23-164.00 MultiCare Valley Hospital MOUMEMORANDUM OF UNDERSTANDING
BETWEEN
City of Spokane Valley
AND
MultiCare Health System
THIS AGREEMENT is made by and between City of Spokane Valley, an agency of the
State of Washington, located at 10210 E Sprague Ave, Spokane Valley, WA 99206, and MultiCare
Health System, d/b/a MultiCare Valley Hospital ("Hospital"), a non-profit corporation organized
and existing under the laws of the State of Washington.
RECITALS:
WHEREAS, Hospital provides a disproportionate share of healthcare services to low-
income patients with special needs and participates in programs that benefit the indigent, uninsured
or underinsured population in the State of Washington;
WHEREAS, Hospital has accepted a Certificate of Need from the State of Washington,
pursuant to which Certificate the Hospital has committed to serving low-income patients with
special needs, all in accordance with the provisions of the Hospital's Certificate of Need and in
accordance with its license issued by the Department of Health;
WHEREAS, Hospital desires to participate in the drug discount program established under
Section 340B of the Public Health Services Act ( the "34013 Program");
WHEREAS, in order to participate in the 340B P ro g r a in, Hospital must have in place
an agreement with a unit of state or local government pursuant to which Hospital commits to provide
healthcare services to low-income individuals who are neither entitled to benefits under Medicare
(Title XVIII of the Social Security Act (SSA)) nor eligible for assistance under Medicaid (Title XIX
of the SSA);
WHEREAS, Hospital desires to make such a formal commitment to the City of Spokane
Valley; and
WHEREAS, City of Spokane Valley desires to clarify and confirm its relationships with
the Hospital, and agrees to accept such commitment on behalf of the citizens of the City of
Spokane Valley.
NOW, THEREFORE, in consideration of the mutual agreements and covenants
contained herein and for other good a valuable consideration, the receipt and sufficiency of which
hereby are acknowledged, it is mutually agreed and covenanted, under seal, by and between the
parties to this Agreement, as follows:
1. Commitment of Hospital to Provide Care to the Indigent, Uninsured, and
Underinsured.
During the term of this Agreement, Hospital agrees to continue its historic
commitment to the provision of healthcare to indigent, uninsured and underinsured residents of
Spokane Valley including low-income residents who do not qualify for Medicaid or Medicare.
Pursuant to this commitment, the Hospital's commitment to provide care will extend to indigent,
uninsured and underinsured residents of the City of Spokane Valley, including low-income
residents who are not entitled to benefits under Title XVIII of the Social Security Act or eligible for
assistance under the State plan of Title XIX of the Social Security Act.. In any event, Hospital will
assure that all patients will receive necessary care, as required by law, regardless of ability to pay.
2. Acceptance and Acknowledgements of City of Spokane Valley.
a. City of Spokane Valley accepts the commitment of Hospital set forth above; and
b. City of Spokane Valley shall provide to Hospital the name, title, email address, and phone
number of a government official who can certify the status of this Agreement, and execute
the attached Certification of Contract Form. The Health Resources and Services
Administration's Office of Pharmacy Affairs (OPA) will send to the government official an
email asking the government official to certify the status of this Agreement. City of Spokane
Valley will ensure that the government official responds to the email from OPA by certifying
the status of this Agreement within five days of receiving the email.
3. Representations of Hospital.
Hospital represents that as of the date hereof:
a. Hospital is a corporation duly organized and validly existing in good standing under the
laws of the State of Washington with the corporate power and authority to enter into and
perform its obligations under this Agreement; and
b. Hospital is a tax-exempt corporation of under Section 501(c)(3) of the Internal Revenue
Code of the United States, as amended and under applicable laws of State of Washington.
4. Term and Termination.
The term of this Agreement shall commence on the last date signed below, and shall continue
until one of the parties terminates this Agreement. This Agreement can be terminated by either party
upon not less than sixty (60) days' prior written notice to the other party. Hospital agrees to notify
the City of Spokane Valley promptly if it ceases to provide the healthcare services committed to
under this MOU. This MOU will terminate immediately if Hospital ceases to provide the healthcare
services committed to under this MOU. The City of Spokane Valley and Hospital reserve the right
to immediately terminate this MOU if Hospital ceases to be eligible for the 340B Program.
5. Notice.
All notices required or permitted to be given under this Agreement shall be deemed given
when delivered by hand or sent by registered or certified mail, return receipt requested, addressed as
follows:
Sent to: City of Spokane Valley
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Attention: John Hohman
City Manager
10210 E Sprague Ave
Spokane Valley, WA 99206
jhohman@spokanevalleywa.gov
509-720-5300
Copy to: Marci Patterson
City Clerk
10210 E Sprague Ave
Spokane Valley, WA 99206
mpatterson@spokanevalleywa.gov
509-720-5102
Sent to: MultiCare Health System
d/b/a MultiCare Valley Hospital
Attention: Hospital President
12606 E Mission Ave.
Spokane Valley, WA 99216
Copy to: MultiCare Health System
d/b/a MultiCare Valley Hospital
PO Box 5299
MS: 315-P 1-SCM
Tacoma, WA 98405
Attn: Contracts & Strategic Sourcing
ContractSupport(a,multicare. org
Phone: (253) 403-3322
6. Governing Law.
This Agreement shall be governed by and construed in accordance with the laws of the
State of Washington.
7. Entire Agreement.
This Agreement constitutes the entire agreement between the parties. This Agreement
replaces and supercedes all prior agreements and understandings with respect to the subject matter
of this Agreement.
SIGNATURE PAGE TO FOLLOW
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IN WITNESS WHEREOF, Hospital and the City of Spokane Valley have executed this
Agreement as of the day and year first written above by their duly authorized representatives.
MultiCare Health System d/b/a MultiCare Valley Hospital :
Name: Tim Lynch
Title: Sr VP -Chief Administrative Officer
City of Spokane Valley
ame:
Title: c<< r- y...�Gs
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Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau OMB No.
0915-0327; Expiration Date: 10/31 /2015 This registration form must be completed and submitted according to the established deadlines that are published
on the OPA website (www.hrsa.loy,/opa).
OFFICE OF PHARMACY AFFAIRS (OPA)
CERTIFICATION OF CONTRACT BETWEEN PRIVATE, NON-PROFIT HOSPITAL AND
STATE/LOCAL GOVERNMENT TO PROVIDE HEALTH CARE SERVICES TO LOW INCOME
INDIVIDUALS
To demonstrate that the hospital meets the statutory definition of covered entity under section
34013(a)(4)(L)(i) as a private non-profit hospital which has a contract with a State or local
government to provide health care services to low income individuals, this certification must be
completed and signed by both parties.
MultiCare Valley Hospital
Name of Hospital
Spokane Valley, WA 99216
City, State, Zip
Pursuant to the requirement of Section 340B of the Public Health Service Act
(42 U.S.C. 256b), I certify that a valid contract (please provide contract number or
identifier if applicable # ) is currently in place between the private, non-
profit hospital named above, and the State or Local Government Entity named below,
to provide health care services to low income individuals who are not entitled to
benefits under Title XVIII of the Social Security Act or eligible for assistance under
the State plan of Title XIX of the Social Security Act. In addition, the authorizing
official certifies that when this contract is no longer valid, appropriate notice will be
provided to the Office of Pharmacy Affairs. The undersigned represents and confirms
that he/she is fully authorized to legally bind the covered entity and certifies that the
contents of any statement made or reflected in this document are truthful and
accurate.
_' '_ August 20, 2023 12:33 PT
Signature of Hospital Authorizing Official Date
Tim Lynch, Sr VP -Chief Administrative Officer
Name and Title of Authorizing Official (e.g., CEO, CFO, COO) (please print or type)
Phone Number Ext. E-Mail Address
Si nature of State or Local Government Official Date
Jah r, h,e � Mar\
a e of ate or Local Governme t Offici I (please print type)
i Y)tk S 0W-ahC l% e Li
Title d Unit of dovernment
D2 E. S e 0 a� e Inl 66
Address
501 170- 5 300
Phone Number Ext. E-Mail Addres
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