HomeMy WebLinkAbout25430COUNTY OF FRESNO
CTEXTRACT
PURCHASING
DATE: 12/21/2009
MlrAmf: THIS EXTRACT IS FOR REFERENCE AND INFORMA TlONAL PURPOSES ONL Y ALL BUSINESS AND MANAGEMENT DECISIONS MUST
• BE GOVERNED BY THE UNDERL YING CONTRACT. ANY QUESTIONS MUST INCLUDE THE CONTRACT NUMBER AND BE ADDRESSED
• TO THE COUNTY'S PURCHASING OFFICE AT 456-7110.
CONTRACT NUMBER: A-09-551
CONTRACT TITLE: Medical Director for Pathways to Recovery
Program
CONTRACT PERIOD: 11/1/2009 thru 10/31/2012 'MAYINCLUDEMULTIPLE
YEARS
USING AGENCIES: DBH
TERMS:
DELIVERY TERMS:
DELIVERY TIME:
BUYER: H Patricia J. Flaherty
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CONTRACT VALUE: $71,390.00 Annual Maximum
LOCATION: DBH
VENDOR NUMBER 0000117416
NAM E1ADDRESS Touchstone Medical Group
724 Medical Center Drive East, Suite 106
Clovis, CA 93611
REPRESENTATIVE: Richard Guzzetta, M.D.
TELEPHONE: (559) 323-4495
FAX: (559) 323-4498
E-MAIL:
BOARDIGROUPISTATE CONTRACT NO: 09-551
REQUISITION NO'S:
5639009686, 5631009683
~New o Cancellation Reference: 952-4745
OR8I18Wal o Shol1Tefm Tic DlIte: U1311/2012 o AdJustment DEvergreen Code: 444
REPORTS: NoneoAddOn o Kill
Or9: 56022116
Suoersedes
COMMODITIES. SERVICES OR MAINTENANCE COVERED UNDER THIS ACTION:
SPECIAL CONDITIONS FOR USE:
11-1-09 to June 30, 2010 Maximum M10unl not to exceed: $47,593.33
7-1-2010 to June 30,2011 Maximum amount not to exceed: $71,390.00
7-1-2011 10 June 30,2012 Maximum aTlount not 10 exceed $71,390.00
• AUTOMATIC RENEWAL: In the absence of notification from vendor to Purchasing, or instructions from County department to Purchasing, this
Agreement will automatically renew for one year on July 1,2010 and July 1,2011.
L011l952·4711
DISTlIIBUTlON REQUESTEDIBY/DATE ADDITIONAL DISTRIBUTION
CONTRACT FILE:
BUYER
VENDOR
AUDITOR:
DEPARTMENT:
REQUISrrrONER
jeb A.Q9-551 AccessRepo~ Extract Page 1 of 1
Agenda Item 45
DATE: October 20, 2009
TO; Board of supervisorsC;;;;;;:;~P~
FROM: Giang T. Nguyen, Director, Department of Beha~ral~&
SUBJECT: Agreement with Touchstone Medical Group for Medical Services at the Pathways
to Recovery Program
RECOMMENDED ACTIONS:
Approve and authorize the Chalnnan to execute an Agreement with Touchstone Medical
Group for medical services to clients in the Pathways to Recovery Program, effective
November 1,2009 through June 30, 2010. ($47,593.33)
Approval of the recommended action will provide mandated medical services to clients in the
Pathways to Recovery (Pathways) Program, located at 515 South Cedar Avenue. Fresno, CA
93702, with no net County cost. The recommended Agreement has two (2) twelve (12) month
renewals ($71,390 each term). Sufficient appropriations will be included in the Department's
requested budget for FY 2010-11 and FY 2011-12 for a total contract cost of $190,373.33.
Approximately ninety (90) days before each term expires, a Board Briefing Report will be
submitted to report on outcome measurements of service. If there are problems with outcomes,
the Department will bring forward to the Board for discussion and direction on contract renewal
or sixty (60) day termination notice before the Agreement is due to expire/renew. The cost for all
seniices will be financed with CalWORKs Mental Health and Substance Abuse Allocation funds,
Drug Medi-cal and Substance Abuse Prevention and Treatment Funding.
ALTERNATIVE ACTION:
If the recommended action is not approved, participants in the Pathways Program will not have
access to medical services and the program will be out of compliance with the California Code of
Regulations, Title 22, Section 5134.1, Drug Medi-Cal Substance Abuse Services.
FISCAL IMPACT:
There is no net County cost associated with the recommended action. Sufficient appropriations
have been included in the Department of Behavioral Health's adopted Fiscal Year (FY) 2009-10
Organization 56022093 ($4,393.33) and 56022116 ($43,200) for the period of November 1,
ADMINISTRATIVE OFFICE REVlEW~~rrr-YJ1mf~~~~:::::';::=~ ---'v-P J f~ age 0
BOAROACnON; DATE_~c~to_~~e~r~~~~O APPROVEDASRECOMMENDED OTHER
ETiJ'.
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DoIUY
UNANIMOUS ANDERSON CASE LARSON PEREA POOCHIGIANX
FC-017 (eForms-<l904)
':2:..J
_
_
Board of Supervisors
Date: October 20, 2009
Page 2
2009 through June 30, 2010. The two (2) twelve (12) month renewals ($71,390 each term) will
be included in the Department's requested budget for FY 2010-11 and FY 2011-12, Organization
56022093 ($6,590) and 56022116 ($64,800). The cost for all services will be financed with
CalWORKs Mental Health, Drug Medi-Cal and Substance Abuse Allocation funds, and
Substance Abuse Prevention and Treatment Funding.
IMPACTS ON JOB CREATION:
There is a direct impact on job creation related to the recommended actions. If approved, the
recommended Agreement will create one (1) part time equivalent contracted position in Fresno
County.
DISCUSSION:
The Pathways Program is a State-certified outpatient treatment program which provides
outpatient substance abuse treatment services for pregnant and parenting women, mental
health services for CalWORKs clients and co-occurring services for clients with co-existing
mental health and substance abuse challenges. Pathways services are provided by
professional staff and include psychosocial assessments, substance abuse assessments,
individual and group treatment, medication services, skill development, case management,
evening family educational and support groups, treatment groups for domestic violence, grief
and loss, victimization, depression and anxiety. These services are aimed toward facilitating
client wellness and recovery, and helping them to work through any employment barriers in
order to ultimately become self-sufficient.
In fiscal year (FY) 2008-09, Pathways served 745 unduplicated participants. In accordance
with Title 22, Section 5134.1, Drug Medi-Cal Substance Abuse Services, Pathways is
mandated to provide a physician to establish medical necessity and to review, approve and
sign initial, follow-up and final treatment plans with fifteen (15) calendar days of the signature
by the counselor. In addition, the recommended vendor assumes responsibility for program
participants, establish, reviews and maintains medical policies and standards, and assures the
quality of medical services given to all Pathways participants.
Through the County's Purchasing Division, a Request for Proposal (RFP) No. 952-4745 for the
provision of medical services was issued on August 19, 2009 and sent to the six (6) physicians
in Fresno County that are Board Certified in Addiction Medicine. The RFP closed September
18, 2009 and there were not any responses received. With Purchasing's approval, the
Department negotiated with the current provider to continue services at the same rates as the
previous Agreement and without any administrative overhead charges. Touchstone Medical
Group has been serving the Pathways program since its inception in May 2000. Continuing
services with Touchstone Medical Group will allow for uninterrupted services to Pathways
clients.
The recommended Agreement would be effective November 1, 2009 through June 30, 2010 and
may be automatically renewed for two (2) twelve (12) month periods. Approximately ninety (90)
days before each term expires, a Board Briefing Report will be submitted to your Board to report
program outcomes. If there are problems with the outcomes, the Department will bring forward
to the Board for discussion and direction on contract renewal or termination. Program and 'fiscal
monitoring will occur monthly for each term of the recommended Agreement. Outcomes have
been designed to meet Title 22 compliance and include establishing medical necessity,
administering physical exams withjn 30 days of admission, review and approval of treatment
plans within 15 days of counselor signature, and review and approve justification for continuation
of services between 5th and 6th month of service. The review of outcomes measurements and all
contract monitoring will be the responsibility of the Substance Abuse Services Division Manager,
under the Director's direction.
FC-017 (eForms-0904)
Board of Supervisors
Date: October 20, 2009
Page 3
Upon approval by your Board, the Department's Director or designee will have authority to non
renew with a thirty (30) day written notice. In the event funding for these services is delayed by
the State Controller, County may defer payment to the Contractor. The amount of the deferred
payment shall not exceed the amount of funding delayed by the State Controller to the County.
The period of time of the deferral by the County shall not exceed the period of time the State
Controller's delay of payment to the County plus 45 days. If the State does not allocate funding
for these services, the County shall not be obligated to reimburse Contractor for these services.
The Director also may modify the maximum compensation as may be necessitated if there is a
reduction in funding from the State or Federal governments.
OTHER REVIEWING AGENCIES:
The Alcohol and Drug Advisory Board was informed of the recommended vendor at their
October 7,2009 meeting.
Fe-017 (eForms-0904)
------
AGT. # 09-551
1 AGREEMENT
2 THlS AGREEMENT is made and entered into this 20th day of October. 2009, by
3 and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter
4 referred to as "COUNTY," and RICHARD GUZZETTA, M.D;, dba TOUCHSTONE MEDICAL
5 GROUP, a sole proprietorship, whose address is 724 Medical Center Drive East, Suite ]06, Clovis,
6 CA 93611, hereinafter referred to as "CONTRACTOR."
7 WITNESSETH
8 WHEREAS, COUNTY, through its Department of Behavioral Health, Substance Abuse
9 Services Division (DBH-SAS) operates Pathways to Recovery (Pathways), a substance abuse, mental
10 health and co-occurring disorder treatment program, located at 515 South Cedar Avenue, Fresno, CA
11 93702; and
12 WHEREAS, COUNTY's DBH-SAS is in need ofa qualified and licensed physician to
13 coordinate and provide medical services pursuant to Title 22 of the California Code of Regulations;
14 and
15 WHEREAS, CONTRACTOR possesses the licensure, certification and experience to provide
16 these services as required by the COUNTY, pursuant to the tenns and conditions of this Agreement.
17 .NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
18 hereto agree as follows:
19 1. SERVICES
20 A. CONTRACTOR shall provide all services and fulfiJl all responsibilities
21 identified in Exhibit A, Swnmary of Services, attached hereto and by this reference incorporated
22 herein.
23 B. CONTRACTOR shall provide all services at the COUNTY owned and operated
24 facility, located at 515 South Cedar Avenue, Fresno, CA 93702.
25 C. CONTRACTOR shall be licensed to practice medicine in the State of California,
.26 be Board Certified in Addiction Medicine and CONTRACTOR must maintain such licensure and
27 certification throughout each tenn of this Agreement, furttter described in Section Twenty-Two (22) of
:2 8 thi s Agreement.
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2. TERM
This Agreement shall become effective on the lSI of November, 2009 and shall terminate
on the 30th day of June, 2010.
This Agreement, subject to State and Federal funding, may be renewed for two (2)
twelve (12) month periods upon the same terms and conditions herein set forth, unless written notice
of non-renewal is given by COUNTY, CONTRACTOR or COUNTY's DBH Director not later than
thirty (30) days prior to the close of the current Agreement.
3. TERMINATION
A. Non-Allocation of Funds -The terms of this Agreement, and the services to be
provided thereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated at any time by giving the CONTRACTOR thirty (30) days advance written notice.
B. Breach of Contract -The COUNTY may immediately suspend or terminate this
Agreement in whole or in part where in the determination of the COUNTY there is:
(1) An illegal or improper use of funds;
(2) A failure to comply with any term of this Agreement;
(3) A substantially incorrect or incomplete report submitted to the COUNTY;
(4) Improperly performed service.
In no event shall any payment by the COUNTY constitute a waiver by the
COUNTY of any breach of this Agreement or any default which may then exist on the part of the
CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the
COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of the
CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR under
this Agreement, which in the judgement of the COUNTY were not expended in accordance with the
terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon demand, or
upon COUNTY's option, such repayments shall be deducted from future payments owing to
CONTRACTOR under this Agreement.
C. Without Cause -Under circumstances other than those set forth above, this
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Agreement may be tenninated by either CON1RACTOR or COUNTY upon the giving of thirty (30)
days advance written notice of an intention to tenninate.
4. COMPENSATION
A. For actual services provided at Pathways, further described in Exhibit A,
COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation at the
rate of Six Hundred and No/IOO Dollars ($600.00) per half-day (4 hours) or proration thereof in half-
hour intervals. In no event shall the maximum compensation paid to CONTRACTOR by COUNTY
exceed Forty-Seven Thousand Five Hundred Ninety-Three and 331100 Dollars ($47,593.33) for the
initial tenn of this Agreement, November 1,2009 through June 30, 2010. For each twelve (12) month
renewal period thereafter, in no event shall the maximum compensation paid to CONTRACTOR by
COUNTY exceed Seventy-One Thousand Three Hundred Ninety and No/Dollars ($71,390.00).
CONTRACTOR's invoices, further described in Section Five (5) of this Agreement, shall reflect
actual services rendered by CONTRACTOR pursuant to the tenns and conditions of this Agreement.
It is understood that all expenses incidental to CONTRACTOR's perfonnance of services under this
Agreement shall be borne by CONTRACTOR.
B. Except as provided below in Section 4.D, payments by COUNTY shall be in
arrears after receipt, verification and approval of CONTRACTOR's monthly itemized invoices by
COUNTY's DBH-SAS. All final claims and/or any final budget modification requests shall be
submitted by CONTRACTOR within sixty (60) days following the final month of service for which
payment is claimed. No action shall be taken by COUNTY's DBH on claims submitted beyond the
sixty (60) day closeout period. Any compensation which is not expended by CONTRACTOR
pursuant to the terms and conditions of this Agreement shall automaticaJJy revert to COUNTY's
DBH-SAS.
c. If CONTRACTOR should fail to comply with any provision of this Agreement,
COUNTY shall be relieved of its obligation for further compensation. CONTRACTOR's and
COUNTY's obligations under this section shall survive the tennination of this Agreement with respect
to services provided during the tenn of this Agreement without regard to the cause of tennination of
this Agreement.
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D. The contract maximum amount as identified in this Agreement may be reduced
based upon State and Federal funding availability. In the event of such action, the COUNTY's DBH
Director or designee shall notify the CONTRACTOR in writing of the reduction in the maximum
amount within thirty (30) days of COUNTY's notification.
In the event that the State of California is unable to meet its financial obligations
and payment to Counties for public mental health and substance abuse services, DBH may delay or
defer payment to CONTRACTOR until such a time as State budget issues are resolved. The amount
of deferred payment shall not exceed the amount of funding delayed by the State Controller to the
COUNTY's DBH-SAS. The deferral by COUNTY shall not exceed the period of time the State
Controller's delay of payment plus forty-five (45) days. In addition, if the State of California does not
allocate funding for services described in the terms and conditions of this Agreement, DBH shall not
be obligated to reimburse CONTRACTOR for services performed.
E. Public Information -CONTRACTOR shall disclose its funding source in all
public information, however, this requirement of disclosure of funding source shall not be required in
spot radio or television advertising.
F. Lobbying Activity -CONTRACTOR shall not directly or indirectly use any of
the funds provided under this Agreement for publicity, lobbying, or propaganda purposes designed to
support or defeat legislation pending before the Congress of the United States or the Legislature of the
State of California.
G. Political Activity -CONTRACTOR shall not directly or indirectly use any of
the funds under this Agreement for any political activity or to further the election or defeat of any
candidate for public office.
H. Cost of Living Adjustment -CONTRACTOR shall not utilize any funds
provided under this Agreement to provide cost of living adjustments to CONTRACTOR.
s. INVOICING
CONTRACTOR shall invoice COUNTY in arrears by the twentieth (20th ) of each month
for actual expenses incurred and services rendered in the previous month to: sas@co.fresno.ca.us with
a copy of the invoice also sent to the assigned Pathways Planning & Support Staff Analyst. Invoices
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shall include each date of service and hours for services actually rendered in accordance with the terms
and conditions of this Agreement. In addition, a monthly report of how many clients were referred to
the DBH Adult System of Care will be included with the invoice. Invoices shall be in a form and in
such detail as acceptable to COUNTY's DBH. No reimbursement for services shall be made until
invoices, reports and outcomes are received and reviewed by COUNTY's DBH.
At the discretion of COUNTY's DBH Director or designee, if an invoice is incorrect or
is otherwise not in proper form or substance, COUNTY's DBH Director or designee shall have the
right to withhold payment as to only that portion of the invoice that is incorrect or improper after five
(5) days prior notice to CONTRACTOR. CONTRACTOR agrees to continue to provide services for a
period of ninety (90) days after notification of an incorrect or improper invoice. If after the ninety
(90) day period, the invoice(s) is still not corrected to COUNTY's DBH satisfaction, COUNTY's
DBH Director or designee may elect to terminate this Agreement, pursuant to the termination
provisions stated in Paragraph Three (3) of this Agreement. In addition, for invoices received ninety
(90) days after the expiration of each term of this Agreement or termination of this Agreement, at the
discretion of COUNTY's DBH Director or designee, COUNTY's DBH shall have the right to deny
payment of any additional invoices received.
6. INDEPENDENT CONTRACTOR
In performance of the work, duties, and obligations assumed by CONTRACTOR under
this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of
CONTRACTOR's officers, agents and employees will at all times be acting and performing as an
independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
employee, joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have
no right to control or supervise or direct the manner or method by which CONTRACTOR shall
perform its work and function. However, COUNTY shall retain the right to administer this
Agreement so as to verify that CONTRACTOR is performing its obligations in accordance with the
terms and conditions thereof. CONTRACTOR and COUNTY shall comply with all applicable
provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction
over matters which are directly or indirectly the subject of this Agreement.
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Because of its status as an independent contractor, CONTRACTOR shall have
absolutely no right to employment rights and benefits available to COUNTY employees.
CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees
all legally-required employee benefits. In addition, CONTRACTOR shall be solely responsible and
save COUNTY harmless from all matters relating to payment of CONTRACTOR's employees,
including compliance with Social Security, withholding, and all other regulations governing such
matters. It is acknowledged that during the term of this Agreement, CONTRACTOR may be
providing services to others unrelated to the COUNTY or to this Agreement.
7. MODIFICATION
A. Any matters of this Agreement may be modified from time to time by the written
consent of all the parties without, in any way, affecting the remainder.
B. CONTRACTOR hereby agrees that changes to the compensation under this
Agreement may be necessitated by a reduction in funding from State and/or Federal sources. The
COUNTY's DBH Director or designee may modifY the maximum compensation depending on State
and Federal funding availability, as stated in Section Four (4) in this Agreement. CONTRACTOR
further understand that this Agreement is subject to any restrictions, limitations, or enactments of all
legislative bodies which affect the provisions, term or funding of this Agreement in any manner.
8. NON-ASSIGNMENT
Neither party shall assign, transfer or subcontract this Agreement nor their rights or
duties under this Agreement without the prior written consent of the other party.
9. HOLD-HARMLESS
CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request,
defend the COUNTY, its officers, agents, and employees from any and all costs and expenses,
including attorney fees and court costs, damages, liabilities, claims, and losses occurring or resulting
to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its
officers, agents, or employees under this Agreement, and from any and all costs and expenses,
including attomey fees and court costs, damages, liabilities, claims, and losses occurring or resulting
to any person, firm, or corporation who may be injured or damaged by the performance, or failure to
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perform, of CONTRACTOR, its officers, agents or employees under this Agreement. In addition,
CONTRACTOR agrees to indemnify COUNTY for Federal, State of California and/or local audit
exceptions resulting from noncompliance herein on the part of the CONTRACTOR.
10. INSURANCE
Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR
or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect, the
following insurance policies throughout the term of this Agreement:
A. Commercial General Liability
Commercial General Liability Insurance with limits of not less than One
Million Dollars ($1,000,000) per occurrence and an annual aggregate of Two
Million Dollars ($2,000,000). This policy shall be issued on a per occurrence
basis.
B. Automobile Liability
Comprehensive Automobile Liability Insurance with limits for bodily injury of
not Jess than Two Hundred Fifty Thousand Dollars ($250,000.00) per person,
Five Hundred Thousand Dollars ($500,000.00) per accident and for property
damages of not less than Fifty Thousand Dollars ($50,000.00), or such
coverage with a combined single limit of Five Hundred Thousand Dollars
($500,000.00). Coverage should include owned and non-owned vehicles used
in connection with this Agreement.
C. Professional Liability
If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N.,
L.C.S.W., L.M.F.T.) in providing services, Professional Liability Insurance
with limits of not less than One Million Dollars ($1,000,000.00) per
occurrence, Three Million Dollars ($3,000,000.00) annual aggregate.
If this coverage is issued on a "claims made" basis, Contractor agrees that it
shall maintain, at its sole expense, in full force and effect for a period of three
(3) years following the termination of this Agreement, one or more policies of
professional liability insurance with limits of coverage as specified herein.
D. Worker's Compensation
A policy of Worker's Compensation insurance as may be required by the
California Labor Code.
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CONTRACTOR shall obtain endorsements to the Commercial General Liability
insurance naming the County of Fresno, its officers, agents, and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned. Such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under CONTRACTOR's policies herein.
This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance
written notice given to COUNTY.
Within thirty (30) days from the date CONTRACTOR executes this Agreement,
CONTRACTOR shall provide certificates of insurance and endorsement as stated above for all of
the foregoing policies, as required herein, to the County of Fresno, DBH-SAS, 515 South Cedar
Avenue, Fresno, CA 93702, Attention: Pathways Staff Analyst, stating that such insurance
coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and
employees will not be responsible for any premiums on the policies; that such Commercial General
Liability insurance names the County of Fresno, its officers, agents and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned; that such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, shall be
excess only and not contributing with insurance provided under CONTRACTOR's policies herein;
and that this insurance shall not be cancelled or changed without a minimum of thirty (30) days
advance, written notice given to COUNTY.
In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
this Agreement upon the occurrence of such event.
All policies shall be with admitted insurers licensed to do business in the State of
California. Insurance purchased shall be purchased from companies possessing a current A.M. Best,
Inc. rating of A FSC VII or better.
III
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11. HIPAA -BUSINESS ASSOCIATE LANGUAGE CONFIDENTIALITY
All services performed by CONTRACTOR under this Agreement shall be in strict
conformance with all applicable Federal, State of California and/or local laws and regulations relating
to confidentiality, including but not limited to, California Civil Code Section 56 el seq., California
Welfare and Institutions Code Sections 5328, 10850 and 14100.2, Health and Safety Code Sections
11977 and 11812, 22 California Code of Regulations Section 51009, and 42 Code of Federal
Regulations Sections 2.1 et seq. CONTRACTOR shall submit to County's monitoring of said
compliance with all State and Federal statutes and regulations regarding confidentiality.
CONTRACTOR shall ensure that no list of persons receiving services under this contract is published,
disclosed, or used for any other purpose except for the direct administration of the program or other
uses authorized by law that are not in conflict with requirements for confidentiality.
Except as otherwise provided in this Agreement, CONTRACTOR, as a Business
Associate of COUNTY, may use or disclose protected health information ("PHI") to perform
functions, activities or services for or on behalf of COUNTY, as specified in this Agreement, provided
that such use or disclosure shall not violate the Health Insurance Portability and Accountability Act
(HIPAA), U.S.c. 1320d el seq., and its implementing regulations including but not limited to 45
C.F.R. Parts 142, 160, 162, and 164 (hereafter known as "the Privacy and Security Rules"). The uses
and disclosures of PHI may not be more expansive than those applicable to COUNTY, as the
"Covered Entity" under the Privacy Rule, except as authorized for management, administrative or
legal responsi bi Ii ties of the Business Associate.
CONTRACTOR shall not use or further disclose PHI other than as permitted or required
by this Agreement, or as required by law.
CONTRACTOR shall implement administrative, physical and technical safeguards that
reasonably and appropriately protect the confidentiality, integrity and availability of PHI that it
, creates, receives, maintains, or transmits on behalf of COUNTY.
CONTRACTOR shaH ensure that any agent, including a subcontractor to whom
CONTRACTOR provides PHI received from COUNTY, or to whom CONTRACTOR provides PHI
which is created on behalf of COUNTY, agrees to the same restrictions and conditions that apply to
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CONTRACTOR with respect to such information.
CONTRACTOR shall report to COUNTY's Department of Behavioral Health (DBH)
Director or designee in writing within five (5) working days of any security incident of which
CONTRACTOR becomes aware. It is understood that if the security incident is not corrected within
sixty (60) days of CONTRACTOR's written notification to COUNTY's DBH Director,
CONTRACTOR acknowledges that the COUNTY's DBH Director or designee may terminate this
Agreement in accordance to Paragraph Three (3) of this Agreement if COUNTY's DBH Director, or
designee, determines that CONTRACTOR has violated a material term of this Agreement.
CONTRACTOR shall provide access, at the request of COUNTY, and in the time and
manner designated by COUNTY, to PHI in a designated record set (as defined in 45 C.F.R. §
164.50 I), to an individual or to COUNTY in order to meet the requirements of 45 C.F.R. §t 64.524
regarding access by individuals to their PHI.
CONTRACTOR shall make any amendment(s) to PHI in a designated record set at the
request of COUNTY, and in the time and manner designated by COUNTY in accordance with 45
C.F.R. § 164.526.
CONTRACTOR shall provide to COUNTY or to an individual, in a time and manner
designated by COUNTY, information collected in accordance with 45 C.F.R. § 164.528, to pennit
COuNTY to respond to a request by the individual for an accounting of disclosures of PHI in
accordance with 45 C.F.R. § 164.528.
CONTRACTOR shall make internal records related to the use, disclosure, and privacy
protection of PHI received from COUNTY, or created/received by CONTRACTOR on behalf of
COUNTY, available to COUNTY or to the Secretary of the United States Department of Health and
Human Services for purposes of investigating or auditing COUNTY's compliance with the Health
Insurance Portability and Accountability Act, in a time and manner designated by COUNTY or the
Secretary.
CONTRACTOR shall, if feasible, return or destroy all PHI received from COUNTY's
DBH, or created or received by CONTRACTOR on behalf of COUNTY's DBH upon expiration or
termination of this Agreement. In the event that CONTRACTOR deems this infeasible,
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CONTRACTOR shall notify COUNTY's DBH of the conditions that make return or destruction
infeasible, and upon mutual agreement of the parties that return or destruction is infeasible, extend the
protections of this Agreement to the PHI in order to limit future disclosures of PHI by
CONTRACTOR.
The parties agree to take such action as is necessary to amend this Agreement as
necessary for COUNTY's DBH to comply with the requirements of the Privacy and Security Rules
and the implementing regulations. Any such changes may be made with the written approval of
COUNTY's Compliance Privacy Officer or designee, and/or the Security Officer or designee should
the Security Officer obtain such authority from the Board of Supervisors.
CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that is
known to CONTRACTOR of a use or disclosure of PHI by CONTRACTOR in violation of the
requirements of this Agreement.
12. DATA SECURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent
disclosure of COUNTY data including sensitive Or personal client infonnation; abuse of County
resources; and/or disruption to County operations, individuals and/or agencies that enter into a
contractual relationship with the COUNTY for the purpose of providing services under this
Agreement must employ adequate data security measures to protect the confidential infonnation
provided to CONTRACTOR by the COUNTY, including but not limited to the following:
\
A. CONTRACTOR-owned MobilelWireless/Handheld Devices may not be
connected to County networks via personally owned mobile, wireless or handheld devices, except
when authorized by COUNTY for telecommuting and then only if virus protection software currency
agreements are in place, and if a secure connection is used.
B. CONTRACTOR-owned Computers or Computer Peripherals may not brought
into the COUNTY for use without prior authorization from the COUNTY's Chief Information Officer
and/or designee(s), including and not limited to mobile storage devices. Data must be stored on a
secure server approved by the COUNTY and transferred by means of a VPN (Virtual Private
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Network) connection, or another type of secure connection of this type if any data is approved to be
transferred.
C. CONTRACTOR County-owned Computer Equipment -CONTRACTOR or
anyone having an employment relationship with the COUNTY may not use COUNTY computers or
computer peripherals on non-COUNTY premises without prior authorization from the COUNTY's
Chief Information Officer and/or designee(s).
D. CONTRACTOR may not store COUNTY's private, confidential or sensitive
data on any hard-disk drive.
E. CONTRACTOR is responsible to employ strict controls to insure the integrity
and security of the COUNTY's confidential information and to prevent unauthorized access to data
maintained in computer files, program documentation, data processing systems, data files and data
processing equipment which stores or processes COUNTY data internally and externally.
F. Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of
128 BIT or higher. Additionally, a password or pass phrase must be utilized.
G. CONTRACTOR is responsible to immediately notify COUNTY of any breaches
or potential breaches of security related to COUNTY's confidential information, data maintained in
computer files, program documentation, data processing systems, data files and data processing
equipment which stores or processes COUNTY data internally or externally.
H. In the event of a breach of security related to COUNTY's confidential client
information provided to CONTRACTOR, COUNTY will manage the response to the incident,
however, CONTRACTOR will be responsible to issue any notification to affected individuals as
required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR will be
responsible for all costs incurred as a result of providing the required notification.
13. NON-DISCRIMINATI ON
A. Eligibility for Services -CONTRACTOR shall not unlawfutly discriminate in
the provision of services because of race, color, creed, national origin, gender, age, or physical or
mental disability as provided by State of California and Federal law in accordance with Title VI of the
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1 Civil Rights Act of 1964 (42 USC Section 2000(d»; Age Discrimination Act of 1975 (42 USC Section
2 1681); Rehabilitation Act of 1973 (29 USC Section 794); Education Amendments of 1972 (20 USC
3 Section 168 I); Americans with Disabilities Act of 1990 (42 USC Section I2 I 32); Title 45, Code of
4 Federal Regulations, Part 84; provisions of the Fair Employment and Housing Act (California
5 Government Code Section 12900); and regulations promulgated thereunder (Title 2, CCR, Section
6 7285.0); Title 2, Division 3, Article 9.5 of the California Government Code commencing with section
7 11135; and Title 9, Division 4, Chapter 6 of the California Code of Regulations commencing with
8 Section 10800.
9 B. Equal Opportunity -CONTRACTOR shall comply with California Government
10 Code, Section 12990 and California Code of Regulations, Title II, Division 4, Chapter 5, in matters
11 related to the development, implementation, and maintenance of a nondiscrimination program.
12 CONTRACTOR shall not discriminate against any employee or applicant for employment because of
13 race, religion, color, national origin, physical or mental disability, marital status, gender, or age. Such
14 practices include retirement, recruitment, advertising, hiring, layoff, termination, upgrading, demotion,
15 transfer, rates of payor other forms of compensation, use of facilities, and other terms and conditions
16 of employment. CONTRACTOR agrees to post in conspicuous places, notices available to all
17 employees and applicants for employment setting forth the provisions of the Equal Opportunity Act
18 (42 USC Section 2000(e» in conformance with Federal Executive Order No. 11246. CONTRACTOR
19 agrees to comply with the provisions of the Rehabilitation Act of 1973 (29 USC Section 794).
20 C. Suspension of Compensation -If an allegation of discrimination occurs, DBH
21 may withhold all further funds, until CONTRACTOR can show by clear and convincing evidence to
22 the satisfaction ofDBH that funds provided under this Agreement were not used in connection with
23 the alleged discrimination.
24 D. Nepotism -Except by consent of the DBH Director or designee, no person shall
25 be employed by CONTRACTOR who is related by blood or marriage to or who is a member of the
26 Board of Directors or an officer of CONTRACTOR.
27 E. New Facilities and Disability Access -New facilities shall be wheelchair
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Section 10820. If a new facility will be utilized, a plan ensuring accessibility to the disabled must be
developed. DBH shall assess, monitor, and document CONTRACTOR'S compliance with the
Rehabilitation Act of 1973 and Americans with Disabilities Act of 1990 to ensure that
recipientslbeneficiaries and intended recipients/beneficiaries of services are provided services without
regard to physical or mental disability and that CONTRACTOR has provided a facility accessible to
the physically disabled.
-14. COMPLAINTS
CONTRACTOR shall Jog all complaints and the disposition of all complaints from a
consumer or a consumer's family. CONTRACTOR shall provide a detailed complaint log of entries
concerning COUNTY-sponsored consumers to COUNTY's DBH at monthly intervals, by the fifteenth
(15th) day of the following month, in a fonnat that is mutually agreed upon. CONTRACTOR shall
post signs infonning consumers of their right to file a complaint or grievance. CONTRACTOR shall
notify COUNTY of all incidents reportable to state I icensing bodies that affect COUNTY consumers
within twenty-four (24) hours of receipt of a complaint.
Within fifteen (15) days after each incident or compliant affecting COUNTY-sponsored
consumers, CONTRACTOR shall provide COUNTY's DBH with the complaint and
CONTRACTOR's disposition of, or corrective action taken to resolve the complaint.
Within fifteen (IS) days after CONTRACTOR submits a corrective action plan to a
California State licensing and/or accrediting body concerning any sentinel event, as that term is
defined by the licensing or accrediting agency, and within fifteen (IS) days after CONTRACTOR
receives a corrective action order from a California State licensing and/or accrediting body to address
a sentinel event, CONTRACTOR shall provide a summary of such plans and orders to COUNTY's
DBH.
15. NO THIRD PARTY BENEFICIARIES
It is understood and agreed by and between the parties that the services provided by
CONTRACTOR for COUNTY herein are soJely for the benefit of the COUNTY, and that nothing in
this Agreement is intended to confer on any person other than the parties hereto any right under or by
reason of this Agreement.
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16. COMPLIANCE WITH LAW AND POLICIES
CONTRACTOR shall comply with all applicable laws, ordinances and regulations in the
perfonnance of its obligations under this Agreement and guidelines applicable to CONTRACTOR's
performance under this Agreement or any local ordinances, regulations, or policies applicable. Such
provisions include, but are not restricted to:
A. CONTRACTOR shall submit accurate, complete and timely claims and cost
reports, reporting only allowable costs.
B. CONTRACTOR shall comply with statistical reporting and program evaluation
systellls as provided in State of California regulations and in this Agreement.
17. CONFLICT OF INTEREST
No officer, agent, or employee of COUNTY who exercises any function or
responsibility for planning and carrying out the services provided under this Agreement shall have any
direct or indirect personal financial interest in this Agreement. CONTRACTOR shall comply with all
Federal, State of California, and local conflict of interest laws, statutes, and regulations, which shall be
applicable to all parties and beneficiaries under this Agreement and any officer, agent, or employee of
COUNTY.
18. DRUG-FREE WORKPLACE
CONTRACTOR shall comply with the requirements of the Drug-Free Work Place Act
of 1990 (California Govenunent Code Section 8350).
19. COMPLIANCE WITH STATE REQUIREMENTS
CONTRACTOR recognizes that COUNTY operates its alcohol and drug program under
an agreement with the State of California Department of Alcohol and Drug Programs, and that under
said agreement the State imposes certain requirements on the COUNTY and its subcontractors.
CONTRACTOR shall adhere to all State requirements, including those identified in Exhibit B,
attached hereto and by this reference incorporated herein.
In addition, CONTRACTOR recognizes that COUNTY operates its mental health
system under an agreement with the State of Cali fomi a Department of Mental Health, and that under
said agreement the State imposes certain requirements on the COUNTY and its subcontractors.
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CONTRACTOR shall adhere to all State requirements, including those identified in Exhibit C,
attached hereto and by this reference incorporated herein.
20. COMPLIANCE WITH FEDERAL REQUIREMENTS
CONTRACTOR recognizes that COUNTY operates its alcohol and drug program with
the use of Federal funds, and that the use of these funds imposes certain requirements on the
COUNTY and its subcontractors. CONTRACTOR shall adhere to all Federal requirements, including
those'identified in Exhibit D, attached hereto and by this reference incorporated herein,
21. REFERENCES TO LAWS AND RULES
In the event any law, regulation, or pol icy referred to in this Agreement is amended
during the term thereof, the parties hereto agree to comply with the amended provision as of the
effective date of such amendment.
22. LICENSING/CERTIFICATES
Throughout each term of this Agreement, CONTRACTOR warrants that it possesses
and shall maintain all licenses, permits, approvals, certificates, waivers and exemptions necessary for
the provision of the services described under the terms and conditions of this Agreement and as
required by local, State of California and/or Federal laws and regulations, and any other applicable
governmental agencies for the conduct of its business and shall operate its business in accordance with
all applicable laws and regulations. CONTRACTOR shall maintain copies of all licenses and/or
certifications noted above and shall allow COUNTY to review these documents upon request.
CONTRACTOR shall notify COUNTY immediately in writing of its inability to obtain or maintain
such licenses, permits, approvals, certificates, waivers and exemptions irrespective of the pendency of
any appeal related thereto. Additionally, CONTRACTOR shall comply with all applicable laws, rules
or regulations, as may now exist or be hereafter changed.
23. CHILD ABUSE REPORTING
CONTRACTOR shall utilize a procedure acceptable to COUNTY to ensure that all of
CONTRACTOR's employees, volunteers, consultants, subcontractors or agents performing services
under this Agreement shall report all known or suspected child abuse or neglect to one or more of the
agencies set forth in Penal Code Section 11165.9. This procedure shall include having all of
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CONTRACTOR's employees, volunteers, consultants, subcontractors or agents performing services
under this Agreement sign a statement that he or she knows of and will comply with the reporting
requirements set forth in Penal Code Section 11166. The statement to be utilized by CONTRACTOR
is set forth in Exhibit E, attached hereto and by this reference incorporated herein.
24. CHARITABLE CHOICE
CONTRACTOR may not discriminate in its program delivery against a client or
potential client on the basis of religion or religious belief, a refusal to hold a religious belief, or a
refusal to actively participate in a religious practice. Any specifically religious activity or service made
available to individuals by the CONTRACTOR must be voluntary as well as separate in time and
location from County funded activities and services. CONTRACTOR shall inform County as to
whether it is faith-based. If CONTRACTOR identifies as faith-based it must submit to Substance
Abuse Services a copy of its policy on referring individuals to alternate treatment CONTRACTOR,
and include a copy of this policy in its client admission forms. The policy must infonn individuals
that they may be referred to an alternative provider if they object to the religious nature of the
program, and include a notice to Substance Abuse Services. Adherence to this policy will be
monitored during annual si te reviews, and a review of client files. If CONTRACTOR identifies as
faith-based, by July I of each year CONTRACTOR will be required to report to Substance Abuse
Services the number of individuals who requested referrals to alternate providers based on religious
objection.
25. EVALUATION AND MONITORING
COUNTY's DBH Director, or designee, shall monilor and evaluate the perfonnance of
CONTRACTOR under this Agreement to determine to the best possible degree the success or failure
of the services provided under this Agreement. At the discretion of the COUNTY, a subcontractor
may be obtained by the COUNTY to independently evaluate and monitor the performance of the
CONTRACTOR. CONTRACTOR shall participate in the evaluation of the program as needed, at the
discretion of COUNTY. CONTRACTOR shall participate in a program review of the program at least
yearly or more frequently, or as needed, at the discretion of COUNTY. The CONTRACTOR agrees
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to supply all information requested by the COUNTY and/or the subcontractor during the program
evaluation, monitoring, and/or review.
26. CULTURAL AND LINGUISTIC COMPETENCE
A. CONTRACTOR shall ensure compliance with Title 6 of the Civil Rights Act of
1964 (42 U.S.C. Section 2000d, and 45 C.F.R. Part 80) and Executive Order 12250 of 1979 which
prohibits recipients of federal financial assistance from discriminating against persons based on race,
color, national origin, gender, disability or religion. This is interpreted to mean that a limited English
proficient (LEP) individual is entitled to equal access and participation in federally funded programs
through the provision of comprehensive and quality bilingual services.
B. CONTRACTOR shall implement policies and procedures for ensuring access
and appropriate use of trained interpreters and material translation services for all LEP consumers,
including, but not limited to, assessing the cultural and linguistic needs of its consumers, training of
staff on the policies and procedures, and monitoring its language assistance program.
CONTRACTOR's procedures must include ensuring compliance of any sub-contracted providers with
these requirements.
C. CONTRACTOR agrees that minors shall not be used as interpreters.
D. CONTRACTOR wiH keep abreast of evidence-based and best practices in
cultural competency in mental health care and treatment to ensure that the CONTRACTOR maintains
current information and an external perspective in its policies. CONTRACTOR will evaluate the
effectiveness of strategies and programs in improving the health status of cultural-defined populations.
E. CONTRACTOR will report its efforts to evaluate cultural and linguistic
activities as part of CONTRACTOR's ongoing quality improvement efforts in the monthly activities
report. Reported infonnation may include consumers' complaints and grievances. results from
consumer satisfaction surveys, and utilization and other clinical data that may reveal health disparities
as a result of cultural and linguistic barriers.
F. CONTRACTOR shall demonstrate experience working with culturally and
linguistically underserved minority populations and have knowledge about the culture and languages
of these intended groups as well as other diverse communities.
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27. LIMITED ENGLISH PROFICIENCY
COUNTY shall provide and pay interpreting and translation services to persons
participating in CONTRACTOR's services who have limited or no English language proficiency,
including services to persons who are deaf or blind. Interpreter and translation services shaH be
provided as necessary to allow such participants meaningful access to the programs, services and
benefits provided by CONTRACTOR. Interpreter and translation services, including translation of
CONTRACTOR's ''vital documents" (those documents that contain information that is critical for
accessing CONTRACTOR's services or are required by law) shall be provided to participants at no
cost to the participant. CONTRACTOR shall ensure that any employees, agents, subcontractors, or
partners who interpret or translate for a program participant, or who directly communicate with a
program participant in a language other than English, demonstrate proficiency in the participant's
language and can effectively communicate any specialized terms and concepts peculiar to
CONTRACTOR's services.
28. RECORDS
A. Record Establishment and Maintenance -CONTRACTOR shall establish and
maintain records in accordance State and Federal rules and regulations in addition to those
requirements prescribed by COUNTY with respect to all matters covered by this Agreement. Except
as otherwise authorized by COUNTY, CONTRACTOR shall retain all other records for a period of
five (5) years after receiving the final payment under this Agreement or the earlier termination oftrus
Agreement, or until State and/or Federal audit findings applicable to such services are resolved,
whichever is later. COUNTY shall maintain ownership of the records upon termination or expiration
of this Agreement.
B. Documentation -CONTRACTOR shall maintain a complete daily census of all
clients served, data collection and all statistical information required by COUNTY's DBH Director, or
designee, and/or Department of Alcohol and Other Drug Programs. CONTRACTOR shall maintain
adequate records on each individual client of services provided by the various program staff in
sufficient detail to make possible an evaluation of services, and contain all the data necessary in
reporting to the State of California, including records of client interviews and progress notes. All
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client records shall be maintained pursuant to applicable State of California and Federal requirements
concerning confidentiality.
C. Reports -CONTRACTOR shall submit to COUNTY monthly fiscal and all
program reports as further described in Section Twenty-Nine (29) and as indicated in Exhibit A.
CONTRACTOR shall also fumish to COUNTY such statements, records, reports, data, and
information as COUNTY may request pertaining to matters covered by this Agreement. All reports
submitted by CONTRACTOR to COUNTY must be typewritten.
D. Suspension of Compensation -In the event that CONTRACTOR fails to
provide reports specified in this Agreement, it shall be deemed sufficient cause for COUNTY to
withhold payments until there is compliance.
E. Disallowances -Payments by COUNTY shall be in arrears, for services
provided during the preceding month, within forty-five (45) days after receipt, verification and
approval of CONTRACTOR invoices by COUNTY'S DBH. If payment for services are denied or
disallowed by State; and subsequently resubmitted to COUNTY by CONTRACTOR, the disallowed
portion will be withheld from the next reimbursement to the CONTRACTOR until COUNTY has
received reimbursement from State for said services.
F. Client Confidentiality -CONTRACTOR shall confonn to and COUNTY shall
monitor compliance with all State and Federal statutes and regulations regarding confidentiality,
including but not limited to confidentiality of information requirements of 42 Code of Federal
Regulations § 2.1 et seq., Welfare and Institutions Code §§ 5328, 10850 and 14 I 00.2, Health and
Safety Code §§ I 1977 and I 18 12, Civil Code, Division I, Part 2.6, and 22 California Code of
Regulations § 51009.
29. REPORTS
The CONTRACTOR shall submit to COUNTY's DBH-SAS such statements, records,
reports, data, and other infonnation as the COUNTY may request pertaining to matters covered by this
Agreement. CONTRACTOR's monthly referral report to the COUNTY's DBH Adult System of Care
shall be due with submitted invoices, further described in Section Five (5) of this Agreement. In the
event that the CONTRACTOR fails to provide such reports or other information required hereunder, it
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shall be deemed sufficient cause for the COUNTY to withhold monthly payments until there is
compliance. In addition, the CONTRACTOR shall provide written notification and explanation to the
COUNTY within fifteen (15) days of any funds received from another source to conduct the same
services covered by this Agreement.
30. PROPERTY OF COUNTY
It is understood that all items and inventory that are located at the COUNTY's facility
shall remain at the facility after termination or expiration of this Agreement. All items purchased with
COUNTY funds shall be retained by COUNTY, as COUNTY property, in the event this Agreement is
terminated or upon expiration of this Agreement.
CONTRACTOR shaH submit actual purchase invoice(s) for the purchase of any fixed
assets with their monthly invoices. In addition, all purchases over Five Thousand and Noll 00 Dollars
($5,000.00), and certain purchases under Five Thousand and Noll 00 Dollars ($5,000.00), including
but not limited to fans, calculators, cameras and other sensitive items, as determined by COUNTY's
DBH Director or designee, made during the life of this Agreement shall be identified as fixed assets
with an assigned COUNTY Accounting Inventory Number. These fixed assets shall be retained by
COUNTY, as COUNTY property, in the event this Agreement is terminated or upon expiration of this
Agreement. The CONTRACTOR agrees to participate in an annual inventory of all COUNTY fixed
assets and shall be physically present when fixed assets are returned to COUNTY possession at the
termination or expiration of this Agreement. CONTRACTOR is responsible for returning to
COUNTY all COUNTY owned fixed assets, or the monetary value of said fixed assets if unable to
produce the fixed assets at the expiration or termination of this Agreement. COUNTY shall be
responsible for the routine maintenance of any COUNTY asset util ized during the term of this
agreement.
31. PROHIBITION ON PUBLICITY
None of the funds, materials, property or services provided directly or indirectly under
this Agreement shall be used for CONTRACTOR's advertising, fundraising, or publicity (i.e.,
purchasing of ticketsIt ables, silent auction donations, etc.) for the purpose of self-promotion.
Notwithstanding the above, publicity of the services described in Section One (1) of this Agreement
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shall be allowed as necessary to raise public awareness about the availability of such specific services
when approved in advance by the Director or designee and at a cost as provided in this Agreement for
such items as written/printed materials, the use of media (i.e., radio, television, newspapers) and any
other related expense(s).
.32. AUDITS AND INSPECTIONS
The CONTRACTOR shall at any time during business hours, and as often as the
COUNTY may deem necessary, make available to the COUNTY for examination all of its records and
data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request
by the COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to
ensure CONTRACTOR's compliance with the terms of this Agreement.
If this Agreement exceeds Ten Thousand and Noll 00 Dollars ($10,000.00),
CONTRACTOR shall be subject to the examination and audit of the State of California Auditor
General for a period of three (3) years after final payment under Contract (California Government
Code Section 8546.7).
Notwithstanding the provisions stated in Paragraph Three (3) of this Agreement, it is
acknowledged by the parties hereto that this Agreement shall continue in full force and effect until all
audit procedures and requirements as stated in this Agreement have been completed to the review and
satisfaction of COUNTY. CONTRACTOR shall bear all costs in connection with or resulting from
any audit and/or inspections including, but not limited to, actual costs incurred and the payment of any
expenditures disallowed by either COUNTY, State, or Federal governmental entities, including any
assessed interest and penalties.
33. NOTICES
The persons and their addresses having authority to give and receive notices under this
Agreement include the following:
COUNTY
Director, Fresno County
Department of Behavioral Health
5108 E. Clinton Way, Suite 108
Fresno, CA 93702
CONTRACTOR
Richard Guzzetta, M.D.
Touchstone Medical Group
724 Medical Drive East, Suite 106
Clovis, CA 93611
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34. CHANGE OF LEADERSHIP I MANAGEMENT
Any and all notices between COUNTY and CONTRACTOR provided for or permitted
under this Agreement or by law, shall be in writing and shall be deemed duly served when personal1y
delivered to one of the parties, or in lieu of such personal service, when deposited in the United States
Mail, postage prepaid, addressed to such party.
In the event of any change in the status of CONTRACTOR'S leadership or
management, CONTRACTOR shall provide written notice to COUNTY within thirty (30) days from
the date of change. Such notification shall include any new leader or manager's name, address and
qualifications. "Leadership or management" shall include any employee, member, or owner of
CONTRACTOR who either a) directs individuals providing services pursuant to this Agreement, b)
exercises control over the manner in which services are provided, or c) has authority over
CONTRACTOR's finances.
35. GOVERNING LAW
The parties agree that for the purpose of venue, performance under this Agreement is in
Fresno County, California.
The rights and obligations of the parties and all interpretation and perfOlmance of this
Agreement shall be governed in all respects by the laws of the State of California.
36. ENTIRE AGREEMENT
This Agreement, including a)) Exhibits attached hereto, constitute the entire Agreement
between the CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes
all previous agreement negotiations, proposals, commitments, writings, advertisements, publications,
and understandings of any nature whatsoever unless expressly included in this Agreement.
III
III
III
III
III
III
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TN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
year first hereinabove written.
ATTEST:
CONTRACTOR:
TOUCHSTONE MEDICAL GROUP
By:~2)HJh'b-
Print Name: ~ -b J')..,ur{A-
Title: ~D,\I:lLJ
Date: to!b{uL
Mailing Address:
Touchstone Medical Group
724 Medical Center Drive, East, Suite 106
Clovis, CA 93611
Phone No.: (559) 323-4495
Contact: Dr. Richard Guzzetta
COUNTY OF FRESNO
By: ~~~~~
Susan Anderson
Chairman, Board of Supervisors
BERNICE E. SEIDEL, Clerk
Board of Supervisors
By Bf~
Date: .0 ('U) r0']_
PLEASE SEE ADDITIONAL
SIGNATURE PAGE ATTACHED
-24 COUNTY OF FRESNO
Fresno, CA
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.APPROVED AS TO ACCOUNTING FORM:
VICKI CROW, C.P.A., AUDITOR-CONTROLLER!
TREASURER-TAX COLLECTOR
BY:~~'~ Date: /tJ-1-o1
APPROVED AS TO LEGAL FORM:
KEVIN BRIGGS, INTERIM COUNTY COUNSEL
()_ I \ ·n/l
By: _....;:.VC-W_VJD----'--_ Date: 'l (Jo!",__
REVIEWED AND RECOMMENDED FOR
APPROVAL:
By: Date: qOtJ/o~&7'~~ --I--~----
Giang T. uyen, SN I '
Director, Department of Behavioral Health
Fund/Subclass: 0001/10000
Organization:
56022093
FY 09/10 FY 10/11 FY 11/12
$4,393.28 $6,590 $6,590
56022116
FY 09/10 FY 10/11 FY 11/12
$43,200 $64,800 $64,800
Account/Program: 7295/0
-25 COUNTY OF FRESNO
Fresno, CA
PATHWAYS TO RECOVERY MEDICAL DIRECTOR
Exhibit A
Page 1 of 3
SUMMARY OF SERVICES
ORGANIZATION: Richard Guzzetta, M.D., TOUCHSTONE MEDICAL GROUP
ADDRESS: 724 Medical Center Drive East, Suite 106
SERVICE ADDRESS: 515 South Cedar Avenue, Fresno, CA 93702
SERVICES: Pathways to Recovery Medical Director Services
TERM:
RENEWAL TERMS:
November 1, 2009 -July 30, 2010
July 1, 2010 -June 30, 2011
July 1, 2011 -June 30, 2012
July 1, 2012 -June 30, 2013
July 1, 2013 -June 30, 2014
INITIAL TERM AMOUNT:
RENEWAL TERM AMOUNT:
$47,593.33
$71,390
SUMMARY OF SERVICES
The County of Fresno, through its Department of Behavioral Health, Substance Abuse Services Division
(DBH-SAS) Pathways to Recovery Program, hereinafter referred to as Pathways, is an outpatient drug and
alcohol treatment program that is certified to provide Drug Medi-Cal Perinatal and Non-Perinatal Outpatient
Drug Free and Day Care Habilitative substance abuse services for women. Pathways also provides mental
health services for both men and women referred from CalWORKs and intensive treatment service for those
clients that have both a substance abuse and mental health diagnosis. Pathways is located in a County
owned and operated facility, whose address is 515 South Cedar Avenue, Fresno, CA 93702.
Services are provided by professional staff, including licensed and unlicensed mental health clinicians,
substance abuse specialists and community mental health specialists. All medical services provided at the
Pathways program are under the direction of CONTRACTOR. CONTRACTOR will provide regularly
scheduled hours and will otherwise be available on-call during Pathways business hours, further described
herein.
Pathways provides services in three tracks:
Track I: Substance abuse treatment for pregnant and parenting women. This is an intensive outpatient
substance abuse treatment program that includes three phases beginning with an intensive five day per
week program, progressing to three days per week, followed by the final phase that requires one day per
week participation. Within Track I each phase lasts approximately three months, with the client completing a
total of nine months of treatment.
Track II: Mental health services for female and male CalWORKs referrals. This is a two-phase treatment
and supported employment-oriented service that addresses barriers that may interfere with employment,
vocational training, or educational goals.
Track III: Ihtensive integrated treatment services for female and male participants who have co-occurring
mental health and substance abuse disorders. Client referrals originate from Track I and Track II.
Pathways is open Monday through Friday 8:00 AM to 5:00 PM, with the exception of County approved
holidays and the following County designated furlough days for Fiscal Year 2009/10:
Exhibit A
Page 2 of 3
Thursday 12/24/09 Monday 1/25/10 Monday 3/15/10 Monday 4/5/10
Please note that designated furlough days are subject to change at the discretion of County's OBH
Director or designee and may not be the same for each Fiscal Year.
For a complete list of County observed holidays, please click the following link:
http://www.co.fresno.ca.uslDepartmentPage.aspx?id=21229&terms=County+Holidays
Pathways also subcontracts a licensed therapeutic child care provider for the Early Intervention Center (The
Center) co~located with Pathways, for the children ages 0-6 whose mothers are enrolled in the Pathways
program. Services are currently provided by Family Development Center, LLC. CONTRACTOR has no
responsibility for oversight or treatment of children enrolled at The Center.
CONTRACTOR REQUIREMENTS:
CONTRACTOR shall:
1. Be a licensed physician in the State of California, Board-Certified in Addiction Medicine and must
maintain such licensure and certification throughout each term of the Agreement.
2. Provide mental health assessments; prescriptions for psychotropic medications, as appropriate; monitor
clients on medication; and refer consumers with severe mental illness, including Major Depressive
Disorder with Psychotic features, Schizophrenia, Psychosis NOS, Schizoaffective Disorder and Bipolar
Disorder to the County's DBH, Adult System of Care.
3. Have admitting privileges to a general acute care hospital or plan, to be approved by the Department of
Alcohol and Drug Programs (ADP), for ensuring needed hospital services are provided to clients.
4. Maintain regularly scheduled hours and on-call hours during Pathways business hours (M-F, 8:00 AM
5:00 PM eXcluding County's holidays and designated furlough days), schedule a minimum of two (2)
half days (defined as 4 hour segments) in the office per week, and participate in Pathways activities that
include, but are not limited to, medical oversight; assessment; patient care; medication monitoring;
clinical staff meetings; clinical treatment reviews; and continuous quality improvement. The regularly
scheduled hours may be subject to change upon mutual agreement by CONTRACTOR and COUNTY's
DBH-SAS.
5. Notify Pathways Clinical Supervisors at least three (3) weeks in advance for absences due to vacation,
conferences, holidays, etc. so that physician coverage can be arranged by the Clinical Supervisors.
6. Assume medical responsibility for Pathways clients; establish, review and maintain medical policies and
standards; assure the quality of medical services given to all patients; and perform duties in accordance
with all State of California and Federal rules and regulations, inclUding, but not limited to, the California
Code of Regulations, Title 22, Section 51341.1: Drug Medi-Cal Substance Abuse Services.
7. Administer physical examinations or sign waivers based on a review of health questionnaires and
substance abuse histories for all clients within thirty (30) days of admission to Pathways.
8. Review and sign treatment plans and updates for all clients to establish medical necessity of treatment
within fifteen (15) days of the counselor's signature. Under Drug Medi-Cal guidelines, treatment plans
must be updated at least every ninety (90) days, or when a change in problem identification or treatment
focus occurs.
9. Review justifications for continuation of services for clients that are completed by counselors and make
a determination on whether to discharge the client or have him/her continue in treatment based on the
medical necessity of treatment, the client's prognosis and the counselor's recommendation.
Exhibit A
Page 3 of 3
10. Attend weekly combined substance abuse and mental health clinical staff meetings to offer consultation
and support Pathways staff.
11. Be available on-call by telephone during business hours for consultations or client care.
12. Maintain client records and comply with all State of California and Federal confidentiality laws.
13. Meet with clients as needed.
14. Operate within CONTRACTOR's scope of practice and according to the ethical standards for their
profession.
15. Support and subscribe to ADP bulletins or guidelines as well as other regulations or documents which
govern the provision of services under the auspices of Pathways program.
16. The CONTRACTOR's use of COUNTY equipment and resources, to include e-mail accounts and
internet resources, shall comport with COUNTY policies, procedures, and protocols. CONTRACTOR's
use of these, any other COUNTY resources, shall be strictly limited to the services contemplated in the
entire agreement.
MONTHLY REPORT & OUTCOMES
CONTRACTOR shall provide the total number of mental health referrals that were sent to DBH, Adult
System of Care.
Outcomes shall meet Title 22 compliance and include administering physical exams within 30 days of
admission, reviewing and signing treatment plans within 15 days of counselor signature, and reviewing and
signing justification for continuation of services between 5th and 6th month of service.
COUNTY RESPONSIBILITIES
1. COUNTY shall provide electricity, telephone service restricted to the (559) service area, alarm system,
routine janitorial service and security services. These services shall be commensurate with the level and
quality of such services provided to Pathways program and facility.
2. COUNTY shall provide access to office equipment including but not limited to e-mail access and a
COUNTY e-mail account, computer, printer and fax that is associated with daily operations of
CONTRACTOR, as determined by COUNTY's DBH-SAS.
Exhibir B
Page I of3
STATE ALCOHOL AND DRUG REQUIREMENTS
1. INDEMNIFICATION
The CONTRACTOR agrees to indemnify, defend and save harmless the
State, its officers, agents and employees from any and all claims and
losses accruing or resulting to any and all contractors, subcontractors,
materialmen, laborers and any other person, firm or corporation furnishing
or supplying work, services, materials or supplies in connection with the
performance of this Agreement and from any and all claims and losses
accruing or resulting to any person, firm or corporation who may be
injured or damaged by the CONTRACTOR in the performance of this
Agreement.
2. INDEPENDENT CONTRACTOR
The CONTRACTOR and the agents and employees of CONTRACTOR,
in the performance of this Agreement, shall act in an independent capacity
and not as officers or employees or agents of State of California.
3. CONTROL REQUIREMENTS
This Agreement is subject to all applicable Federal and State laws and
regulations. The provisions of this Agreement are not intended to
abrogate any provisions of law or regulation existing or enacted during the
term of this Agreement.
4. NON -DISCRIMINATION PROVISION
A. Eligibility for Services
CONTRACTOR shall prepare and make available to COUNTY
and to the public all eligibility requirements to participate in the
program plan set forth in CONTRACTOR's response to the RFP.
No person shall, because of ethnic group identification, age, sex,
color, disability, medical condition, national origin, race, ancestry,
marital status, religion, religious creed, political belief or sexual
preference be excluded from participation, be denied benefits of, or
be subject to discrimination under any program or activity
receiving Federal or State of California assistance.
B. Employment Opportunity
CONTRACTOR shall comply with COUNTY policy, and the
Equal Employment Opportunity Commission guidelines, which
forbids discrimination against any person on the grounds of race,
color, national origin, sex, religion, age, disability status, or sexual
preference in employment practices. Such practices include
Exhibit B
Page 2 of3
retirement, recruitment advertising, hiring, layoff, termination,
upgrading, demotion, transfer, rates of payor other forms of
compensation, use of facilities, and other terms and conditions of
employment.
C. Suspension of Compensation
If an allegation of discrimination occurs, COUNTY may withhold
all further funds, until CONTRACTOR can show clear and
convincing evidence to the satisfaction of COUNTY that funds
provided under this Agreement were not used in connection with
the alleged discrimination.
D. Nepotism
Except by consent of COUNTY's Department of Behavioral
Health Director, or designee, no person shall be employed by
CONTRACTOR who is related by blood or marriage to, or who is
a member of the Board of Directors or an officer of
CONTRACTOR.
5. CONFIDENTIALITY
CONTRACTOR shall conform to and COUNTY shall monitor
compliance with all State of California and Federal statutes and
regulations regarding confidentiality, including but not limited to
confidentiality of information requirements at Part 2, Title 42, Code of
Federal Regulations; California Welfare and Institutions Code, sections
14100.2, 11977, t 18 t 2,5328;Division 10.5 and 10.6 of the California
Health and Safety Code; Title 22, California Code of Regulations, section
51009; and Division 1, Part 2.6, Chapters 1-7 of the CaJifornia Civil Code.
6. REVENUE COLLECTION POLICY
CONTRACTOR shall conform to all policies and procedures regarding
revenue collection issued by the State under the provisions oftbe Health
and Safety Code, Division 10.5.
7. EXPENDITURE OF STATE GENERAL AND FEDERAL FUNDS
CONTRACTOR agrees that all funds paid out by the State shall be used
exclusively for providing alcohol and/or drug program services,
administrative costs, and allowable overhead.
0147cdbh
Exhibit B
Page 3 of3
8. ACCESS TO SERVICES
CONTRACTOR shall provide accessible and appropriate services in
accordance with Federal and State statutes and regulations to all eligible
persons.
9. REPORTS
CONTRACTOR agrees to participate in surveys related to the
performance of this Agreement and expenditure of funds and agrees to
provide any such information in a mutually agreed upon format.
10. AUDITS
All State and Federal funds furnished the CONTRACTOR pursuant to this
Agreement along with required COUNTY match, related patient and
. participant fees, third-party payments, or other related revenues and funds
commingled with the foregoing funds are subject to audit by the State.
The State may audit all aJcohol and drug program revenue and
expenditures contained in this Agreement for the purpose of establishing
the basis for the subsequent year's negotiation.
11. RECORDS MAINTENANCE
A. CONTRACTOR shall maintain books, records, docwnents, and
other evidence necessary to monitor and audit this Agreement.
B. CONTRACTOR shall maintain adequate program and fiscal
records relating to individuals served under the tenns of this
Agreement, as required, to meet the needs of the State in
monitoring quality, quantity, fiscal accountability, and accessibility
of services. Information on each individual shall include, but not
be limited to, admission records, patient and participant interviews
and progress notes, and records of service provided by various
service locations, in sufficient detail to make possible an
evaluation of services provided and compliance with this
Agreement.
0147cdbh
Exhibit C
Page 1 of2
STATE MENTAL HEALTH REQUIREMENTS
1. CONTROL REQUIREMENTS
The COUNTY and its subcontractors shall provide services in accordance with all
applicable Federal and State statutes and regulations.
2. PROFESSIONAL LICENSURE
All (professional level) persons employed by the COUNTY Mental Health
Program (directly or through contract) providing Short-DoylelMedi-Cal services
have met applicable professional licensure requirements pursuant to Business and
Professions and Welfare and Institutions Codes.
3. CONFIDENTIALITY
CONTRACTOR shall conform to and COUNTY shall monitor compliance with
all State of Cali fomi a and Federal statutes and regulations regarding
confidentiality, including but not limited to confidentiality of information
requirements at 42, Code of Federal Regulations sections 2.1 et seq; California
Welfare and Institutions Code, sections 14100.2, 11977, 11812,5328; Division
10.5 and 10.6 of the California Health and Safety Code; Title 22, California Code
of Regulations, section 51009; and Division I, Part 2.6, Chapters 1-7 of the
California Civil Code.
4. NON-DISCRIMINATION
A. Eligibility for Services
CONTRACTOR shall prepare and make available to COUNTY and to the
public all eligibility requirements to participate in the program plan set
forth in the Agreement. No person shall, because of ethnic group
identification, age, gender, color, disability, medical condition, national
origin, race, ancestry, marital status, religion, religious creed, political
belief or sexual preference be excluded from participation, be denied
benefits of, or be subject to discrimination under any program or activity
receiving Federal or State of California assistance.
B. Employment Opportunity
CONTRACTOR shall comply with COUNTY policy, and the Equal
Employment Opportunity Commission guidelines, which forbids
discrimination against any person on the grounds of race, color, national
origin, sex, religion, age, disability status, or sexual preference in
employment practices. Such practices include retirement, recruitment
advertising, hiring, layoff, termination, upgrading, demotion, transfer,
Exhibit C
Page 2 of2
rates of payor other fOnTIS of compensation, use of facilities, and other
terms and conditions of employment.
C. Suspension of Compensation
If an allegation of discrimination occurs, COUNTY may withhold all
further funds, until CONTRACTOR can show clear and convincing
evidence to the satisfaction of COUNTY that funds provided under this
Agreement were not used in connection with the alleged discrimination.
D. Nepotism
Except by consent of COUNTY's Department of Behavioral Health
Director, or designee, no person shall be employed by CONTRACTOR
who is related by blood or marriage to, or who is a member of the Board
of Directors or an officer of CONTRACTOR.
S. PATIENTS'RIGHTS
CON1RACTOR shaJl comply with applicable laws and regulations, including but
not limited to, laws, regulations, and State policies relating to patients' rights
Exhibit D
Page 1 of3
FEDERAL REQUIREMENTS
SINGLE AUDIT CLAUSE
As a subrecipient of Federal financial assistance, CONTRACTOR (S) agrees to
participate, as applicable, in the County audit, perfonned in accordance with the
requirements of the Single Audit Act of 1984 (31 USC section 7502) and subject
to the tenns of either OMB Circulars A-128 or A-133, to the County of Fresno.
Such audit shall be delivered to DBH (to the attention of the program funding this
Agreement) for review not later than one (1) year after the close of the
subrecipient's fiscal year in which the funds supplied through this Agreement are
expended. Failure to comply with this Act may result in DBH perfonning the
necessary audit tasks or, at the DBH's option, in the DBH contracting with a
qualified accountant to perfonn this audit. All audit costs related to this
Agreement are the sole responsibility of CONTRACTOR (S) who agrees to take
corrective action to eliminate any material noncompliance or weakness found as a
result of such audit. Audit work perfonned by DBH under this paragraph shall be
billed at DBH cost as detennined by the Auditor-ControllerlTreasurer-Tax
Collector.
FEDERAL CERTIFICATIONS
Certification Regarding Debannent, Suspension, Ineligibility and Voluntary
Exclusion-Lower Tier Covered Transactions.
A. DBH and CONTRACTOR (S) recognize that Federal assistance funds will
be used under the terms of this Agreement. For purposes of this
paragraph, DBH will be referred to as the "prospective recipient".
B. This certification is required by the regulations implementing
Executive Order 12549, Debannent and Suspension, 29 CFR Part 98,
section 98.510, Participants' responsibilities. The regulations were
published as Part VII of the May 26, 1988 Federal Register (pages
19160-192 1 1).
1) The prospective recipient of Federal assistance funds
certifies by entering this Agreement, that neither it nor its
principals are presently debarred, suspended, proposed for
debannent, declared ineligible, or voluntarily excluded
from participation in this transaction by any Federal
department or agency.
2) The prospective recipient of funds agrees by entering into
this Agreement, that it shall not knowingly enter into any
lower tier covered transaction with a person who is
. debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction,
Exhibit D
Page 2 of3
FEDERAL REQUIREMENTS
unless authorized by the Federal department or agency with
which this transaction originated.
3) Where the prospective recipient of Federal assistance funds
is unable to certify to any of the statements in this
certification, such prospective participant shall attach an
explanation to this Agreement.
4) The prospective recipient shall provide immediate written
notice to DBH if at any time prospective recipient learns
that its certification in this clause of this Agreement was
erroneous when submitted or has become erroneous by
reason of changed circumstances.
5) The prospective recipient further agrees that by entering
this Agreement, it will include a clause identical to this
clause of this Agreement, and titled "Certification
Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion-Lower Tier Covered Transactions", in
all lower tier covered transactions and in all solicitations
for lower tier covered transactions.
6) The certification in this Clause of this Agreement is a
material representation of fact upon which reliance was
placed by COUNTY when this transaction was entered
into.
AUDIT
CONTRACTOR (S) shall grant DBH, State of California (if applicable), the
Federal grantor agency, the Comptroller General of the United States, or any of
their duly authorized representatives access to any books, documents, papers, and
records of the CONTRACTOR (8) which are directly pertinent to this Agreement
for the purpose of audits, examinations, excerpts and transactions. The
CONTRACTOR (S) must retain all such required records for three (3) years after
CONTRACTOR (S) makes final payment and all other pending matters are
closed.
CLEAN AIR AND WATER
In the event funding under this Agreement exceeds one hundred thousand dollars
($100,000.00), the CONTRACTOR (8) must comply with all applicable
standards, orders, or requirements issued under section 306 of the Clean Air Act
(42 U.S.c. 1857 (h», section 506 of the Clean Water Act (33 U.S.C. 1368),
Exhibil D
Page30f3
FEDERAL REQUIREMENTS
Executive Order 11738, and Environmental Protection Agency Regulations (40
CFR part 32).
ENERGY EFFICIENCY
The CONTRACTOR (S) must comply with the mandatory standards and policies
relating to energy efficiency which are contained in the state energy conservation
plan issued in compliance with Energy Policy and Conservation Act (Pub. L.
94-163).
REPORTING REQUIREMENTS, COPYRIGHT AND PATENTS
The awarding agency's reporting requirements are stated in this Agreement. The
awarding agency's requirements and regulations pertaining to copyright and rights
in data, and patent rights with respect to any discovery or invention which arise or
is developed in the course of or under this Agreement (if any), are likewise stated
in this Agreement.
NON-DISCRIMINATION PROVISION
A. During the performance of this Agreement, CONTRACTOR (S)
shall not unlawfully discriminate against any employee or
applicant for employment because of race, religion, color, national
origin, ancestry, physical disability, medical condition, marital
status, age or gender.
B. CONTRACTOR (S) shall ensure that the evaluation and treatment
of their employees and applicants for employment are free of such
discrimination.
C. CONTRACTOR (S) agrees to the provisions of section 504 of the
Rehabilitation Act of 1973, as amended, pertaining to the
prohibition of discrimination against qualified handicapped
persons in all Federally-assisted programs or activities, as detailed
in regulatio~s signed by the Secretary of Health and Welfare
Agency, effective June 2, 1977, and found in the Federal Register,
Volume 42, No.86, dated May 4, 1977.
D. CONTRACTOR (S) shall ensure the treatment of program
recipients shall be free of such discrimination.
Exhibit E
NOTICE OF CHILD ABUSE REPORTING LAW
The undersigned hereby acknowledges that Penal Code section 11166 and the contractual
obligations between County of Fresno (COUNTY) and Touchston Medical Group (CONTRACTOR),
related to provision of medical services for Pathways to Recovery, require that the undersigned report
all known or suspected child abuse or neglect to one or more of the agencies set forth in Penal Code
(P.c.) section (§) 11165.9.
For purposes of the undersigned's child abuse reporting requirements, "child abuse or neglect"
includes physicaJ injury inflicted by other than accidental means upon a child by another person,
sexual abuse as defined in P .C. §11165.1, neglect as defined in P.c. §11165.2, willful cruelty or
unjustifiable punishment as defined in P.C. §I J 165.3, and unlawful corporal punishment or injury as
defined in P.c. §11165.4.
. A child abuse report shall be made whenever the undersigned, in his or her professional
capacity or within the scope of his or her employment, has knowledge of or observes a child whom the
undersigned knows or reasonably suspects has been the victim of child abuse or neglect. (P.C
§11166.) The child abuse report shall be made to any police department or sheriff's department (not
including a school district police or security department), or to any county welfare department,
including Fresno County Department of Children and Family Services' 24 Hour CARELINE. (See PC
§11165.9.)
. For purposes of child abuse reporting, a "reasonable suspicion" means that it is objectively
reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person
in a like position, drawing, when appropriate, on his or her training and experience, to suspect child
abuse or neglect. The pregnancy of a child does not, in and of itself, constitute a basis for reasonable
suspicion of sexual abuse. (P.c. §11166(a)(I).)
Substantial penalties may be imposed for failure to comply with these child abuse reporting
req uirements.
Further information and a copy of the law may be obtained from the department head or
designee.
I have read and understand the above statement and agree to comply with the child abuse reporting
requirements.
SIGNATURE DATE
CERTIFICATE OF DELIVERY OF DOCUMENT
I am employed by the County of Fresno as a Deputy Clerk of the Board of
Supervisors. On October 20.2009 I delivered a copy of Agreement No. 09-551
. (Item No. 45) to the Chairman of the Fresno County Board of Supervisors.
~Q'~KelleYMCfeary
Deputy Clerk