board of county commissioners agenda thursday, may · pdf fileboard of county commissioners...

BOARD OF COUNTY COMMISSIONERS AGENDA THURSDAY, MAY 05,2016,9:00 AM

COMMISSION CHAMBERS, ROOM B-11 I. PROCLAMATIONS/PRESENTATIONS

II. UNFINISHED BUSINESS

III. CONSENT AGENDA

1. Consider approval of a date change from August 30-September 1, 2016 to January 9-13, 2017 for previously approved out-of-state travel for one employee to attend the Nurse Family Partnership training-Health Agency LHD.

IV. NEW BUSINESS

A. COUNTY CLERK- Cynthia Beck

I. Consider all voucher payments.

2. Consider correction orders.

B. PARKS + RECREATION- John Knight

1. Consider approval of request to solicit bids for the resurfacing and extensive re-caulking of 18 tennis courts at the Kossover Tennis Center at Felker Park at an estimated cost of $120,000.00 with funding from the Parks and Recreation Building Maintenance Fund.

2. Consider out-of-state travel for two employees to attend the Special Park District Forum in Cleveland Ohio and the National Association of County and Recreation Officials Summer Annual Meeting to be held in Long Beach, California with the Shawnee County Parks and Recreation Foundation paying for the airfare and lodging costs and the Parks and Recreation budget paying a total of $1,600.00 for registrations for both conferences.

C. CORRECTIONS -Brian Cole

1. Consider approval of request to post and fill one vacant custodian position at an annual salary, including benefits, of $31,582.42.

D. HEALTH AGENCY- Allison Alejos/ Alice Weingartner

1. Consider authorization and execution of Contract C138-2016 with the Kansas Children's Service League (KCSL) for outreach, prevention and early intervention services for at-risk families with young children or those families expecting children with $360,000.00 in grant funding for KCSL and $408,000.00 to the Health Agency--LHD.

2. Consider approval of request for out-of-state travel for an employee to attend a Community Health Conference in Oklahoma City with costs being paid by a partner entity with the exception of staff time and mileage--CHC.

3. Acknowledge binding of Medical Professional Liability Insurance for all Health Agency staff members in a total amount of$34,980.00-Health Agency.

E. COUNTY COUNSELOR- Rich Eckert

1. Legislative Update.

V. ADMINISTRATIVE COMMUNICATIONS

VI. EXECUTIVE SESSIONS

April29, 2016

TO:

FROM:

Shawnee County Health Agency

Board of Commissioners Shawnee County

Allison Alejos 0-ov-Director - Local Health Department

Leading the Way to a Healthier Shawnee County ,

RE: CONSENT AGENDA- Date change for Nurse Family Partnership Training

Action Requested: Approval of date change for out-of-state travel for one Shawnee County Health Agency- Local Health Department (SCHA-LHD) Registered Nurse to attend the Nurse Family Partnership training originally scheduled for August 30-September 1, 2016 in Denver, Colorado. The dates have changed to January 9-13, 2017 in Denver, Colorado.

On March 17, 2016 out of state travel for a SCHA-LHD Registered Nurse to attend Nurse Family Partnership training was approved by the Board of County Commissioners. We have been notified that the class scheduled from August 30-September 1, 2016 is full. The next opportunity for this required training is January 9-13, 2017.

AA/tnjc

1615 SW 8th Topeka, KS 66606 I 785.251.2000 www.shawneehealth.org

Shawnee County '"'ll .. ;)j tf

recreation April29, 2016

TO:

FROM:

RE:

Board of Commissioners

Shawnee County ~

John E. Knight, Director .. ~ Parks + Recreation

Request to Solicit Bids- Resurfacing Kossover Tennis Courts Outdoor Adventure- Sports Division

Board of Commissioners approval is requested to solicit bids to resurface 18 tennis courts at the Kossover Tennis Center at Felker Park. The courts are also in need of extensive re-caulking to prevent water infiltration between sections of concrete and under the courts. Excessive moisture infiltration could result in heaving of the courts necessitating repairs at a greater cost.

The surfaces at Kossover Tennis Center were last resurfaced in 2004. Generally you can expect 6-8 years of useful life from a surface before it needs to be redone. Skill level and amount of play can affect this life span. An estimated cost to resurface the 18 courts at Kossover Tennis Center is $120,000.

Shawnee County Parks + Recreation manage 82 outdoor sport courts throughout the park system. Of these courts, 62 need periodic resurfacing, 17 need to be re-lined periodically and 3-6 can or should be removed from our inventory. Of the 62 courts that need to be resurfaced 44 see significant use with the 18 tennis courts at Kossover Tennis Center and the 18 pickleball courts at Hughes Park seeing extensive use. The 8 tennis courts at Lake Shawnee see regular use and the balance see sporadic use. At a 6-8 year cycle of re-surfacing the department should be resurfacing or relining 1 0-13 courts per year. It is anticipated that the department will seek to re-surface courts at Lake Shawnee, Hillcrest Park and Shawnee North Community Park next year. Exact locations may change as priorities shift while the department catches up on this deferred maintenance.

The great majority of higher level tennis play occurs at the Kossover Tennis Center. The center is recognized as one of the premier tennis centered athletic complexes in the State and annually hosts high school leagues, regional and state tournaments. Local tennis clubs host tournaments annually that attract players from throughout the Midwest. Kossover Tennis Center is also the site for the annual Sunflower State Games and the Kansas Senior Olympic tennis activities. These events have a net positive economic impact to Topeka and Shawnee County. Staff is currently working with the Topeka Tennis Association (TTA) to develop a partnership with the Shawnee County Parks &

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Recreation Foundation. This partnership would bring the TTA's 501 (c) 3 funds under the umbrella of the Shawnee County Parks & Recreation Foundation and the Topeka Community Foundation. These funds having the same goals could acquire and use tax-deductible contributions, to reduce the burden on government for major improvements and keeping the Kossover Tennis Center a first class facility.

Chapter five of the Parks and Recreation Master Plan addresses Park and Facility Analysis. Section 5. 2. 2 Opportunities identifies; resurface park roads, parking lots, trails, basketball and tennis courts and sports fields where deterioration is seen and develop a resurfacing schedule to address existing parks as necessary. These tennis courts are in need of being resurfaced, the department runs a risk of increased repair costs if this preventive maintenance is delayed.

Funding is available through the Parks & Recreation Building Maintenance Fund. This Fund is appropriate as the Kossover Tennis Center in Felker Park are grounds that were acquired through the Federal Lands to Parks Program with revenues from activities at Felker Park going directly into the Building Maintenance Fund for repairs to parks and recreation facilities.

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recreation May 2, 2016

TO:

FROM:

RE:

Board of County Commissioners Shawnee County \ ~

John E. Knight, Director J Parks + Recreation

Out-of-State Travel-Educational Opportunities

Board of Commissioners approval is requested for out-of-state travel for two (2) employees to two (2) to the following educational opportunities. Out-of-state travel is requested to Cleveland, Ohio for the Special Park District Forum and to Long Beach, California for the National Association of County Parks and Recreation Officials (NACPRO) Summer Annual Meeting. Out-of-State travel is also requested to.

The 2016 Special Park District Forum will be held June 13 through 17 in Cleveland, Ohio. This conference will be hosted by Cleveland Metroparks and will demonstrate their key role in economic development and the resurgence of Cleveland's urban core. Of particular importance to Shawnee County will be the opportunity to learn from Cleveland Metro park's Watershed Stewardship Center, the development of their urban Rivergate Park, and unique partnerships including Merwin's Wharf full-service restaurant.

The NACPRO Board of Directors meeting will be held in conjunction with the NaCo Annual Conference and Exposition in Long Beach, California. The Annual Meeting will include educational sessions led by Los Angeles County, Department of Parks and Recreation on July 23 and July 25, 2015. A key focus of this year's meeting will be a focus on the unique partnerships and unique facilities that have been developed by Los Angeles County, Department of Parks and Recreation which have received many state and national awards over the years for their innovative programs and facilities.

On July 24, the NACPRO Board of Directors will hold their annual meeting during the day and that same evening will be the NACPRO Annual Banquet. Shawnee County Parks + Recreation submitted several nominations for these prestigious national awards. One submission was selected to receive national recognition; the Outstanding Volunteer A ward will be presented to Shawnee County Parks + Recreation at the Awards Banquet.

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The Shawnee County Parks & Recreation Master Plan identified where the depmiment needs to center their energy and values as the department strives to be a best-practice agency. The County Commission and staff recognize how impmiant it is to maintain a first-class parks and recreation system to keep people living and working in the county and the economic impact the department has on the city and county. As the implementation of the Master Plan continues it is evident that the department will require a continued business plmming approach and support from staff to operate in the most efficient and effective manner. The NACPRO Annual Conference and Exposition provides an excellent opportunity to facilitate the implementation.

The Shawnee County Parks & Recreation Foundation will pay for the airfare and lodging costs for the out-of-state travel. The Shawnee County General Fund through the Parks and Recreation budget will be responsible for the registration costs, per diem reimbursements for these events. For attendance at the Special Park District Forum the registration cost will be $500 per person and for attendance at the NACPRO Annual Conference the registration cost is less than $300 per person.

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DATE:

TO:

FROM:

SUBJECT:

Shawnee County

Department of Corrections 501 S.E. 8th Street - Topeka, Kansas 66607

Brian W. Cole, Director

Adult Detention Facility- 501 SE 8th- Topeka, Kansas 66607- (785) 291-5000- FAX (785) 291-4924 Youth Detention Facility- 401 SE 8th- Topeka, Kansas 66607- (785) 233-6459- FAX (785) 291-4963 Corrections Annex- 818 SE Adams- Topeka, Kansas 66607- (785) 291-5000- FAX (785) 291-4930

April21, 2016

Board of County Commissioners ,

Brian Cole, Director ~

Request to Post and Fill One Vacant Custodian Position

I am requesting to post and fill one vacant Custodian position (DF1261) for the Department of Corrections (DOC). The annual salary, including benefits of a Custodian is $31,582.42. This position became vacant March 31, 2016; the employee who held this position did not successfully complete the probationary period. This position is responsible for the sanitation of those areas where inmate trustees cannot be utilized. If this position is left vacant, it will be very difficult for the other custodial staff to maintain their assigned areas and the additional areas without the need for costly overtime. The department has attempted to do this in the past and the sanitation of the facility suffered.

I will be happy to answer any questions you may have.

BC:sr

cc: Betty Greiner, Director of Administrative Services James Crowl, Director of Human Resources Evelyn Kendall, Deputy Director Stephanie Rahn, Division Manager File


j) 1

Leading the Way to a Healthier Shawnee County

April28, 2016

TO:

FROM:

RE:


Allison Alejos ()_(}..--Director - Local Health Department

Renewal of Agreement with Kansas Children's Service League - Outreach, Prevention and Early Intervention Services

Action Requested: Approval to renew the agreement between Shawnee County Health Agency (SCHA) and Kansas Children's Service League (KCSL).

This renewal agreement between SCHA and KCSL provides the opportunity to continue offering an intensive home visitation program for at-risk families with young children or those families who are expecting children. Together, private funds of $384,000 from United Way, fiscal agent for Early Childhood Block Grant and federal funds in the amount of $384,000 from Medicaid Match will result in a total of $768,000 in fiscal year 2017 for the Shawnee County Community$360,000 going to Kansas Children's Service League and $408,000 to SCHA. There is no cost to the county.

All services to families are voluntary and are focused on helping at-risk families be successful. The SCHA public health nursing. model of this program is called Nurse Family Partnership and the KCSL model is called "Healthy Families Topeka." These programs are evidence based prevention programs.

AA/dc Encl.

Cc: Diane Creek, Family Health Services Division Manager


SHAWNEE COUNTY AGREEMENT NO. C.\3<6-2016

OUTREACH, PREVENTION AND EARLY INTERVENTION SERVICES KCSL

Now, on this day of ,2016, the Kansas Children's Service League, hereinafter referred to as "KCSL", and the Board of County Commissioners of the County of Shawnee, Kansas, providing the described services through the Shawnee County Health Agency, hereinafter referred to as "the County" do come together and make the following statements, covenants and agreements;

WHEREAS, the County has contracted with the Kansas Department of Health and Environment, hereinafter referred to as "KDHE", to provide Outreach, Prevention and Early Intervention Services and,

WHEREAS, the County wishes to enter into an agreement with KCSL in order to implement its responsibilities under the KDHE contract, and KCSL wishes to assume responsibility for performing said services.

NOW, THEREFORE, in consideration of the mutual agreements and covenants hereinafter stated, the parties agree as follows:

1. County's Agreement with KDHE. Attached hereto, marked as Exhibit "A" and incorporated herein by reference, is Shawnee County Contract No. C59-2016 renewing Shawnee County Contract No. C324-2013 and setting forth the compensation schedule for the period of July 1, 2016 through June 30, 2017.

2. KCSL's Obligations and Services. KCSL agrees, in partnership with the County, to assume and satisfy the Service Contractor Responsibilities as stated in Section III of Shawnee County Contract No. C324-20 13.

3. Outcomes and Reporting. It is mutually agreed that outcomes and data will be tracked and reported by the Shawnee County Health Agency. The Agency will submit data quarterly and annually regarding the program's success, with the first reports being due one month after the first quarter of the grant year. For purposes of this Agreement, the "grant year" begins on July 1, 2016 and ends on June 30, 2017.

4. Provisions in Shawnee County Contract No. C324-2013 Incorporated into this Agreement. KCSL and Shawnee County mutually agree to be bound to those contract terms and conditions specified in Shawnee County Contract No. C324-2013 under those sections entitled: "Suspension!fermination," "Termination for Unavailability of Funds," "Retention of and Access to Records," "Independent Contractor Status," "Confidentiality," and "Attachments."

5. Qonsideratton, The Counly agl'Ces to pay KCSL~ and KCSL agrees to accept :from County, fo1' services provided hereunde1·, tl sum not to exceed $360,000 dud11g the conh·aot yeat•, The money paid by the com1ty to KCSL \mde1· this Agreement is be to derived, In equal ammmts, :ll·om two so\nces: up tp $180,000 fi•om the Enl'ly Childhood Block Grant issued to the County ft·om United Way of 01·eater Topeka, and \lP to $180,000 fl·om the Outt·eaoh, Pl'evenUon and Endy· Intervention Se1·vices pl'Ogt·am funds issued by KDHE to the County pea• Conh·act #CS9-2016. The thneftame fm· payments to KCSL as required by this contract shall om·1·espond with the Co\mty's aotualt•eoeJpt of said ftmds ft·om KDHE 011 the deslgnnted qumlel'ly basis wlth each relat~d payment due to KCSL not latet· than tbh1y (30) days thereafte1•,

6, :rerm nncl Te1•minatlon of Agl'eement. This agt·eement shall be effective ft'Om J\lly 1, 2016 through J\me 30,2017. In the event that eithet· the pdva.te donations fl'om United Way of 01·entet· Topeka to the County or Federal fimmcial purtlolpatlon from KDHE is not available ol' becomes unavailable, this Contract shall bQ tmtomntlonlly te1·mlnnted wltho\tt furtllet' action by tl1e pnl'ties het·eto and all obHgatlons assumed hereunder shall cease. In addition) el1her party may terminate this Agreement by glvJng the other pm·ty Wl'ltten notice oftetmination at least thlrty. (30) days prior to the terminntion date identified In the wl'itten notice oftel'Jninatlon.

IN WITNESS WHEREOF, each of the undersigned has caused this Agl'eement to be exeouted by its duly authol'ized rep1·esentatives as of tho day and year fit·st above wl'ltten.

Dona Booe, President/CEO Kansas ClllldL'On's Service League

Mlobole A. Buhler, Chah· Board of County Conunisslonel's of the . County of Shawnee, Kansas providing services Through the Shawnee Co\mty Health Agency

AITEST:

Cynthia A. Beok1 Shawnee County Clet·k

'/-:19 ~j(g Date

Date

. Approved as to LaQ~IIty ~~Form: patEtq~~· ~~tiJI.lt!M? _____ ~ ASST{J.5Cf05~JNSELOR

Rev. 09/2013 A Tl'AC:UMENT To

SIIAWNilt: Colli\'T\' CONTRACT C. __ ~

CONfBAC'fliAL 111t0VISJONS AITACHMEN'l' 'lbe undersigned pul1ics agrc~ that the following provisions "'" hereby inc(lrporotcd into the con1rnc1 to \\i2* i!.Js attached 1111 made a part thereof, $Qfd eontrncl being dnted the "'.:.r day of · • 20_.

I. ]);&\!~ !I!:R!:!N CONrllOLI.!NO Pn0}18!0NS. It it expressly agreed that the temlS ol' raoh and owry provision in this lliiRchmrnt shall provclil and control over the terms of nny other conJll~ling provision In amy other docmn~nttelnting lo and 11 pnrt ol'the cOJllmcl in \\tlich this IIIIRChlllCilt is incorpotatcd.

2. AG!IJ!'!lMRNT Wll'l! 1<,\N§'AS !,AW. II Is agreed by and betm:c11 tho undersigned tbpt Qll disputes and matters whalsoovcr arising under, in connection with or lncidcntlo this contract shall bo litigated, If 111 all, in ond before 11 Court lo~atcd In lhe State of KanS11S, U.S.A., to llu: exclushm of tho Courts of any other states or country. All coJllmctual ngrccments shall w stlbjeclto, 8(1\'Cmcd by, nnd con,lnted aetordlng to tho lnws or lh\! Stnlo or 1\0oSilS,

3, 'I'&UMJNt\T!ON PliE TO I..\£K OJ7 FUNDING Art•ttoPBJATION. Sba\\neo County is subject to th~ Kansas Cash I111Sis 1-"w, K.S.A 10·1101 elseq. Jr, in tiK'judglllCIII of the FinaMIIII AdministmtPr, 1\udit-Ffnpnce Otllcv, sufficient funds 11~ not appropriated to continuo tho function pcrform~'d In this ogr«mcnl nnd for tlte payment 11f the chnrgcs hereundt>r, Count)' mR)' tcnuinote thi$ agreement ot tho end of it$ ctlrrcnt llJcal year. C<1unty ngrces 10 gh·ll \\Tiltcn notice of lcmtlnatlon to cotnrac!or atltast thirly (JO) days prior to the end of its current Jlsc11l y~11r. In lhc event this agreement is lemlinllleil pnrsmmtto this pllrnglllph, Cotlllly will pa)•lo tho contractor nil r\'3Uiar contmctuul pnynletlts lneum:d through tho end of such fiscal )'C<tr. Tho termination of tho COiltrncr pursunnt to thi$ pnmsraph shall not cause nny penally to bo charged to th~ Count)' or the contrnctor.

<1. PI§C!aUM&B OJ.• l.rAnrJ.Jn•. Nellhcr tho County or Sha\\t~co nor any dCJ11111ment thereof shnll hold hamtless or inlkmnify 1111)' contractGr tbr nny liobilit)• wllft~ver.

S. •\NU·DIWUIM!NAT!ON CLAW!£. 'lltc crmtractor agrees: (a) to l!ompl)' ''ith the Knns11s Act Against Di~criminatlon (K.S.A. 44-1001 tl~rq.) and th~ Knnsa$ Aso Discrimination in Employment Act, (K.S.A. 44· II II el ffl/.) nnd the Ollplicable> provisions or tho Amorlenns Wilh Disnbilllio$ Act (42 U.S.C. 12101 tt .teq.) (AOA) and to not discritninnll.' ngninst nny cx-rson ~cnuso of mce, religion, color, se~>, di!illbDil)', lllltionnl origin or ancestry, or nge in the admission ofPcccss to or trcatm~nl or Clllllfoyrn~nt in, its programs or ncli\•itlcs; (b) to Include in nil solicitnlions or mlvcrtisemcnts lbr employees, tho phlliSo "equnl OllJlortunlty employor''; tel to comt•ly with the reporting requirements s~t our in K.S.A. 44·1031 and K.S.A. 44· I 116; (d) to include those provisions in every subcolltri\CI or purchnsc order s11 that the)• ore binding upon such subcontrnctor or vendor; Cc) lhnt n t11ihtrc to comply with the reporting rcqulr~mtnts of(e) alxwe or irthe contmotor is round guilty of nny \'lolatlon of such acts by tho Kan,as Human Rights Commission, such \•lolation shnll constllulo n breach oJ'contraot; (t) iflhc conuacting agenoy d~letminea lhnt the contmctor hos violated ftJlplicnblo provlsioiiS of ADA, lhat violnlion sltall constlhllo a brench of contmcl; (B) il' (c) or (I) occurs, tlte contra~ may he cnnccUcd, temlinatcd or suspended in whole or in pari by th11 County. Parties to this COIIIrnot understand that subsections (b) throu&h (0) or this pamgmph numberS ore not 11ppllcable ton contmctor whQ ('Jnploys tbwcr thnn Jour employcea or \\iloso contract with the Count)' totals SS,OtiO or l\'ss during this fiscal y~nr.

6. t\(:C:EPTA!iCE Or CONTIIAC'l'. 'llais contract shall not be considered accepted, npproved or oth~rwisc cll'cl:tivo until thl' required approvals and certlfl~11tions have been given anti thi$ Is sl8flm by the Donrcl of County Commissioners oflh!! County of Shn\mee, Kansas.

1. t\!IDJTRAIIOX, .QMdAgFA~. WARMNIIES. Notwithstanding any languns~ to tho contmry, no intcrprehuion shnll w nllowtd to tlnd the County hus agreed to binding orbilrntlon, or the Jm)'mcnl of dnmns~~ or pcnnhics upon tho occ~trrenco of o conth•scncy. Jlurlhcr, tho County shoJI not ngr~o to pay nttomcy fees ond tnt~ pnyment charges; nnd n11 provisions will bo given olTcet which anempts to cKclu~. modif)', di~laim or otherwise nttcrnpt to limit implied warranties of mcrchanta~bilil)•and fllne.u for 11 parlicmlar purpose.

8. Bt:ri!&SEi\1j\T!VE1s A!Dl!OIII!)' To Crumtocr. By signing Ibis documcm, the repr(ISOntotivo or the contmctor thcrelly rer1rcs~nls that such pmon Is duly authorized by thv tontrllctor to execute this dooumeut on bchall' of tho conlmctotllnd tb11ttho contmotor Pgrccsto bo bound by tho provisions th~reoJ'.

9, Jt!jB.I'OXSJU!!.m' JiOR T,\XEs. 'lllc County shall not be responsible for, nor indemnifY a eontraotor for, nny ll:den~l, state or local ln)Ccs \\hloh tnll)' be fmposeil or levied uponlhCl subjeel RlQiter of this contmct.

I 0. JKSOn.\NCF.. Tht: Cotllll)' shall not bo requireil to purohm, My insumnco nsainsl Joss or damnge to m1y personal propeny to which this controcl rclntc&, ntlT shnllthis controet require tho County to establish n ''s\'IJ~insurnncc" fund IQ protrn agoln$t nn)' such loss or IIMlngo. Subjtct to the provisions of tho Knnsos Ton Claims Act (K.S.A. 1S· 610 I er srq.), the nndor or lcssPr shoJI ~nr the risk otany loss or dlllllng\t to &II)' pcrsonal proprrt)•to which \'Cndor or lessor holdslitl~.

\'RND~~'l'Hr\C'f'OR:

~A~iV..-By:

:f:,e:v· rknf f t1tiiJ

IJOARO OF COliNT\' COMMISSIONRRS SH,\WNKE (:QliNT\', 1\ANSAS

Mirhclc A. Htlhlcr, Chnir

Dalo;

ATTF.S'l'l

Cynthia A. Uecl:, Sha\\1lee County Cieri::

AMENDMENT THREE to the

AGREEMENT between the

SHAVVldi:E COUNTY CONTRACT #. QJ~-~ \ \.o

KDHE20l4-008

KANSAS DEPARTMENT OF HEALTH AND ENVIRONIMENT DIVISION OF HEALTH CARE FINANCE

and the SHAWNEE COUNTY BOARD OF COUNTY COMMISSIONERS

and the SHAWNEE COUNTY HEALTH DEPARTMENT

for Outreach. Prevention and Earlv Intervention Services

The above parties entered Into an original contract in August, 2013 to develop, implement, and maintain a voluntary program that provides outreach, prevention and early intervention services to new, low-income parents and children with emphasis on adolescent and pregnant teen parents of at-risk Infants in Shawnee County, Kansas.

The parties hereto agree to renew the original contract referenced above as follows:

1. The contractor wishes to exercise the third of three (3) optional one-year renewals with a term of July 1, 2016 through June 30, 2017.

2. Total funding for the period referenced above shall not exceed $768,000.00; said amount comprising the County's certified matching funds of $384,000.00 and the federal financial participation amount of $384,000.00.

3. All remaining terms and conditions of the original agreement and subsequent addenda shall remain the same.

IN WITNESS HEREOF, the parties hereto affix their signatures to this Third Amendment.

SHAWNEE COUNTY, KANSAS

SHAWNEE COUNTY HEALTH DEPARTMEMT

Date

KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT

Susan Mos1er, MD, BA, FACS Secretary and State Health Officer

Date

KDHE2014-008

2

April29,2016

TO:

FROM:

RE:



Alice Weingartner~ Director - Community Health Center


Out of State travel to attend a Community Health Conference in Oklahoma City, OK on May 12-14, 2016.

Action Requested: Approval for a Community Health Center staff member's time and mileage to be covered by the county while attending a community health conference in Oklahoma City, OK on May 12-14, 2016.

With the anticipated transition of the Community Health Center to a non-profit entity, a community health center staff person has been invited to attend a conference in Oklahoma City, OK. Expenses associated for attending the conference; with the exception of staff time and mileage are being paid by a partner entity.

AW/tnjc

1615 SW 8th Topeka, KS 66606 I 785.251.2000 www .shawneehealth.org

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CONFERENCE SCHEDULE

Wednesday, May 11

• 6:00pm, Student Volunteer Training at Country Inn and Suites (dining room)

Thursday, May 12

• 10:00- 7:00pm, Registration • 10:00 - 11:30 am, Student Volunteer Training • 1:00 - 5:00 pm, Intensive Track Sessions

o TED talks, CCHF style. Featuring entertaining and fast paced presentations o Unapologetic Apologetics: Science, Faith and Healthcare o Reconcilable Differences: Rebuilding Relationships o Opioid Misuse and Addiction: Recognition - Intervention - Communication

• 2:00-3:30 pm, Student Volunteer Training • 7:00- 9:00pm, Plenary 1: Dr. Bob Paeglow • 9:00 - 10:00 pm, Ice Cream Social

Friday, May 13

• 8:00- 9:00am, Bible study with John Perkins • 9:30 -11 :30 am, Plenary 2: Dr. Brenda Salter McNeil • 11:30- 1:00pm, Lunch served in The Village • 1:00- 5:00pm, Workshop Sessions • 5:00-7:00 pm, Dinner On Your Own • 7:00- 9:00pm, Trivia Night

Saturday, May 14

• 8:00- 8:45 am, Bible study with Val Tramonte • 9:00- 11:30 am, Workshop Sessions • 11-30 - 1:00pm, Lunch served in The Village • 1:00- 2:30pm, Plenary 3: James Brooks, MDiv

April28, 2016

TO:

FROM:



Alice Weingartner } ,_. Director - Community Health Center

Allison Alejos (lCV Director - Local Health Department

J) 3


RE: CONSENT AGENDA- Acknowledge binding of Medical Professional Liability Insurance for Shawnee County Health Agency

Action Requested: Acknowledge binding of Medical Professional Liability Insurance for Shawnee County Health Agency (SCHA) employees, excluding physicians.

This policy covers all SCHA staff members whether providing medical or administrative responsibilities.

The premium for the 2016-2017 SCHA Medical Professional Liability Insurance policy has decreased by $3,180.00 from last year due to some staffing changes and how data was reported. The renewal cost for the 2016-2017 coverage is $33,000 for the professional liability annual premium and $1,980 for the Surplus Lines Tax for a total amount due of $34,980.

AW/tnjc Encl.


Shavvnee County Health Agency

Medical Professional Liability Proposal

Effective Date: 4/3/2016

Expiration Date: 4/3/2017

Presented On: 03/30/2016

Willis of Greater Kansas, Inc. 3615 SW 291h Street Topeka, KS 66614 (888) 444·2331 Wtllts

Table of Contents

Marketing Summary ..................................................................................................................... 3

Financial Summary .............................................................................................•........................ 3

Direction for Binding ..................................................................................................................... 4

Important Notices ........................................................................................................................ 5

The coverage summary contained in this proposal is not intended to reflect the full terms, conditions and exclusions of the proposed insurance contracts, but rather are to provide you with a brief outline of the coverage we recommend for your operations. For a complete understanding of the coverage terms and conditions, policy forms should be consulted.

While every effort has been made to provide a brief outline of the insurance as complete and accurate as possible, it does not contain a full restatement of the contracts. In the event of any conflict or omission, the terms of the actual contract of insurance shall be paramount in every instance.

21Page

MARKETING SUMMARY Thank you for the opportunity to market your insurance requirements. The results of our negotiations with the carriers we approached are summarized below. This proposal is presented in conjunction with the Standard Terms and Conditions for US Property & Casualty Retail Accounts which [is enclosed I was previously provided to you.]

Carrier Name i Intermediary Name i Coverage Response I Premium Comm.

CNA N/A

KaMMCO N/A

FINANCIAL SUMMARY

See attached Side-by-Side Comparison

Medical Professional Liability Medical Professional Liability

Quoted

Quoted

Please let us know if you would like a copy of any quote not included in this Proposal.

$33,000 (Plus Tax)

$35,000

10%

7.5%

Willis negotiates commission rates with certain insurers on a corporate level. If the rate on your placement is lower than the negotiated rate, Willis will collect the difference directly from the insurer. These payments will not increase the cost of your insurance or otherwise impact your premium or rates. These negotiated rates are detailed at: http://www.willis.com/About Willisffhe Willis Way/Commission Rates/.

Payment Terms Please review the premium payment terms as set forth in this proposal. We will not be responsible for any consequences that may arise from any delay or failure by you to pay the amount payable by the indicated date.

Coverage Carrier I Billed by Payment Terms

Medical Professional Liability CNA Agency Annual

31Page

DIRECTION FOR BINDING Please review this proposal and advise of any changes or questions you may have. To request the binding of coverage, please complete and sign the following or contact me with your binding instructions.

0 As recommended by Willis in the Financial Summary.

Or

0 Asfollows: (lnserl complete Instructions for binding Including carrier, limits, options, etc.)

· Shawnee County Board of Commissioners

Signature Date

Tille

PrinledName

4f P .; I? e

IMPORTANT NOTICES

Surplus Lines The premium quoted for the professional insurance is subject to Surplus Lines Tax which is in addition to the premium charged.

SjPar,e

STATEMENT OF INSURED

THIS FORM MUST BE COMPLETED IN DETAIL FOR EACH NEW RISK PLACED AND FOR RENEWAL OF PREVIOUSLY PLACED RISKS. A COPY OF THIS

STATEMENT MUST BE PROVIDED TO THE INSURED AND MAINTAINED IN AGENT'S FILES.

INSURED: Shawnee County Health Agenc~-------- COVERAGE TYPE: Professional Liability

POLlCY PERIOD:_..i_t_l_t201_6TO _j__l] _ _l 2017

Check one of the options below:

0 EXEMPT COMMERCIAL PURCHASER (defined in Sec. 527(5) of the Dodd-Frank Act) As required by K.S.A. 40-246b, this will certify that I, the undersigned, have requested insurance coverage to be placed on my behalf with a company that is non-admitted or licensed to transact business in the State of Kansas. I understand, that as an exempt commercial purchaser, contrary to K.S.A. 40-246b, a diligent search of the admitted market is not required to place this coverage with a company that is non-admitted or licensed to transact business in this state. I further understand that such insurance may or may not be available from the admitted market that may provide greater protection with more regulatory oversight.

GjALL OTHER INSUREDS (Other than exempt commercial purchasers) As required by K.S.A. 40-246b, this will certify that I, the undersigned, have requested insurance coverage to be placed on my behalf with a company that is non-admitted or licensed to transact business in the State of Kansas. I understand that in accordance with K.S.A. 40-246b, that mere rate differential shall not be grounds for placing a particular risk with a non-admitted company when an admitted company would accept such risk at a different rate.

It is further acknowledged that the following information regarding placement of insurance with a non-admitted company, has been provided by the licensed excess lines agent:

I. The insurance coverage requested will be provided by an insurance company that is non-admitted or licensed to transact business in the State of Kansas, and whose name appears on the list of non-admitted companies maintained by the Commissioner oflnsurance. The non-admitted insurers' financial condition, policy forms, rates and trade practices are not subject to review or the jurisdiction of the Commissioner of Insurance.

2. ·There shall be no liability on the part of, and no cause of action of any nature shall arise against the Commissioner of Insurance, employees thereof, or the State of Kansas because the name of an insurance company appears or docs not appear on the list of non-admitted companies maintained by the Commissioner of Insurance.

3. The policies or contracts of insurance issued by a non-admitted insurance company do not come under the protection afforded by the Kansas insurance Guaranty Association Act (K.S.A. 40-2901, et seq.).

4. If the insurance company affording coverage is subsequemly determined to be insolvent, the licensed excess lines agent placing such business with a company nonadmitted to transact business in Kansas is, by giving you the information contained herein, relieved of any responsibility to the insured as it relates to such solvency.

5. Premium tax in the amount equal to 6% of the gross premiums shall be collected from Insured and remitted to the Commissioner of Insurance by licensed agent. Where the insurance covers propenies, risks or exposures located or to be performed both in and out of this state, the sum payable shall be computed based on: a) An amount equal to 6% of that portion of the gross premiums allocated to this state; plus b) an amount equal to the portion of the premiums allocated to other states or territories on the basis of the tax

rates and fees applicable to properties, risks or exposures located or to be performed outside oflhis state; less

c} the amount ofgrpss p~emiums allocated to this state and returned to the insured. (K.S.A. 40-246c}

Insured Agent Date

0 I was unavailable or otherwise unable to sign this statement prior to the effective date of coveruge

soi,7·11l

1------ -- ------ ---- -

D EXPOSURE COMPARISON

a brief outline of the

__ -~hawnee Coun_~y:_Board of Commissioner~----

Comm

~0

Please refer to the actual terms and conditions for a determination of coveraae.

----- --------_______ __ _____ ___ Sha~!!_ee Counf¥ ~card of Commissi?ners

. . - . --- ... . -- - .... . ... -- . ··-···- -. -- --··. ·-- ...

~~DICJ.'L !'~OF~SSIQ~!'L LI~B~~~1_~9M.f.l~RISQ~-(~_~v._i~~~--3/~1/~Q~ 6) ______ _ ·-----·· .. -·- ·-------·--·---a::ffo ... tiua Date 4/3/2015

4/3/2016 4/3/2017

4/3/2016

·- -------- - ------------ · ·--------------· -- --- --- · ----- · -- -----c-ontinenial casually-company-- ----COrlilnenfarcasualty company

. Deductibles ~ . ..

i Each Occurrence (Indemnity Only) j- ·- .. --- - -- ·- ·-···--· .. -- ..

·-~---------···---------- ·-- -·--__ A~g __ ?N A g XV

A A ··--·-- ------- - --·---· ... -------- ..... ·-------·- ____ , _________________ _

CNA71820XX (02-2015) CNA71820XX (02-2015) -- -- .... - - - --·

Surplus Lines Surplus Lines .. - -------··· --------·-·· ·-- ···-·------- ·-

$36,000

$2,160

$36,000

$38,160

$500,000 -----$500,000

$10,000

Agency

$500,000

$500,000

--

$10,000

The information provided is only a brief outline of the policy_ Please referto the actual policy terms and conditions for a determination of coverage. Page2

Shawnee County Board of Commissioners --·-- - -. - . -- -----

i '1 -----·- - - ------- _ .. _ J ·-·---- --- - - - ... MEDI~~-~-~~OFE~S~!)N~~!:!~~ILI!X.f_Q~PA~I-~Qr-J ~~_eyi~~~-3/~) /2016)_ .

4/3/2015 4/3/2016 ------- ------------· ----

4/3/2016 4/3/2017 ----4/3/2016

Extensions of Coverage Including Yet Not Limited To ------ -- -------·-- . .. ---- --··--- -- .

'Forms & Endorsements r--:----.--- --·----- --- ---- -------

____ CN_A_71_817XXC (04-2014) CNA71817XXC (04-2014}

___________ -~~A.~2640XX (09-2012} _ _ CNA62640XX (09-2012)

_____ ~-NA7181~X~~_7~2914) _____ __ CNA71818XX (09-2015)

_______ --~~A71819X~ (0_~-~0_1,3)____ _ __ _ CNA71819XX (09-2015} CNA71871XX (02-2014) CNA71871XX (02-2014)

lation & Nonrenewal Amendatory Endorsement ·---···· ------- ----·-- - ·- ·--· ------------ ..... ____ -·----~~~?1876_XX (03-20~------------c~~!-~876XX (03-2013L __ _

• Deductible Endorsement (applicable to damages only) CNA71952XX- 3/1/2013 CNA71952XX- 3/1/2013 f - --- - -·. . • ---- -- --:Disciplinary Proceedings Supplementary Payments CNA71890XX- 3/1/2013 CNA71890XX- 3/112013

····- -- -· 'E-;.;;ergency i:v~c~ati~~ Expenses Endo-;:;e~;;i -

IIHIPPA~r~~~e!dJngSuppl~~~~~~-~ayment~- _______________________ ·------------------ ____ _

CN71880- 3/1/2013

CNA71884XX- 3/1/2013

CN71880XX- 3/1/2013 ------· --- -·

CNA71884XX- 3/1/2013

Independent Contractor (see Addllnterests) (Dietitians and Social Workers as per schedule on file with 1shawnee County Health Agency) ...... -- ---· ---- .. ··-·· ------ ... ---··--. -------. Media Expenses Supplementary Payments

------- - - ---------- ---------Misconduct Sublimit

CNA71922XX- 3/1/2013

CNA71887XX- 4/1/2014

CNA71857XX- 3/1/2013

CNA850042XX- 2/01/2016

CNA71887XX- 4/1/2014 --- -· -------CNA71

The information provided is only a brief outline of the policy. Please refer to the actual policy terms and conditions for a determination of coverage. Page3

Shawnee County Board of Commissioners --------------------------~

- ~ - .

E~l_9~-~ ~R9FE~~.!Q"!~~ ~~-~f31L!!_':f COIYIP~RISO~ (Revised ~~:3~~~_!!~_!;_) __ ... . ff.:.,.thu:o Date

, Additional Coverages -1--·-··- --··- .. . ...... ··- . --- -- . ·--· ·- ·- -· ..

j, Defense costs are in addition to the limits of liablity ------ -- .. . . .. ------------- --------------·· --------

HIPAA Liability

..

Disciplinary Proceedings Liability

·Each Claim ~i ------·- ··-··· ----:Aggregate

- .J ----·--- -- - -- -- ------ -- -

jEmergency Evacuation Liability

i Eac-h Claim

"Aggregate

HIPPA Liability

Expense

Claim

'Aggregate

'Minimum Earned Premium- 25% '-.Sexual Misconduct Sublimit

- TEach Claim -·! - -·

·---- ·----- ------

-------.-----

4/3/2015 4/3/2016 ---· ·--------~

4/3/2016

----·--·-··

4/3/2017

4/3/2016

- --·- ---. - -. ----1

---- ·----------·--------------$1 0,000 $10,000

----·- --------$10,000 $10,000

$10,000 $10,000

$10,000 $1

$25,000 $25,000

$25,000 $25,000

$10,000 $10,000

$10,000 $10,000

$25,000 $25,000 - ·---- ----·-- - ------ ------ ·--------

$25,000 $25,000

--------------- --------.

$1 00,000 $100,000

$300,000 -- --------~

The information provided is only a brief outline of the policy. Please refer to the actual policy terms and conditions for a determination of coverage. Page4

_ S_h~-~~eE!_ ~o_unty ~oar~ C?f Co~~!~~~!!_ers

' .. J. . ..... --·· ·-- ·-··-- . --- ·- --- . ····-· -- - ·-

MEDICAL PR()FES§_IQN~~_LJ~~I_L~TYf()~P~~-~Q_N_ (~~~i~~-~ ~~~~l_2_Q~~)__ ___ _

1--- --- ----- --- ------- --- --- -- -

:Robin Jackson, LSCSW _, _____________ . ---------- ---····--. -----------!Susan "Shereen" Ellis, LSCSW ]Dietitians in LHD -------- -------------

:patricia Dunavan, AD

_ _;~ayPow~ll _ ;Mary Johnson_

Barb Beier - -· ~Donna Wiens

---r----------

!Sandra Dickinson + ---- -- ---iJana Patton

4/3/2015 4/3/2016

4/3/2016 4/3/2017 ----------

4/3/2016

----------------------

--- -------------------·

The information provided is only a brief outline of the policy_ Please refer to the actual policy terms and conditions for a determination of coverage_ PageS

Willis Towers Watson 1.11111.1

Standard Terms and Conditions for U.S. Property & Casualty Retail Accounts

Please note the following terms and conditions related to your decision to utilize Willis Towers Watson to purchase insurance coverage, products and/or services:

Services and Responsibilities

The services we provide to you will rely in significant part on the facts. information and direction provided by you or your authorized representatives. In order to make our relationship work, we must each provide the other with accmate and timely facts, information and direction as is reasonably required. You must provide us with complete and accurate information regarding your loss experience, risk exposures, and changes in the analysis or scope of your risk exposures and any other information reasonably requested by us or insurers. It is important that you advise us of any material changes in your business operations that may affect our services or the insurance coverages we place for you. A factor or circumstance is material if it would influence the judgment of a prudent insurer in determining premium and whether or not they would underwrite the risk. Therefore, all information which is material to your coverage requirements or which might influence insurers in deciding to accept your business, finalizing the terms to apply and/or the cost of cover, must be disclosed. Failure to make full disclosure of material facts might potentially allow insurers to avoid liability for a particular claim or to void the contract. This duty of disclosure applies equally at renewal of your existing coverage and upon placement of new lines of coverage. Willis Towers Watson will not be responsible for any consequences which may arise from any delayed, inaccurate or incomplete information.

We will assess the financial soundness of the insurers we recommend to provide your coverages based on publicly available information. including that produced by wellrecognized rating agencies. Upon request, we will provide you with our analysis of such insurers. We cannot, however, guarantee or warrant the solvency of any insurer or any intermediary that we may use to place your coverage.

If you have a multi-year policy, it is important that you understand the limitations associated with the coverage options and the possibility that the financial strength of the carrier may change throughout the term of the policy. We recommend that you reviev. the insurer's ratings for any downgrades during the term of this multi-year policy.

The tina! decisions with respect to all matters relating to your insurance coverages, risk management, and loss control needs and activities are yours. We will procure the insurance coverage chosen by you, prepare or forward insurance binders, and review and transmit policies to you.

If your insurance risks are in more than one jurisdiction, we, where required, will liaise between you and insurers to agree how to apportion the premium between applicable jurisdictions, and the amount of insurance premium tax payable in each jurisdiction. In providing such services, Willis Towers Watson is acting in its capacity as an insurance

US Retail Condllmns Page I oJ' 10 OS Junuury 20 16

Willis Towers Watson 1.1•1•1.1

broker. You should seek your own advice in relation to such tax laws where you consider it necessary. We will not be liable to you should the apportionment of premium or amount of tax payable under the policy be challenged by any tax authority. In addition, we will not be liable to you should the insurers fail, or refuse, to collect and pay such insurance premium tax to the relevant authorities.

We will review all binders, policies and endorsements for the purpose of confirming their accuracy and conformity to negotiated specifications and your instructions and advise you of any errors in, or recommended changes to. such policies. You agree that you will also review all such documents and advise us of any questions you have or of any document or provision which you believe may not be in accordance with your instructions as soon as possible, and in no event longer than two weeks. after you receive them. Your coverage is defined by the terms and conditions detailed in your insurance policies and endorsements. Your review of these documents. and any review you may seek from outside legal counsel or insurance consultants, is expected and essential.

We will meet, as requested by you, with your representatives to explain coverage and policies. We will promptly respond to your requests for coverage information, analysis of changing market conditions. and assistance in reporting subsequent changes in information to insurance companies and service providers.

In our capacity as insurance brokers, we do not provide legal or tax advice. We encourage you to seek any such advice you want or need from competent legal counsel or tax professionals.

Confidentiality

We will treat information you provide us in the course of our professional relationship as confidential and will use it only in performing services for you. except as directed by you or stated herein. We may share this information with third parties as may be required to provide our services. We may also disclose this information to the extent required to comply with applicable laws or regulations or the order of any court or tribunal. We may share this information with other affiliated Willis Towers Watson companies in order to help provide our services and for matters connected with the management, development or operation of our and their business, and to the extent we do so, any such affiliated Willis Towers Watson companies will also keep your information confidential subject to our agreement with you. By providing us with data, you agree and represent that you are fully authorized to possess that data and to provide it to us, and further that we are fully authorized to obtain, maintain, process and transfer such data in a commercially reasonable manner and as we reasonably deem advisable in order to provide our services. You also agree that we may aggregate and anonymise your information and may disclose to third parties certain anonymised or industry-wide statistics or other information which may include information relating to you. but that we will not, without your consent, reveal any information specific to you other than on an anonymised basis and as part of an industry or sector-wide comparison. In our use of the information that you provide us, we agree that we will comply with all applicable privacy laws, and that we have

Page 2 of 10 05 January 20 16

Willis Towers Watson lal 111 1.1

implemented and will maintain commercially reasonable and appropriate security measures in order to protect sensitive information from unauthorized use or disclosure. Records you provide us will remain your property and will be returned to you upon request, although we will have the right to retain copies of such records to the extent required in the ordinary course of our business or by law. You will treat any information we provide to you, including data, recommendations, proposals, or reports, as confidential, and you will not disclose it to any third parties. You may disclose this information to the extent required to comply with applicable laws or regulations or the order of any court or tribunal. We retain the sole rights to all of our proprietary computer programs, systems, methods and procedures and to all files developed by us.

Willis Towers Watson represents and warrants that, with respect to the personal information of any Massachusetts resident, (I) it has and is capable of maintaining appropriate security measures to protect Personal Information consistent with 20 I CMR 17.00 and any applicable federal regulations; and (2) as of the Agreement Effective Date, it has and will at all times during the term of this Agreement, maintain a comprehensive written information security program that complies with applicable privacy and data security laws. Willis Towers Watson's information security program shall contain at least the following:

• Reasonable restrictions upon physical access to records containing personal information and storage of such records and data in locked facilities, storage areas or counters.

• Regular monitoring to ensure that the comprehensive information security program is operating in a manner reasonably calculated to prevent unauthorized access to or unauthorized use of personal information; and upgrading information safeguards as necessary to limit risks.

• Reviewing the scope of the security measures at least annually or whenever there is a material change in business practices that may reasonably implicate the security or integrity of records containing personal information.

• Documenting responsive actions taken in connection with any incident involving a breach of security, and mandatory post-incident review of events and actions taken, if any, to make changes in business practices related to protection of personal information.

Carrier Quotes

The quotes we have provided to you are based upon the information that you have provided to us. If you discover that previously submitted information is inaccurate or incomplete, please advise us immediately so that we can attempt to revalidate terms with insurers.

US Retall Cundttlons Puge 3 llf' IU 05 Jan~ary 20 16

Willis Towers Watson 1.1'1'1•1

A carrier quote is an offer to provide coverage. Offers can be modified or withdrawn prior to your acceptance through your order to bind coverage. The quote itself is not a legally binding commitment or a conftrmation of actual coverage. Should you choose to bind coverage. we will secure a formal commitment. typically in the form of a binder on a form issued or approved by the carrier(s) at issue.

Compensation and Disclosure

Willis Towers Watson is an insurance producer licensed to do business worldwide, including in all 50 states and the District of Columbia. Insurance producers are authorized by their license to work with insurance purchasers and discuss the benefits and terms and conditions of insurance contracts; to offer advice concerning the substantive benefits of particular insurance contracts; to sell insurance; and to obtain insurance for purchasers. The role of an insurance producer in any particular transaction involved one or more of these activities.

The compensation that will be paid to Willis Towers Watson will vary based on the insurance contract it sells. Depending on the insurer and insurance contract you select. compensation may be paid by the insurer selling the insurance contract or by another third party. Such compensation may be contingent and may vary depending on a number of factors. including the insurance contract and insurer you select. In some cases, other factors such as the volume of business Willis Towers Watson provides to the insurer or the profitability of insurance contracts Willis Towers Watson provides to the insurer also may affect compensation. Willis Towers Watson may accept this compensation in locations where it is legally permissible. and meet standards and controls to address conflicts of interest. Because insurers account for contingent payments when developing general pricing, the price you pay for your policies is not affected whether Willis Towers Watson accepts contingent payments or not. If you prefer that we not accept contingent compensation related to your policy, we will request that your insurer(s) exclude your business from their contingent payment calculations.

Upon request. Willis Towers Watson will provide you with additional information about the compensation Willis Towers Watson expects to receive based in whole or in part on your purchase of insurance, and (if applicable) the compensation expected to be received based in whole or in part on any alternative quotes presented to you.

To the extent Willis Towers Watson is compensated by commissions paid to us by insurers, they will be earned for the entire policy period at the time we place policies for you. We will be paid the commission percentage stated for the placement of your insurance as indicated, and will receive the same commission percentage for all subsequent renewals of this policy unless we negotiate a different commission percentage with you.

Willis Towers Watson negotiates commission rates with certain insurers on a corporate level. If the rate on your placement is lower than the negotiated rate, Willis Towers Watson will collect the difference directly from the insurer. These payments will not

US Retail Condit10ns P~ge 4 of !0 05 Janual'\ 20 16


increase the cost of your insurance or otherwise impact your premium or rates. These negotiated rates are detailed at: http://www.willis.com/!\bout Willis/l"ht: Willis Way/Commission Rates/.

WiiiPLACE, a proprietary online tool. provides Willis Towers Watson brokers with access to global placement information so that we can seek to develop solutions for you with appropriate markets at competitive prices and terms. Some insurers pay Willis Towers Watson a fee for annual reporting on their book of business. Some of these insurers also pay Willis Towers Watson an additional fee for more detailed reporting on placements matched through the WiiiPLACE system. Any insurer payments related to the WiiiPLACE system will not increase the cost of your insurance.

Willis Towers Watson develops panels of insurers in certain market segments. Participating insurers are reviewed on a variety of factors. Commission rates on panel placements may be higher than rates paid on business placed outside of the panel process. Willis Towers Watson discloses its commission rates to clients on quotes obtained through the panel process prior to binding the coverage. In some instances. insurers pay an administration fee to participate in the panel process, or for additional reporting. Your Willis Towers Watson broker will provide you with additional information on Willis Towers Watson Panels upon request.

Where permitted by applicable law, Willis Towers Watson may assess a policy service fee. The fee is on a per-policy basis and is calCulated on the premium amount. The policy service fee is compensation to Willis Towers Watson for such value-added services and resources including dedicated industry practices, technical resources, placement support and our strategic outcomes practices. The fee is not required by any insurer or regulator. nor is it included in the premium charged. It will be listed separately on your invoice. It is not necessary to procure a policy to obtain many of these and other services on a consultancy basis for a separate fee.

In some cases the use of a wholesale broker may be beneficial to you. We will not directly or indirectly place or renew your insurance business through a wholesale broker unless we first disclose to you in writing any compensation we or our corporate parents, subsidiaries or affiliates will receive as a result.

If wholesalers, underwriting managers or managing general agents have a role in providing insurance products and services to you, they will also earn and retain compensation for their role in providing those products and services. If any such parties are corporate parents, subsidiaries or affiliates of ours, any compensation we or our corporate parents, subsidiaries or affiliates will receive will be included in the total compensation we disclose to you. If such parties are not affiliated with LIS, and if you desire more information regarding the compensation those parties will receive, please contact us and we will assist you in obtaining this information.

liS Rctatl Condtlions Pagc5ofl0 us Janual) 2U 16


In the ordinary course of business we may also receive and retain interest on premiums you pay from the date we receive the funds until Vve pay them to the insurers or their intermediaries, or until we return them to you after we receive such funds.

Commission schedules and other compensation arrangements related to our services on your behalf may change over time and may not always be congruent with your specific policy period. Willis Towers Watson will provide you with accurate information to the best of our knowledge when information is presented to you. but it is possible that compensation arrangements may change over time. We will update you on any changes to our compensation prior to your renewal, and will do so at any time upon your request.

As an insurance intermediary. we normally act for you. However. we or our corporate parents, subsidiaries or affiliates may provide services to insurers for some insurance products. These services may include (a) acting as a managing general agent, program manager or in other similar capacities which give us binding authority enabling us to accept business on their behalf and immediately provide coverage for a risk; (b) arranging lineslips or similar facilities which enable an insurer to bind business for itself and other insurers; or (c) managing lineslips for insurers. Contracts with these insurers may grant us certain rights or create certain obligations regarding the marketing of insurance products provided by the insurers.

We may place your insurance business under such a managing general agent's agreement. binding authority, lineslip or similar facility when we reasonably consider that these match your insurance requirements/instructions. When we intend to do so, we shall inform you and disclose the compensation payable to Willis Towers Watson in connection with the placement of the insurance coverage.

We may also provide reinsurance brokerage services to insurers with which your coverage is placed pursuant to separate agreements with those insurers. We may be compensated by the insurers for these services in addition to any commissions we may receive for placement of your insurance coverages.

Subsidiaries of Willis North America Inc are members of a major international group of companies. In addition to the commissions received by us from insurers for placement of your insurance coverages. other parties, such as excess and surplus lines brokers. wholesale brokers, reinsurance intermediaries, underwriting managers and similar parties (some of which may be owned in whole or in part by our corporate parents or affiliates), may earn and retain usual and customary commissions for their role in providing insurance products or services to ym1 under their separate contracts with insurers or reinsurers.

The insurance market is complex, and there could be other relationships which are not described in this document which might create conllicts of interest. If a conflict arises for which there is no practicable way of complying with this commitment, we will promptly inform you and withdraw from the engagement. unless you wish us to continue to provide the services and provide your written consent. Please let us know in writing if

t.:S Ketal! C:und1110ns Page 6 of 10 05 Janu~r\ 2016

Willis Towers Watson 1.1 1111.1

you have concerns or we will assume that you understand and consent to our providing our services pursuant to these terms.

The Foreign Account Tax Compliance Act (FATCA) is a U.S. law aimed at foreign financial institutions and other financial intermediaries (including insurance companies and intermediaries such as brokers) to prevent tax evasion by U.S. citizens and residents through offshore accounts. FA TCA only applies if you are a U.S. company or individual or a non-U.S. company paying premium through a U.S. insurance broker to a non-U.S. insurer. In order to comply with F ATCA, insurance companies and intermediaries must meet certain legal requirements. Insurance placed with an insurance company that is not FATCA compliant may result in a 30% withholding tax on your premium. Where FATCA is applicable to you. in order to avoid this withholding tax, Willis Towers Watson will only place your insurance with FATCA-compliant insurers and intermediaries for which no withholding is required unless you instruct us to do otherwise and provide your advance written authorization to do so. If you do instruct Willis Towers Watson to place your insurance with a non-FATCA compliant insurer or intermediary, you may have to pay an additional amount equivalent to 30% of the premium covering U.S.-sourced risks to cover the withholding tax. If you instruct us to place your insurance with a non-FA TCA compliant insurer but you do not agree to pay the additional 30% withholding if required, we will not place your insurance with such insurer. Please consult your tax adviser for full details ofF A TCA.

Premium Financing

You may choose to use a premium finance company. property appraiser, structured settlement firm or other similar service provider in connection with the insurance coverages we place for you or the services we provide to you. Premium finance options are not always available, but where they are, Willis Towers Watson currently works with industry leading finance providers for this service. Where permitted by law. we receive a fee for the administrative services we provide those companies. These services include processing the premium finance applications and marketing and sales support they do not have. If you would like more information about the fee we receive, please let us know.

Premium Payment/Handling of Funds

You agree to provide immediately available funds for payment of premiums by the payment dates specified in the insurance policies, invoices or other payment documents. Failure to pay premium on time may prevent coverage from incepting or result in cancellation of coverage by the insurer. We will not be responsible for any consequences that may arise from any delay or failure by you to pay the amount payable by the indicated date.

We will handle any premiums you pay through us and any funds which we receive from insurers or intermediaries for payment or return to you in accordance with the requirements and restrictions of applicable state and federal insurance laws and regulations and state unclaimed property laws. In some cases we may transfer your funds

US Retail Conditions l'uge 7 11f 10 05 January 2016

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directly to insurers. In other cases we may be required to transfer your funds to third parties such as wholesale brokers. excess and surplus lines brokers, or managing general agents for carrying out transactions for you.

Surplus Lines Placements

If a surplus lines, non-admitted and/or non-licensed insurer was used to quote your coverage, their premium rates, coverage terms and policy forms are not regulated by your home state. Their premium is subject to a surplus lines premium tax which is in addition to the premium. In the event of insolvency you will not be indemnified by any state guaranty fund for unpaid claims.

Claims

We will inform you of the reporting requirements for c !aims, including where claims should be reported and the method of reporting to be used, if applicable. Please carefully review any claims-reporting instructions or information we provide. Failure to timely and properly report a claim may jeopardize coverage for the claim. In addition, you should retain copies of all insurance policies and coverage documents as well as claims-reporting instructions after termination of the policies because in some cases you may need to report claims after termination of a policy.

Ethical Business Practice

We do not tolerate unethical behavior either in our own activities or in those with whom we seek to do business. We will comply with all applicable laws, regulations, and rules.

Sanctions

The sanctions profile of different business(es) may ditTer on the basis of a number of complex factors. Whether a sanctions program applies to you depends on a number of factors, including your ownership structure, control. location, and the nationality of your employees. In certain circumstances, the United States and other countries prohibit or restrict companies from conducting business in certain jurisdictions (e.g. Cuba), and can sanction companies who conduct such business. We cannot advise on the applicability of sanctions programs either to you or to insurers nor can we guarantee or otherwise warrant the position of any insurer under existing or future sanctions programs. You should take legal advice as you deem appropriate in this regard.

We will comply with all applicable sanctions programs and you are advised that, where obliged by law, we may have to take certain actions, including freezing of funds held on behalf of parties and individuals as required by sanctions programs.

LJS Retail Cond111ons l'ag~8ofl0 US Janual) 2016


Intellectual Property

Willis Towers Watson shall own and retain all right, title. and interest in and to the following (collectively, "Willis Towers Watson Property"): (i) all software, hardware, technology, documentation, and information provided by Willis Towers Watson in connection with the Claim and Risk Control Services; (ii) all ideas. know-how. methodology, models and techniques that may be developed, conceived, or invented by Willis Towers Watson during its performance under this Agreement; and (iii) all worldwide patent, copyright, trade secret, trademark and other intellectual property rights in and to the property described in clauses (i) and (ii) above. Accordingly, all rights in the Willis Towers Watson Property are hereby expressly reserved.

Electronic Communication

We agree that we may communicate with each other from time to time by electronic mail, sometimes attaching further electronic data as and when the circumstances require attachments. By consenting to this method of communication you and we accept the inherent risks (including the security risks of interception of or unauthorized access to such communications, the risks of corruption of such communications and the risks of viruses or other harmful devices). We each agree, however, that we will employ reasonable virus checking procedures on our computer systems, and we will each be responsible for checking all electronic communications received for viruses. You will also be responsible for checking that messages received are complete. In the event of a dispute neither of us will challenge the legal evidentiary standing of an electronic document, and th~ Willis Towers Watson system shall be deemed the definitive record of electronic communications and documentation.

Please note that our system blocks certain tile extensions for security reasons. including, but not necessarily limited to, .rar .. text, .vbs, .mpeg, .mp3, .cmd, .cpl, .wav, .exe, .bat . . scr .. mpq, .avi .. com, .pif. .wma, .mpa .. mpg, .jpeg. Emails with such files attached will not get through to us; and no message will be sent to tell you they have been blocked. If you intend to send us emails with attachments, please verify with us in advance that our system will accept the proposed form of attachment.

Other Agreements

To the extent there is a conflict between these terms and conditions and a separately negotiated and signed agreement between you and Willis Towers Watson, the relevant portions of the signed agreement will control.

Severability

The provisions of this agreement shall be severable and, in the event any provision or portion of any provision shall be construed by any court of competent jurisdiction to be invalid, the same shall not invalidate any other provision of this agreement or the remainder of the enforceable portion of the provision.

US Retail Conditions Pugc 9 \lf 10 05 Janua~ 2016

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Termination

In the event of termination, we will be entitled to receive and retain any commissions payable under the terms of our commission agreements with the insurers in relation to policies placed by us, whether or not the commissions have been received by us.

Our obligation to render services under the agreement ceases on the effective date of termination of the agreement. Nevertheless, we will process all remaining deposit premium installments on policies in effect at the time of termination. Claims and premium or other adjustments may arise after our relationship ends. Such items are normally handled by the insurance broker serving you at the time the claim or adjustment arises. However, it may be mutually agreed that we will provide services in these areas after the termination of our relationship for mutually agreed additional compensation. The obligations set forth under "Confidentiality" above shall survive any termination of the agreement.

Choice of Law

Our agreement for services shall be governed by and construed in accordance with the laws of the state in which our office is located.

Inquiries and Complaints

Your satisfaction is important to us. If you have questions or complaints, please inform the person who handles your account or contact the head of our office. Alternatively. you may call 1-866-704-5115, the toll free number we have set up exclusively for client feedback and complaints.

US Retail C"nd1110ns Page I 0 ui' 10 05 Junuary 2016

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