HomeMy WebLinkAboutbocc.con.430.2016 - BOCC CONTRACT
LETTER OF INTENT BETWEEN ASPEN VALLEY HOSPITAL
COUNTY AND MOUNTAIN FAMILY HEALTH CENTERS TO PROVIDE SPACE AND
ONGOING OPERATIONAL SUPPORT FOR MEDICAL,BEHAVIORAL HEALTH,
AND DENTAL SERVICES TO LOW-INCOME POPULATIONS IN PITKIN COUNTY.
This Letter of Intent (hereafter "Agreement") is entered into this 11a day of , 2016
between Terry Collins, Interim CEO Aspen Valley Hospital District. Ross Brooks, CEO
Mountain Family Health Centers, and Jon Peacock, Pitkin County Manager. This Agreement is
intended to outline each organization's mutual obligations as they relate to providing space in the
mid-Roaring Fork Valley for Mountain Family Health Centers to provide primary medical care,
behavioral health and dental health services to low-income resident, of Pitkin County.
RECITALS
WHEREAS, Mountain Family Health Centers is a Federally Qualified Health Center dedicated
to providing high-quality integrated primary medical, behavioral and dental health care for the
medically underserved, regardless of ability to pay, and
WHEREAS, in Pitkin County, there are currently 4,500 individuals living below 200% of the
Federal Poverty Level (defined as at or below $23,760 annual income for a single individual and
at or below $48,600 for a family of four) Mountain Family Health currently serves 2,000 low-
income and Medicaid patients annually in Pitkin County, and estimates that as of this agreement
there are another 2,500 low income and Medicaid patients unable to he served in Pitkin County
due to lack of exam rooms, facilities, and affordable care options; and
WHEREAS, Aspen Valley Hospital District is a fully accredited Critical Access Hospital and
Level III Trauma Center; and
WHEREAS, Aspen Valley Hospital District is committed to the overall health and wellbeing of
the hospital district's population, regardless of ability to pay, and recognizes that one of the most
effective ways to accomplish this goal is to ensure consistent access to quality integrated primary
medical,behavioral and dental care, and
WHEREAS, Aspen Valley Hospital District has a strong history of supporting Mountain Family
Health Centers with operating cash subsidies and in-kind contributions.
WHEREAS, Aspen Valley Hospital District finds it will not be possible to donate space at 234
Cody Lane, Basalt, to Mountain Family Health Centers beyond March 2018; and
WHEREAS, Pitlan County is committed to the health, safety and wellbeing of its residents and
has a history of partnering with Aspen Valley Hospital District through the Healthy Community
Fund to provide operating cash subsidies for Mountain Family Health Centers; and
s. . .'/ :v
NHFARAe n:'.,county has leased property at 123 Emma Road, Basalt, to provide
temporary office space for County Employee's during construction and remodel of the
Courthouse Plaza project expected to be completed in June 2018: and
WHEREAS, the County has an opportunity to purchase the building at 123 Emma Road, Basalt
which would allow the County to provide space that will meet current and future space needs for
Mountain Family Health Centers by providing up to 9,000 sq./ft. of space for primary care,
behavioral health and dental operatories; and
WHEREAS, Mountain Family Health Centers, Aspen Valley Hospital District and Pitkin
County desire to enter into a three way partnership to ensure Mountain Family Health's ability to
provide high-quality integi ated piimary medical, behavioral and dental health services to all
medically underserved residents of Pitkin County, regardless of ability to pay.
WITNESSETH
NOW, THEREFORE, for and in consideration of the premises, the mutual covenants and
agreements herein contained, the foregoing Recitals, and other good and valuable consideration,
the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:
1. County Obligation.
a. The Count}'is under contract to purchase space at 123 Emma Road, Basalt, for
the purpose of providing temporary office space for County Employees e hilt
construction of an addition and remodel of the Courthouse Plaza is accomplished
in Aspen (estimated completion date of May, 2018). Upon x acating its space at
123 Emma Road the County agrees to enter into a long-term. 20 year lease, with
Mountain Family Health Centers, for up to 9,000 sq/ft. of space. The terms of
the lease shall include the following
i. The space will be leased for an initial sum of$150,000 a year. The lease
shall include an annual increase of 2 OSb or one half of Denver-Boulder-
Crcc1c CPI v,lythe.er IS V,eater
n. Mounlmn family Health Ccnlers will be responsible ror all tenant
101provemcnts as lurthcr dlxussed In 5cc10n 3 ui this agreement,
maintenance within their space. and utilities.
u,. The County .hall be responsible for tlic share of Co," mon Arca
Maintenance and Common Area capital improvements associated with the
space leased by Mountain Family Health Centers Common Area
Maintenance for the purpose of the lease shall include landscapup
additions or redesigns, exterior painting,exterior or parking lot lighting
fixtures. paying or resurfacing, sidewalk repair and replacement, roofing.
or repairs and upgrades to central plumbing, electrical, sewer,and HVAC
systems. Mountain Family health will be responsible for all repair and
maintenance specific to the space they occupy and tenant Improvements
made per section 3 of this agreement. The only exceptions shall be any
County approved improvements added to Common Areas by Mountain
Family Health Centers which shall he maintained in good repair at
Mountain Family Health Center's expense.
b. In addition to contributions to provide physical space for Mountain Family Health
Centers, the County recognizes that Mountain Family Health Centers will require
additional ongoing operating subsidies to cover the gap between revenues
provided through Medicaid. Medicare, grants and donations and the actual
operating costs of providing high-quality integrated primary medical, behavioral
and dental health care for the medically underserved in the Roaring Fork Valley,
regardless of ability to pay. The County agrees to enter into a separate agreement
with Mountain Family Health regarding ongoing operating subsidies. Until such
an agreement is reached the County agrees to continue providing $75,000 towards
operations in addition to the lease space described more fully in the remainder of
this agreement.
2. Aspen Valley Hospital District Obligation:
a. Upon Mountain Family Health vacating Aspen Valley Hospital District's facility
at 234 Cody Lane the Hospital agrees to provide financial support for Mountain
Family Health Center's Basalt facilities as follows:
i. From June 1, 2018-May 31, 2019 Aspen Valley Hospital District agrees to
provide funding to Mountain Family Health Centers Basalt in the amount
of$150,000 to support lease expense at 123 Emma Road in Basalt.
Annually thereafter, the amount to he paid by Aspen Valley Hospital
District to Mountain Family Health Centers shall increase annually by 2%
or one half of Denver-Boulder-Greeley CPI whichever is more.
b. In addition to contributions to provide physical space for Mountain Family Health
Centers, Aspen Valley Hospital District recognizes that Mountain Family Health
will require additional ongoing operating subsidies to cover the gap between
revenues provided through Medicaid, Medicare, grants and donations and the
actual operating costs of providing high-quality integrated primary medical,
behavioral and dental health care for the medically underserved in the Roaring
Fork Valley. regardless of ability to pay. The Aspen Valley Hospital District
agrees to enter into a separate agreement with Mountain Family Health Centers
regarding ongoing operating subsidies Until such an agreement is reached Aspen
Valley Hospital District agrees to continue covering Mountain Family Health's
operating funding gap currently estimated at $135,000.
3. Mountain Family Health Centers Obligation.
a Mountain Family Health Centers will be entitled to occupy the leased space, and
receive operational subsidy contributions from Aspen Valley Hospital District and
Pitkin County so long as:
i. Mountain Family Health Centers is providing high-quality integrated
primary medical, behavioral and dental health care for the medically
underserved in Pitkin County regardless of ability to pay. and
ii Mountain Family Health Centers maintains its designation as a Federally
Qualified Health Center (FQHC) under Section 330 of the U.S. Public
Health Services Act.
b Reporting Upon occupying the leased space in 2018 Mountain Family Health
Centers agrees to report in writing to Aspen Valley Hospital District and Pitkin
County the following information for the first and second quarters of the calendar
year, and ss.ceitr and fourth quarters of the calendar year:
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i. Total unduplicated patients served at MFHC Basalt's location, including
total medical, dental, and behavioral health patients and visits.
u. Of those patients served in 3.b i. above, the percentage of patients residing
m Pitkin County
iii The payer mix of the patients served at the MFHC Basalt location.
iv. Financial statements for MFHC Basalt showing total revenue, total
expense, operating profi/loss, and operating profit/loss attributable to
Pitkin County residents.
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,nother national MI 1fl accred.dn i,a.d>
.,. r.,,,cn, ..'t' f.,ct'on results at mr„e Basalt, as defined by ,he AEcn y f.,r
Iieanhs ate Rese.,tiu and Oualur `AI lRO) u. .m,athet national patient
sausractiun urbanization. ` ` I
C. Twice a year Mountain Mundy health will cncUutc a n1000ng with [he Pitkin
County Manager or their designee. the Aspen Valley Hospital District CEO or
their designee. and the Mountain Family Health Center CEO or their designee to
discuss reports as described in paragraph 3 b
d. Tenet Improvements- Mountain Family Health Centers agrees, at their expense to
make all tenant improvements in the lease space as necessary to provide services
to Pitkin County residents regardless of ability to pay. Initial improvements shall
include at a minimum the following elements unless otherwise agreed to by the
County in writing'
i. Nine medical exam rooms;
ii. Four dental operatories;
iii Two behavioral health rooms;
iv. An emergency generator sized to support Mountain Family Health
operations;
v. Development of second access that is ADA compliant;
vi Any ancillary improvements necessary to support MFHC.
It is currently estimated that these improvements will cost between $2.0-
2.25million. MFHC will share capital budget projections and three-year operating
projections with both Pitkin County and Aspen Valley Hospital.
4. Transition Strategy:
If Mountain Family Health Centers will be without space to provide services prior to June
2018, the three parties (Pitkin County. Aspen Valley Hospital District, and Mountain
Family Health Centers) agree to collaboratively develop and finalize by October 1, 2017,
a transition strategy for the period prior to June 2018 The Transition Strategy shall
include:
a Physical space for MFHC
b. Ongoing Aspen Valley Hospital District and Pitkin County operational subsidy
contributions to MFHC Basalt
5. Term:
This agreement shall commence as of the date first written above and shall automatically
renew for one-year increments unless terminated by one of the signing parties upon one
hundred and eighty(180) days' notice or otherwise terminated under the provisions in
5.a or 5.b below.
a. In the event of default, any party shall have the option to discontinue their
obligations under this agreement and terminate the agreement upon 90 days
written notice during which the defaulting party shall have the opportunity to cure
the default.
b. Both the County and Aspen Valley Hospital District are political subdivisions and
pursuant to Article 10 Section 20 of the Colorado Constitution all fiscal
obligations of this agreement are subject to annual appropriations by the Board of
Commissioners and Aspen Valley Hospital District Board. Failure of the Aspen
Valley Hospital District Board or the Board of County Commissioners to make
appropriations pursuant to this agreement shall render the agreement terminated.
IN WITNESS WHEREOF, the parties hereto enter into this Agreement as of the day and year
first above written.
Aspen Valley Hospital District,
Terry IlittS,'Interi Executive Officer
Mountain Family Health Centers,
Ross kot s k•. •r ief Executive Officer
Pitkin County
2—
Jun reacucht (Aunty Manager