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475 IV. ADDITIONAL REOUIREMENTS <br />476 A. CONTRACTOR shall provide those medical reports required by CITY for Custodial <br />477 Patients provided services pursuant to this Agreement. At a minimum, CONTRACTOR shall <br />478 provide a written Medical Service Activity Report for services provided hereunder. The report <br />479 shall include, but not be limited to, Date of Service, Booking Number, Name of Inmate, <br />480 Attending nurse or physician, Brief description of problem, Brief description of disposition and <br />481 Amount billed to the City of Santa Ana. Medical Service Activity Report will be submitted to <br />482 CITY daily. <br /> <br />483 B. UTILIZATOIN REVIEW/QUALITY ASSURANCE- <br /> <br />484 1. CONTRACTOR shall maintain a Utilization Review (U.R.) program and a <br /> <br />485 Quality Assurance (Q.A.) program for the review of all services provided pursuant to this <br />486 Agreement. Subject to all confidentiality laws, and upon request, CONTRACTOR shall provide <br />487 CITY with a written copy of its Q.A. and U.R. procedures together with such periodic statistical <br />488 reports, encounter data and other information which may result from Q.A. and U.R. activities for <br />489 Custodial Patients. The extent and format of such information shall be determined, in writing, by <br />490 CITY. Such programs shall meet the requirements of all appropriate Federal and State Laws and <br />491 regulations. <br />492 2. "Responsible Physician" means the physician who provides On-Site Medical <br />493 Services to Custodial Patients at the Santa gna Jail. CONTRACTOR'S designee, Director of <br />494 Operations or Designee, shall develop written U.R. and Q.A. procedures. CONTRACTOR'S <br />495 Utilization Review personnel shall perform concurrent U.R. inconjunction with the Responsible <br />496 Physician and provide periodic reports to CONTRACTOR'S Health Authority. <br />497 3. "Health Authority" means CONTRACTOR'S Medical Director. The Health <br />498 Authority will assume responsibility for the reviewing, approving, and implementing of medical <br />499 policies and procedures. The Health Authority and CONTRACTOR'S Director of Operations <br />500 will work closely with CITY to insure appropriateness and adequacy of inmate health care. <br />501 4. For cases in which CITY and CONTRACTOR, disagree regarding the level, <br />502 appropriateness, or quality of care including the need for Inpatient or Outpatient Care, the <br />503 CONTRACTOR'S Responsible Physician, the CONTRACTOR'S Nurse Practitioner, the <br />504 CONTRACTOR'S Director of Operations, and the CITY'S Jail Administrator will meet and <br />505 attempt to resolve the disagreement. If the disagreement is not thereby resolved within thirty <br /> <br />16 <br /> <br /> <br />