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HomeMy WebLinkAboutAgreement A-22-006 with LPC.pdf1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AGREEMENT This Agreement is made and entered into this ______ day of ___________ 2022, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as “COUNTY”, and LPC CONSULTING ASSOCIATES, INC, whose address is, 1451 River Park Drive, Suite 100, Sacramento, CA 95815, hereinafter referred to as “CONTRACTOR” (collectively the “parties”). W I T N E S S E T H: WHEREAS, COUNTY, through its Department of Behavioral Health, Substance Use Disorder Services (DBH-SUDS) has determined there is a need for Fresno County youth and young adults to receive alcohol and drug abuse prevention services; and WHEREAS, COUNTY is authorized to contract with privately operated agencies for the provision of alcohol and drug abuse prevention services; and WHEREAS, CONTRACTOR has the staff, and is willing and able to provide prevention evaluation services required by COUNTY, pursuant to the terms and conditions of this Agreement. NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties hereto agree as follows: 1.SERVICES A.CONTRACTOR shall provide all services and fulfill all responsibilities identified in Exhibit A, Scope of Work, attached hereto and by this reference incorporated herein. B.CONTRACTOR shall align evaluations, services, and practices with the vision, mission, and guiding principles of the DBH, as further described in Exhibit B, "Fresno County Department of Behavioral Health Guiding Principles of Care Delivery", attached hereto and by this reference incorporated herein and made part of this Agreement. C.CONTRACTOR’s administrative level agency representative, who is duly authorized to act on behalf of the CONTRACTOR, must attend regularly scheduled monthly Behavioral Health Board Substance Use Disorder Sub-Committee meetings, CONTRACTOR meetings and quarterly Prevention Provider meetings, as deemed necessary by DBH Director or her designee. D.CONTRACTOR shall comply with all contract monitoring and compliance protocols, procedures, data collection methods, and reporting requirements conducted by the COUNTY. Agreement No. 22-006 4th January 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 F.CONTRACTOR’s staff may be required to attend meetings and trainings on an as- needed basis, which may include but are not limited to prevention and fiscal trainings provided by the State of California. 2.T ERM The Agreement shall become effective upon execution and shall terminate on the 30th day of June 2025. This Agreement may be extended for one (1) additional consecutive twelve (12) month period and one (1) additional six (6) month period upon written approval of both parties no later than thirty (30) days prior to the first day of the next twelve (12) month or six (6) month extension period. The DBH Director, or designee, is authorized to execute such written approval on behalf of COUNTY based on CONTRACTOR’s satisfactory performance. 3.T ERMINATION 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 CONTRACTOR thirty (30) days advance written notice. B.Breach of Contract - COUNTY may immediately suspend or terminate this Agreement in whole or in part, where in the determination of 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 COUNTY; 4)Improperly performed service. In no event shall any payment by COUNTY constitute a waiver by COUNTY of any breach of this Agreement or any default which may then exist on the part of CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to COUNTY with respect to the breach or default. COUNTY shall have the right to demand of CONTRACTOR the repayment to COUNTY of any funds disbursed to CONTRACTOR under this Agreement, which in the judgment of COUNTY were not expended in accordance with the terms of this Agreement. CONTRACTOR shall promptly refund any such funds upon demand or, at COUNTY’s option, such repayment shall be deducted from future 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 payments owing to CONTRACTOR under this Agreement. C.Without Cause - Under circumstances other than those set forth above, this Agreement may be terminated by CONTRACTOR or COUNTY upon thirty (30) days advance written notice of an intention to terminate the Agreement. COUNTY’s DBH Director, or designee, is authorized to execute such written notice on behalf of COUNTY. 4.COMPENSATION A.For actual services provided as identified in the terms and conditions of this Agreement, including Exhibit A, COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive compensation in accordance with Exhibit C, “Budget Summary,” attached hereto and by this reference incorporated herein. Payment shall be made upon certification or other proof satisfactory to COUNTY’s DBH that services have actually been performed by CONTRACTOR as specified in this Agreement. For the period effective upon execution through June 30, 2022 in no event shall actual services performed be in excess of Forty Thousand and No/100 Dollars ($40,000.00). For the period July 1, 2022 through June 30, 2023, in no event shall actual services performed be in excess of Eighty-Five Thousand and No/100 Dollars ($85,000.00). For the period July 1, 2023 through June 30, 2024, in no event shall actual services performed be in excess of Ninety Thousand and No/100 Dollars ($90,000.00). For the period July 1, 2024 through June 30, 2025, in no event shall actual services performed be in excess of One Hundred Fifteen Thousand and No/100 Dollars ($115,000.00). If this agreement is renewed for an additional one-year period pursuant to Section 2, TERM, for the period July 1, 2025 through June 30, 2026, in no event shall actual services performed be in excess of One Hundred Sixty Thousand and No/100 Dollars ($160,000.00). If this agreement is renewed for an additional six-month period pursuant to Section 2, TERM, for the period July 1, 2026 through December 31, 2026, in no event shall actual services performed be in excess of Fifty Thousand and No/100 Dollars ($50,000.00). In no event shall services performed under this Agreement be in excess of Five Hundred Forty Thousand and No/100 Dollars ($540,000.00). It is understood that all expenses incidental 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 to CONTRACTOR’s performance of services under this Agreement shall be borne by CONTRACTOR. B. Except as provided below regarding State payment delays, payments shall be made by COUNTY to CONTRACTOR in arrears, for services provided during the preceding month, within forty-five (45) days after the date of receipt, verification, and approval of CONTRACTOR’s monthly itemized invoices and required reports further described in Section Twenty-Seven (27), REPORTS of this Agreement, by COUNTY’s DBH. C. If CONTRACTOR should fail to comply with any provision of this Agreement, COUNTY shall be relieved of its obligation for further compensation. All final invoices 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 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 automatically revert to COUNTY. D. The contract maximum amount as identified in this Agreement and in Exhibit C may be reduced based upon State and Federal funding availability. In the event of such action, the COUNTY’s DBH Director or her 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 substance abuse services, COUNTY may delay or defer payment to CONTRACTOR until such a time as the 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. 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, COUNTY 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. 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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. 5.INVOICING CONTRACTOR shall invoice COUNTY in arrears by the twentieth (20th) day of each month for actual expenses incurred and services rendered in the previous month electronically to dbhinvoicereview@fresnocountyca.gov and dbh-invoices@fresnocountyca.gov, with a carbon copy email to the assigned COUNTY’s DBH Staff Analyst. CONTRACTOR shall include all corresponding document submitted and identified by line item, as identified in Exhibit C. Supporting documentation shall include but is not limited to receipts, invoices received, and documented administrative / overhead costs. No reimbursement for services shall be made until invoices, reports and outcomes are received, reviewed and approved by COUNTY’s DBH. Support documents will be made available upon request. 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. CONTRACTOR must maintain such financial records for a period of three (3) years or until 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 any dispute, audit or inspection is resolved, whichever is later. CONTRACTOR will be responsible for any disallowances related to inadequate documentation. 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 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. 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 COUNTY or to this Agreement. 7.SUBCONTRACTS CONTRACTOR shall be required to assume full responsibility for all services and activities covered by this Agreement, whether or not CONTRACTOR is providing services directly. Further, CONTRACTOR shall be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from this Agreement. CONTRACTOR shall obtain written approval from COUNTY’s DBH Director, or designee, 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 before subcontracting any of the services delivered under this Agreement, unless previously budgeted at time of award. COUNTY’s DBH Director, or designee, retains the right to approve or reject any request for subcontracting services. Any transferee, assignee, or subcontractor will be subject to all applicable provisions of this Agreement, and all applicable State and Federal regulations. CONTRACTOR shall be held primarily responsible by COUNTY for the performance of any transferee, assignee, or subcontractor unless otherwise expressly agreed to in writing by COUNTY’s DBH Director, or designee. The use of subcontractors by CONTRACTOR shall not entitle CONTRACTOR to any additional compensation that is provided for under this Agreement. 8.MODIFICATION 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. Changes to expense category (i.e., Salary & Benefits, Client Support, Facilities/Equipment, Operating Expenses, Administrative Expenses, Special Expenses, Fixed Assets, etc.) subtotals in the budgets, and changes to the volume of units of services/types of service units to be provided as set forth in Exhibit C, that do not exceed 10% of the maximum compensation payable to the CONTRACTOR may be made with the written approval of COUNTY’s DBH Director, or designee. Said modifications shall not result in any change to the annual maximum compensation amount payable to CONTRACTOR, as stated in this Agreement. 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 her designee may modify the maximum compensation depending on State and Federal funding availability, as stated in Section Four (4), COMPENSATION in this Agreement. CONTRACTOR further understands 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. 9.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. /// 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 10.HOLD HARMLESS CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY’s request, defend 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 attorney 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 perform, of CONTRACTOR, their officers, agents or employees of covenants and duties under this Agreement. CONTRACTOR agrees to indemnify COUNTY for Federal and/or State of California audit exceptions resulting from noncompliance herein on the part of the CONTRACTOR. 11.INSURANCE Without limiting 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 or a program of self-insurance, including but not limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA) throughout the term of this Agreement: A.Commercial General Liability Commercial General Liability Insurance with limits of not less than Two Million Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including completed operations, product liability, contractual liability, Explosion-Collapse-Underground, fire legal liability or any other liability insurance deemed necessary because of the nature of this contract. B.Automobile Liability Comprehensive Automobile Liability Insurance with limits no less than One Million Dollars ($1,000,000) per accident for bodily injury and property damage. Coverage should include any automobile 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., etc.) in providing services, Professional Liability Insurance with limits of 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 not less than One Million Dollars ($1,000,000) per occurrence, Three Million Dollars ($3,000,000) annual aggregate. 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. E.Molestation CONTRACTOR shall have either separate policy or an umbrella policy with endorsements covering sexual abuse/molestation coverage or have a specific endorsement on their General Commercial liability policy covering sexual abuse/molestation. The policy limits for this policy shall be One Million Dollars ($1,000,000) per occurrence with a Two Million Dollars ($2,000,000) annual aggregate. The policy shall be on a per occurrence basis. F.Cyber Liability Cyber Liability Insurance, with limits not less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to duties and obligations undertaken by CONTRACTOR(S) in this agreement and shall include, but not be limited to, claims involving infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion and network security. The policy shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit monitoring expenses with limits sufficient to respond to these obligations. 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. CONTRACTOR hereby waives its right to recover from COUNTY, its officers, agents, and employees any amounts paid by the policy of worker’s compensation insurance required by this 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Agreement. CONTRACTOR is solely responsible to obtain any endorsement to such policy that may be necessary to accomplish such waiver of subrogation, but CONTRACTOR’s waiver of subrogation under this paragraph is effective whether or not CONTRACTOR obtains such an endorsement. Within thirty (30) days from the date each CONTRACTOR signs this Agreement, said CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 1925 E. Dakota Ave, Fresno, California, 93726, Attention: Public Behavioral Health Division, stating that such insurance coverages 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 for such worker’s compensation insurance the CONTRACTOR has waived its right to recover from the COUNTY, its officers, agents, and employees any amounts paid under the insurance policy and that waiver does not invalidate the insurance policy; 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 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, 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 from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better. 12.HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT COUNTY and CONTRACTOR each consider and represent themselves as covered entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104-191(HIPAA) and agree to use and disclose protected health information as required by law. 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 COUNTY and CONTRACTOR acknowledge that the exchange of protected health information between them is only for treatment, payment, and health care operations. COUNTY and CONTRACTOR intend to protect the privacy and provide for the security of Protected Health Information (PHI) pursuant to the Agreement in compliance with HIPAA, the Health Information Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH), and regulations promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA Regulations) and other applicable laws. As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require CONTRACTOR to enter into a contract containing specific requirements prior to the disclosure of PHI, as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) of the Code of Federal Regulations (CFR). 13.DATA SECURITY For the purpose of preventing the potential loss, misappropriation or inadvertent access, viewing, use or disclosure of COUNTY data including sensitive or personal client information; 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 information provided to CONTRACTOR by the COUNTY, including but not limited to the following: A.CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices CONTRACTOR may not connect to COUNTY networks via personally-owned mobile, wireless or handheld devices, unless the following conditions are met: 1)CONTRACTOR has received authorization by COUNTY for telecommuting purposes; 2)Current virus protection software is in place; 3)Mobile device has the remote wipe feature enabled; and 4)A secure connection is used. B.CONTRACTOR-Owned Computers or Computer Peripherals CONTRACTOR may not bring CONTRACTOR-owned computers or computer 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 peripherals into the COUNTY for use without prior authorization from the COUNTY’s Chief Information Officer, and/or his or her designee(s), including but not limited to mobile storage devices. If data is approved to be transferred, data must be stored on a secure server approved by the COUNTY and transferred by means of a Virtual Private Network (VPN) connection, or another type of secure connection. Said data must be encrypted. C. COUNTY-Owned Computer Equipment CONTRACTOR may not use COUNTY computers or computer peripherals on non- COUNTY premises without prior authorization from the COUNTY’s Chief Information Officer, and/or his or her designee(s). D.CONTRACTOR may not store COUNTY’s private, confidential or sensitive data on any hard-disk drive, portable storage device, or remote storage installation unless encrypted. E.CONTRACTOR shall be responsible to employ strict controls to ensure the integrity and security of COUNTY’s confidential information and to prevent unauthorized access, viewing, use or disclosure of 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 violations, 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.COUNTY shall provide oversight to CONTRACTOR’s response to all incidents arising from a possible breach of security related to COUNTY’s confidential client information provided to CONTRACTOR. 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 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 14.NON-DISCRIMINATION During the performance of this Agreement, CONTRACTOR and its subcontractors shall not deny the contract’s benefits to any person on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran status, nor shall they discriminate unlawfully against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military or veteran status. CONTRACTOR shall insure that the evaluation and treatment of employees and applicants for employment are free of such discrimination. CONTRACTOR and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code §12800 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit. 2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government Code (Gov. Code §11135-11139.5), and the regulations or standards adopted by the awarding state agency to implement such article. CONTRACTOR shall permit access by representatives of the Department of Fair Employment and Housing and the awarding state agency upon reasonable notice at any time during the normal business hours, but in no case less than twenty-four (24) hours notice, to such of its books, records, accounts, and all other sources of information and its facilities as said Department or Agency shall require to ascertain compliance with this clause. CONTRACTOR and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. (See Cal. Code Regs., tit. 2, §11105) CONTRACTOR shall include the Non-Discrimination and compliance provisions of this clause in all subcontracts to perform work under this Agreement. 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 solely 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. 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 16.COMPLIANCE WITH LAWS AND POLICIES CONTRACTOR shall comply with all applicable laws, ordinances and regulations in the performance of its obligations under this Agreement and guidelines applicable to CONTRACTORS’ 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 systems as provided in State of California regulations and in this Agreement. C.CONTRACTOR shall comply with Substance Abuse Prevention and Treatment (SAPT) – Prevention Specific Requirements identified on Exhibit D, attached hereto and incorporated herein by reference. D.In the event any law, regulation, or policy 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. Exhibits will be updated as needed and no formal amendment of this contract is required for new rules to apply. 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. In addition, no employee of COUNTY shall be employed by CONTRACTOR to fulfill any contractual obligations with COUNTY. CONTRACTOR shall also 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.DISCLOSURE OF SELF-DEALING TRANSACTIONS This provision is only applicable if the CONTRACTOR is operating as a corporation (a for- profit or non-profit corporation) or if during the term of this Agreement, the CONTRACTOR changes its status to operate as a corporation. 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Members of the CONTRACTOR’s Board of Directors shall disclose any self-dealing transactions that they are a party to while CONTRACTOR is providing goods or performing services under this Agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTOR is a party and in which one or more of its directors has a material financial interest. Members of the Board of Directors shall disclose any self-dealing transactions that they are a party to by completing and signing a “Self-Dealing Transaction Disclosure Form”, attached hereto as Exhibit E and incorporated herein by reference and made part of this Agreement, and submitting it to the COUNTY prior to commencing with the self-dealing transaction or immediately thereafter. 19.TAX EQUITY AND FISCAL RESPONSIBILITY ACT To the extent necessary to prevent disallowance of reimbursement under Section 1861(v) (1) (I) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[I]), until the expiration of four (4) years after the furnishing of services under this Agreement, CONTRACTOR shall make available, upon written request of the Secretary of the United States Department of Health and Human Services, or upon request of the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of this Agreement and such books, documents, and records as are necessary to certify the nature and extent of the costs of these services provided by CONTRACTOR under this Agreement. CONTRACTOR further agrees that in the event CONTRACTOR carries out any of its duties under this Agreement through a subcontract, with a value or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over a twelve (12) month period, with a related organization, such Agreement shall contain a clause to the effect that until the expiration of four (4) years after the furnishing of such services pursuant to such subcontract, the related organizations shall make available, upon written request of the Secretary of the United States Department of Health and Human Services, or upon request of the Comptroller General of the United States General Accounting Office, or any of their duly authorized representatives, a copy of such subcontract and such books, documents, and records of such organization as are necessary to verify the nature and extent of such costs. 20.SINGLE AUDIT CLAUSE A.If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars and No/100 Dollars ($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 conduct an annual audit in accordance with the requirements of the Single Audit Standards as set forth in Office of Management and Budget (OMB) 2 CFR 200. CONTRACTOR shall submit said audit and management letter to COUNTY. The audit must include a statement of findings or a statement that there were no findings. If there were negative findings, CONTRACTOR must include a corrective action plan signed by an authorized individual. CONTRACTOR agrees to take action to correct any material non- compliance or weakness found as a result of such audit. Such audit shall be delivered to COUNTY’s DBH Business Office for review within nine (9) months of the end of any fiscal year in which funds were expended and/or received for the program. Failure to perform the requisite audit functions as required by this Agreement may result in COUNTY performing the necessary audit tasks, or at COUNTY’s option, contracting with a public accountant to perform said audit, or, may result in the inability of COUNTY to enter into future agreements with CONTRACTOR. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR. B.A single audit report is not applicable if CONTRACTOR’s Federal contracts do not exceed the Seven Hundred Fifty Thousand and No/100 Dollars ($750,000.00) requirement or CONTRACTOR’s only funding is through Drug-related Medi-Cal. If a single audit is not applicable, a program audit must be performed and a program audit report with management letter shall be submitted by CONTRACTOR to COUNTY as a minimum requirement to attest to CONTRACTOR’s solvency. Said audit report shall be delivered to COUNTY’s DBH Business Office for review, no later than nine (9) months after the close of the fiscal year in which the funds supplied through this Agreement are expended. Failure to comply with this Act may result in COUNTY performing the necessary audit tasks or contracting with a qualified accountant to perform said audit. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR who agrees to take corrective action to eliminate any material noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under this Section shall be billed to the CONTRACTOR at COUNTY’s cost, as determined by COUNTY’s Auditor-Controller/Treasurer-Tax Collector. C.CONTRACTOR shall make available all records and accounts for inspection by COUNTY, the State of California, if applicable, the Comptroller General of the United States, the Federal Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a period of at 17 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 least three (3) years following final payment under this Agreement or the closure of all other pending matters, whichever is later. 21.REFERENCES TO LAWS AND RULES In the event any law, regulation, or policy 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.CHILD ABUSE REPORTING CONTRACTOR shall utilize a procedure acceptable to COUNTY to ensure that all of CONTRACTORS’ 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 CONTRACTORS’ 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 F, attached hereto and by this reference incorporated herein. 23.EVALUATION AND MONITORING COUNTY’s DBH Director or her designee shall monitor and evaluate the performance 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 for time periods as determined by COUNTY. CONTRACTOR shall participate in a program review at least yearly, or as needed, at the discretion of COUNTY. The CONTRACTOR agrees to supply all information requested by the COUNTY, County-subcontracted evaluator, State and/or Federal agency during program evaluation, monitoring, and/or review. COUNTY shall recapture from CONTRACTOR the value of any services or other expenditures determined to be ineligible based on the COUNTY or State monitoring results. At the discretion of the COUNTY recoupment can be made through a future invoice reduction or reimbursement 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 by the CONTRACTOR. 24.CULTURAL COMPETENCY As related to Cultural and Linguistic Competence, CONTRACTOR shall comply with: A.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, sex, 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.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. The CONTRACTOR’s procedures must include ensuring compliance of any sub-contracted providers with these requirements. C.CONTRACTOR shall not use minors as interpreters. D.CONTRACTOR shall provide and pay for 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 shall 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. E.CONTRACTORS shall submit to COUNTY for approval, within ninety (90) days from date of contract execution, CONTRACTORS’s plan to address all fifteen (15) National Standards for 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Culturally and Linguistically Appropriate Service (CLAS), as published by the Office of Minority Health and as set forth in Exhibit G, “National Standards on Culturally and Linguistically Appropriate Services”, attached hereto and incorporated herein by reference and made part of this Agreement. As the CLAS standards are updated, CONTRACTORS’s plan must be updated accordingly. COUNTY’s annual on-site review of CONTRACTOR shall include collection of documentation to ensure all national standards are implemented. As requested by COUNTY, CONTRACTORS shall be responsible for conducting an annual CLAS self-assessment and providing the results of the self-assessment to the COUNTY. The annual CLAS self-assessment instruments shall be reviewed by the COUNTY and revised as necessary to meet the approval of the COUNTY. 25.RECORDS A.Record Establishment and Maintenance - CONTRACTOR shall establish and maintain records in accordance with 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 of this Agreement, or until State and/or Federal audit findings applicable to such services are resolved, whichever is later. B.Reports – If required, CONTRACTOR shall submit to COUNTY monthly fiscal and all program reports as further described in Section Twenty-Seven (27), REPORTS and as indicated in Exhibit A. CONTRACTOR shall also furnish 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. C.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. D.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 CONTRACTORS’ invoices by COUNTY. If payment for services is denied or disallowed by State; and subsequently resubmitted to COUNTY by CONTRACTOR, the disallowed portion will be withheld from 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 the next reimbursement to the CONTRACTOR until COUNTY has received reimbursement from State for said services. E.Client Confidentiality – CONTRACTOR shall conform 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 14100.2, Health and Safety Code §§ 11977 and 11812, Civil Code, Division 1, Part 2.6, and 22 California Code of Regulations § 51009. 26.DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST INFORMATION This provision is only applicable if CONTRACTOR is a disclosing entity, fiscal agent, or managed care entity as defined in Code of Federal Regulations (C.F.R), Title 42 § 455.101 455.104, and 455.106(a)(1),(2). In accordance with C.F.R., Title 42 §§ 455.101, 455.104, 455.105 and 455.106(a)(1),(2), the following information must be disclosed by CONTRACTOR by completing Exhibit H, “Disclosure of Ownership and Control Interest Statement”, attached hereto and by this reference incorporated herein and made part of this Agreement. CONTRACTOR shall submit this form to COUNTY’s DBH within thirty (30) days of the effective date of this Agreement. Additionally, CONTRACTOR shall report any changes to this information within thirty-five (35) days of occurrence by completing Exhibit H. CONTRACTOR is required to submit a set of fingerprints for any person with a five (5) percent or greater direct or indirect ownership interest in CONTRACTOR. COUNTY may terminate this Agreement where any person with a five (5) percent or greater direct or indirect ownership interest in the CONTRACTOR did not submit timely and accurate information and cooperate with any screening method required in CFR, Title 42, Section 455.416. Submissions shall be scanned portable document format (pdf) copies and are to be sent via email to DBHAdministration@fresnocountyca.gov, Attention: Contracts Administration. COUNTY may deny enrollment or terminate this Agreement where any person with a five (5) percent or greater direct or indirect ownership interest in CONTRACTOR has been convicted of a criminal offense related to that person’s involvement with the Medicare, Medicaid, or Title XXI program in the last ten (10) years. 27.REPORTS CONTRACTOR shall submit to COUNTY such statements, records, reports, data, and 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 other information as the COUNTY may request pertaining to matters covered by this Agreement. In the event that CONTRACTOR fails to provide such reports or other information required hereunder, it 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. 28.PROPERTY OF COUNTY A.All purchases over Five Thousand and No/100 Dollars ($5,000.00) shall be identified as fixed assets and shall be maintained in COUNTY’s Asset Management System. Certain purchases under Five Thousand and No/100 Dollars ($5,000.00) including but not limited to computers, copiers, televisions, 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 assets that can be inventoried and maintained in COUNTY’s DBH Asset Inventory System. These assets shall be retained by COUNTY, as COUNTY property, in the event this Agreement is terminated or upon expiration of this Agreement. CONTRACTOR agrees to participate in an annual inventory of all COUNTY fixed and inventoried assets and shall by physically present when fixed and inventoried 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 and inventoried assets, or the monetary value of said assets if unable to produce the assets at the expiration or termination of this Agreement. CONTRACTOR further agrees to the following: 1)To maintain all items of equipment in good working order and condition, normal wear and tear is expected; 2)To label all items of equipment, to perform periodic inventories as required by COUNTY and to maintain an inventory list showing where and how the equipment is being used, in accordance with procedures developed by COUNTY. All such lists shall be submitted to COUNTY within ten (10) days of any request therefore; and 3)To report in writing to COUNTY immediately after discovery, the lost or theft of any items of equipment. For stolen items, the local law enforcement agency must be contacted 22 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 and a copy of the police report submitted to COUNTY. B.The purchase of any equipment by CONTRACTOR with funds provided hereunder shall require the prior written approval of COUNTY’s DBH, shall fulfill the provisions of this Agreement as appropriate, and must be directly related to CONTRACTOR’s services or activity under the terms of this Agreement. COUNTY’s DBH may refuse reimbursement for any costs resulting from equipment purchased, which are incurred by CONTRACTOR, if prior written approval has not been obtained from COUNTY. C.The terms and conditions described in this Section are not applicable to the leasing of vehicles by CONTRACTOR with the funds provided under this Agreement. 29.PUBLIC PROHIBITION 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 tickets/tables, 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 shall be allowed as necessary to raise public awareness about the availability of such specific services when approved in advance by COUNTY’s DBH Director, or his or her designee, and at a cost to be provided in Exhibit C for such items as written/printed materials, the use of media (i.e., radio, television, newspapers) and any other related expense(s). 30.ASSURANCES In entering into this Agreement, CONTRACTOR certifies that it is not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs: that it has not been convicted of a criminal offense related to the provision of health care items or services; nor has it been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. If COUNTY learns, subsequent to entering into a contract, that CONTRACTOR is ineligible on these grounds, COUNTY will remove CONTRACTOR from responsibility for, or involvement with, COUNTY’s business operations related to the Federal Health Care Programs and shall remove such CONTRACTOR from any position in which CONTRACTOR’s compensation, or the items or services rendered, ordered or prescribed by CONTRACTOR may be paid in whole or part, 23 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 directly or indirectly, by Federal Health Care Programs or otherwise with Federal Funds at least until such time as CONTRACTOR is reinstated into participation in the Federal Health Care Programs. A.If COUNTY has notice that CONTRACTOR has been charged with a criminal offense related to any Federal Health Care Program, or is proposed for exclusion during the term of any contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the accuracy of any claims submitted to any Federal Health Care Program. At its discretion given such circumstances, COUNTY may request that CONTRACTOR cease providing services until resolution of the charges or the proposed exclusion. B.CONTRACTOR agrees that all potential new employees of CONTRACTOR or subcontractors of CONTRACTOR who, in each case, are expected to perform professional services under this Agreement, will be queried as to whether: (1) they are now or ever have been excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) they have been convicted of a criminal offense related to the provision of health care items or services; and or (3) they have been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. 1)In the event the potential employee or subcontractor informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR hires or engages such potential employee or subcontractor, CONTRACTOR will ensure that said employee or subcontractor does no work, either directly or indirectly relating to services provided to COUNTY. 2)Notwithstanding the above, COUNTY at its discretion may terminate this Agreement in accordance with Section Two (2) of this Agreement, or require adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a timeframe to be determined by COUNTY to protect the interests of COUNTY consumers. C.CONTRACTOR shall verify (by asking the applicable employees and subcontractors) that all current employees and existing subcontractors who, in each case, are expected 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 to perform professional services under this Agreement (1) are not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) have not been convicted of a criminal offense related to the provision of health care items or services; and (3) have not been reinstated to participation in the Federal Health Care Program after a period of exclusion, suspension, debarment, or ineligibility. In the event any existing employee or subcontractor informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or has been convicted of a criminal offense relating to the provision of health care services, CONTRACTOR will ensure that said employee or subcontractor does no work, either direct or indirect, relating to services provided to COUNTY. 1)CONTRACTOR agrees to notify COUNTY immediately during the term of this Agreement whenever CONTRACTOR learns that an employee or subcontractor who, in each case, is providing professional services under this Agreement is excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or is convicted of a criminal offense relating to the provision of health care services. 2)Notwithstanding the above, COUNTY at its discretion may terminate this Agreement in accordance with Section Three (3) of this Agreement, or require adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a timeframe to be determined by COUNTY to protect the interests of COUNTY clients. D.CONTRACTOR agrees to cooperate fully with any reasonable requests for information from COUNTY, which may be necessary to complete any internal or external audits relating to CONTRACTOR’s compliance with the provisions of this Section. E.CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’s violation of CONTRACTOR’s obligations as described in this Section. 31.DISCLOSURE – CRIMINAL HISTORY AND CIVIL ACTIONS CONTRACTOR is required to disclose if any of the following conditions apply to them, their 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 owners, officers, corporate managers and partners (hereinafter collectively referred to as “CONTRACTOR”): A.Within the three (3) year period preceding the Agreement award, they have been convicted of, or had a civil judgment rendered against them for: 1)Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; 2)Violation of a federal or state antitrust statute; 3)Embezzlement, theft, forgery, bribery, falsification, or destruction of records; or 4)False statements or receipt of stolen property. B.Within a three (3) year period preceding their Agreement award, they have had a public transaction (federal, state, or local) terminated for cause or default. Disclosure of the above information will not automatically eliminate CONTRACTOR from further business consideration. The information will be considered as part of the determination of whether to continue and/or renew the Agreement and any additional information or explanation that a CONTRACTOR elects to submit with the disclosed information will be considered. If it is later determined that the CONTRACTOR failed to disclose required information, any contract awarded to such CONTRACTOR may be immediately voided and terminated for material failure to comply with the terms and conditions of the award. CONTRACTOR must sign a “Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions” in the form set forth in Exhibit I attached hereto and by this reference incorporated herein and made part of this Agreement. Additionally, CONTRACTOR must immediately advise the COUNTY in writing if, during the term of this Agreement: (1) CONTRACTOR becomes suspended, debarred, excluded or ineligible for participation in federal or state funded programs or from receiving Federal funds as listed in the excluded parties’ list system (http://www.epls.gov); or (2) any of the above listed conditions become applicable to CONTRACTOR. CONTRACTOR shall indemnify, defend and hold the COUNTY harmless for any loss or damage resulting from a conviction, 26 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 debarment, exclusion, ineligibility or other matter listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility Matters. 32.AUDITS AND INSPECTIONS CONTRACTOR shall at any time during business hours, and as often as COUNTY may deem necessary, make available to COUNTY for examination all of its records and data with respect to the matters covered by this Agreement. CONTRACTOR shall, upon request by COUNTY, permit 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 No/100 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 Section Three (3), TERMINATION 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 having authority to give and receive notices under this Agreement and their addresses include the following: COUNTY CONTRACTOR Director, County of Fresno LPC Consulting Associates, Inc. Department of Behavioral Health 1451 River Park Drive, Suite 100 1925 E. Dakota Ave Sacramento, CA 95815 Fresno, CA 93726 All notices between the COUNTY and CONTRACTOR provided for or permitted under this Agreement must be in writing and delivered either by personal service, by first-class United States mail, 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 by an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by personal service is effective upon service to the recipient. A notice delivered by first-class United States mail is effective three (3) COUNTY business days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one (1) COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the next beginning of a COUNTY business day), provided that the sender maintains a machine record of the completed transmission. For all claims arising out of or related to this Agreement, nothing in this Section establishes, waives, or modifies any claims presentation requirements or procedures provided by law, including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with Section 810). 34.CHANGE OF LEADERSHIP / 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 personally 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 CONTRACTORS’ 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 CONTRACTORS’ finances. 35.CONFIDENTIALITY OATH CONTRACTOR shall ensure that all of its employees sign a written confidentiality oath, attached hereto as Exhibit J, before the begin employment with CONTRACTOR and shall renew said documents annually thereafter. CONTRACTOR shall retain each employee’s written confidentiality oath 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 for COUNTY and DHCS inspection for a period of six (6) years following the termination of this agreement. 36.GOVERNING LAW Venue for any action arising out of or related to the Agreement shall only be in Fresno County, California. The rights and obligations of the parties and all interpretation and performance of this Agreement shall be governed in all respects by the laws of the State of California. 37.SEVERABILITY If any non-material term, provision, covenant, or condition of this Agreement is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions shall remain in full force and effect, and shall in no way be affected, impaired or invalidated. 38.ELECTRONIC SIGNATURE The parties agree that this Agreement may be executed by electronic signature as provided in this section. An “electronic signature” means any symbol or process intended by an individual signing this Agreement to represent their signature, including but not limited to (1) a digital signature; (2) a faxed version of an original handwritten signature; or (3) an electronically scanned and transmitted (for example by PDF document) of a handwritten signature. Each electronic signature affixed or attached to this Agreement (1) is deemed equivalent to a valid original handwritten signature of the person signing this Agreement for all purposes, including but not limited to evidentiary proof in any administrative or judicial proceeding, and (2) has the same force and effect as the valid original handwritten signature of that person. The provisions of this section satisfy the requirements of Civil Code section 1633.5, subdivision (b), in the Uniform Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). Each party using a digital signature represents that it has undertaken and satisfied the requirements of Government Code section 16.5, subdivision (a), paragraphs (1) through (5), and agrees that each other party may rely upon that representation. This Agreement is not conditioned upon the parties conducting the transactions under it by electronic means and either party may sign this Agreement with an original handwritten signature. /// 29 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 39.ENTIRE AGREEMENT This Agreement, including all Exhibits, constitute the entire Agreement between the CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous negotiations, proposals, commitments, writings, advertisements, publications, and understandings of any nature whatsoever unless expressly included in this Agreement. /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year 2 first hereinabove written. 3 4 LPC CONSUL Tl G ASSOCIATES, INC. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ~- (Au horized Signature) Brian Pacheco , Chairman of the Board of ~ Supervisors of the County of Fresno ,{\(J (ook. ~ CJ-i;e £:0ec,u:iNC~ Print Name & Title '/ lJ?c., ~s~rs A.:ssoC&fil1 f ~c: . I 4S\ ~v-c.{ P0:k..) r S-k,f (JD s~ Mailing Address CA-~S" ATTEST: Print FOR ACCOUNTING USE ONLY: Fund: Subclass : ORG : Account: 0001 10000 56302081 7295/0 30 Bernice E. Seidel Clerk of the Board of Supervisors County of Fresno , State of California Exhibit A - Page 1 of 19 1 SUMMARY OF SERVICES ORGANIZATION: CONTRACTOR Consulting Associates, Inc. SERVICE: Evaluation of Substance Use Disorder Prevention Services and Substance Use Disorder Strategic Prevention Plan Development OFFICE ADDRESS: 1451 River Park Drive, Suite 100, Sacramento, CA 95815 OFFICE TELEPHONE: (916) 448-8026 CONTACT(S): Michele Darling, CEO & Research Director Allison Burke, Senior Associate Tracey Weld, Senior Associate AGREEMENT PERIOD: Effective upon execution to June 30, 2025, with one additional twelve month period and one six month renewal period AMOUNT: $ 40,000 Effective upon execution – June 30, 2022 $ 85,000 July 1, 2022 – June 30, 2023 $ 90,000 July 1, 2023 – June 30, 2024 $ 115,000 July 1, 2024 – June 30, 2025 $ 160,000 July 1, 2025 – June 30, 2026 $ 50,000 July 1, 2026 – December 31, 2026 CONTRACT MAXIMUM: $540,000 I.SUMMARY OF SERVICES CONTRACTOR will provide evaluation and support services to Fresno County Department of Behavioral Health Substance Use Disorder (DBH SUD) Services. CONTRACTOR’s primary role will be to evaluate the countywide SUD Prevention Program. CONTRACTOR will also support DBH SUD Services staff in developing elements of the 2026-2031 SUD Strategic Prevention Plan. II.CONTRACTOR’s RESPONSIBILITIES CONTRACTOR shall provide evaluation and support services as indicated below. A.SUD Prevention Program Evaluation Plan The evaluation of Fresno County’s Substance Use Disorder (SUD) Prevention Program will include both process and outcome components that address each prevention activity and the comprehensive countywide program. The evaluation will be guided by the objectives stated in the 2021-26 Fresno County Strategic Prevention Plan (SPP), and incorporate the collection of quantitative and qualitative data to describe program implementation and measure impact. The process evaluation will seek to document and describe the range of Exhibit A - Page 2 of 19 2 prevention services delivered, while the outcome evaluation will measure changes in participant SUD knowledge, attitudes, and behaviors using activity-specific surveys as well as an annual survey that collects data from students in schools receiving recurring prevention programming. CONTRACTOR will use an evaluation approach that collects meaningful, shared, and useful data to advance program implementation and inform decision making and accountability. i.Evaluation Research Questions The evaluation will center on the activities described in the prevention provider’s scope of work, and measure the outcomes and objectives listed in the 2021-26 SPP logic models. Table 1 below displays the overarching research questions that will guide the development and implementation of the evaluation. These broad questions will facilitate the framing of evaluation data collection and analysis, and help define data sources. Table 1. Evaluation Research Questions Research Questions Process Outcome What prevention activities are implemented across the County, where are they implemented, and how many people do they reach? X Who are the participants/recipients of the prevention activities? X What are the successes, challenges, and lessons learned associated with implementing prevention services? X How does SUD knowledge, attitudes, beliefs, and behaviors change among youth in schools with prevention services? X To what extent does the prevention activities achieve the objectives listed in Fresno County’s SPP? X ii.Data Collection Methods & Data Sources CONTRACTOR will work closely with the County and prevention provider to discuss the nuances of the prevention program scope of work in order to refine the evaluation activities and develop an infrastructure for data collection. At minimum, the evaluation will include the following data collection components: a.Fresno County Student Insights Survey To measure intermediate and long-term program outcomes, the prevention provider will administer the Fresno County Student Insights Survey (Insights Survey) to students in the schools they serve. The tool, created by CONTRACTOR in collaboration with the prevention providers during the previous SUD prevention funding cycle (2015-2021), serves as a means to collect SUD-related attitude, knowledge, and behavior data in Fresno County where many large school districts no longer administer the California Healthy Kids Survey (CHKS). However, if school districts resume participation in the CHKS, the evaluation will utilize this data in place of the Insights Survey. To update the Insights Survey questionnaire for the current SPP, Exhibit A - Page 3 of 19 3 CONTRACTOR will work with the prevention provider and DBH SUD Services staff to include new survey questions and/or modify questions to align with the data needed to measure the outcomes in the 2021-2026 SPP. The survey will be made available online and on paper, and pilot-tested with a sample of youth before administration to ensure questions are appropriate and comprehensible for a diverse youth population. The survey will be translated into Spanish and any other language deemed necessary to reach youth in Fresno County. Annually, the prevention provider will administer the Insights Survey to students in the schools they serve, with baseline data collected in FY 2021/22 and yearly comparison data collected through the final fiscal year (FY 2025/26). The same school sites will be surveyed each year to monitor changes in youth attitudes and behavior related to prevention efforts over time. b.Participant Surveys. The evaluation will also include a number of activity-specific survey tools to measure the immediate impact of prevention programming on the knowledge and attitudes of youth and parent participants. CONTRACTOR will work with the prevention provider staff to develop or update the following survey tools for in-person and/or online administration. •Youth Development Survey: administered annually to youth participating in recurring prevention activities, such as FNL/CL/FNL Kids, to measure changes in knowledge and skills related to advocacy and healthy decision making. •Prevention Plus Wellness (PPW) Program Pre- and Post-Surveys: administered to youth completing SUD prevention curricula, such as SPORT and InShape, to measure changes in alcohol and drug knowledge and attitudes resulting from the program. •Mentoring Program Survey: administered to youth mentoring program participants at the conclusion of the program to measure outcomes related to life skills, positive coping, and decision making skills. •Parent Presentation Survey: administered to parents participating in educational presentations to measure changes in SUD knowledge, assess overall satisfaction with content, and obtain feedback to improve the services. •Adult Ally Survey: administered to members of the Adult Ally Advisory Council, the Youth Development Coalition, and FNL/CL/FNL Kids Chapter Advisors at the end of each fiscal year to measure knowledge acquired and level of relationship building with youth. c.Tracking Tools. As part of the process evaluation, the prevention provider will use tracking tools to document all prevention activities and services. The following tracking Exhibit A - Page 4 of 19 4 tools will be developed or updated by CONTRACTOR in collaboration with prevention provider staff: • Activity Tracking Log: will track the number, type, and location of activities, such as advisory/coalition meetings, educational presentations, and outreach activities, as well as the number of youth and parents/adult participants and number of materials distributed. Data collection and data entry will occur regularly, as the Log is completed by prevention provider staff via an online Google tracking system. Process data from the Activity Tracking Logs will be entered into PPSDS by the prevention provider on a quarterly basis. • Drop Box Tracking Log: will track the pounds of prescription drugs collected by each drop box site. Quarterly, the prevention provider will obtain data from the law enforcement agencies maintaining drop boxes in Fresno County and enter the data into the tracking log. d. Observations To collect qualitative information about prevention services, CONTRACTOR staff will attend and observe select virtual activities (such as coalition meetings, town halls, or youth events) each year. This will help CONTRACTOR staff provide an accurate description of prevention services in evaluation reports, and allow CONTRACTOR to build and maintain relationships with the prevention provider and DBH SUD Services staff throughout the five-year project. e. Document Review CONTRACTOR will obtain materials and/or photos from the prevention provider to complete a document review of select prevention activities such as social norms campaigns, media campaigns, and advisory council and coalition meetings. These materials will contribute to an understanding of the activities implemented so as to measure short-term process outcomes, and will provide examples of campaign messaging for inclusion in the annual evaluation reports. f. Staff Focus Groups CONTRACTOR will conduct biannual focus groups with prevention provider’s staff. A mid-year focus group will document implementation successes and challenges to date, and troubleshoot any data collection challenges. A second focus group will be conducted at the conclusion of each fiscal year, for CONTRACTOR to gain a deeper understanding of project activities and to gather final reflections including lessons learned and next steps. The focus group protocol will elicit input related to: (1) observations about emerging alcohol and drug use trends or behaviors, (2) identification of implementation successes, challenges, and needs, (3) how youth and young adults are responding to prevention services, and (4) lessons learned about implementing prevention programs. This qualitative data will enrich the evaluation with descriptive details that the survey data cannot capture. Focus group responses will offer context for the evaluation findings and provide the basis for telling the story of prevention efforts. Exhibit A - Page 5 of 19 5 III.Data Analysis Prevention provider staff will enter implementation data into an internal Google tracking system and the Primary Prevention SUD Data Service (PPSDS) database managed by the California Department of Health Care Services. At the end of each fiscal quarter, CONTRACTOR will review the data in the Google tracking system and DBH SUD Services staff will run PPSDS data reports and submit the reports to CONTRACTOR for analysis and inclusion in a quarterly data dashboard. The dashboards will provide a status report of the prevention provider’s quarterly progress on implementation objectives. This process will help DBH SUD Services, prevention provider, and CONTRACTOR monitor progress throughout the project term, and will provide an added level of data quality control. Outcome data analysis will occur annually, and focus on the goals and objectives listed in the SPP logic models. Insights Survey data from the first year (FY 2021/22) will be used as the baseline for measuring change over the five-year project term. Analysis will include frequency distributions and rates of change for each question in the Insights Survey and participant surveys, including demographic questions. An annual comparison of Insights Survey data will track youth attitudes and behaviors over time in order to determine if and when program outcomes are achieved. Final analysis performed at the end of the grant term (FY 2025/26) will incorporate more advanced statistical analysis methods. IV.Reporting CONTRACTOR will present evaluation results in quarterly data dashboards and annual written evaluation reports. a.Quarterly Data Dashboard The data dashboards will display prevention provider data from tracking logs and PPSDS to document progress on the implementation objectives by substance (alcohol, marijuana, and prescription drugs), and will be shared with the prevention provider and DBH SUD Services on a quarterly basis. The dashboards will establish an ongoing feedback loop between the prevention provider and CONTRACTOR on the status of activities, promote data reporting accuracy, and alert all parties to data collection or data entry issues in a timely manner. b.Annual Evaluation Report The annual evaluation report will present results from all process and outcome data collected for each fiscal year. CONTRACTOR will describe the evaluation findings in the context of progress toward the goals and objectives outlined in the SPP, and will include information about the prevention provider’s successes, challenges, and lessons learned. CONTRACTOR will submit draft reports to key prevention provider and DBH SUD Services staff for review and feedback before finalizing each evaluation report. Exhibit A - Page 6 of 19 6 V.Roles & Responsibilities Fresno County, prevention provider, and CONTRACTOR will all play an important role in a successful evaluation of the SUD Prevention Program. The primary roles and responsibilities for conducting the evaluation are as follows: a.CONTRACTOR will be responsible for establishing the evaluation approach and overseeing the evaluation, developing data collection tools, conducting observations of program activities, holding focus groups with the prevention provider staff, analyzing evaluation data, developing quarterly data dashboards, writing the annual evaluation report, and providing ad hoc technical assistance to the prevention provider staff. b.Prevention Provider will be responsible for collaborating with CONTRACTOR on data collection tool development, maintaining all tracking logs, administering the Insights Survey and other participant surveys, and working with CONTRACTOR to submit data and coordinate staff focus groups. Prevention provider staff will also be responsible for entering all process data in PPSDS on a quarterly basis. c.DBH Staff will be responsible for translating the updated Insights Survey into Spanish, printing copies of the Insights Survey, and pulling PPSDS data to share with CONTRACTOR each quarter. DBH SUD Services will convene meetings with the prevention provider and CONTRACTOR, as needed, to discuss evaluation and data collection issues and plan for upcoming evaluation tasks. DBH SUD Services will also be responsible for sharing evaluation reports with their stakeholders (see Chapter 6 of the 2021-26 SPP for the evaluation dissemination plan). VI.Timeline In general, evaluation data collection will occur on an ongoing basis. Activity Tracking Logs will be completed by the prevention provider staff daily or weekly, while activity-specific participant surveys will be administered at the conclusion of activities and events or at the end of each project year for participants in recurring activities. Focus groups with prevention provider staff will be conducted every six months, and the Insights Survey will be conducted once each school year. All process data will be entered and analyzed quarterly for inclusion in data dashboards, while outcome data from participant surveys and the Insights Survey showing progress toward the SPP objectives will be analyzed annually and presented in the annual evaluation report. VII.Evaluation Plan Summary by SPP Outcome The tables on the following pages present a summary of the Evaluation Plan by short-term outcomes (Table 2), intermediate outcomes (Table 3), and long-term outcomes (Table 4). For each outcome, the evaluation plan includes the associated performance measures, data collection methods, tools or data sources, responsible parties, and timeframe of completion. This plan will provide a framework for measuring and reporting all program outcomes, and is based on a thorough review and understanding the prevention provider’s scope of work as well as the Planning Chapter and Implementation Chapter contained in the 2021-26 SPP. Exhibit A - Page 7 of 19 7 Table 2. Evaluation Plan for Short-Term Outcomes (A = Alcohol, M = Marijuana, P = Prescription Drugs) Short -Term Outcome Indicator/ Performance Measure Data Collection Tools/ Data Source Responsible Party Timeframe Receive buy-in (in the form of a written agreement) from schools to host youth education programs A M P Completed MOUs Copy of MOUs Prevention Provider 2021/22 Calculate the number of youth reached through marijuana prevention alternative activities between 2015 and 2020 to establish a baseline. M # of youth reached through marijuana prevention activities between 2015 and 2020 2015-2020 Data Dashboards CONTRACTOR 2021/22 Develop a mentoring program framework M Description of program framework Copy of Mentoring Program framework Prevention Provider CONTRACTOR 2021/22 Establish a pilot mentoring program that can serve 8 to 10 youth M # of mentors recruited and trained Prevention provider staff focus group Prevention Provider CONTRACTOR 2022/23 Form a coalition comprised of youth-serving organizations, local government, law enforcement, education, and youth to support the development/ implementation of prevention services (AM) Establish and maintain a countywide coalition composed of 15 different agencies/partners to work on Rx prevention strategies and the procurement of resources to support the Rx box program (P) A M P # of meetings # of participants Sign-in/attendance sheets Meeting minutes Prevention Provider CONTRACTOR Measured quarterly 2021- 2026 Recruit a total of 1,200 youth from schools with high substance use rates per the Insights Survey or CHKS, to participate in education programs that include curriculum about positive coping and decision-making skills (A: 300, M: 600, P: 300) A M P # of youth participating in prevention programming by location Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured quarterly 2021- 2026 Recruit a total of 335 youth to participate in leadership/empowerment building/prosocial activities or mentoring programs (A: 200, M: 65, P: 70) A M P # of youth participating in youth development/advocacy events # of youth participating in Mentoring Program by location Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured quarterly 2021- 2026 Provide a minimum of 144 presentations (48 annually) for parents about positive parental involvement, the A M # of parents participating in Activity Tracking Log Prevention Measured quarterly Exhibit A - Page 8 of 19 8 Short -Term Outcome Indicator/ Performance Measure Data Collection Tools/ Data Source Responsible Party Timeframe harms/risks of alcohol/marijuana/ Rx and legal consequences of providing them to minors (A: 48, M: 48, P: 48) P presentations by location PPSDS Provider CONTRACTOR County staff 2021-2026 Recruit 8 to 10 youth for the mentoring program who are deemed at risk for marijuana use or showing early phase marijuana use M # of youth mentees recruited Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured quarterly 2022- 2026 Provide a minimum of 90 presentation (30 annually) for youth about legal consequences of providing marijuana to minors M # of youth presentations Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured quarterly 2021- 2026 On an annual basis, provide a minimum of 16 presentations for parents/adults about the health impacts of marijuana use M # of parent presentations Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured quarterly 2021- 2026 40 parents/guardians participate in education programs annually M # of parents participating in marijuana education programs Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured quarterly 2021- 2026 Implement a youth-led, countywide social norms education campaign geared toward youth A M Description and reach of countywide social norms campaign Activity Tracking Log Media analytics Campaign photos/materials Prevention provider staff focus group PPSDS Prevention Provider CONTRACTOR County staff Measured annually 2022- 2026 Implement a countywide media campaign to educate youth and adults on the consequences of providing alcohol/marijuana to youth and underage drinking/marijuana use (AM) Implement a countywide education campaign about Rx drop boxes in Fresno County and the consequences of Rx use and providing Rx to others (P) A M P Description and reach of countywide media campaign Activity Tracking Log Media analytics Campaign photos/materials Prevention provider staff focus group PPSDS Prevention Provider CONTRACTOR County staff Measured annually 2022- 2026 Exhibit A - Page 9 of 19 9 Table 3. Evaluation Plan for Intermediate Outcomes (A = Alcohol, M = Marijuana, P = Prescription Drugs) Intermediate Outcome Indicator/ Performance Measures Data Collection Tools/ Data Source Responsible Party Timeframe 70% of youth will increase their knowledge about positive coping and decision-making skills as measured by a posttest with a retrospective pre-test A M P % of youth with increased knowledge and skills PPW Pre/Post Survey Youth Development Survey Mentoring Program Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 The percentage of youth who believe alcohol/marijuana is easy to access will decrease by 1% A M % of youth who believe alcohol/marijuana is easy to access Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 The percentage of youth who disapprove of underage drinking will increase by 2% A % of youth who disapprove of underage drinking Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 50% of youth will report an increased negative attitude toward marijuana use as measured by a mentoring program survey M % of youth with increased negative attitude toward marijuana Mentoring Program Survey Prevention Provider CONTRACTOR Measured annually 2021-2024 The number of youth who participate in alternative activities will increase by 5% M # of youth participating in alternative activities by location Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured annually 2021-2024 The percentage of youth who have knowledge of the health impacts of marijuana use will increase by 2% M % of youth who have knowledge of health impacts of marijuana Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 70% parents/guardians will increase their knowledge about providing a positive parental environment and the harmful consequences of youth marijuana M % of parents who increase their knowledge about parenting and marijuana Parent Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 The percentage of youth misusing prescription drugs in the past 30 days will decrease by 1% P % of youth reporting 30 day use of prescription drugs Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 Establish two additional prescription drug drop boxes in Fresno County P # of drop boxes established by location Prevention provider staff focus group Prevention Provider CONTRACTOR Measured annually 2021-2025 The pounds of Rx drugs collected through the drop box program will increase as compared to the baseline in 2020 P # of pounds of prescription drugs collected by drop box location Drop Box Tracking Log Prevention Provider CONTRACTOR Measured annually 2021-2025 The percentage of youth who report medications are locked up in their home will increase by 10% as compared to baseline in 2021/22 P % of youth reporting prescription drugs are locked up in their home Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2025 Exhibit A - Page 10 of 19 10 Table 4. Evaluation Plan for Long-Term Outcomes (A = Alcohol, M = Marijuana, P = Prescription Drugs) Long-Term Outcome Indicator/ Performance Measures Data Collection Tools/ Data Source Responsible Party Timeframe The percentage of youth who believe alcohol/ marijuana/ prescription drugs are easy to access will have decreased by 2% A M P % of youth who believe alcohol/marijuana/ prescription drugs are easy to access Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2026 The percentage of youth who disapprove of underage drinking will increase by 3% A % of youth who disapprove of underage drinking Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2026 The percentage of youth who believe people close to them (e.g., friends, parents) disapprove of using marijuana will increase by 2% M % of youth who believe friends and parents disapprove of using marijuana Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2026 The percentage of youth who believe marijuana is harmful will increase by 2% M % of youth who believe marijuana is harmful Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2026 10% more youth will participate in alternative activities M # of youth participating in alternative activities by location Activity Tracking Log PPSDS Prevention Provider CONTRACTOR County staff Measured annually 2021-2026 80% of youth will report the mentoring they received helped them to feel good about themselves and increased their social competence M % of youth who report the mentoring helped them Mentoring Program Survey Prevention Provider CONTRACTOR Measured annually 2021-2026 The percentage of youth misusing prescription drugs in the past 30 days will decrease by 2% P % of youth misusing prescription drugs in past 30 days Insights Survey Prevention Provider CONTRACTOR Measured annually 2021-2026 Exhibit A - Page 11 of 19 11 VIII.Cultural Competence The evaluation of the SUD Prevention Initiative will be culturally responsive to the focus population of youth and young adults ages 10 to 20. The prevention provider will be considered the expert on Fresno County youth, and CONTRACTOR will work in collaboration with the prevention provider’s staff to ensure data collection protocols and tools are appropriate for the diversity of young people in Fresno County. To this end, CONTRACTOR will ask the prevention provider to engage a small but diverse number of youth to pilot test the draft surveys prior to data collection in order to gather feedback that can contribute to survey improvements. Because of the diverse racial and ethnic demographic makeup of Fresno County, the Insights Survey and participant surveys will be offered in English, Spanish, and other languages deemed necessary to reach youth and parents. CONTRACTOR and prevention provider will be sensitive to the cultural differences of the groups they are collecting data from and sharing evaluation findings with, taking into account the language and mode of dissemination (i.e., radio, social media, or websites) and culturally-specific channels (i.e., Spanish-speaking radio or television). The annual analysis of Insights Survey data will include examining SUD-related knowledge, attitude, and behavior measures across racial/ethnic groups and by gender to determine if there are any significant racial or gender disparities in outcomes. It will be important to highlight these findings in the evaluation report and communicate them to DBH SUD Services and the prevention provider in case a shift in programming is needed to address large disparities or if additional cultural competency practices for certain prevention activities is indicated. IX.Sustainability At the onset of the grant term, the evaluator will engage prevention provider staff in the evaluation planning process in order to generate buy-in and promote sustainability of the evaluation activities. For example, the evaluator will collaborate with the prevention provider to develop data collection tools, train prevention provider staff to collect survey data, and create an ongoing feedback loop by sharing quarterly data. Youth and young adults will be included in the evaluation and data collection processes when possible. For example, youth may help with survey administration as well as reviewing evaluation data and helping interpret survey findings. To further support the sustainability of the evaluation and the initiative as a whole, the evaluator will generate recommendations based on the evaluation findings and include those recommendations in the Annual Evaluation Report. DBH SUD Services and prevention provider can use the evaluation findings and recommendations to determine if program implementation is on track and/or if there are any modifications needed to reach certain populations or address emerging trends. The recommendations will also be shared with DHCS, Fresno County DBH administrators, the Fresno County Behavioral Health Board, and prevention provider’s Advisory Council. This reporting process will allow the County, prevention provider, and stakeholders to use the findings for program planning and improvement so as to support the sustainability of Fresno County’s SUD prevention efforts. Exhibit A - Page 12 of 19 12 Finally, CONTRACTOR will remain flexible, making changes or modifications to the evaluation throughout the grant term to address challenges and barriers or to take advantage of new opportunities as they arise. CONTRACTOR will monitor changes to the implementation plan by attending County-led meetings as needed, and by holding focus groups with provider staff every six months to keep abreast of activities. Through these same methods, the evaluation will seek to document the prevention provider’s best practices for SUD prevention, so as to lift up successful strategies and thus promote the sustainability of the work. B. SUD Strategic Prevention Plan (SPP) Development CONTRACTOR will support Fresno County Department of Behavioral Health Substance Abuse Disorder Services (DBH SUD Services) with developing components of the 2026- 2031 Strategic Prevention Plan (SPP). CONTRACTOR will participate in the development of the SPP by serving in the following roles and capacities for the six SPP chapters. Fresno County staff will be responsible for the elements of the plan that are not listed below. I. Chapter 1 County Profile CONTRACTOR will be partially involved in developing this chapter. a. CONTRACTOR will collect data for the Fresno County profile section of this chapter, which will include geographic data, population by jurisdiction, resident demographics, employment, etc. b. CONTRACTOR will analyze the data, create tables and figures, and draft the profile section of the chapter. c. CONTRACTOR will review and edit the remainder of the chapter as drafted by DBH SUD Services before it is submitted to DHCS for review. II. Chapter 2 Assessment CONTRACTOR will be fully responsible for developing this chapter. a. CONTRACTOR will identify community level SUD indicators (e.g., incidence and prevalence of substance use, treatment admissions data, and data related to risk factors or consequences of substance use). b. CONTRACTOR will collect, compile, and analyze this secondary data, and create tables and figures. c. CONTRACTOR will conduct focus groups and/or interviews with targeted stakeholders (i.e., members of the SPP Planning Group, local youth, treatment providers, etc.) to address quantitative data gaps and gain a nuanced understanding of the issues and needs (CONTRACTOR will rely on DBH SUD Services staff to refer stakeholders, youth, and other representatives from the community to participate in these focus groups/interviews). d. CONTRACTOR will draft the Assessment chapter and make revisions based on DBH SUD Services and DHCS feedback. e. Concurrently, CONTRACTOR staff will participate in three virtual meetings with the SPP Planning Group (CONTRACTOR will rely on DBH SUD Services staff to Exhibit A - Page 13 of 19 13 invite stakeholders and representatives from the community to participate in this group prior to the first meeting). •Meeting 1 (facilitated by DBH SUD Services): Introduce the CONTRACTOR team and stakeholders, inform the group about the SPP planning process, and solicit input for data sources and resources (i.e., indicator data and focus group/interview candidates). •Meeting 2 (facilitated by CONTRACTOR): Present preliminary quantitative data to the group, and include a discussion of group members’ interpretations of the data collected to date. •Meeting 3 (facilitated by CONTRACTOR): Share draft components of the Assessment Chapter to gather group members’ input and feedback. III.Chapter 3 Capacity Building CONTRACTOR will not be involved in developing this chapter. a.CONTRACTOR will review and edit this chapter as drafted by DBH SUD Services before it is submitted to DHCS for review. IV.Chapter 4 Planning CONTRACTOR will be partially involved in developing this chapter. a.CONTRACTOR will participate in two virtual meetings with DBH SUD Services staff to discuss and develop the logic model section of this chapter, leading staff through a brief logic model development workshop. b.Based on discussion with DBH SUD Services staff, CONTRACTOR staff will draft the SPP logic models and submit them to DBH SUD Services for inclusion in the chapter. c.CONTRACTOR will review and edit the remainder of this chapter as drafted by DBH SUD Services before it is submitted to DHCS for review. V.Chapter 5 Implementation CONTRACTOR will not be involved in developing this chapter. a.CONTRACTOR will review and edit this chapter as drafted by DBH SUD Services before it is submitted to DHCS for review. VI.Chapter 6 Evaluation CONTRACTOR will be fully responsible for developing this chapter. a.CONTRACTOR will review the finalized Implementation chapter and/or provider SOW to identify the proposed prevention activities. b.CONTRACTOR will draft the Evaluation chapter, and make revisions based on DBH SUD Services and DHCS feedback. Exhibit A - Page 14 of 19 14 Attachment A | CONTRACTOR Work Plan 2022-26 Year 1 (Jan-June 2022) Staff Hours* Tasks Milestones/ Deliverables Timeline Planning 24 Meet with prevention provider staff to develop a plan for data collection. Collectively review prevention provider scope of work and proposed evaluation plan, expectations, and tentative schedule. Revise evaluation plan based on meeting with prevention provider. Final evaluation plan Jan-Feb 2022 Provide prevention provider with summary of data collection activities and timeline for completion Prevention Provider Data Collection Timeline March 2022 Tool Development 85 Develop and/or revise tracking logs and survey tools (including the Insights Survey), based on prevention provider needs and scope of work. Obtain feedback from prevention provider and make edits as needed Final data collection forms March 2022 Develop and/or revise web-based data collection system for prevention provider data entry Database system April 2022 Update Insights Survey administration protocol and share with prevention provider Insights Survey protocol April 2022 Develop prevention provider staff focus group protocols (mid-year and year-end) Final focus group protocols May 2022 Data Collection & Analysis 165 Obtain PPSDS data from DBH staff PPSDS dataset Quarterly Analyze quarterly data and produce newly designed data dashboards. Obtain feedback from prevention provider and make edits as needed Data dashboards Quarterly Observe virtual prevention activities/meetings Meeting notes Ongoing Schedule and conduct year-end prevention provider staff focus group Focus group transcript June 2022 *Hours are estimates and may be modified, by mutual consent, by DBH Director, or designee, and by CONTRACTOR during the contract term. Exhibit A - Page 15 of 19 15 Year 2 (July 2022 - June 2023) Staff Hours* Tasks Milestones/ Deliverables Timeline Data Collection & Analysis 318 Obtain PPSDS data from DBH staff PPSDS dataset Quarterly Analyze quarterly data and produce data dashboards. Obtain feedback from prevention provider and make edits as needed Data dashboards Quarterly Observe virtual prevention activities/ meetings Meeting notes Ongoing Analyze all participant survey data Survey results July-Aug 2022 Analyze Insights Survey data and trends Insights Survey results July-Aug 2022 Complete document review of all campaign and educational materials and meeting minutes Written description of prevention activities July-Aug 2022 Analyze prevention provider staff focus group data Focus group findings July-Aug 2022 Reporting210 Draft Year 1 evaluation report, obtain feedback from prevention provider and make edits as needed Draft evaluation report July-Sept 2022 Submit annual evaluation report to DBH staff Annual evaluation report Sept 2022 Focus Groups 15 Schedule and conduct mid-year prevention provider staff focus group Focus group transcript Nov/Dec 2022 Schedule and conduct year-end prevention provider staff focus group Focus group transcript June 2023 *Hours are estimates and may be modified, by mutual consent, by DBH Director, or designee, and by CONTRACTOR during the contract term. Exhibit A - Page 16 of 19 16 Year 3 (July 2023 - June 2024) Staff Hours* Tasks Milestones/ Deliverables Timeline Data Collection & Analysis300 Obtain PPSDS data from DBH staff PPSDS dataset Quarterly Analyze quarterly data and produce data dashboards. Obtain feedback from prevention provider and make edits as needed Data dashboards Quarterly Observe virtual prevention activities/meetings Meeting notes Ongoing Analyze all participant survey data Survey results July-Aug 2023 Analyze Insights Survey data and trends Insights Survey results July-Aug 2023 Complete document review of all campaign and educational materials and meeting minutes Written descriptions of prevention activities July-Aug 2023 Analyze prevention provider staff focus group data Focus group findings July-Aug 2023 Reporting180 Draft Year 2 evaluation report, obtain feedback from prevention provider and make edits as needed Draft evaluation report July-Sept 2023 Submit annual evaluation report to DBH staff Annual evaluation report Sept 2023 Focus Groups 15 Schedule and conduct mid-year prevention provider staff focus group Focus group transcript Nov/Dec 2023 Schedule and conduct year-end prevention provider staff focus group Focus group transcript June 2024 *Hours are estimates and may be modified, by mutual consent, by DBH Director, or designee, and by CONTRACTOR during the contract term. Exhibit A - Page 17 of 19 17 Year 4 (July 2024 - June 2025) Staff Hours* Tasks Milestones/ Deliverables Timeline Data Collection & Analysis 235 Obtain PPSDS data from DBH staff PPSDS dataset Quarterly Analyze quarterly data and produce data dashboards. Obtain feedback from prevention provider and make edits as needed. Data dashboards Quarterly Observe virtual prevention activities/ meetings Meeting notes Ongoing Analyze all participant survey data Survey results July-Aug 2024 Analyze Insights Survey data and trends Insights Survey results July-Aug 2024 Complete document review of campaign and educational materials and meeting minutes Written description of prevention activities July-Aug 2024 Analyze prevention provider staff focus group data Focus group findings July-Aug 2024 Reporting 180 Draft Year 3 evaluation report, obtain feedback from prevention provider and make edits as needed Draft evaluation report July-Sept 2024 Submit annual evaluation report to DBH staff Annual evaluation report Sept 2024 Focus Groups 15 Schedule and conduct mid-year prevention provider staff focus group Focus group transcript Nov/Dec 2024 Schedule and conduct year-end prevention provider staff focus group Focus group transcript June 2025 SPP Chapters 1 & 2 200 SPP Chapter 1: Collect and analyze secondary data, draft county profile section Draft profile section March 2025 SPP Chapter 2: Identify, collect, and analyze secondary data for needs assessment Data tables April 2025 SPP Chapter 1: Review and edit chapter drafted by DBH SUD Services Edits to Chapter 1 May 2025 SPP Chapter 2: Plan and participate in first meeting with SPP Planning Group Meeting notes May 2025 SPP Chapter 2: Obtain list of interview/focus group candidates from DBH staff, draft interview and focus group protocols Interview and focus group protocols May 2025 SPP Chapter 2: Schedule and conduct interviews/focus groups, analyze data Interview and focus group findings June 2025 *Hours are estimates and may be modified, by mutual consent, by DBH Director, or designee, and by CONTRACTOR during the contract term. Exhibit A - Page 18 of 19 18 Year 5 (July 2025 - June 2026) Staff Hours* Tasks Milestones/ Deliverables Timeline SPP Chapters 2-6 385 SPP Chapter 2: Plan and facilitate second meeting with SPP Planning Group Meeting notes July 2025 SPP Chapter 2: Plan and facilitate third meeting with SPP Planning Group Meeting notes Aug 2025 SPP Chapter 2: Draft chapter and submit to DBH staff for review, make edits Chapter 2 Sept 2025 SPP Chapter 3: Review and edit chapter drafted by DBH staff Edits to Chapter 3 Nov 2025 SPP Chapter 4: Participate in two meetings with DBH staff to develop logic models SPP logic models Nov-Dec 2025 SPP Chapter 4: Review and edit chapter drafted by DBH staff Edits to Chapter 4 Feb 2026 SPP Chapter 5: Review and edit chapter drafted by DBH staff Edits to Chapter 5 April 2026 SPP Chapter 6: Draft chapter and submit to DBH staff for review, make edits Chapter 6 May 2026 Data Collection & Analysis 225 Obtain PPSDS data from DBH staff PPSDS dataset Quarterly Analyze quarterly data and produce data dashboards. Make edits as needed Data dashboards Quarterly Observe prevention activities/meetings Meeting notes Ongoing Analyze all participant survey data Survey results July-Aug 2025 Analyze Insights Survey data and trends Insights Survey results July-Aug 2025 Complete document review of campaign and educational materials/meeting minutes Written description of prevention activities July-Aug 2025 Analyze prevention provider staff focus group data Focus group findings July-Aug 2025 Reporting 180 Draft Year 4 evaluation report, obtain feedback from prevention provider and make edits as needed Draft evaluation report July-Sept 2025 Submit annual evaluation report to DBH staff Annual evaluation report Sept 2025 Focus Groups 15 Schedule and conduct mid-year prevention provider staff focus group Focus group transcript Nov/Dec 2025 Schedule and conduct final prevention provider staff focus group Focus group transcript June 2026 *Hours are estimates and may be modified, by mutual consent, by DBH Director, or designee, and by CONTRACTOR during the contract term. Exhibit A - Page 19 of 19 19 Year 6 (July-Dec 2026) Staff Hours* Tasks Milestones/ Deliverables Timeline Data Analysis 100 Request PPSDS data from DBH staff PPSDS dataset July 2026 Analyze Year 5 participant survey data Survey results July-Aug 2026 Complete document review of Year 5 campaign and educational materials and meeting minutes Written description of prevention activities July-Aug 2026 Analyze prevention provider staff focus group data from Year 5 Focus group findings July-Aug 2026 Analyze Insights Survey data and trends Insights Survey results Aug-Nov 2026 Reporting 174 Draft final evaluation report containing cumulative evaluation results and outcomes from Years 1-5. Obtain feedback from prevention provider and make edits as needed. Draft final evaluation report Aug-Dec 2026 Submit final evaluation report to DBH staff Final evaluation report Dec 2026 *Hours are estimates and may be modified, by mutual consent, by DBH Director, or designee, and by CONTRACTOR during the contract term. Guiding Principles of Care Delivery 1 rev 2017 Dec DBH VISION: Health and well-being for our community. DBH MISSION: The Department of Behavioral Health is dedicated to supporting the wellness of individuals, families and communities in Fresno County who are affected by, or are at risk of, mental illness and/or substance use disorders through cultivation of strengths toward promoting recovery in the least restrictive environment. DBH GOALS: Quadruple Aim •Deliver quality care •Maximize resources while focusing on efficiency •Provide an excellent care experience •Promote workforce well-being GUIDING PRINCIPLES OF CARE DELIVERY: The DBH 11 principles of care delivery define and guide a system that strives for excellence in the provision of behavioral health services where the values of wellness, resiliency, and recovery are central to the development of programs, services, and workforce. The principles provide the clinical framework that influences decision-making on all aspects of care delivery including program design and implementation, service delivery, training of the workforce, allocation of resources, and measurement of outcomes. 1.Principle One - Timely Access & Integrated Services o Individuals and families are connected with services in a manner that is streamlined, effective, and seamless o Collaborative care coordination occurs across agencies, plans for care are integrated, and whole person care considers all life domains such as health, education, employment, housing, and spirituality o Barriers to access and treatment are identified and addressed o Excellent customer service ensures individuals and families are transitioned from one point of care to another without disruption of care Exhibit B - Page 1 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 2 rev 2017 Dec 2.Principle Two - Strengths-based o Positive change occurs within the context of genuine trusting relationships o Individuals, families, and communities are resourceful and resilient in the way they solve problems o Hope and optimism is created through identification of, and focus on, the unique abilities of individuals and families 3.Principle Three - Person-driven and Family-driven o Self-determination and self-direction are the foundations for recovery o Individuals and families optimize their autonomy and independence by leading the process, including the identification of strengths, needs, and preferences o Providers contribute clinical expertise, provide options, and support individuals and families in informed decision making, developing goals and objectives, and identifying pathways to recovery o Individuals and families partner with their provider in determining the services and supports that would be most effective and helpful and they exercise choice in the services and supports they receive 4.Principle Four - Inclusive of Natural Supports o The person served identifies and defines family and other natural supports to be included in care o Individuals and families speak for themselves o Natural support systems are vital to successful recovery and the maintaining of ongoing wellness; these supports include personal associations and relationships typically developed in the community that enhance a person’s quality of life o Providers assist individuals and families in developing and utilizing natural supports. 5.Principle Five - Clinical Significance and Evidence Based Practices (EBP) o Services are effective, resulting in a noticeable change in daily life that is measurable. o Clinical practice is informed by best available research evidence, best clinical expertise, and client values and preferences o Other clinically significant interventions such as innovative, promising, and emerging practices are embraced Exhibit B - Page 2 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 3 rev 2017 Dec 6.Principle Six - Culturally Responsive o Values, traditions, and beliefs specific to an individual’s or family’s culture(s) are valued and referenced in the path of wellness, resilience, and recovery o Services are culturally grounded, congruent, and personalized to reflect the unique cultural experience of each individual and family o Providers exhibit the highest level of cultural humility and sensitivity to the self- identified culture(s) of the person or family served in striving to achieve the greatest competency in care delivery 7.Principle Seven - Trauma-informed and Trauma-responsive o The widespread impacts of all types of trauma are recognized and the various potential paths for recovery from trauma are understood o Signs and symptoms of trauma in individuals, families, staff, and others are recognized and persons receive trauma-informed responses o Physical, psychological and emotional safety for individuals, families, and providers is emphasized 8.Principle Eight - Co-occurring Capable o Services are reflective of whole-person care; providers understand the influence of bio-psycho-social factors and the interactions between physical health, mental health, and substance use disorders o Treatment of substance use disorders and mental health disorders are integrated; a provider or team may deliver treatment for mental health and substance use disorders at the same time 9.Principle Nine - Stages of Change, Motivation, and Harm Reduction o Interventions are motivation-based and adapted to the client’s stage of change o Progression though stages of change are supported through positive working relationships and alliances that are motivating o Providers support individuals and families to develop strategies aimed at reducing negative outcomes of substance misuse though a harm reduction approach o Each individual defines their own recovery and recovers at their own pace when provided with sufficient time and support Exhibit B - Page 3 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 4 rev 2017 Dec 10.Principle Ten - Continuous Quality Improvement and Outcomes-Driven o Individual and program outcomes are collected and evaluated for quality and efficacy o Strategies are implemented to achieve a system of continuous quality improvement and improved performance outcomes o Providers participate in ongoing professional development activities needed for proficiency in practice and implementation of treatment models 11.Principle Eleven - Health and Wellness Promotion, Illness and Harm Prevention, and Stigma Reduction o The rights of all people are respected o Behavioral health is recognized as integral to individual and community well-being o Promotion of health and wellness is interwoven throughout all aspects of DBH services o Specific strategies to prevent illness and harm are implemented at the individual, family, program, and community levels o Stigma is actively reduced by promoting awareness, accountability, and positive change in attitudes, beliefs, practices, and policies within all systems o The vision of health and well-being for our community is continually addressed through collaborations between providers, individuals, families, and community members Exhibit B - Page 4 of 4 Fresno County Department of Behavioral Health Employee Salaries Acct #Position FTE Admin Direct Total 1101 Research Director -$ 754$ 754$ 1102 Senior Associate - 27,540 27,540 1103 Research Associate/Data Visualist - 7,740 7,740 Personnel Salaries Subtotal 0.00 -$ 36,034$ 36,034$ -$ 36,034$ 36,034$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6002 3,966 3,966$ Acct #Amount 8101 SB920 and Realignment 40,000$ 40,000$ SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. Fiscal Year (FY) 2021-22 Professional Liability Insurance EMPLOYEE SALARIES & BENEFITS TOTAL: PROGRAM EXPENSES ADMINISTRATIVE EXPENSES TOTAL 1000: SALARIES & BENEFITS NET PROGRAM COST: PROGRAM FUNDING SOURCES 40,000$ TOTAL PROGRAM EXPENSES TOTAL PROGRAM FUNDING SOURCES:40,000$ -$ SUBSTANCE USE DISORDER FUNDS TOTAL Line Item Description 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description Exhibit C - 1 of 12 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 36,034 Employee Salaries 36,034 1101 Research Director 754 Research Director will provide overall leadership support to the operations. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 4 hours x $190 hr/rate = $754 1102 Senior Associate 27,540 Two Senior Associates will co-manage the project and oversee the day-to-day operation and coordination of resources. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 180 hours x $153 hr/rate = $27,540 1103 Research Associate/Data Visualist 7,740 Research Associate and Data Visualist will conduct research analysis and data visualization evaluation activities. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 90 hours x $86 hr/rate = $7,740 6000: ADMINISTRATIVE EXPENSES 3,966 6001 Administrative Overhead - 6002 Professional Liability Insurance 3,966 Annual insurance premium, including abuse and molestation coverage to meet County insurance requirements. Estimated annual premium - $3,966 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:40,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:40,000 BUDGET CHECK:- SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING PROGRAM EXPENSE LPC Consulting Associates, Inc. Fiscal Year (FY) 2021-22 Budget Narrative Exhibit C - 2 of 12 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Research Director -$ 1,892$ 1,892$ 1102 Senior Associate - 62,466 62,466 1103 Research Associate/Data Visualist - 16,625 16,625 Personnel Salaries Subtotal 0.00 -$ 80,983$ 80,983$ -$ 80,983$ 80,983$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6002 4,017 4,017$ Acct #Amount 8101 SB920 and Realignment 85,000$ 85,000$ SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. Fiscal Year (FY) 2022-23 PROGRAM EXPENSES 1000: SALARIES & BENEFITS EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description ADMINISTRATIVE EXPENSES TOTAL Professional Liability Insurance PROGRAM FUNDING SOURCES TOTAL PROGRAM EXPENSES 85,000$ 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description SUBSTANCE USE DISORDER FUNDS TOTAL TOTAL PROGRAM FUNDING SOURCES:85,000$ NET PROGRAM COST: -$ Exhibit C - 3 of 12 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 80,983 Employee Salaries 80,983 1101 Research Director 1,892 Research Director will provide overall leadership support to the operations. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 9 hours x $217 hr/rate = $1,892 1102 Senior Associate 62,466 Two Senior Associates will co-manage the project and oversee the day-to-day operation and coordination of resources. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 359 hours x $174 hr/rate = $62,466 1103 Research Associate/Data Visualist 16,625 Research Associate and Data Visualist will conduct research analysis and data visualization evaluation activities. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 175 hours x $95 hr/rate = $16,625 6000: ADMINISTRATIVE EXPENSES 4,017 6001 Administrative Overhead - 6002 Professional Liability Insurance 4,017 Annual insurance premium, including abuse and molestation coverage to meet County insurance requirements. Estimated annual premium - $4,017 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:85,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:85,000 BUDGET CHECK:- SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. PROGRAM EXPENSE Fiscal Year (FY) 2022-23 Budget Narrative Exhibit C - 4 of 12 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Research Director -$ 2,161$ 2,161$ 1102 Senior Associate - 66,528 66,528 1103 Research Associate/Data Visualist - 16,200 16,200 Personnel Salaries Subtotal 0.00 -$ 84,889$ 84,889$ -$ 84,889$ 84,889$ 3000: OPERATING EXPENSES Acct #Amount 3006 1,061 1,061$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6002 4,050 4,050$ Acct #Amount 8101 SB920 and Realignment 90,000$ 90,000$ SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. Fiscal Year (FY) 2023-24 PROGRAM EXPENSES 1000: SALARIES & BENEFITS EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Travel / Staff Mileage OPERATING EXPENSES TOTAL: Line Item Description ADMINISTRATIVE EXPENSES TOTAL Professional Liability Insurance PROGRAM FUNDING SOURCES TOTAL PROGRAM EXPENSES 90,000$ 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description SUBSTANCE USE DISORDER FUNDS TOTAL TOTAL PROGRAM FUNDING SOURCES:90,000$ NET PROGRAM COST: -$ Exhibit C - 5 of 12 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 84,889 Employee Salaries 84,889 1101 Research Director 2,161 Research Director will provide overall leadership support to the operations. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 9 hours x $246 hr/rate = $2,161 1102 Senior Associate 66,528 Two Senior Associates will co-manage the project and oversee the day-to-day operation and coordination of resources. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 336 hours x $198 hr/rate = $66,528 1103 Research Associate/Data Visualist 16,200 Research Associate and Data Visualist will conduct research analysis and data visualization evaluation activities. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 150 hours x $108 hr/rate = $16,200 3000: OPERATING EXPENSES 1,061 3006 Travel / Staff Mileage 1,061 Travel for 2 staff to attend in-person meetings, attend focus groups, and conduct interviews. Cost will cover mileage, lodging, meals and incidentals. 6000: ADMINISTRATIVE EXPENSES 4,050 6002 Professional Liability Insurance 4,050 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:90,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:90,000 BUDGET CHECK:- SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. PROGRAM EXPENSE Fiscal Year (FY) 2023-24 Budget Narrative Exhibit C - 6 of 12 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Research Director -$ 2,433$ 2,433$ 1102 Senior Associate - 72,100 72,100 1103 Research Associate/Data Visualist - 30,281 30,281 Personnel Salaries Subtotal 0.00 -$ 104,815$ 104,815$ -$ 104,815$ 104,815$ 3000: OPERATING EXPENSES Acct #Amount 3006 1,093 1,093$ 5000: SPECIAL EXPENSES Acct #Amount 5004 5,000 5,000$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6001 4,092$ 4,092$ Acct #Amount 8101 SB920 and Realignment 115,000$ 115,000$ SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. Fiscal Year (FY) 2024-25 PROGRAM EXPENSES 1000: SALARIES & BENEFITS EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Travel / Staff Mileage OPERATING EXPENSES TOTAL: SPECIAL EXPENSES TOTAL: Line Item Description Line Item Description Interpreter / Translation Services ADMINISTRATIVE EXPENSES TOTAL Administrative Overhead PROGRAM FUNDING SOURCES TOTAL PROGRAM EXPENSES 115,000$ 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description SUBSTANCE USE DISORDER FUNDS TOTAL TOTAL PROGRAM FUNDING SOURCES:115,000$ NET PROGRAM COST: -$ Exhibit C - 7 of 12 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 104,815 Employee Salaries 104,815 1101 Research Director 2,433 Research Director will provide overall leadership support to the operations. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 10 hours x $256 hr/rate = $2,433 1102 Senior Associate 72,100 Two Senior Associates will co-manage the project and oversee the day-to-day operation and coordination of resources. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 350 hours x $206 hr/rate = $72,100 1103 Research Associate/Data Visualist 30,281 Research Associate and Data Visualist will conduct research analysis and data visualization evaluation activities. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 270 hours x $112 hr/rate = $30,281 3000: OPERATING EXPENSES 1,093 3006 Travel / Staff Mileage 1,093 Travel for 2 staff to attend in-person meetings, attend focus groups, and conduct interviews. Cost will cover mileage, lodging, meals and incidentals. 5000: SPECIAL EXPENSES 5,000 5004 Interpreter / Translation Services 5,000 Cost will cover interpreter/translations service which may be needed when hosting stakeholder focus groups/interviews as part of the Strategic Prevention Planning process. Annual estimate - $5,000 6000: ADMINISTRATIVE EXPENSES 4,092 6001 Administrative Overhead 4,092 Annual insurance premium, including abuse and molestation coverage to meet County insurance requirements. Estimated annual premium - $4,092 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:115,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:115,000 BUDGET CHECK:- SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. PROGRAM EXPENSE Fiscal Year (FY) 2024-25 Budget Narrative Exhibit C - 8 of 12 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Research Director -$ 2,222$ 2,222$ 1102 Senior Associate - 128,400 128,400 1103 Research Associate/Data Visualist - 22,932 22,932 Personnel Salaries Subtotal 0.00 -$ 153,554$ 153,554$ -$ 153,554$ 153,554$ 3000: OPERATING EXPENSES Acct #Amount 3006 2,252 2,252$ 6000: ADMINISTRATIVE EXPENSES Acct #Amount 6002 4,194 4,194$ Acct #Amount 8101 SB920 and Realignment 160,000$ 160,000$ SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. Fiscal Year (FY) 2025-26 PROGRAM EXPENSES 1000: SALARIES & BENEFITS EMPLOYEE SALARIES & BENEFITS TOTAL: Line Item Description Travel / Staff Mileage OPERATING EXPENSES TOTAL: Line Item Description ADMINISTRATIVE EXPENSES TOTAL Professional Liability Insurance PROGRAM FUNDING SOURCES TOTAL PROGRAM EXPENSES 160,000$ 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description SUBSTANCE USE DISORDER FUNDS TOTAL TOTAL PROGRAM FUNDING SOURCES:160,000$ NET PROGRAM COST: -$ Exhibit C - 9 of 12 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 153,554 Employee Salaries 153,554 1101 Research Director 2,222 Research Director will provide overall leadership support to the operations. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 8 hours x $266 hr/rate = $2,222 1102 Senior Associate 128,400 Two Senior Associates will co-manage the project and oversee the day-to-day operation and coordination of resources. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 600 hours x $214 hr/rate = $128,400 1103 Research Associate/Data Visualist 22,932 Research Associate and Data Visualist will conduct research analysis and data visualization evaluation activities. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 196 hours x $117 hr/rate = $22,932 3000: OPERATING EXPENSES 2,252 3006 Travel / Staff Mileage 2,252 Travel for 2 staff to attend in-person meetings, attend focus groups, and conduct interviews. Cost will cover mileage, lodging, meals and incidentals. 6000: ADMINISTRATIVE EXPENSES 4,194 6002 Professional Liability Insurance 4,194 Annual insurance premium, including abuse and molestation coverage to meet County insurance requirements. Estimated annual premium - $4,194 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:160,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:160,000 BUDGET CHECK:- SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. PROGRAM EXPENSE Fiscal Year (FY) 2025-26 Budget Narrative Exhibit C - 10 of 12 Employee Salaries Acct #Position FTE Admin Direct Total 1101 Research Director -$ 950$ 950$ 1102 Senior Associate - 38,520 38,520 1103 Research Associate/Data Visualist - 10,530 10,530 Personnel Salaries Subtotal 0.00 -$ 50,000$ 50,000$ -$ 50,000$ 50,000$ Acct #Amount 8101 SB920 and Realignment 50,000$ 50,000$ TOTAL PROGRAM FUNDING SOURCES:50,000$ NET PROGRAM COST: -$ SUBSTANCE USE DISORDER FUNDS TOTAL 8100 - SUBSTANCE USE DISORDER FUNDS Line Item Description PROGRAM FUNDING SOURCES TOTAL PROGRAM EXPENSES 50,000$ EMPLOYEE SALARIES & BENEFITS TOTAL: SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. Fiscal Year (FY) 2026-27 PROGRAM EXPENSES 1000: SALARIES & BENEFITS Exhibit C - 11 of 12 ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE 1000: SALARIES & BENEFITS 50,000 Employee Salaries 50,000 1101 Research Director 950 Research Director will provide overall leadership support to the operations. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 4 hours x $266 hr/rate = $950 1102 Senior Associate 38,520 Two Senior Associates will co-manage the project and oversee the day-to-day operation and coordination of resources. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 180 hours x $214 hr/rate = $38,520 1103 Research Associate/Data Visualist 10,530 Research Associate and Data Visualist will conduct research analysis and data visualization evaluation activities. Hourly rates include wages, payroll taxes, paid time off, and other benefits like health and dental insurance and retirement plan contributions. 90 hours x $117 hr/rate = $10,530 TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:50,000 TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:50,000 BUDGET CHECK:- SUD PREVENTION PROGRAM EVALUATION AND STRATEGIC PREVENTION PLANNING LPC Consulting Associates, Inc. PROGRAM EXPENSE Fiscal Year (FY) 2026-27 Budget Narrative Exhibit C - 12 of 12 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) SPECIFIC REQUIREMENTS Fresno County, through the Department of Behavioral Health, makes substance use disorder treatment services available throughout the county to Medi-Cal eligible beneficiaries through funds provided under an Intergovernmental Agreement with the California Department of Health Care Services. The County, and all contracted providers, must comply with the terms of the Intergovernmental Agreement, and any amendments thereto, including but not limited to the following: 1.RESTRICTIONS ON USE OF SABG FUNDS TO PAY FOR SERVICES REIMBURSABLE BY MEDI-CAL CONTRACTOR shall ensure that billing SABG funds only occurs for services that are not reimbursable by Medi-Cal. If CONTRACTOR utilizes SABG funds to pay for a service included in the DMC-ODS, CONTRACTOR shall maintain documentation sufficient to demonstrate that Medi-Cal reimbursement was not available. This documentation shall be provided to COUNTY at the time of billing and retained in the beneficiary file for review. 2.STATE ALCOHOL AND DRUG REQUIREMENTS A.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. B.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. C.CONTROL REQUIREMENTS This Agreement is subject to all applicable Federal and State laws, regulations and standards. CONTRACTOR(S) shall establish written procedures consistent with State-County Contract requirements. 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. D.CONFIDENTIALITY Exhibit D - Page 1 of 13 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, 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 1, Part 2.6, Chapters 1-7 of the California Civil Code. E.REVENUE COLLECTION POLICY CONTRACTOR shall conform to all policies and procedures regarding revenue collection issued by the State under the provisions of the Health and Safety Code, Division 10.5. F.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. G.ACCESS TO SERVICES CONTRACTOR shall provide accessible and appropriate services in accordance with Federal and State statutes and regulations to all eligible persons. H.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. I.AUDITS All State and Federal funds furnished to the CONTRACTOR(S) pursuant to this Agreement along with related patient 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 alcohol and drug program revenue and expenditures contained in this Agreement for the purpose of establishing the basis for the subsequent year's negotiation. J.RECORDS MAINTENANCE 1)CONTRACTOR shall maintain books, records, documents, and other evidence necessary to monitor and audit this Agreement. 2)CONTRACTOR shall maintain adequate program and fiscal records relating to individuals served under the terms 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 Exhibit D - Page 2 of 13 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. 3.FEDERAL CERTIFICATIONS CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS A.DBH and CONTRACTOR recognize that Federal assistance funds will be used under the terms of this Agreement. For purposes of this section, DBH will be referred to as the "prospective recipient". B.This certification is required by the regulations implementing Executive Order 12549, Debarment 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 19160-19211). 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 debarment, 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, 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 CONTRACTOR shall provide immediate written notice to DBH if at any time CONTRACTOR 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 into 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. Exhibit D - Page 3 of 13 C.CONTRACTOR shall not employ or subcontract with any party listed in the government wide exclusions in the System for Award Management (SAM) in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp. p. 189) and 12689 (3 CFR part 1989., p. 235), “Debarment and Suspension.” SAM exclusions contain the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. If CONTRACTOR employs or subcontracts an excluded party, DHCS has the right to withhold payments, disallow costs, or issue a CAP, as appropriate, pursuant to HSC Code 11817.8(h). 4.SMOKING PROHIBITION REQUIREMENTS CONTRACTOR shall comply with Public Law 103-227, also known as the Pro-Children Act of 1994 (20 USC Section 6081, et seq.), and with California Labor Code Section 6404.5, the California Smoke-Free Workplace Law. 5.CONFIDENTIALITY OATH CONTRACTOR shall ensure that all of its employees sign a written confidentiality oath, attached hereto as Attachment A, before they begin employment with CONTRACTOR and shall renew said document annually thereafter. CONTRACTOR shall retain each employee’s written confidentiality oath for COUNTY and DHCS inspection for a period of six (6) years following the termination of this agreement. 6.CULTURALLY COMPETENT SERVICES CONTRACTOR shall ensure equal access to quality care by diverse populations by adopting the federal Office of Minority Health Culturally and Linguistically Appropriate Service (CLAS) national standards and complying with 42 CFR 438.206(c)(2). CONTRACTOR shall promote the delivery of services in a culturally competent manner to all beneficiaries, including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity. 7.ADA CONSIDERATIONS CONTRACTOR shall ensure that physical access, reasonable accommodations, and accessible equipment for Medicaid beneficiaries with physical or mental disabilities are provided to all beneficiaries. 8.ADDITIONAL CONTRACT RESTRICTIONS This Contract is subject to any additional restrictions, limitations, or conditions enacted by the Congress, or any statute enacted by the Congress, as well as federal or Exhibit D - Page 4 of 13 state governments which may affect the provisions, terms, or funding of this Contract in any manner. 9.HATCH ACT CONTRACTOR shall comply with the provisions of the Hatch Act (Title 5 USC, Sections 1501-1508), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. 10.UNLAWFUL USE OF DRUGS AND ALCOHOL OR UNLAWFUL USE MESSAGES CONTRACTOR shall ensure that information produced with Federal funds pertaining to drug and alcohol related programs contains a clearly written statement that there shall be no unlawful use of drugs or alcohol associated with the program. Additionally, CONTRACTOR shall ensure that no aspect of the program includes any message in materials, curricula, teachings, or promotion of the responsible use, if the use is unlawful, of drugs or alcohol pursuant to Health and Safety Code (HSC) 11999- 11999.3. CONTRACTOR must sign the Unlawful Use of Drugs and Alcohol Certification, attached hereto as Attachment B, incorporated herein by reference and made part of this Agreement agreeing to uphold the obligations of HSC 11999 – 11999.3. This agreement may be unilaterally terminated, without penalty, if CONTRACTOR or a subcontractor that is a private entity is determined to have violated a prohibition of the Unlawful Use of Drugs and Alcohol message or has an employee who is determined by the DBH Director or her designee to have violated a prohibition of the Unlawful Use of Drugs and Alcohol message. 11.LIMITATION ON USE OF FUNDS FOR PROMOTION OF LEGALIZATION OF CONTROLLED SUBSTANCES CONTRACTOR shall ensure that none of the funds made available through this Agreement with COUNTY may be used for any activity that promotes the legalization of any drug or other substance included in Schedule I of Section 202 of the Controlled Substances Act (21 USC 812). 12.NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS FOR RELIGIOUS CONTRACTORS CONTRACTOR shall establish such processes and procedures as necessary to comply with the provisions of Title 42, USC, Section 300x-65 and Title 42, CFR, Part 54 to prohibit discrimination against nongovernmental organizations and certain individuals on the basis of religion in the distribution of government funds to provide substance abuse services and to allow the organizations to accept the funds to provide the services to the individuals without impairing the religious character of the organizations or the religious freedom of the individuals. Exhibit D - Page 5 of 13 13.COUNSELOR CERTIFICATION CONTRACTOR shall ensure that any counselor or registrant providing intake, assessment of need for services, treatment or recovery planning, individual or group counseling to participants, patients, or residents in a DHCS licensed or certified program is required to be certified as defined in Title 9, Division 4, Chapter 8. 14.INTRAVENOUS DRUG USE (IVDU) TREATMENT CONTRACTOR shall ensure that beneficiaries in need of IVDU treatment shall be encouraged to undergo AOD treatment adhering to provisions in 42 USC 300x- 23 and 45 CFR 96.126(e). DHCS shall monitor programs for compliance with this requirement. 15.TUBERCULOSIS TREATMENT CONTRACTOR shall ensure the following related to Tuberculosis (TB): A.Routinely make available TB services to each individual receiving treatment for AOD use and/or abuse. B.Reduce barriers to patients’ accepting TB treatment. C.Develop strategies to improve follow-up monitoring, particularly after patients leave treatment, by disseminating information through educational bulletins and technical assistance. 16.TRAFFICKING IN PERSONS PROVISIONS – PRIVATE ENTITY CONTRACTOR shall conform to all Federal statutes and regulations prohibiting trafficking in persons, as well as trafficking-related activities, including, but not limited to the trafficking of persons provisions in Section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA) as amended by Section 1702. CONTRACTOR, CONTRACTOR’s employees, subrecipients, and subrecipients’ employees may not: A.Engage in severe forms of trafficking in persons during the period of time that the award is in effect; B.Procure a commercial sex act during the period of time that the award is in effect; or C.Use forced labor in the performance of the award or subawards under the award. This agreement may be unilaterally terminated, without penalty, if CONTRACTOR or a subrecipient that is a private entity is determined to have violated a prohibition of the TVPA or has an employee who is determined by the DBH Director or her designee to have violated a prohibition of the TVPA through conduct that is either associated with performance under the award or imputed to the CONTRACTOR or their subrecipient using the standards and due process for imputing the conduct of Exhibit D - Page 6 of 13 an individual to an organization that are provided in 2 C.F.R. Part 180, “OMB Guidelines to Agencies on Government-wide Debarment and Suspension (Nonprocurement). CONTRACTOR must inform the DBH Director or her designee immediately of any information received from any source alleging a violation of a prohibition of the TVPA. CONTRACTOR must sign a certification annually acknowledging the Trafficking Victims Protection Act of 2000 requirements (TVPA Certification), attached hereto as Attachment C, incorporated herein by reference and made part of this Agreement and must require all employees to complete annual TVPA training. 17.BYRD ANTI-LOBBYING AMENDMENT CONTRACTOR certifies that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 USC 1352. CONTRACTOR shall also disclose to DHCS any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. 18.NONDISCRIMINATION IN EMPLOYMENT AND SERVICES CONTRACTOR certifies that under the laws of the United States and the State of California, incorporated into the State-County Intergovernmental Agreement, CONTRACTOR shall not unlawfully discriminate against any person. 19.FEDERAL LAW REQUIREMENTS CONTRACTORS shall comply with the following Federal law requirements: A.Title VI of the Civil Rights Act of 1964, Section 2000d, as amended, prohibiting discrimination based on race, color, or national origin in federally funded programs. B.Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq.) prohibiting discrimination on the basis of race, color, religion, sex, handicap, familial status or national origin in the sale or rental of housing. C.Age Discrimination Act of 1975 (45 CFR Part 90), as amended (42 USC Sections 6101 – 6107), which prohibits discrimination on the basis of age. D.Age Discrimination in Employment Act (29 CFR Part 1625). Exhibit D - Page 7 of 13 E.Title I of the Americans with Disabilities Act (29 CFR Part 1630) prohibiting discrimination against the disabled in employment. F.Americans with Disabilities Act (28 CFR Part 35) prohibiting discrimination against the disabled by public entities. G.Title III of the Americans with Disabilities Act (28 CFR Part 36) regarding access. H.Rehabilitation Act of 1973, as amended (29 USC Sectio n 794), prohibiting discrimination on the basis of individuals with disabilities. I.Executive Order 11246 (42 USC 2000(e) et seq. and 41 CFR Part 60) regarding nondiscrimination in employment under federal contracts and construction contracts greater than $10,000 funded by federal financial assistance. J.Executive Order 13166 (67 FR 41455) to improve access to federal services for those with limited English proficiency. K.The Drug Abuse Office and Treatment Act of 1972, as amended, relating to nondiscrimination on the basis of drug abuse. L.The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism. 20.STATE LAW REQUIREMENTS CONTRACTOR shall comply with the following State law requirements: A.Fair Employment and Housing Act (Government Code Section 12900 et seq.) and the applicable regulations promulgated thereunder (California Administrative Code, Title 2, Section 7285.0 et seq.). B.Title 2, Division 3, Article 9.5 of the Government Code, commencing with Section 11135. C.Title 9, Division 4, Chapter 8, commencing with Section 10800. D.No state or Federal funds shall be used by COUNTY, or CONTRACTOR, for sectarian worship, instruction, and/or proselytization. No state funds shall be used by CONTRACTOR, or CONTRACTOR, to provide direct, immediate, or substantial support to any religious activity. E.Noncompliance with the requirements of nondiscrimination in services shall constitute grounds for state to withhold payments Exhibit D - Page 8 of 13 under this Agreement or terminate all, or any type, of funding provided hereunder. 21.INFORMATION ACCESS FOR INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY CONTRACTOR shall comply with all applicable provisions of the Dymally- Alatorre Bilingual Services Act (Government Code sections 7290 -7299.8) regarding access to materials that explain services available to the public as well as providing language interpretation services. CONTRACTOR shall comply with the applicable provisions of Section 1557 of the Affordable Care Act (45 CFR Part 92), including, but not limited to, 45 CFR 92.201, when providing access to: A.Materials explaining services available to the public, B.Language assistance, C.Language interpreter and translation services, and D.Video remote language interpreting services. 22.INTERIM SERVICES CONTRACTOR must adhere to the State-County Contract requirement to provide Interim Services in the event that an individual must wait to be placed in treatment. Interim Substance Abuse Services means services that are provided until an individual is admitted to a substance abuse treatment program. The purposes of the services are to reduce the adverse health effects of such abuse, promote the health of the individual, and reduce the risk of transmission of disease. At a minimum, interim services include counseling and education about HIV and tuberculosis (TB), about the risks of needle-sharing, the risks of transmission to sexual partners and infants, and about steps that can be taken to ensure the HIV and TB transmission does not occur, as well as referral for HIV or TB treatment services if necessary. For pregnant women, interim services also include counseling on the effects of alcohol and drug use on the fetus, as well as referral for prenatal care. Records must indicate evidence that Interim Services have been provided and documentation will be reviewed for compliance. 23.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 Exhibit D - Page 9 of 13 identifies as faith-based it must submit to DBH Contracts Division - SUD 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 inform 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 SUD Services. Adherence to this policy will be monitored during annual site reviews, and a review of client files. If CONTRACTOR identifies as faith-based, by July 1 of each year CONTRACTOR will be required to report to SUD Services the number of individuals who requested referrals to alternate providers based on religious objection. In addition, CONTRACTOR shall comply with the provisions of Title 42, USC, Section 300x-65 and Title 42, CFR, Part 54. 24.MINIMUM QUALITY DRUG TREATMENT STANDARDS CONTRACTOR shall comply with the Minimum Quality Drug Treatment Standards for SABG for all Substance Use Disorder (SUD) treatment programs. The Minimum Quality Drug Treatment Standards are attached hereto and by this reference incorporated herein as Attachment D. 25.RISK ASSESSMENT CONTRACTOR shall comply with the sub-recipient pre-award risk assessment requirements contained in 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards. COUNTY, as the SABG first-tier sub- recipient, shall review the merit and risk associated with all potential grant second-tier sub- recipients (CONTRACTOR) annually prior to making an award. COUNTY shall perform and document annual subrecipient pre-award risk assessments for each CONTRACTOR and retain documentation for audit purposes. 26.CONTROL REQUIREMENTS Performance under this Agreement is subject to all applicable Federal and State laws, regulations and standards. In accepting the State drug and alcohol combined program allocation pursuant to California Health and Safety Code section 11757, CONTRACTOR shall establish written accounting procedures consistent with applicable Federal and State laws, regulations and standards, and shall be held accountable for audit exceptions taken by the State or COUNTY for failur e to comply with these requirements. These requirements include, but may not be limited to, those set forth in this Agreement, and: A.HSC, Division 10.5, Part 2 commencing with Section 11760. B.Title 9, California Code of Regulations (CCR) (herein referred to as Title 9), Division 4, commencing with Section 9000. C.Government Code, Title 2, Division 4, Part 2, Chapter 2, Article 1.7. D.Government Code, Article 7, Federally Mandated Audits of Block Grant Funds Allocated to Local Agencies, Chapter 1, Part 1, Divisio n 2, Title 5, commencing at Section 53130. E.Title 42 United State Code (USC), Sections 300x-21 through 300x- 31, 300x-34, 300x-53, 300x-57, and 330x-64 through 66. Exhibit D - Page 10 of 13 F.Title 2, CFR 200 -The Uniform Administration Requirements, Cost Principles and Audit Requirements for Federal Awards. G.Title 45, Code of Federal Regulations (CFR), Sections 96.30 through 96.33 and Sections 96.120 through 96.137. H.Title 42, CFR, Sections 8.1 through 8.6. I.Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2, Subparts A - E). J.Title 21, CFR, Sections 1301.01 through 1301.93, Department of Justice, Controlled Substances. K.State Administrative Manual (SAM), Chapter 7200 (General Outline of Procedures). 27.DRUG FREE WORKPLACE CONTRACTOR shall comply with the requirements of the Drug-Free Work Place Act of 1990 (California Government Code section 8350). 28.YOUTH TREATMENT GUIDELINES CONTRACTOR shall follow the “Youth Treatment Guidelines,” available at the DHCS web address at: http://www.dhcs.ca.gov/individuals/Pages/youthSUDservices.aspx and by this reference incorporated herein, in developing and implementing youth treatment programs funded under this Agreement until such time new Youth Treatment Guidelines are established and adopted. No formal amendment of this contract is required for new guidelines to apply. 29.HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996 If any of the work performed under this Agreement is subject to the HIPAA, CONTRACTOR shall perform the work in compliance with all applicable provisions of HIPAA. As identified in Exhibit F of the State County Intergovernmental Agreement, DHCS, COUNTY and CONTRACTOR shall cooperate to assure mutual agreement as to those transactions between them, to which this Provision applies. Refer to Exhibit F for additional information. A.Trading Partner Requirements 1)No Changes: CONTRACTOR hereby agrees that for the personal health information (PHI), it shall not change any definition, data condition or use of a data element or segment as proscribed in the federal Health and Human Services Transaction Standard Regulation [45 CFR Part 162915(a)]. 2)No Additions: CONTRACTOR hereby agrees that for PHI, it shall not add any data elements or segments to the maximum data set as proscribed in the HHS Transaction Standard Regulation [45CFR Part 162.915 (b)]. Exhibit D - Page 11 of 13 3)No Unauthorized Uses: CONTRACTOR hereby agrees that for PHI, it shall not use any code or data elements that are marked ‘not used” in the in the HHS Transactions Implementation specification or are not in the HHS Transaction Standard’s implementation specification [45CFR Part 162.915 (c)]. 4)No Changes to Meaning or Intent: CONTRACTOR hereby agrees that for PHI, it shall not change the meaning or intent of the HHS Transaction Standard’s implementation specification [45CFR Part 162.915 (d)]. B.Concurrence for Test Modifications to HHS Transaction Standards CONTRACTOR agrees and understands that there exists the possibility that DHCS or others may request an extension from the uses of a standard in the HHS Transaction Standards. If this occurs, CONTRACTOR agrees that it shall participate in such test modifications. C.Adequate Testing CONTRACTOR is responsible to adequately test all business rules appropriate to their types and specialties. If the CONTRACTOR is acting as a clearinghouse for enrolled providers, CONTRACTOR has obligations to adequately test all business rules appropriate to each and every provider type and specialty for which they provide clearinghouse services. D.Deficiencies The CONTRACTOR agrees to cure transactions errors or deficiencies identified by DHCS, and transactions errors or deficiencies identified by an enr olled CONTRACTOR if the COUNTY is acting as a clearinghouse for that CONTRACTOR. If the CONTRACTOR is a clearinghouse, the CONTRACTOR agrees to properly communicate deficiencies and other pertinent information regarding electronic transactions to enrolled CONTRACTORS for which they provide clearinghouse services. E.Code Set Retention Both Parties understand and agree to keep open code sets being processed or used in this Agreement for a least the current billing period or any appeal period, whichever is longer. F.Data Transmission Log Both Parties shall establish and maintain a Data Transmission Log, which shall record any and all data transmissions taking place between the Parties during the term of this Agreement. Each Party shall take necessary and reasonable steps to ensure that such Data Transmission Logs constitute a current, accurate, complete and unaltered record of any and all Data Transmissions between the Parties, and shall be retained by each Party for no less than twenty-four (24) months following the date of the Data Transmission. The Data Transmission Log may be maintained on computer Exhibit D - Page 12 of 13 media or other suitable means provided that, if necessary to do so, the information contained in the Data Transmission Log may be retrieved in a timely manner and presented in readable form. Exhibit D - Page 13 of 13 Exhibit E - Page 1 of 2 SELF-DEALING TRANSAC TION DISCLOSURE FORM In order to conduct business with the County of Fresno (hereinafter referred to as “COUNTY”), members of a CONTRACTOR(S)’ board of directors (hereinafter referred to as “County Contractor”), must disclose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the COUNTY. A self-dealing transaction is defined below: “A self-dealing transaction means a transaction to which the corporation is a party and in which one or more of its directors has a material financial interest” The definition above will be utilized for purposes of completing this disclosure form. INSTRUCTIONS (1)Enter board member’s name, job title (if applicable), and date this disclosure is being made. (2)Enter the board member’s company/agency name and address. (3)Describe in detail the nature of the self-dealing transaction that is being disclosed to the COUNTY. At a minimum, include a description of the following: a.The name of the agency/company with which the corporation has the transaction; and b.The nature of the material financial interest in the corporation’s transaction that the board member has. (4)Describe in detail why the self-dealing transaction is appropriate based on applicable provisions of the Corporations Code. (5)Form must be signed by the board member that is involved in the self-dealing transaction described in Sections (3) and (4). Exhibit E - Page 2 of 2 (1) Company Board Member Information: Name: Date: Job Title: (2) Company/Agency Name and Address: (3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to): (4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a): (5) Authorized Signature Signature: Date: Exhibit F – Page 1 of 1 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 LPC CONSULTING ASSOCIATES, INC. (CONTRACTOR), 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 physical 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. §11165.3, 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)(1).) Substantial penalties may be imposed for failure to comply with these child abuse reporting requirements. Further information and a copy of the law may be obtained from the County of Fresno Department head or designee. I have read and understand the above statement and agree to comply with the child abuse reporting requirements. __________________________________ ________________________ SIGNATURE DATE National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations to: Principal Standard: 1.Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs. Governance, Leadership, and Workforce: 2.Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources. 3.Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area. 4.Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis. Communication and Language Assistance: 5.Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services. 6.Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing. 7.Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided. 8.Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area. Engagement, Continuous Improvement, and Accountability: 9.Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization’s planning and operations. 10.Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities. 11.Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery. 12.Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area. 13.Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness. 14.Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints. 15.Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public. Think Cultural Health https://www.thinkculturalhealth.hhs.gov/ contact@thinkculturalhealth.hhs.gov Exhibit G - Page 1 of 2 The Case for the National CLAS Standards Health equity is the attainment of the highest level of health for all people.1 Currently, individuals across the United States from various cultural backgrounds are unable to attain their highest level of health for several reasons, including the social determinants of health, or those conditions in which individuals are born, grow, live, work, and age,2 such as socioeconomic status, education level, and the availability of health services.3 Though health inequities are directly related to the existence of historical and current discrimination and social injustice, one of the most modifiable factors is the lack of culturally and linguistically appropriate services, broadly defined as care and services that are respectful of and responsive to the cultural and linguistic needs of all individuals. Health inequities result in disparities that directly affect the quality of life for all individuals. Health disparities adversely affect neighborhoods, communities, and the broader society, thus making the issue not only an individual concern but also a public health concern. In the United States, it has been estimated that the combined cost of health disparities and subsequent deaths due to inadequate and/or inequitable care is $1.24 trillion.4 Culturally and linguistically appropriate services are increasingly recognized as effective in improving the quality of care and services.5,6 By providing a structure to implement culturally and linguistically appropriate services, the National CLAS Standards will improve an organization’s ability to address health care disparities. The National CLAS Standards align with the HHS Action Plan to Reduce Racial and Ethnic Health Disparities7 and the National Stakeholder Strategy for Achieving Health Equity,8 which aim to promote health equity through providing clear plans and strategies to guide collaborative efforts that address racial and ethnic health disparities across the country. Similar to these initiatives, the National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the United States. Of all the forms of inequality, injustice in health care is the most shocking and inhumane. — Dr. Martin Luther King, Jr. Bibliography 1. U.S. Department of Health and Human Services, Office of Minority Health (2011). National Partnership for Action to End Health Disparities. Retrieved from http://minorityhealth.hhs.gov/npa 2. World Health Organization. (2012). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en/ 3. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Healthy people 2020: Social determinants of health. Retrieved from http://www. healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39 4. LaVeist, T. A., Gaskin, D. J., & Richard, P. (2009). The economic burden of health inequalities in the United States. Retrieved from the Joint Center for Political and Economic Studies website: http://www. jointcenter.org/sites/default/files/upload/research/files/The%20Economic%2 0Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf 5. Beach, M. C., Cooper, L. A., Robinson, K. A., Price, E. G., Gary, T. L., Jenckes, M. W., Powe, N.R. (2004). Strategies for improving minority healthcare quality. (AHRQ Publication No. 04-E008-02). Retrieved from the Agency of Healthcare Research and Quality website: http://www.ahrq.gov/downloads/pub/evidence/pdf/minqual/minqual.pdf 6. Goode, T. D., Dunne, M. C., & Bronheim, S. M. (2006). The evidence base for cultural and linguistic competency in health care. (Commonwealth Fund Publication No. 962). Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/usr_doc/Goode_evidencebasecultlinguisticcomp_962.pdf 7. U.S. Department of Health and Human Services. (2011). HHS action plan to reduce racial and ethnic health disparities: A nation free of disparities in health and health care. Retrieved from http:// minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf 8. National Partnership for Action to End Health Disparities. (2011). National stakeholder strategy for achieving health equity. Retrieved from U.S. Department of Health and Human Services, Office of Minority Health website: http://www.minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286 Think Cultural Health https://www.thinkculturalhealth.hhs.gov/ contact@thinkculturalhealth.hhs.gov Exhibit G - Page 2 of 2 Exhibit H – Page 1 of 2 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT I.Identifying Information Name of entity D/B/A Address (number, street) City State ZIP code CLIA number Taxpayer ID number (EIN) Telephone number ( ) II.Answer the following questions by checking “Yes” or “No.” If any of the questions are answered “Yes,” list names and addresses of individuals or corporations under “Remarks” on page 2. Identify each item number to be continued. A.Are there any individuals or organizations having a direct or indirect ownership or control interest of five percent or more in the institution, organizations, or agency that have been convicted of a criminal offense related to the involvement of such persons or organizations in any of the programs established YES NO by Titles XVIII, XIX, or XX? ......................................................................................................................... ❒ ❒ B.Are there any directors, officers, agents, or managing employees of the institution, agency, or organization who have ever been convicted of a criminal offense related to their involvement in such programs established by Titles XVIII, XIX, or XX? ...................................................................................... ❒ ❒ C.Are there any individuals currently employed by the institution, agency, or organization in a managerial, accounting, auditing, or similar capacity who were employed by the institution’s, organization’s, or agency’s fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only) ........... ❒ ❒ III.A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names and addresses under “Remarks” on page 2. If more than one individual is reported and any of these persons are related to each other, this must be reported under “Remarks.” NAME ADDRESS EIN B.Type of entity: ❒ Sole proprietorship ❒Partnership ❒Corporation❒Unincorporated Associations ❒Other (specify) C.If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations under “Remarks.” D.Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities? (Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses of individuals, and provider numbers. .......................................................................................................... ❒❒ NAME ADDRESS PROVIDER NUMBER Exhibit H – Page 2 of 2 YES NO IV. A. Has there been a change in ownership or control within the last year? ....................................................... ❒ ❒ If yes, give date. B. Do you anticipate any change of ownership or control within the year?....................................................... ❒ ❒ If yes, when? C. Do you anticipate filing for bankruptcy within the year?................................................................................ ❒ ❒ If yes, when? V.Is the facility operated by a management company or leased in whole or part by another organization?.......... ❒ ❒ If yes, give date of change in operations. VI.Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... ❒ ❒ VII. A. Is this facility chain affiliated? ...................................................................................................................... ❒ ❒ (If yes, list name, address of corporation, and EIN.) Name EIN Address (number, name) City State ZIP code B.If the answer to question VII.A. is NO, was the facility ever affiliated with a chain? (If yes, list name, address of corporation, and EIN.) Name EIN Address (number, name) City State ZIP code Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the information requested may result in denial of a request to participate or where the entity already participates, a termination of its agreement or contract with the agency, as appropriate. Name of authorized representative (typed) Title Signature Date Remarks Exhibit I - Page 1 of 2 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS INSTRUCTIONS FOR CERTIFICATION 1.By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2.The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3.The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4.The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5.The terms covered transaction, debarred, suspended, ineligible, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. CERTIFICATION (1)The prospective primary participant certifies to the best of its knowledge and belief, that it, its owners, officers, corporate managers and partners: (a)Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b)Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; Exhibit I - Page 2 of 2 (c)Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2)Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Signature: Date: (Printed Name & Title) (Name of Agency or Company) PRIVACY AND SECURITY AGREEMENT REGARDING AUTHORIZED ACCESS TO CONFIDENTIAL PROTECTED HEALTH INFORMATION FOR FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH (DBH) EMPLOYEES AND/OR NON-DBH SUD SERVICES WORKFORCE MEMBERS OATH OF CONFIDENTIALITY As a condition of obtaining access to any Protected Health Information (PHI) that is necessary to carry out my function with DBH, I ___________________________, agree to not divulge any PHI to unauthorized persons. Furthermore, I maintain that I will not publish or otherwise make public any information regarding persons who receive Substance Use Disorder Services such that the persons who receive or have received such services are identifiable. Access to such data shall be limited to Fresno County DBH personnel, subcontractors, and subcontractors’ personnel who require this information in the performance of their duties and have signed an Oath of Confidentiality with DBH. By signing this oath, I agree to uphold the security and confidentiality requirements outlined by the Medi- Cal Privacy and Security Agreement signed by DBH, surveillance and safeguarding announcements issued by DHCS, and other applicable terms and stipulations provided by the HIPAA doctrine as well as other relevant state and federal regulations. I hereby certify my understanding of the need to: 1.Exercise due care to preserve data integrity and confidentiality. 2.Treat passwords and user accounts as confidential information. 3.Take reasonable precautions to ensure the protection of PHI from unauthorized access. 4.Notify DHCS when there is a possible security violation including unauthorized access to PHI by completing a “Privacy Incident Report” at: http://www.dhcs.ca.gov/formsandpubs/laws/priv/Pages/DHCSBusinessAssociatesOnly.aspx and return the completed form to: privacyofficer@dhcs.ca.gov. I recognize that unauthorized release of confidential information may make me subject to civil and criminal sanctions pursuant to the provisions of the Welfare and Institutions Code Section 14100.2, Welfare and Institutions Code Section 5328 et seq. and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). I further acknowledge that the unauthorized release of confidential information as described in this document may result in disciplinary action up to and including termination of any office of employment or contract. Agency Name: Signature: ____________________________________ Date: ____________________________________ Exhibit J - Page 1 of 1