3% or less of the value of
products dispensed to Covered Persons, and retains these fees for its own
account. In addition, WeIlPoint will retain a portion of the rebate payments that.it
receives from manufacturers, as compensation from EHS for its Formulary
development and rebate contracting services.
Except as set forth in Article VIII(H), Sponsor agrees that EHS may retain as
compensation for its Formulary development and management services the
balance of the payments passed on to it from WeIlPoint that are in excess of the
Rebate paid to Sponsor pursuant to Article VIII(B) and Exhibit A.
EHS will include at least ninety-five percent (95%) of the prescription drugs on the
WeIlPoint National Formulary on each EHS Formulary and one hundred percent
(100%) of WellPoint's 100 Top Rebatable Drugs on the EHS Formulary. Sponsor
agrees that to receive"the Rebate described in Article VIII(B) above, Sponsor must
exercise its discretion to adopt the EHS National Formulary as modified, and the
Top Rebatable drug list. The Rebate payments described in Article VIII(B) and
Exhibit A will not apply for periods of non-compliance.
If, after the date of this Agreement, as the result of the adoption of any applicable
law, regulation or guideline or any substantial change in the interpretation or
administration thereof, or as the result of substantial changes in drug industry
practice regarding manufacturer discounts and/or rebates, manufacturer discounts
or rebates are no longer available, EHS may give notice thereof to Sponsor and
EHS will be entitled to equitable adjustment of the Rebate, including, but not limited
to, elimination of any Rebate in its entirety, to be remitted to Sponsor. If, as a result
of the occurrence of any of the preceding events, EHS eliminates Sponsor's
Rebate in its entirety, Sponsor may, upon sixty (60) days written notice, terminate
this Agreement.
10804:57940 ■OL 6 16 PAGE I /
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CONFIDENTIAL
IX.
In the event EHS determines on audit that prescription claim data submitted on
behalf of Sponsor was inaccurate or that certain claims were not Rebate-eligible,
EHS reserves the right to offset such moneys against future Rebate payments due
Sponsor and/or recover from Sponsor Rebate amounts which are determined to
have been paid inappropriately.
Sponsor agrees that as a condition of participation in the Rebate program that
Sponsor will not negotiate or arrange or contract in any way for rebates on
prescription drugs from any manufacturer. Breach of this Section may result in
immediate termination of Sponsor's participation in the Rebate program and shall
entitle EHS to keep one hundred percent (100%) of any and all Rebates due on
behalf of Sponsor under this Agreement which have not been paid to Sponsor.
ULARY
Sponsor agrees that its right to use the Formulary is limited to use of the Formulary
in connection with its Plan. Sponsor further agrees that, except in connection with
such limited use, it shall not copy, distribute, sell or otherwise provide the
Formulary to any third party without EHS's prior written approval.
Upon termination of this Agreement, Sponsor shall cease all use of the Formulary
and shall destroy or return to EHS all copies in its or subcontractor's or affiliate's
possession. Upon EHS's request, Sponsor shall provide proof to EHS that it has
complied with the terms and conditions of this Section.
X. I kECORDS AND DATA
Subject to the provisions of this Agreement regarding PHI, EHS shall maintain for
six (6) years after the respective record is created, in original form or on electronic
media, the claims and paper claim forms supporting the Invoices and other records
sufficient to verify payments made to Member Pharmacies. EHS and Sponsor
shall allow each other to audit, review and duplicate such records and any other
records in their possession that relate primarily to the obligations undertaken by
either party under this Agreement, with any such audit rights expiring six (6)
months after the end of, and being limited to, payments within a current term. The
review and duplication of records shall be allowed upon reasonable notice during
regular business hours at the place of business of the record holder and shall be
subject to all applicable state and federal laws and regulations regarding the
confidentiality of such records, as well as any confidentiality and audit provisions in
contracts. Duplication and auditing shall be at the cost of the requesting party.
Sponsor acknowledges that reimbursement rates for pharmacy services paid by
EHS to Member Pharmacies are not necessarily a pass through of contracted rates
between EHS and Sponsor. Sponsor shall not have the right to audit, review or
otherwise access information regarding contracted reimbursement rates or
amounts of payments from EHS to Member Pharmacies. Upon request, EHS shall
verify to Sponsor that all claims made by Member Pharmacies for Benefits
provided to Covered Persons have been paid by EHS.
EHS shall retain full ownership rights over all compilations and analyses generated
by EHS, as well as all property, technology, software and other data utilized by EHS
in its performance under this Agreement. Ownership rights shall include, but are
not limited to, all rights associated with trade secrets, copyrights, trademarks and
patents. EHS shall retain the right to use all data and information received from
Sponsor, Covered Person or Member Pharmacies provided that: (a) such use shall
not violate any Covered Person's right of confidentiality; and (b) such use shall
conform to Article XI.
All records, reports and other data provided by EHS to Sponsor under this
Agreement are for Sponsor's use in claims administration and plan management,
and EHS disclaims all liability arising out of Sponsor's other use or dissemination of
the reports and summaries. Sponsor represents that it has permission from each
inty-110804: 57940 VOL 0 -PAGE 45
CONFIDENTIAL
Covered Person, whether through Plan documents or otherwise, for EHS to provide
to Sponsor all such records, reports and other data regarding prescription and
medical information relating to him/her. Sponsor shall treat as confidential any
information which individually identifies a Covered Person or physician/prescriber.
EHS and Sponsor acknowledge that certain information, reports and data
generated under this Agreement may be subject to applicable confidentiality of
medical records laws, including those addressed as PHI, and the parties agree to
comply in all material respects with such laws.
Should Sponsor require on line access to confidential prescription information
contained in reports, records and other data, it shall be provided only in accordance
with and upon execution of an on line access agreement to be mutually agreed to
in writing.
Disclosure to Third Party Agents
(i) Directives to Disclose. From time to time during the term of the Agreement,
Sponsor may direct EHS to provide information that EHS, its Member Pharmacies,
or EPS has collected regarding Covered Persons to agents of Sponsor. EHS will
comply with those directives, in accordance with the terms of this Agreement.
(ii) Permission of Covered Persons. Sponsor represents that it will have obtained
from each Covered Person his/her permission, whether through Plan documents or
otherwise, for Sponsor and/or EHS, its Member Pharmacies, or EPS to provide to
Sponsor's agents any records, reports and other data compiled or prepared by
EHS, its Member Pharmacies or EPS regarding prescription and medical
information relating to him/her which are the subject of a directive to disclose.
(iii) Confidentiality Agreements with Agents. Sponsor represents that for each
agent to which it may direct EHS to disclose patient-identifiable information,
Sponsor has in place, or will have in place prior to the directive, an agreement
requiring the agent to treat as confidential any information which individually
identifies a Covered Person or physician/prescriber, and prohibiting the agent from
disclosing any such information without express authorization from Sponsor or the
Covered Person.
(iv) Disclosure to Minimum Extent Necessary. To the extent possible, Sponsor will
limit its directives for disclosure of PHI to its agents to the minimum information
necessary to achieve the desired purpose.
(v) Form of Directives. All directives for disclosure of PHI will be in writing and will
identify all Covered Persons whose records or files should be disclosed, by means
of patient names or identifiers, dates of service, particular drug dispensed, or such
other identifying characteristics as are appropriate for the purpose of the
disclosure. The directives shall also identify what information from the file shall be
disclosed and for what time period. EHS shall retain copies of all such directives
for a period of six (6) years.
EHS shall maintain a Disaster Recovery Plan to protect and/or recover records that
are essential to the continuing operation of Sponsor's Plan in the event of a
disaster. Upon reasonable request, EHS shall provide Sponsor a brief written
statement summarizing the status of its Disaster Recovery Plan, where Sponsor
acknowledges that such Disaster Recovery Plan is confidential. As of the date this
Agreement is signed, EHS represents the following as key components to its
Disaster Recovery Plan: (a) advanced software applications regulate the computer
systems and communication lines, and issue an alert when problems arise; (b)
EHS's data centers are protected by back-up generators to guard against power
outages; (c) EHS's data centers are protected by automated fire suppression
systems; (d) EHS's claims processing system maintains a full, duplicate "mirror"
system at another location that will resume processing if the primary site
inty-110804: 57940 VOL 68PAGE ~
CONFIDENTIAL
XI.
experiences a disaster, with such duplicate system tested for operability; (e) EHS
maintains redundant servers for all critical servers; and (f) EHS maintains offsite
storage of tape back-ups of critical servers. Key EHS employees have remote dial-
in access and could be re-located to another site in Pittsburgh, Pennsylvania
should the main location suffer a disaster. There are also two remote mail service
sites EHS has available, through its mail service pharmacy affiliate EPS, to relocate
EHS pharmacy benefit management employees to. In addition, during downtime,
unaffiliated Member Pharmacies can contact EHS's Pharmacy Help Desk to
receive eligibility and reimbursement information.
The parties acknowledge that, in its role as a pharmacy benefits manager, EHS will
evaluate the Plan and act to improve its operations and cost-effectiveness. This
may include review of Covered Person prescription histories and drug utilization
reviews for safety and cost control. In addition, EHS may conduct medication
compliance programs, and/or therapeutic equivalent and generic interchange
programs, to support the EHS Formulary or to achieve formulary utilization targets.
EHS may also send newsletters or other communications to Covered Persons
regarding their health conditions or their medications. EHS may receive funding
from manufacturers to support the Covered Person communications associated
with these programs. Sponsor will provide notice to its Covered Persons regarding
such programs, consistent with the requirements of HIPAA and its implementing
regulations, and will obtain such authorization or consent from its Covered Persons
as may be required by applicable law, rule, regulation or legal process, for EHS to
operate such programs.
PROVISIONS FOR PROTECTED HEALTH INFORMATION
EHS and Sponsor hereby agree that EHS shall be permitted to use or disclose PHI
provided or made available from Sponsor to perform any function, activity or
service for, on behalf of, Sponsor as specified in this Agreement, provided that
such use or disclosure would not violate HIPAA and the HIPAA Regulations if done
by Sponsor.
EHS and Sponsor each covenants and agrees that it shall:
(1) Not further use or disclose PHI other than as permitted or required by this
Agreement or as required by applicable law or regulation.
(2) Establish and maintain appropriate safeguards as necessary to prevent the
use or disclosure of PHI other than as permitted under this Agreement.
(3) Upon request, report to the other party any use or disclosure of PHI that it
is aware of that is not provided for or allowed by this Agreement.
(4) Ensure that any of its agents or subcontractors, or other third parties with
which it does business that are provided PHI by such party are aware of
and bound to such party's obligations under this Agreement relating to PHI.
(5) Make available to the Secretary of the U.S. Department of Health and
Human Services all internal practices, books and records relating to the
use and disclosure of PHI for purposes of determining compliance with
federal privacy laws and regulations.
(6) Mitigate, to the extent practicable, any harmful effect that is known to the
party of a use or disclosure of PHI by such party in violation of the
requirements of this Agreement.
EHS covenants and agrees that it shall:
(1) Make available to Sponsor such information as Sponsor may require to
fulfill Sponsor's obligations to provide access to, amendment of, and
account for disclosures with respect to PHI pursuant to HIPAA and the
HIPAA Regulations, including, but not limited to, 45 CFR §§164.524,
164.526, and 164.528.
SA-RMG- zosCounty-110804: 57940 VOL 09 PAGE `I
CONFIDENTIAL
(2) Maintain the EHS Claims System and related administrative reporting
systems in compliance with the standards established under law including
The National Council for Prescription Drug Programs (NCPDP)
Telecommunications Standard Implementation Guide and equivalent
NCPDP Batch Transaction Standard and Implementation Guide versions
as adopted under regulation.
EHS and Sponsor each agrees that it shall not use or disclose PHI in a manner that
is contrary to its obligations under this Agreement. Notwithstanding the foregoing,
EHS and Sponsor each agrees that each party may:
(1) Use PHI in its possession for its proper management and administration
and to fulfill any of its present or future legal responsibilities provided that
such uses are permitted under federal, state, local and other applicable
confidentiality laws.
(2) Use PHI in its possession to provide data aggregation services relating to
the health care operations, as provided for in 45 CFR §164.501, of
Sponsor.
(3) Disclose PHI in its possession to third parties for the purpose of such
disclosing party's proper management and administration or to fulfill any of
such disclosing party's present or future legal responsibilities provided that
(i) the disclosures are required by law, as provided for in 45 CFR §164.501,
or (ii) the disclosing party has received from the third party written
assurances that the PHI will be held confidentially, that the PHI will only be
used or further disclosed as required by law or for the purpose for which it
was disclosed to the third party, and that the third party will notify the
disclosing party of any instances of which it is aware in which the
confidentiality of the information has been breached, as required under 45
CFR §164.504(e)(4).
(4) De-identify any and all PHI provided that the de-identification conforms to
the requirements of 45 CFR §164.514(b), and further provided that the
parry so de-identifying maintains the documentation required by 45 CFR
§164.514(b), which may be in the form of a written assurance from the
other party. Pursuant to 45 CFR §164.502(d)(2), de-identified information
does not constitute PHI and is not subject to the PHI terms of this
Agreement.
(5) Have PHI contained in claims made by Member Pharmacies for
processing of Benefits.
With respect to the use and/or disclosure of PHI by EHS, Sponsor hereby agrees:
(1) to use appropriate safeguards to maintain and ensure the confidentiality,
privacy, and security of PHI transmitted to EHS pursuant to this
Agreement, in accordance with the standards and requirements of HIPAA
and the HIPAA Regulations, until such PHI is received by EHS.
(2) to inform EHS of any changes in, or withdrawal of, the consent or
authorization provided to Sponsor by Individuals pursuant to 45 CFR
§164.506 or §164.508.
(3) to notify EHS, in writing and in a timely manner, of any arrangements
permitted or required of Sponsor under 45 CFR Parts 160 and 164 that
may impact in any manner the use and/or disclosure of PHI by EHS under
this Agreement, including, but not limited to, restrictions on the use and/or
disclosure of PHI as provided for in 45 CFR §164.522 agreed to by
Sponsor.
SA-RMG azosCounty-110804: 57940 VOL / ~ 'PAGE f/
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XII.
(4) that EHS may make any use and/or disclosure of PHI permitted under 45
CFR §164.512.
Upon termination or expiration of the Agreement, EHS shall return to Sponsor any
and all PHI received from, or created by, EHS on behalf of Sponsor that is
maintained by EHS in any form whatsoever, including any copies or replicas. If
returning the PHI to Sponsor is not feasible, EHS shall destroy any and all PHI
maintained by EHS in any form whatsoever, including any copies or replicas.
Should the return or destruction of PHI be determined by EHS to be not feasible,
the parties agree that the PHI terms of this Agreement shall extend to the PHI until
otherwise indicated by Sponsor, and any further use or disclosure of the PHI by
EHS shall be limited to that purpose which renders the return or destruction of the
PHI infeasible. The parties agree that return or destruction of PHI is not feasible
for EHS in the areas of auditing, liability, quality assurance, and related matters.
Accordingly, EHS may retain PHI and related information for such purposes after
termination or expiration of the Agreement.
AND TERMINATION OF AGREEMENT
This Agreement shall be for an initial term of thirty-six (36) months commencing on
the Effective Date and shall automatically renew for successive twelve (12) month
periods subject to the remaining provisions of this Article XII.
This Agreement may be terminated as follows:
1. At the expiration of any current term, whether that be a thirty-six (36) month
initial term or a twelve (12) month renewal term, if a party provides at least
ninety (90) days prior notice of nonrenewal to the other party;
2. By either party in the event the parties are unable to agree on changes in
Administrative Fees as provided in Article VII hereof;
3. By either party if the other party shall materially default in its performance
of this Agreement and such default is not cured within thirty (30) days after
notice from the non-defaulting party specifying the nature of the default;
4. Notwithstanding anything herein to the contrary, by EHS, on forty-eight (48)
hours notice to Sponsor, if Sponsor shall fail at any time to make any
payment required pursuant to this Agreement by the due date or fails at
any time to provide or maintain the security required by EHS under this
Agreement. Such notice shall not be effective and this Agreement shall
not terminate if Sponsor shall cure the default not later than the next
business day following the giving of notice;
5. By either party upon written notice to the other party upon the occurrence
of any of the following events: (a) a material adverse change subsequent to
the date hereof in the financial condition or prospect of the other party; or
(b) a default or an event that with the passage of time would constitute a
material default in respect of any obligation of the other party for borrowed
money, whether as borrower, guarantor or otherwise; or
6. By either party on written notice to the other if the other party violates a
material term of this Agreement regarding Article XI "Special Provisions for
Protected Health Information" and timely cure is not possible.
In the event of a termination hereunder:
EHS shall have the right to notify its Member Pharmacies that Covered
Persons' EHS identification cards for the Plan become invalid as of the
termination date; and
10804:57940 OL &Y PAGE 0
CONFIDENTIAL
2. The liability of Sponsor for obligations incurred up to the effective
termination date, including all costs of collection and reasonable attorneys'
fees, shall survive termination.
In the event of termination of this Agreement, EHS agrees to provide data EHS has
and that Sponsor's replacement pharmacy benefits manager ("Replacement PBM")
shall reasonably require to perform Replacement PBM functions for Sponsor,
provided that the data requirements of such Replacement PBM are reasonable and
consistent with pharmacy benefit manager industry expectations. It is understood
that for retail claims data, EHS provides a billing tape or other media in standard
NCPDP 2.0 format at no cost to Sponsor. If Sponsor or Replacement PBM needs
some element of data that is not on EHS's NCPDP 2.0 format, such data element
shall be provided, if available in EHS records, on a time and materials or special
quote basis. It is understood that for mail service claims data, EHS can provide a
claims file to Sponsor or Replacement PBM at a cost to be mutually agreed upon.
EHS shall have no obligation to provide the data until such fee is mutually agreed
to. EHS may provide the data by electronic wire communication or a media type
such as disk, tape, CD or the like. EHS shall not be required to perform anything in
this paragraph unless Sponsor has provided EHS with at least ninety (90) days
notice of its need for the data. If this Agreement terminates before such ninety (90)
day period can occur, EHS shall still have ninety (90) days to provide the data. Any
and all data disclaimers set forth in this Agreement shall apply to this paragraph,
except that EHS shall be responsible for correcting at no cost to Sponsor or
Replacement PBM the data errors for which EHS is solely responsible and which
are brought to the attention of EHS by Sponsor or Replacement PBM.
XIII.
I notices pertaining to this Agreement shall be delivered in person, sent by certified mail,
(livered by receipted courier, or transmitted by facsimile and confirmed in writing (sent by
ceipted courier or certified mail) to a party at the address or facsimile number shown in
is Agreement, or such other address or facsimile number as a party may notify the other
arty from time to time. Notices delivered in person, and notices dispatched by facsimile
for to 4:30 PM, recipient's time, Monday through Friday (legal holidays excepted), shall be
.emed received on the day sent. All other facsimiles and notices shall be deemed to have
:en received on the business day following receipt; provided, however, if such day falls on
weekend or legal holiday, receipt shall be deemed to occur on the next business day.
)tices may also be transmitted electronically between the parties provided that proper
rangements are made in advance to facilitate such communications and provide for their
~curity and verification.
Notices to EHS shall be addressed to:
TDI Managed Care Services, Inc.
d/b/a EHS
620 Epsilon Drive
Pittsburgh, Pennsylvania 15238
Attn.: Vice President, PBM Operations
Facsimile No.: 412.967.2333
Notices to Sponsor shall be addressed to:
Brazos County
300 East 26th Street, Suite 107
Bryan, Texas 77803
Attn: Loraine Nichols
Facsimile No.: 979.823.6993
nty-110804: 57940 VOL 6~-PAGE SO
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XIV.
; DISCLAIMERS
The EHS Claims System is dependent upon the accurate transmission and
processing of data by electronic means. EHS shall not be liable for any damages or
claims arising out of any interruption in transmission or processing, except where:
(a) it is solely at fault; and (b) it had reasonable opportunity to prevent the
interruption.
Nothing in this Agreement shall be construed or be deemed to create any rights or
remedies in any third party, including, but not limited to, a Covered Person.
Further, it is hereby acknowledged that EHS and Sponsor are independent entities.
Nothing in this Agreement shall be construed or be deemed to create: (a) a
principal-agent relationship between EHS and Sponsor; or (b) a joint venture.
EHS shall use ordinary care and reasonable diligence in the performance of its
duties under this Agreement. Sponsor acknowledges that this Agreement is not a
contract for the sale of goods, and that EHS is not the sole generator of data for the
EHS Claims System, which comes from various sources, including but not limited
to Sponsor and Covered Persona EHS DISCLAIMS ALL EXPRESS AND ALL
IMPLIED WARRANTIES OF ANY KIND, INCLUDING, BUT NOT LIMITED TO,
ANY WARRANTY AS TO THE QUALITY, ACCURACY OR SUITABILITY FOR
ANY PARTICULAR PURPOSE OF THE DATA USED OR GENERATED BY THE
EHS CLAIMS SYSTEM, EXCEPT THAT EHS SHALL NOT ADVERSELY AFFECT
THE QUALITY, ACCURACY OR SUITABILITY OF DATA IT RECEIVES FROM
OTHERS.
THE PARTIES AGREE THAT IN NO EVENT SHALL EHS HAVE ANY LIABILITY
TO SPONSOR OR ANY COVERED PERSON IN CONNECTION WITH THE
ACTS OR OMISSIONS OF ANY MEMBER PHARMACY OR PHARMACIST WHO
PERFORMS ANY SERVICES IN CONNECTION WITH THIS AGREEMENT. EHS
SHALL NOT, UNDER ANY CIRCUMSTANCES, BE LIABLE OR RESPONSIBLE
FOR INJURY, INCLUDING DEATH, SUFFERED BY ANY COVERED PERSON
FROM. ANY PRESCRIPTION DRUG DISPENSED OR NOT DISPENSED BY ANY
MEMBER PHARMACY OR PHARMACIST USING THE EHS DUR SYSTEM FOR
ANY PURPOSE, OR FOR ANY SIDE-EFFECTS OR OTHER CONSEQUENTIAL
OR INCIDENTAL DAMAGES OF ANY KIND OR DESCRIPTION WHATSOEVER
FROM THE USE, OR NON-USE, OF ANY SUCH PRESCRIPTION DRUG, IT
BEING EXPRESSLY UNDERSTOOD THAT SUCH LIABILITY AND
RESPONSIBILITY RESTS ENTIRELY UPON THE MEMBER PHARMACY OR
PHARMACIST DISPENSING THE PRESCRIPTION DRUG.
EHS represents that the Pharmacy Services Agreement EHS has with Member
Pharmacies obligates Member Pharmacies to: (a) procure and maintain
professional liability and malpractice insurance with limits of no less than one
million dollars ($1,000,000) for each claim and three million dollars ($3,000,000) in
the aggregate, as well as comprehensive general liability insurance to insure
against any claim for damages arising by reason of personal injury or death caused
directly or indirectly by the provision of pharmacy services; and (b) indemnify and
hold harmless Sponsor and EHS, as well as their respective affiliates, officers,
directors, partners, employees, and agents ("Indemnitees"), from and against any
claims, liabilities, damages, judgments, or other losses (including reasonable
attorneys' fees) imposed upon or incurred by the Indemnitees and arising out of or
as a result of Member Pharmacy's breach of the Pharmacy Services Agreement
and any acts or omissions of Member Pharmacy, or its affiliates, officers, directors,
shareholders, employees, and agents in connection with Member Pharmacy's
performance of any of its services, duties and obligations under the Pharmacy
Services Agreement. EHS represents and warrants that it shall be responsible for
the performance of all the obligations of its affiliate EPS under this Agreement.
110804:57940 VOL ( y1PAG GI
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In no event shall EHS, its affiliates, directors, officers, employees, agents and
parent be liable for (i) any third party claims against Sponsor, its affiliates, directors,
officers, employees, agents or parent for losses or damages except for the
indemnification provisions set forth in this Agreement, or (ii) any indirect, special,
incidental, consequential (including lost profit or savings) damages, even if EHS is
informed of their possibility.
Each party agrees to defend, indemnify and hold harmless the other party, its
affiliates and each of their respective directors, officers, employees, agents or
assigns from and against any and all actions, causes of action, claims, suits and
demands whatsoever, and from all damages, liabilities, costs, charges, debts,
fines, government investigations, proceedings, and expenses whatsoever
(including reasonable attorneys' fees and expenses related to any litigation or other
defense of any claims), which may be asserted or for which they may now or
hereafter become subject arising in connection with (i) any misrepresentation,
breach of warranty or non-fulfillment of any undertaking on the part of the party, its
affiliates, directors, officers, employees, and agents under this Agreement; and (ii)
any claims, demands, awards, judgments, actions, and proceedings made by any
person or organization arising out of or in any way connected with the party's
performance under this Agreement, or that of its affiliates, directors, officers,
employees, and agents.
Except for any EPS liability or special assessments EHS has agreed to pay under
an applicable performance guarantee, if any, in no event shall the liability of EHS,
its affiliates, directors, officers, employees, agents and parent entities under or in
connection with this Agreement exceed the actual loss or damage to Sponsor, its
affiliates, directors, officers, employees and agents up to the amount of the
Administrative Fees paid to EHS by Sponsor hereunder for the three (3) month
period immediately preceding the date on which the claim arose. However,
provided that Sponsor advises EHS of any Invoice error, miscalculation, or
discrepancy within thirty (30) days of an Invoice or an independent audit, the
inaccurate Invoice amount in question shall be credited in a lump sum manner to
Sponsor in the first available Invoice following resolution and agreement of the
inaccurate amount in question. The foregoing sentence shall also apply to any
credit owed Sponsor arising from the claim processing EHS conducts with Member
Pharmacies. If no Invoices are pending, EHS shall pay Sponsor the amounts due
directly.
XV.
ENERAL
Assignment. Neither this Agreement nor any of the obligations to be performed
hereunder may be assigned, directly or indirectly, by either party without the prior
written consent of the other party; provided, however, that the preceding restriction
shall not apply to the transfer by EHS of all or substantially all of EHS Claims
System processing or. EHS DUR services or to any transfer made by EHS to an
affiliate or parent of EHS (or to any entity which succeeds to EHS's business
through a sale, merger or other similar corporate change transaction). Any
assignment or attempted assignment in violation of this restriction shall be void.
This Agreement binds and inures to the benefit of the parties hereto and their
permitted successors and assignees.
Force Majeure. Neither party shall be liable in any manner for any delay or failure to
perform its obligations hereunder which are beyond such party's reasonable
control, including without limitation, any delay or failure due to strikes, labor
disputes, riots, earthquakes, storms, floods or other extreme weather, fires,
explosions, acts of God, embargoes, war or other outbreak of hostilities, delay of
carriers, suppliers or telecommunications providers, or government acts or
regulations. If the period of non-performance exceeds sixty (60) days, the
unaffected party shall have the right to terminate this Agreement by written notice
to the affected party, without liability except to pay for services rendered prior to
such event.
a nty-1 10804:57940 VOL L 114PAG'~ L-c
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Waiver. Any failure by either party to enforce or require the performance by the
other party of any of the terms or conditions of this Agreement shall not constitute a
waiver of a breach of any such term or condition thereafter occurring.
Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall be deemed to be an original as against any party whose
signature appears thereon, and all of which shall together constitute one and the
same agreement. This Agreement shall become binding when one or more
counterparts hereof, individual or taken together, shall bear the signatures of all of
the parties reflected hereon as the signatories.
Severability. Any invalidity, illegality or unenforceability of any provision of this
Agreement in any jurisdiction shall not invalidate or render illegal or unenforceable
the remaining provisions hereof in such jurisdiction and shall not invalidate or
render illegal or unenforceable such provision in any other jurisdiction.
Governing Law and Jurisdiction. This Agreement shall be governed and construed
in accordance with the laws of the Commonwealth of Pennsylvania without regard
to conflict of law provisions thereof. Any action or proceeding by or against either
party or with respect to or arising out of this Agreement shall be instituted and
litigated in the state or federal courts located in the Commonwealth of
Pennsylvania. Each party acknowledges that this Agreement was freely and
voluntarily negotiated and entered into, and that such parties had the opportunity to
review same. Accordingly, the parties agree that this Agreement shall not be
interpreted against the drafting party merely by virtue of such party having drafted
this Agreement.
Further Assurances. Each party further assures the other that it shall reasonably
cooperate and reasonably take such action as may be necessary to implement this
Agreement. The parties acknowledge that federal, state, local and other laws
relating to electronic data security and privacy are rapidly evolving and that
amendment of the Agreement maybe required to provide for procedures to ensure
compliance with such developments. The parties agree to take such action as is
necessary to comply with the standards and requirements of HIPAA, the HIPAA
Regulations and other applicable laws relating to the security or confidentiality of
PHI, provided that EHS shall not incur additional expenses to comply with such
future laws and regulations without a mutually agreed to amendment to this
Agreement.
Exclusivity. Sponsor agrees that during the term of this Agreement, it shall not
utilize the services of another entity to provide the services EHS has agreed to
perform under this Agreement.
Survival. Any term of this Agreement which by its nature extends beyond the
termination or expiration hereof shall survive, including but not limited to
indemnities, confidentiality obligations, liability limitations, and dispute resolution
provisions.
Confidentiality. Each party, as well as its agents and designees, shall keep this
Agreement and any business information exchanged hereunder confidential,
unless consent for disclosure is obtained from the other party. If disclosure of the
Agreement or business information exchanged hereunder is required by law, the
affected party shall promptly notify the other party so a protective order can be
requested.
anty-110804:57940 VOL-- n YJAG F
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Entire Agreement and Amendments. This Agreement, together with any Riders,
Exhibits, or other attachments hereto, constitutes the entire understanding between
the parties hereto with respect to the subject matter hereof. Except as otherwise
expressly contemplated herein, no prior oral or written communication with respect
to the subject matter hereof, nor any supplement, modification, waiver or
amendment of this Agreement unless executed in writing by the parties hereto,
shall be binding. Notwithstanding the provisions of this Section, EHS may amend
this Agreement or any attachment hereto without the consent of Sponsor in order
for this Agreement to fully comply with all applicable federal, state or local laws and
regulations; provided however that EHS notifies Sponsor of such amendment.
by
N WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed
espective officers or representatives duly authorized so to do.
TDI MffAGED CARE SERVICES, INC.
d/b/a S
By:
Nami
Title:
Date:
BRAZOS
By:
Name:
Title: Qe
Date: l/(co~~CaCX-F
10804:57940 VO L G 'PAGE
CONFIDENTIAL
EXHIBIT A
A.
B.
C.
D.
E.
PRICING AND ADMINISTRATIVE FEES
AIL PHARMACY PRICING: The lower of Usual and Customary or:
ND DRUGS: AWP -15% + $2.25 Dispensing Fee
GENERIC DRUGS: NetMAC + $2.25 Dispensing Fee
I-MAC GENERIC DRUGS: AWP -15% + $2.25 Dispensing Fee
_ SERVICE PHARMACY PRICING:
DRUGS:
C GENERIC DRUGS:
WMAC GENERIC DRUGS:
=CIALTY PHARMACY PRICING:
AWP -21% + $1.00 Dispensing Fee
NetMAC + $1.00 Dispensing Fee
AWP -21% + $1.00 Dispensing Fee
AWP -15% + $2.50 Dispensing Fee
DMINISTRATIVE FEES:
ETAIL BASE CLAIMS PROCESSING FEE (PER PAID/REVERSED CLAIM) $0.25
AIL BASE CLAIMS PROCESSING FEE (PER PAID/REVERSED CLAIM) $0.25
IRECT MEMBER REIMBURSEMENT (PER SUBMITTED CLAIM) $1.50
OREIGN DIRECT MEMBER REIMBURSEMENT
(PER SUBMITTED CLAIM) $5.00
UBMISSION OF ELIGIBILITY (FROM PAPER DOCUMENTS)
Start Up (Per Person) ($250 minimum) $1.00
Updates (Per Person) $1.00
(EHS will not bill client for less than 25 manual updates per month)
DDITIONAUREPLACEMENT ID CARDS (SET OF TWO) $1.00
(Two EHS identification cards included in base fee)
EBATE AMOUNT:
1.35 per all paid retail and $4.45 per all paid mail service prescriptions, subject to a
ormulary Management fee of $0.00 per claim.
VOL 0 PAGE
10804:57940 -°'h7 "
CONFIDENTIAL
F.
FEES:
EPORTING (OTHER THAN STANDARD)
Customized Programming Per Hour $100.00
In the event Sponsor requests EHS to provide non-standard or customized
services, including special research projects, reports, system changes to
accommodate changes in Sponsor's Plan or system, or other tasks to be
specifically performed for and on behalf of Sponsor, EHS may require Sponsor to
pay EHS such additional charge as mutually agreed upon by the parties in writing
before the services are provided.
R COMMUNICATIONS MATERIALS
Start up materials include two EHS identification cards, Plan brochure, mail service
enrollment and postage paid envelope, and Formulary. (Actual cost of postage will
be billed to Sponsor for direct mailings of communication materials to Covered
Persons.) There is no charge for bulk shipments of communication materials to
Sponsor locations.
KER FEES
Sponsor represents and warrants to EHS that Third Party Consultant AEL Rx, with
offices at 440 First Street, Lake Oswego, Oregon 97034 is acting on Sponsor's
behalf unless Sponsor otherwise informs EHS in writing, and that EHS may rely on
same. Sponsor acknowledges that EHS is not a party to the agreement between
Sponsor and Third Party Consultant, and that EHS may rely on those parties to
govern their relationship, including of any disclosures, accordingly.
G.
ELLANEOUS:
PLEMENTATION CREDIT
EHS shall credit or pay to Sponsor an Implementation credit of $1.25 per head of
household.
110804:57940 VOL W PAG `J
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CONFIDENTIAL
EHS BASIC PER CLAIM SERVICES
Basic
claim services provided in the paid claim fee include:
S CLAIMS SYSTEM - A fully automated on-line, real-time claims processing system.
S Claims System provides greater ability to tailor prescription drug plans to maximize
refits and to utilize a range of proven cost management approaches.
ETWORK MANAGEMENT - EHS maintains a Help Desk with 800 number service for the
ember Pharmacies to facilitate the point-of-service processing available through the EHS
laims System.
REHENSIVE REPORT PACKAGE - A standard package of reports includes
it cost, utilization control data and savings information related to the specific services
CURRENT EHS DUR - EHS Claims System will transmit informational concurrent
utilization review messages to Member Pharmacies as described in Exhibit C.
IDENTIFICATION CARDS - EHS will provide identification cards in accordance with
Ill(B).
TOMER SERVICE - EHS maintains a Help Desk with 800 number service for Covered
ons to answer inquires concerning Member Pharmacy locations and prescription
fit questions.
lD57
110804: 57940
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EXHIBIT B
MAIL SERVICE PHARMACY
A.
B.
C.
ROLLMENT MATERIALS
PS will provide to EHS for distribution to Sponsor and/or Covered Persons an enrollment
ackage including a carrier envelope, a brochure describing the details of the services
rovided, a postage paid order envelope, a Sponsor announcement letter, and patient
rofile request forms.
ROVISION OF PRESCRIPTION DRUGS
PS will provide prescription drugs to all Covered Persons in the United States who have
~ovided EPS with prescription request forms containing sufficient information to maintain a
atient profile. Prescriptions will be mailed to Covered Persons within an average three
asiness days of receipt of prescription request forms, subject to product availability and
e need to contact the Covered Person's physician for prescription clarifications.
=CIAL QUALITIES OF EPS
Postage paid envelopes for all clients
IVR ordering capabilities
WEB ordering capabilities
Complete order tracking and turn around time statistics and reports
Total Quality Management programs for quality assurance and accuracy reporting
Therapeutic Drug Management Program for brand to generic drug usage,
reporting, and savings to drug spend
Therapeutic Drug Brand drug interchange opportunities for changes to less
expensive AWP products
Specialized biotech product growth hormones, and EDI Transactions for ordering,
processing and reporting
Toll free 800 number with 24 hour availability of registered pharmacist 7 days/week
0. Dedicated customer service representatives for clients
1. Reporting and guarantees on service levels for average speed to answer calls, and
abandoned call rates
2. Bar code technology for fulfillment process
3. Robotics in prescription fulfillment for accuracy in dispensing
4. Client service customer service manager
5. Automated check refunds for overpayments (not coupons or credit vouchers)
6. Each new prescription is reviewed by two different registered pharmacists.
nty-110804: 57940 VOL PAGE: ~ G
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EXHIBIT C
EHS DUR SERVICES
ESCRIPTION OF CONCURRENT DUR SERVICES
EHS shall provide the EHS concurrent DUR system, which operates through the
EHS Claims System. The EHS Claims System will edit claims for the following:
1. Acute/Maintenance Dose Editing
2. Drug Regimen Compliance Checking
3. Drug/Drug Interaction Edits
4. Drug Interactions Conflict Code DD
5. Drug-Inferred Health State Checks
6. Drug to Age Checking
7. Drug to Sex Edit Checking
8. Duplicate Therapy Checking
9. Duplicate Rx Checking
10. FDB/MS Duplicate Therapy
11. Late Refill Check
ESCRIPTION OF RETROSPECTIVE DUR SERVICES
EHS shall provide the EHS Retrospective DUR system, which operates through the
EHS Claims System. The EHS Claims System will edit claims for the following:
1. Drug/Drug Interaction
In addition, if requested by Sponsor, the EHS Claims System will also edit claims
for the following:
1. Acute Frequency - Proton Pump Inhibitor Program
2. Brand to Generic (DAW1)
3. High Utilization
4. Retail to Mail
5. Therapeutic Duplication
EHS shall perform the following either on its own or through its affiliate EPS:
1. Analyze available Covered Person data to determine appropriateness and
cost effectiveness of prior drug usage and historical prescribing patterns as
indicated by EHS's computerized retrospective management edits outlined
above.
110804: 57940.,.
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CONFIDENTIAL
2. Based upon the foregoing analysis, contact the prescriber, pharmacy, or
Covered Person where appropriate to suggest modifications to current or
future therapy.
3. Provide Sponsor with monthly reports of EHS's activity relating to the
interventions deemed appropriate.
4. Provide Sponsor with monthly reports of the savings relating to the
interventions deemed appropriate.
5. Beginning six (6) months after the Effective Date, invoice Sponsor on a
monthly basis for fifty percent (50%) of the cost savings realized as a result
of EHS's operation of the Retrospective Drug Utilization Review. A line
item charge equal to fifty percent (50%) of the Total Savings amount for
the invoice period will appear on the monthly invoice.
Sponsor shall pay EHS for the Retrospective DUR cost savings within ten (10) days
after receipt of the invoice, as outlined in the Sponsor Agreement.
Ill. IfHARMACIST DISCRETION
he information generated in connection with EHS DUR services is intended as an
formational guide to, and not a substitute for, the knowledge, expertise, skill, and
dgment of physicians, pharmacists, or other health care providers. Sponsor
;knowledges and agrees that the EHS DUR system will provide information to the
ember Pharmacy, but the EHS DUR system cannot prevent Member Pharmacies from
spensing prescriptions or providing other goods and services in opposition to information
ey receive through the EHS DUR system. Sponsor acknowledges that Member
harmacies are individually responsible for acting or not acting upon information generated
1d transmitted through the EHS DUR system, and for performing services in each
risdiction consistent with the scope of their licenses.
r concurrent DUR programs, EHS, on behalf of Sponsor, shall advise Member
armacies that the EHS DUR system should not be relied upon as a substitute for their
)fessional judgment.
IV. PATIENT INFORMATION LIMITATIONS
ie EHS DUR system is necessarily limited by the amount of Covered Person information
put into the EHS Claims System from prescription claims and from information provided
Sponsor. Meaningful Covered Person information which may not be available to EHS
r purposes hereof, includes, but is not limited to, Covered Person diagnoses, utilization of
-ugs obtained without utilizing the EHS Claims System and weight and other physical
iosyncrasies of a Covered Person. EHS shall have no affirmative obligation to acquire
formation concerning any Covered Person where information is insufficient or not
(ailable to enable the EHS DUR system to determine whether or not intervention or
porting is indicated.
e EHS concurrent DUR system is highly automated, without any individual review in most
-umstances.
)ective DUR programs utilize systematic filters in conjunction with clinical pharmacist
to target interventions.
~2, /00
110804:57940 Vol , ; t] P'
CONFIDENTIAL
V.
HS DATABASE LIMITATIONS
he EHS DUR database is a collection of databases of clinical drug data and drug
ispensing information developed and maintained partly by EHS and partly by independent
rug database companies. Sponsor acknowledges and agrees that EHS has and may
onsult with outside software and other vendors, as well as consulting health care
rofessionals and any recognized compendia, to provide databases and other information
s EHS deems necessary or helpful to include in the EHS DUR database. EHS shall
ndeavor to update the EHS DUR database on a reasonable basis to reflect changes in
tandards for pharmaceutical prescribing; however, Sponsor acknowledges that no
atabase will contain all currently available information on accepted medical practice or
rescribing practices. In most cases, vendors and professionals limit or exclude warranties
:garding the information or services provided to EHS. Such limitations and exclusions are
corporated into Article XIV by this reference. BASED UPON THE FOREGOING,
PONSOR FURTHER ACKNOWLEDGES AND AGREES THAT EHS SHALL NOT BE
IABLE FOR ANY TORTS, COSTS, DAMAGES, EXPENSES, CLAIMS, SUITS OR
ROCEEDINGS OF ANY TYPE ARISING IN CONNECTION WITH (1) MEDICAL OR
CIENTIFIC JUDGMENTS MADE IN CREATING THE EHS DUR DATABASE OR ANY
THER DATABASES AND REPORTS UPON WHICH THE EHS DUR SERVICES ARE
ASED OR (II) ANY FAILURE TO INCLUDE INFORMATION IN THE EHS DUR
ATABASE.
SA-RMG- zosCounty-1 10804: 57940 23
CONFIDENTIAL
EXHIBIT D
THERAPEUTIC DRUG MANAGEMENT
'EUTIC DRUG MANAGEMENT PROGRAM
EHS shall:
1) Contact the Covered Person or the Covered Person's physician to obtain
their consent to convert to a lower cost, therapeutic or generic equivalent
medication.
2) With the appropriate consents, convert the Covered Person to a lower
cost, therapeutic or generic equivalent medication.
3) Provide Sponsor with monthly reports of drug conversions and cost
savings.
4) Invoice Sponsor monthly for one-half of the cost savings.
5) Allow either Covered Person or physician to opt out of the therapeutic drug
management program. If physician opts out, EHS shall not contact
physician or his/her patient Covered Persons for the therapeutic drug
management program.
Sponsor shall pay EPS or EHS, as directed by EHS, one-half the cost savings
within ten (10) days after receipt of an invoice thereof by electronic funds transfer.
Each party has the right to cancel the foregoing therapeutic drug management
program upon thirty (30) days written notice to the other party.
Kx-A
nty-110804: 57940 24
CONFIDENTIAL
RIDER 1
TO THE TDI MANAGED CARE SERVICES, INC. D/B/A EHS
SPONSOR AGREEMENT
SPECIAL PROVISIONS FOR BRAZOS COUNTY.
A cabilit . Brazos County with a principal place of business at 300 East 26th Street, Suite
10 Bryan, Texas 77803 ("Sponsor", which is acting on behalf of its Plan) has entered into the
TD (Managed Care Services, Inc. d/b/a EHS Sponsor Agreement (the "Sponsor Agreement")
wit TDI Managed Care Services, Inc. d/b/a EHS, with principal place of business at 620
20p on Drive, Pittsburgh, Pennsylvania 15238 ("EHS") with an Effective Date of January 1,
Iflict. under which EHS has made its retail pharmacy network and its mail service pharmacy
affe, Thrift Drug, Inc. d/b/a Express Pharmacy Services, with a place of business at 620
Ep n Drive, Pittsburgh, Pennsylvania 15238 ("EPS") available to Sponsor's Covered
Pe ns. To the extent of a conflict between this Rider and the Sponsor Agreement and any
Ex its thereto, this Rider shall govern. However, mere silence on a matter shall not constitute
a (Capitalized terms not specifically defined in this Rider have the same meaning
attted to them in the Sponsor Agreement).
1. Ac4~unt Management
EHS will make a representative available for a minimum of four (4) account
management meetings per year, or such other number as is agreed to by
both EHS and Sponsor.
Account management meetings are defined as scheduled meetings with
Sponsor's designated benefit representative(s) to review plan utilization,
performance, and/or financial status.
Liq
One thousand five hundred dollars ($1,500) penalty per scheduled meeting
missed by EHS, provided that EHS was provided with timely notice of such
meeting.
EHS will monitor on a quarterly basis and document and report results
annually relative to this guarantee within thirty (30) days following the end
of the Sponsor Agreement year.
2. Culloomer Service: Telephone Inquiries
Liq
Customer Service Response Time: Average time to answer customer
service calls will be thirty (30) seconds or less, based on EHS's book-of-
business statistics.
Telephone inquiries are defined as those telephone calls received by EHS'
customer service department from Covered Persons. Business day is
defined as normal working day Monday through Friday 9:00 AM until 5:00
PM Eastern Time, excluding holidays, that EHS administrative offices are
open to conduct business.
Fifteen percent (15%) of the total management fees collected annually if
this standard is not met.
110804:57940 25
rr _ _ _
CONFIDENTIAL
rement
EHS will monitor on a monthly basis and document and report results
annually relative to this guarantee within thirty (30) days following the end
of the Sponsor Agreement year.
3. M#1I Service Prescription Turnaround Time: Routine Prescriptions
ard: Average annual turnaround time for prescriptions received during each
year of the plan, requiring no intervention in business days measured from
date mail order prescription received to date mail order prescription
shipped will be two (2) business days or less. A minimum annual volume
of 5,000 mail service prescriptions applies.
Pharmacist-approved prescriptions are defined as those prescriptions for
which product is available at EPS and which do not require a pharmacist to
contact the prescriber/physician for clarification, consultation, or
intervention before dispensing. Prescriptions requiring intervention are
defined as those prescriptions for which eligibility issues exist or the
product is not available at EPS and/or which require the pharmacist to
contact the presciber/physician or Covered Person for clarification,
consultation, or other intervention before dispensing. Business day is
defined as Monday through Friday, excluding holidays, that EPS is open for
dispensing prescriptions.
Twenty percent (20%) of the total management fees collected annually,
during each year of the plan, if this standard is not met.
rement
EHS will monitor on a monthly basis and document and report results
annually relative to this guarantee within thirty (30) days following the end
of the Sponsor Agreement year.
4. M1111 Service Dispensing Accuracy
ard: Ninety-nine and seventy-five hundredths of a percent (99.75% or 0.9975)
or greater of prescriptions will be dispensed by EPS with no errors. A
minimum annual volume of 5,000 mail service prescriptions applies.
ition: A dispensing error is defined as incorrect medication or incorrect strength.
Liq dated
Da ages: Twenty percent (20%) of the total management fees collected annually if
this standard is not met.
Me urement
Cri ria: EHS will monitor on a monthly basis and document and report results
annually relative to this guarantee within thirty (30) days following the end
of the Sponsor Agreement year.
5. I.DJ Card Production
New ID Cards will be produced and released for distribution within an
average of four (4) business days from receipt of an accepted and
released eligibility file.
A new ID card is defined as the initial ID Card(s) that is provided to a
participating program Head-of-household upon enrollment in the program.
~Ef
110804:57940 ~6~
TT _
CONFIDENTIAL
idated
Ten percent (10%) of the total management fees collected in the first year
of the Sponsor Agreement if this standard is not met.
EHS will monitor on a monthly basis and document and report results
annually relative to this guarantee with a final reconciliation within thirty (30)
business days following the end of the respective Sponsor Agreement
year, as set forth above.
6. C"ms Processing Turnaround Time - Clean Claims
Paper claims not requiring additional review will be released for
reimbursement or responded to within an average of seven (7) business
days from receipt, based on a book of business basis.
ition: Paper claim is defined as each prescription claim contained on the Direct
Member Reimbursement (DMR) form which is keyed into the EHS
pharmacy claims system. Business day is defined as any day from Monday
through Friday from 9:00 AM until 5:00 PM Eastern Time, excluding
holidays, that our administrative offices are open to conduct business.
Fifty percent (50%) of the total paper claim management fees collected
annually if this standard is not met.
EHS will monitor on a monthly basis, and document and report results
relative to this guarantee annually, within thirty (30) days following the end
of the Sponsor Agreement year.
7. Agkiegate Limit of Performance Standards
above performance guarantees are subject to an aggregate annual penalty limit of eighty
)ercent (85%0) of the total management fees collected for that given year.
al Agreement Regarding Guarantees. If either EHS or EPS is prohibited or prevented in
ay from performing any of the above guarantees as a result of Sponsor's failure to
n any of its obligations as set forth in the Sponsor Agreement or as a result, directly or
tly, of any change in federal, state, or local law, regulation or agency action, or for any
beyond EHS' or EPS' control, including without limitation, acts of God or the public
flood or storm, or strikes, EHS and EPS shall not be in breach of such guarantees or be
d to pay any special assessment associated with such guarantees.
Pa r1hent of Guarantees. EHS shall refund any amounts owed to Sponsor under this-Rider by
l
ing such amounts to pending invoices within sixty (60) days following the anniversary of
the pplicable Sponsor Agreement year, or if no such invoices are pending, by direct payment
cr111
to 2onsor.
110804:57940 4 " 6 G
tT
CONFIDENTIAL
T 40m. This Rider shall be effective as of January 1, 2004 and shall continue until December
3 , 2006.
AGREED T0:
TDI M 'NAGED CARE SERVICES, INC. BRAZOS COUNTY
d/b/a S
By: By:
Name Name: n S
Title: Title: l s yn~ Sr~a. ,
Date: Date: t t ~LCo ~ 2nL34
SA-RMG razosCounty-110804:57940 1 ~w ~Q
A. The AI
B. The I
of all
the fd
Group
Group
By.,
Date_ I
Item Five
Administrative Charges and Credits
lstrative Charge, calculated Monthly, shall be equal to the sum of the amounts obtained by
the total number of covered Subscriber Units by category by the appropriate factors shown
ne~ital
$4.16 For each composite Subscriber Unit
Nation Administrative Charge shall be equal to the amount obtained by multiplying the sum
red Subscriber Units during the three Months immediately preceding the date of termination by
shown below.
Dental
$2 -33 For each composite Subscriber Unit
Item Six
Plan Coverage
Plan's Health Benefit flare coverage inclusive of the following:
D Managed Health Care coverage
editional (Out-of-Area) Indemnity Benefit coverage
mprehensive Dental Care coverage
of County Brazos Blue Cross and Blue Shied of Texas
l~
By: lLG_
Patricia Hemingway ident
Date:
:IN
- N .
'ry^,
V, A
M.
V~
411
Form No. A. (Rev.03)/SCH
Page 3
4P A G~ 80950JAN.04
.2
Brazos County
Administrative Services
Dental
AD= 1/1/2005
Composite ANNUAL"
705 705
'RATI CHARGE $4.16 $35,194
' This nual projection is based on the current enrollment; the actual results will differ.
TERMINATION
Run-Off Adnii istration $2.93 $6,197
Upon ter I ination, the run-off factors above will be multiplied times the total of all memberships
actually posed during each of the three months immediately preceding contract termination
and the ult will be the obligation of the Employer; the TOTAL above is based on the current
enrollme . (The Run-Off Administration amount is due and payable whether or not BCBST
process the run-off claims.)
-an el fi ctive date no later than 1/1/2005
-Emp er maintaining current contribution percentage levels
-mini m enrollment of 705 employees, with approximately 38% covering dependents
-a m hly enrollment of no fewer than 670 employees
-fees clude broker fees and commissions
-The finitions, limitations, exclusions, and contract provisions of the BCBSTX Administrative Services Agreement,
Cla Jes Administrative Document and the BCBSTX Master Benefit Plan Document will be applicable unless specked otherwise
-no a tional taxes being imposed and no increase in existing taxes
-BCB X being the only carrier offered
- stan rd BCBSTX benefits, reports, services, and materials
-Our do not include an Agent of Record commission.
• Cos ssociated with special services or custom materials provided by BCBSTX will be
supp ental billed separate and apart from the Administrative Charges outlined on
this ib1t.
The employer is rl+onsible for any Administrative Services Taxes due for benefits paid under the
proposed Agreem0 t.
County of Brazos Dental.16521 DEFANGED-xis
64 Prim' &8
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Subject: B S Dental Renewal
@cstx.gov>, <joconnell@cstx.gov>, <ckirk@bryantx.gov>,
<lnich @co.brazos.tx.us>
To: <jwillia f;-Irimes(d)bcbstx.com>
Cc: <Lana BCBS has Mgreed to a rate pass on the dental for 1/1/05-12/31/05.
Jarrad Wi
McGriff, S
els and Williams
(469) 232
64 ph
(469)232-:
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(214) 435
49 cell
jwills@mc
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www.mca
com
Printed for 44raine Nichols <lnichols@co.brazos.tx.us>
Page 1 of 1'
11/10/2004
/I
BRAZOS COUNTY
BRYAN. TEXAS
BRAZOSCOUNTY
RESOLUTION
`Whereas, the Commissioners Court of Brazos County has previously authorized funding for a part-time
Magistrate and confirmed the appointment of Dana Zachary to serve as the Magistrate for Brazos County under Texas
Government Code §54.1101 et. seq.; and
Whereas, Texas Government Code §54.1106 authorizes the judge of a court in this county having family law
jurisdiction to refer to a magistrate any matter that may be referred to an Associate Judge (formerly known as Family
Law Masters) appointed under the Family Code; and
'Whereas, Texas Family Code §201.001 authorizes the judge of a court in this county having jurisdiction of a suit
under Titles 1, 4 and 5 of the Texas Family Code to appoint a full-time or part-time associate judge to perform any of
the duties authorized with the consent and approval of the Commissioners Court, to jointly appoint one or more
magistrates to serve the courts in this county; and
`GlNereas; Texas Family Code §51.04 authorizes the Juvenile Board in Brazos County, to appoint a referee to
conduct hearings under Title 3 of the Texas Family Code; and
40ereas, the Honorable Reva L. Towslee Corbett, the Juvenile Referee for Brazos County since January 1,
1997, has tendered her resignation to be effective on December 3, 2004, due to her election as Presiding Judge of the
335h District Court serving Austin, Bastrop, Burleson, and Washington Counties; and
`Whereas, the judges of the district courts and county courts at law in Brazos County have requested the
Commissioners Court to authorize the Magistrate to assume the duties of an Associate Judge and Juvenile Referee; and
'Whereas, the Commissioners Court is of the opinion that the authorization for the magistrate to assume the
duties authorized for an Associate Judge and Juvenile Referee under the Texas Family Code is in the best interest of the
citizens of Brazos County;
Be It There
,fore 4jrsorw4 that the Commissioners Court of Brazos County, Texas authorizes, consents, approves,
and confirms the action of the judges of the district courts and county courts at law and the Juvenile Board of Brazos
County, Texas to appoint Dana Zachary, to serve the district and county courts at law and perform any and all duties
authorized by law as Magistrate, Associate Judge, and Juvenile Referee, effective November 29, 2004; and
Be It Further 4ZfsoCv ,4 that the salary of Dana Zachary, as Magistrate, shall continue to be paid for the remainder
of the current fiscal year, as previously approved by this court in the current budget, and as Associate Judge and
Juvenile Referee, shall be paid for the remainder of the current fiscal year from the Juvenile Court Referee Division
(#25500100) of the General Fund at the annual salary rate of $36,930.00; and
Be It Further 4ZFso1wt4 that Dana Zachary, as Magistrate, Associate Judge, and Juvenile Referee, shall be
classified for the purposes of receiving employee benefits from Brazos County as a full-time employee; and
Be It FurtherWgso`w4 that amount of the magistrate' fee that may be imposed as costs against the nonprevailing
party in each case heard by the Magistrate shall continue to be $50.00.
APPROVED in Regular Session of the Commissi ners C u azos County, Texas, on this 16`h day of November,
2004.
Randy Sims
County Judge
Commissioner Eric Caldwell
Precinct I
Commissioner Duane Peters
Precinct 2
A6e,.7-
Commissioner e y Mallard ~]I Commissioner Carey Cauley
Precinc 3 L PAGE Precinct 4
Paolntlon 004.022
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