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HomeMy WebLinkAboutAgreement A-22-176.pdf Agreement No. 22-176 1 AGREEMENT 2 3 THIS AGREEMENT is made and entered into this V day of May, 2022, by and between the 4 COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter referred to as 5 "COUNTY", and each Contractor listed in Exhibit A, "Drug Medi-Cal Services Vendor List," attached hereto 6 and by this reference incorporated herein, collectively herein after referred to as "CONTRACTOR", and 7 such additional CONTRACTOR as may, from time to time during the term of this Agreement, be added by 8 COUNTY. Reference in this Agreement to "party" or"parties" shall be understood to refer to COUNTY and 9 each CONTRACTOR, unless otherwise specified. 10 WITNESSETH: 11 WHEREAS, COUNTY is authorized through its Intergovernmental Agreement with the California 12 Department of Health Care Services, hereinafter referred to as State or DHCS, to subcontract for Drug 13 Medi-Cal services (DMC) in Fresno County; and 14 WHEREAS, COUNTY is authorized to contract with privately operated agencies for the provision 15 of alcohol and other drug treatment services, pursuant to Title 9, Division 4 of the California Code of 16 Regulations and Division 10.5 (commencing with Section 11750) of the California Health and Safety 17 Code; and 18 WHEREAS, CONTRACTOR(S) are certified by the State to provide services required by the 19 COUNTY, pursuant to the terms and conditions of this Agreement. 20 NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions herein 21 contained, the parties hereto agree as follows: 22 1. SERVICES 23 A. CONTRACTOR shall fulfill all the responsibilities of providing Drug Medi-Cal 24 substance use disorder treatment services at State certified locations to eligible persons served of Fresno 25 County, as identified in this Agreement, including all Exhibits, incorporated herein by reference and made 26 part of this Agreement. 27 28 DMC Master Agreement -1 1 B. CONTRACTOR shall provide services as described in Exhibit B, Modality of Service 2 Descriptions, attached hereto and incorporated by this reference. 3 C. CONTRACTOR shall comply with requirements stated within the Intergovernmental 4 Agreement as listed in Exhibit C, Drug Medi-Cal Specific Requirements, attached hereto and by this 5 reference incorporated herein; and with all other provisions set forth in the Intergovernmental Agreement, 6 made available by the Department of Behavioral Health (DBH) at the following web address and by this 7 reference incorporated herein: https://www.co.fresno.ca.us/departments/behavioral-health/home/for- 8 providers/contract-providers/substance-use-disorder-providers. CONTRACTOR is referred to therein as 9 "Subcontractor" and COUNTY is referred to therein as "Contractor." 10 D. CONTRACTOR shall comply with the Fresno County Substance Use Disorder 11 (FCSUD) Provider Manual, herein after referred to as the "Provider Manual" and by this reference 12 incorporated herein, available at the DBH website at: 13 https://www.co.fresno.ca.us/departments/behavioral-health/home/for-providers/contract- 14 providers/substance-use-disorder-providers. No formal amendment of this agreement is required for 15 changes to the Provider Manual to apply. 16 E. CONTRACTOR shall align program, services, and practices with the vision and 17 mission within Exhibit D, DBH Guiding Principles of Care Delivery, attached hereto and by this reference 18 incorporated herein. Contractor may be required to utilize and integrate clinical tools such as Reaching 19 Recovery at DBH's discretion. 20 Employees involved in a crisis incident should be offered appropriate Employee 21 Assistance Program (EAP) or similar related wellness and recovery assistance. In conjunction with the 22 County DBH's Principles of Care delivery and wellness of the workforce, Contractors shall align their 23 practices around this vision and ensure needed debriefing services are offered to all employees involved 24 in a crisis incident. Employees shall be afforded all services to strengthen their recovery and wellness 25 related to the crisis incident. Appropriate follow-up with the employee shall be carried out and a plan for 26 workforce wellness shall be submitted to the County's DBH. 27 F. CONTRACTORs must complete intake for all persons served (including persons 28 served referred by Drug Court or Probation) within timeframes specified below from initial contact: DMC Master Agreement -2 1 1) Outpatient and Intensive Outpatient within ten (10) business days; 2 2) Opioid Treatment Programs (OTP) within three (3) business days; and 3 3) Residential services within ten (10) business days. 4 4) Contractors shall comply with reporting requirements of Court or Probation 5 relating to beneficiary status change and treatment progress if an appropriate Release of Information 6 (ROI) is in place. 7 G. CONTRACTOR shall maintain, at CONTRACTOR's cost, a computer system 8 compatible with COUNTY's current billing and electronic health record (EHR) system for the provision of 9 submitting information required under the terms and conditions of this Agreement. CONTRACTOR shall 10 complete billing and EHR data entry as follows: initial contact, when applicable; admissions; California 11 Outcomes Measurement System (CaIOMS) reporting; American Society of Addiction Medicine (ASAM) 12 level of care reporting; discharge; and no show/missed appointments and referrals. 13 H. CONTRACTOR's staff will be required to attend regularly occurring meetings such 14 as Cultural Humility Committee and All-Provider Meetings and trainings on an as-needed basis, which 15 includes but is not limited to, trainings related to SUD treatment, fiscal processes, cultural competency, 16 compliance and reporting requirements. Refer to the Annual Provider Training Plan available on the 17 provider webpage at: https://www.co.fresno.ca.us/departments/behavioral-health/home/for- 18 providers/contract-providers/substance-use-disorder-providers. 19 2. ADDITIONS/DELETIONS OF CONTRACTOR(S) 20 COUNTY's DBH Director, or his or her designee, reserves the right at any time during the 21 term of this Agreement to add new CONTRACTOR(S) to those listed in Exhibit A, "DMC Services Vendor 22 List." It is understood any such additions will not affect compensation paid to the other CONTRACTOR(S), 23 and therefore such additions may be made by COUNTY without notice to or approval from other 24 CONTRACTOR(S) under this Agreement. These same provisions shall apply to the deletion of any 25 CONTRACTOR listed in Exhibit A, "DMC Services Vendor List," except that deletions shall be made by 26 written mutual agreement between the COUNTY and the particular CONTRACTOR to be deleted or shall 27 be in accordance with the provisions of Section Four (4), TERMINATION, of this Agreement. 28 DMC Master Agreement -3 1 3. TERM 2 The term of this Agreement shall be for a period of three (3) years, commencing on July 1, 3 2022 through and including June 30, 2025. This Agreement may be extended for two (2) additional 4 consecutive twelve (12) month periods upon written approval of both parties no later than thirty(30)days 5 prior to the first day of the next twelve (12) month extension period. The DBH Director, or his or her 6 designee, is authorized to execute such written approval on behalf of COUNTY based on CONTRACTOR's 7 satisfactory performance. 8 4. TERMINATION 9 A. Non-Allocation of Funds-The terms of this Agreement, and the services to be 10 provided hereunder, are contingent on the approval of funds by the appropriating government agency. 11 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement 12 terminated, at any time by giving the CONTRACTOR thirty (30) days advance written notice. 13 B. Breach of Contract- The COUNTY may immediately suspend or terminate this 14 Agreement in whole or in part, wherein the determination of the COUNTY there is: 15 1) An illegal or improper use of funds; 16 2) A failure to comply with any term of this Agreement; 17 3) A substantially incorrect or incomplete report submitted to the COUNTY; or 18 4) Improperly performed service. 19 In no event shall any payment by the COUNTY constitute a waiver by the COUNTY of any 20 breach of this Agreement or any default which may then exist on the part of the CONTRACTOR. Neither 21 shall such payment impair or prejudice any remedy available to the COUNTY with respect to the breach or 22 default. The COUNTY shall have the right to demand of the CONTRACTOR the repayment to the 23 COUNTY of any funds disbursed to the CONTRACTOR under this Agreement, which in the judgment of 24 the COUNTY were not expended in accordance with the terms of this Agreement. The CONTRACTOR 25 shall promptly refund any such funds upon demand. 26 C. Without Cause - Under circumstances other than those set forth above, this 27 Agreement may be terminated by COUNTY upon the giving of thirty (30) days advance written notice of 28 an intention to terminate to CONTRACTOR. DMC Master Agreement -4 1 D. Voluntary Termination of Intergovernmental Agreement - The COUNTY may 2 terminate its Agreement with DHCS at any time, for any reason, by giving sixty (60) days written notice 3 to DHCS. In the event the Intergovernmental Agreement is terminated, COUNTY may terminate this 4 contractor agreement. CONTRACTOR shall be paid for services provided to beneficiaries up to the date 5 of termination. 6 5. COMPENSATION 7 A. COMPENSATION - In no event shall services performed under this Agreement be 8 in excess of annually negotiated reimbursement rates agreed upon by COUNTY and CONTRACTOR 9 during the term of this Agreement and approved by DHCS, incorporated herein as Exhibit E, "Fresno 10 County Drug Medi-Cal Rates" as updated annually. In no event will the negotiated reimbursement rates 11 be in excess of the COUNTY's maximum rate approved by DHCS. It is understood that all expenses 12 incidental to CONTRACTOR's performance of services under this Agreement shall be borne by 13 CONTRACTOR. 14 1) COUNTY shall reimburse non-NTP CONTRACTOR(S) the negotiated 15 contractor-specific rates. Contractor rates cannot exceed the DHCS-approved county maximum rates 16 established in the annual fiscal plan. 17 2) COUNTY shall reimburse NTP CONTRACTOR(S) the lesser of the 18 uniform statewide daily reimbursement rate, as published annually by DHCS and incorporated in to 19 Exhibit E, or the CONTRACTOR's usual or customary charge to the public. 20 3) Payments by COUNTY shall be in arrears, based on CONTRACTOR's 21 monthly invoices submitted for services provided during the preceding month, within forty-five (45) days 22 after receipt, verification and approval of CONTRACTOR's monthly invoices by COUNTY's DBH. If 23 payment for services is denied or disallowed by State, and subsequently resubmitted to COUNTY by 24 CONTRACTOR, disallowed portion will be withheld from the next reimbursement to CONTRACTOR 25 until COUNTY has received reimbursement from State for said services. If CONTRACTOR is not in 26 compliance with periodic reporting requirements as described in Exhibit F, Provider Reporting 27 Requirements, then payments shall be held until compliance is achieved. 28 DMC Master Agreement -5 1 4) CONTRACTOR must accept, as payment in full, the amounts paid by 2 DHCS in accordance with the Intergovernmental Agreement. CONTRACTOR may not demand any 3 additional payments from DHCS, person served, or other third-party payers. 4 5) CONTRACTOR shall comply with 45 CFR 162.410(a)(1) for any subpart 5 that would be a covered health care provider if it were a separate legal entity. For purposes of this 6 paragraph, a covered health care provider shall have the same definition as set forth in 45 CFR 7 160.103. DHCS shall make payments for covered services only if CONTRACTOR is in compliance with 8 federal regulations. 9 B. COMPLIANCE — If CONTRACTOR should fail to comply with any provision of this 10 Agreement, COUNTY shall be relieved of its obligation for further compensation. CONTRACTOR's and 11 COUNTY's obligations under this section shall survive the termination of this Agreement with respect to 12 services provided during the term of this Agreement without regard to the cause of termination of this 13 Agreement. 14 C. QUALITY ASSURANCE — For services rendered herein, CONTRACTOR shall 15 assure that an on-going quality assurance component is in place and is occurring. CONTRACTOR shall 16 assure that clinical records for each participant are of such detail and length that a review of said record 17 will verify that appropriate services were provided. If the record is unclear, incomplete, and/or indicates 18 that appropriate services were not provided, COUNTY reserves the right to withhold payment for the 19 applicable unit(s) of service. 20 D. PUBLIC INFORMATION — CONTRACTOR shall disclose its funding source in all 21 public information. Communication products must follow DBH graphic standards, including typefaces 22 and colors, to communicate our authority and project a unified brand. This includes all media types and 23 channels and all materials on and offline that are created as part of DBH's efforts to provide information 24 to the public. Communication products must include a funding acknowledgement determined by the 25 level of funding provided by DBH as follows: 26 1) A Program of Fresno County Department of Behavioral Health (100% 27 funded); 28 DMC Master Agreement -6 1 2) Funding provided by Fresno County Department of Behavioral Health 2 (50% or more funded); 3 3) Funded, in part, by County of Fresno Department of Behavioral Health 4 (less than 50% funded); and 5 4) A partnership, with funding by Fresno County department of Behavioral 6 Health (any funding amount). 7 E. LOBBYING ACTIVITY— CONTRACTOR shall not directly or indirectly use any of 8 the funds provided under this Agreement for publicity, lobbying, or propaganda purposes designed to 9 support or defeat legislation pending before the Congress of the United States or the Legislature of the 10 State of California. 11 F. POLITICAL ACTIVITY— CONTRACTOR shall not directly or indirectly use any of 12 the funds under this Agreement for any political activity or to further the election or defeat of any 13 candidate for public office. 14 6. INVOICING 15 A. COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive 16 compensation at negotiated Drug Medi-Cal rates. CONTRACTOR shall enter billing information into the 17 COUNTY's designated information system by the fifteenth (15th) of every month. Billing process shall be 18 in accordance with the DHCS DMC Billing Manual, and by this reference incorporated herein, available 19 at the DBH website at https://www.co.fresno.ca.us/departments/behavioral-health/home/for- 20 providers/contract-providers/substance-use-disorder-providers. In addition to billing, non-NTP 21 CONTRACTOR(S) shall submit on a monthly basis by the twenty-fifth (25th), an Operational Expense 22 Report, per modality of service, along with a general ledger, payroll register and supporting 23 documentation for any line items selected. For the purposes of verifying that costs are allowable and 24 equitable, CONTRACTOR shall submit any additional documentation as deemed necessary by DBH. 25 Non-NTP CONTRACTORs are all CONTRACTORs that are not DEA licensed Narcotic Treatment 26 Programs. 27 B. CONTRACTORs that elect to use the COUNTY's electronic health records 28 system (EHR) shall be invoiced in arrears by the fifth (5th) day of the month for the prior month's hosting DMC Master Agreement -7 1 fee for access to COUNTY's EHR in accordance with the fee schedule set forth in Exhibit G, "Electronic 2 Health Records Software Charges," attached hereto and incorporated herein by this reference and 3 made part of this Agreement. COUNTY shall invoice CONTRACTOR(S) annually for the annual 4 maintenance and licensing fee for access to COUNTY's electronic information system in accordance 5 with the fee schedule as set forth in Exhibit G. CONTRACTOR shall provide payment for these 6 expenditures to COUNTY's Department of Behavioral Health, Accounts Receivable, P.O. Box 712, 7 Fresno, CA 93717-0712, Attention: Business Office, within forty-five (45) days after the date of receipt 8 by CONTRACTOR of the invoicing provided by COUNTY. 9 C. COUNTY's DBH shall invoice CONTRACTOR on an annual basis the amount of 10 $75 per clinical position to access The Change Companies ASAM training modules which are required 11 to be completed upon hire and prior to delivering clinical services then annually thereafter. 12 7. LICENSING-CERTIFICATES 13 Throughout each term of this Agreement, CONTRACTOR and CONTRACTOR's staff shall 14 maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions necessary for the 15 provision of the services hereunder and required by the laws and regulations of the United States of 16 America, State of California, the County of Fresno, and any other applicable governmental agencies. 17 CONTRACTOR shall notify COUNTY immediately in writing of its inability to obtain or maintain such 18 licenses, permits, approvals, certificates, waivers and exemptions irrespective of the pendency of any 19 appeal related thereto. Additionally, CONTRACTOR and CONTRACTOR's staff shall comply with all 20 applicable laws, rules or regulations, as may now exist or be hereafter changed. 21 8. RESIDENTIAL AOD CERTIFICATION 22 A. The COUNTY requires CONTRACTOR(S) of residential Alcohol and Other 23 Substance Use Disorder treatment services to obtain the DHCS Alcohol and Other Drug Program (AOD) 24 Certification, including the program's American Society of Addiction Medicine (ASAM) level of care 25 designation or certification. 26 B. Residential CONTRACTOR(S) shall maintain a current AOD Certification during the 27 term of this Agreement. 28 C. COUNTY shall terminate this Agreement immediately in the event any of the DMC Master Agreement -$ 1 following occurs: 2 1) CONTRACTOR fails to submit to the COUNTY a copy of the AOD 3 Certification within thirty (30) days after being approved by the DHCS, or 4 2) Certification is not maintained throughout the contract term. 5 9. PERINATAL SERVICES 6 CONTRACTOR shall comply with the requirements of the "Perinatal Practice Guidelines," 7 available at the DHCS web address at: https://www.dhcs.ca.gov/individuals/Pages/Perinatal- 8 Services.aspx and by this reference incorporated herein, until such time new Perinatal Practice 9 Guidelines are updated and adopted. No formal amendment of this contract is required for new 10 guidelines to apply. Additionally, CONTRACTOR shall comply with the perinatal requirements stated in 11 Exhibit C, "Drug Medi-Cal Specific Requirements" and the FCSUD Provider Manual. No formal 12 amendment of this contract is required for new guidelines or amendments to Exhibit C or the FCSUD 13 Provider Manual to apply. 14 CONTRACTOR shall comply with federal and state mandates to provide alcohol and 15 other drug treatment services deemed medically necessary for Medi-Cal eligible: (1) pregnant and 16 postpartum women, and (2) youth under age 21 who are eligible under the Early and Periodic 17 Screening, Diagnostic, and Treatment (EPSDT) Program. 18 CONTRACTOR shall require that counselors of perinatal DMC services are properly 19 certified to provide these services and comply with the requirements contained in Title 22, § 51341.1, 20 Services for Pregnant and Postpartum Women and Title 9 commencing with section 10360. 21 10. PROHIBITION ON PUBLICITY 22 None of the funds, materials, property or services provided directly or indirectly under this 23 Agreement shall be used for CONTRACTOR's advertising, fundraising, or publicity (i.e., purchasing of 24 tickets/tables, silent auction donations, etc.)for the purpose of self-promotion. Notwithstanding the above, 25 publicity of the services described in Section One (1), SERVICES, of this Agreement shall be allowed as 26 necessary to raise public awareness about the availability of such specific services when approved in 27 advance by the DBH Director, or his or her designee, and at a cost to be provided for such items as 28 written/printed materials, the use of media (i.e., radio, television, newspapers) and any other related DMC Master Agreement -g 1 expense(s). Communication products must follow DBH graphic standards, including typefaces and 2 colors, to communicate our authority and project a unified brand. This includes all media types and 3 channels and all materials on and offline that are created as part of DBH's efforts to provide information 4 to the public. 5 11. NO THIRD-PARTY BENEFICIARIES 6 It is understood and agreed by and between the parties that the services provided by 7 CONTRACTOR for COUNTY herein are solely for the benefit of the COUNTY, and that nothing in this 8 Agreement is intended to confer on any person other than the parties hereto any right under or by reason of 9 this Agreement. 10 12. INDEPENDENT CONTRACTOR 11 In performance of the work, duties and obligations assumed by CONTRACTOR under this 12 Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of the 13 CONTRACTOR'S officers, agents, and employees will at all times be acting and performing as an 14 independent contractor, and shall act in an independent capacity and not as an officer, agent, servant, 15 employee,joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no right 16 to control or supervise or direct the manner or method by which CONTRACTOR shall perform its work and 17 function. However, COUNTY shall retain the right to administer this Agreement so as to verify that 18 CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof. 19 CONTRACTOR and COUNTY shall comply with all applicable provisions of law and the 20 rules and regulations, if any, of governmental authorities having jurisdiction over matters the subject 21 thereof. 22 Because of its status as an independent contractor, CONTRACTOR shall have absolutely 23 no right to employment rights and benefits available to COUNTY employees. CONTRACTOR shall be 24 solely liable and responsible for providing to, or on behalf of, its employees all legally-required employee 25 benefits. In addition, CONTRACTOR shall be solely responsible and save COUNTY harmless from all 26 matters relating to payment of CONTRACTOR'S employees, including compliance with Social Security 27 withholding and all other regulations governing such matters. It is acknowledged that during the term of this 28 Agreement, CONTRACTOR may be providing services to others unrelated to the COUNTY or to this DMC Master Agreement -10- 1 Agreement. 2 13. NON-ASSIGNMENT/SUBCONTRACTS 3 Neither party shall assign, transfer or sub-contract this Agreement nor their rights or duties 4 under this Agreement without the prior written consent of the other party. 5 CONTRACTOR shall be required to assume full responsibility for all services and activities 6 covered by this Agreement, whether or not CONTRACTOR is providing services directly. Further, 7 CONTRACTOR shall be the sole point of contact with regard to contractual matters, including payment of 8 any and all charges resulting from this Agreement. 9 If CONTRACTOR should propose to subcontract with one or more third parties to carry out 10 a portion of services covered by this Agreement, any such subcontract shall be in writing and approved as 11 to form and content by COUNTY's DBH Director, or his or her designee, prior to execution and 12 implementation. COUNTY's DBH Director, or his or her designee, shall have the right to reject any such 13 proposed subcontract. Any such subcontract together with all activities by or caused by CONTRACTOR 14 shall not require compensation greater than the total budget contained herein. An executed copy of any 15 such subcontract shall be received by COUNTY before any implementation and shall be retained by 16 COUNTY. CONTRACTOR shall be responsible to COUNTY for the proper performance of any 17 subcontract. Any subcontractor shall be subject to the same terms and conditions that CONTRACTOR is 18 subject to under this Agreement. 19 It is expressly recognized that CONTRACTOR cannot engage in the practice of physical 20 health medicine. If any medical services outside of the scope of the CONTRACTOR's medical director are 21 provided in connection with the services under this Agreement, such medical services shall be performed 22 by an independent contract physician. In this instance, the requirements of the Confidential Medical 23 Information Act (Civil Code 56 et seq.) shall be met. 24 If CONTRACTOR hires an independent contract physician, CONTRACTOR shall require 25 and ensure that such independent contract physician carries at least the following insurance coverages: 26 A. Professional Liability 27 Professional Liability (Medical Malpractice) Insurance, with limits of not less than One Million 28 Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) annual aggregate. DMC Master Agreement -1 1- 1 B. Cyber Liability 2 Cyber Liability Insurance, with limits not less than $2,000,000 per occurrence or claim, 3 $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to the duties and obligations as is 4 undertaken by CONTRACTOR in this Agreement and shall include, but not be limited to, claims involving 5 infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade 6 dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, 7 release of private information, alteration of electronic information, extortion and network security. The policy 8 shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit 9 monitoring expenses with limits sufficient to respond to these obligations. 10 Definition of Cyber Risks. "Cyber Risks" include but are not limited to (i) Security 11 Breaches, which may include Disclosure of Personal Information to an Unauthorized Third Party; (ii) breach 12 of any of the Contractor's obligations under Section#of this Agreement; (iii) infringement of intellectual 13 property, including but not limited to infringement of copyright, trademark, and trade dress; (iv) invasion of 14 privacy, including release of private information; (v) information theft; (vi) damage to or destruction or 15 alteration of electronic information; (vii) extortion related to the Contractor's obligations under this 16 Agreement regarding electronic information, including Personal Information; (viii) network security; (ix)data 17 breach response costs, including Security Breach response costs; (x) regulatory fines and penalties related 18 to the Contractor's obligations under this Agreement regarding electronic information, including Personal 19 Information; and (xi) credit monitoring expenses. 20 C. Molestation 21 Sexual abuse/molestation liability insurance with limits of not less than One Million Dollars 22 ($1,000,000.00) per occurrence, Two Million Dollars ($2,000,000.00) annual aggregate. This policy shall be 23 issued on a per occurrence basis. 24 CONTRACTOR will also ensure that the independent contract physician shall maintain, at 25 their sole expense, in full force and effect for a period of three (3) years following the termination of this 26 Agreement, one or more policies of professional liability insurance with limits of coverage as specified 27 herein. 28 // DMC Master Agreement -12 1 14. CONFLICT OF INTEREST 2 No officer, agent, or employee of COUNTY who exercises any function or responsibility for 3 planning and carrying out the services provided under this Agreement shall have any direct or indirect 4 personal financial interest in this Agreement. CONTRACTOR shall comply with all Federal, State of 5 California, and local conflict of interest laws, statutes, and regulations, which shall be applicable to all 6 parties and persons served under this Agreement and any officer, agent, or employee of COUNTY. 7 15. DISCLOSURE OF SELF-DEALING TRANSACTIONS 8 This provision is only applicable if the CONTRACTOR is operating as a corporation (a 9 for-profit or non-profit corporation) or if during the term of the agreement, the CONTRACTOR changes 10 its status to operate as a corporation. 11 Members of the CONTRACTOR's Board of Directors shall disclose any self-dealing 12 transactions that they are a party to while CONTRACTOR is providing goods or performing services 13 under this agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTOR 14 is a party and in which one or more of its directors has a material financial interest. Members of the 15 Board of Directors shall disclose any self-dealing transactions that they are a party to by completing and 16 signing a Self-Dealing Transaction Disclosure Form, attached hereto as Exhibit H, and incorporated 17 herein by reference, and submitting it to the COUNTY prior to commencing with the self-dealing 18 transaction or immediately thereafter. 19 16. ASSURANCES 20 In entering into this Agreement, CONTRACTOR certifies that it is not currently excluded, 21 suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; that it has 22 not been convicted of a criminal offense related to the provision of health care items or services; nor has it 23 been reinstated to participation in the Federal Health Care Programs after a period of exclusion, 24 suspension, debarment, or ineligibility. If COUNTY learns, subsequent to entering into a contract, that 25 CONTRACTOR is ineligible on these grounds, COUNTY will remove CONTRACTOR from responsibility 26 for, or involvement with, COUNTY's business operations related to the Federal Health Care Programs and 27 shall remove such CONTRACTOR from any position in which CONTRACTOR's compensation, or the 28 items or services rendered, ordered or prescribed by CONTRACTOR may be paid in whole or part, directly DMC Master Agreement -13- 1 or indirectly, by Federal Health Care Programs or otherwise with Federal Funds at least until such time as 2 CONTRACTOR is reinstated into participation in the Federal Health Care Programs. Further the 3 CONTRACTOR agrees to the Disclosure of Criminal History and Civil Actions and Certification regarding 4 debarment suspension and other responsibility matters primary covered transactions; CONTRACTOR 5 must sign an appropriate Certification regarding debarment, suspension, and other responsibility matters, 6 attached hereto as Exhibit I, incorporated herein by reference and made part of this Agreement. 7 A. If COUNTY has notice that CONTRACTOR has been charged with a criminal 8 offense related to any Federal Health Care Program or is proposed for exclusion during the term on any 9 contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the accuracy of any 10 claims submitted to any Federal Health Care Program. At its discretion given such circumstances, 11 COUNTY may request that CONTRACTOR cease providing services until resolution of the charges or the 12 proposed exclusion. 13 B. CONTRACTOR agrees that all potential new employees of CONTRACTOR or 14 subcontractors of CONTRACTOR who, in each case, are expected to perform professional services under 15 this Agreement, will be queried as to whether(1)they are now or ever have been excluded, suspended, 16 debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2)they have been 17 convicted of a criminal offense related to the provision of health care items or services; and or(3)they have 18 been reinstated to participation in the Federal Health Care Programs after a period of exclusion, 19 suspension, debarment, or ineligibility. 20 1) In the event the potential employee or subcontractor informs 21 CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been 22 convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR hires 23 or engages such potential employee or subcontractor, CONTRACTOR will ensure that said employee or 24 subcontractor does not work, either directly or indirectly relating to services provided to COUNTY. 25 2) Notwithstanding the above, COUNTY at its discretion may terminate this 26 Agreement in accordance with Section Four (4), TERMINATION, of this Agreement, or require adequate 27 assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or 28 subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to services provided DMC Master Agreement -14- 1 to COUNTY. Such demand for adequate assurance shall be effective upon a time frame to be determined 2 by COUNTY to protect the interests of COUNTY persons served. 3 C. CONTRACTOR shall verify (by asking the applicable employees and 4 subcontractors)that all current employees and existing subcontractors who, in each case, are expected to 5 perform professional services under this Agreement (1) are not currently excluded, suspended, debarred, 6 or otherwise ineligible to participate in the Federal Health Care Programs; (2) have not been convicted of a 7 criminal offense related to the provision of health care items or services; and (3) have not been reinstated to 8 participation in the Federal Health Care Program after a period of exclusion, suspension, debarment, or 9 ineligibility. In the event any existing employee or subcontractor informs CONTRACTOR that he or she is 10 excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, 11 or has been convicted of a criminal offense relating to the provision of health care services, 12 CONTRACTOR will ensure that said employee or subcontractor does not work, either direct or indirect, 13 relating to services provided to COUNTY. 14 1) CONTRACTOR agrees to notify COUNTY immediately during the term of 15 this Agreement whenever CONTRACTOR learns that an employee or subcontractor who, in each case, is 16 providing professional services under this Agreement is excluded, suspended, debarred or otherwise 17 ineligible to participate in the Federal Health Care Programs, or is convicted of a criminal offense relating to 18 the provision of health care services. 19 2) Notwithstanding the above, COUNTY at its discretion may terminate this 20 Agreement in accordance with the Section Four (4), TERMINATION, of this Agreement, or require 21 adequate assurance (as defined by COUNTY)that no excluded, suspended or otherwise ineligible 22 employee or subcontractor of CONTRACTOR will perform work, either directly or indirectly, relating to 23 services provided to COUNTY. Such demand for adequate assurance shall be effective upon a time frame 24 to be determined by COUNTY to protect the interests of COUNTY persons served. 25 D. CONTRACTOR agrees to cooperate fully with any reasonable requests for 26 information from COUNTY which may be necessary to complete any internal or external audits relating to 27 this Agreement. 28 E. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty DMC Master Agreement -15- 1 imposed upon COUNTY by the Federal Government as a result of CONTRACTOR's violation of the terms 2 of this Agreement. 3 17. MODIFICATION 4 Any matters of this Agreement may be modified from time to time by the written consent of 5 all the parties without, in any way, affecting the remainder. 6 Notwithstanding the above, changes to Section One (1), SERVICES, as needed to 7 accommodate changes in State and Federal Law relating to SUD treatment may be made with the signed 8 written approval of COUNTY's DBH Director, or his or her designee, and respective CONTRACTOR(S) 9 through an amendment approved by County Counsel and Auditor. 10 18. INSURANCE 11 Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR or any 12 third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect, the following 13 insurance policies or a program of self-insurance, including but not limited to, an insurance pooling 14 arrangement or Joint Powers Agreement (JPA)throughout the term of the Agreement: 15 A. Commercial General Liability 16 Commercial General Liability Insurance with limits of not less than Two Million 17 Dollars ($2,000,000.00) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000.00). 18 This policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including 19 completed operations, products liability, contractual liability, Explosion-Collapse-Underground, fire legal 20 liability or any other liability insurance deemed necessary because of the nature of this contract. 21 B. Automobile Liability 22 Comprehensive Automobile Liability Insurance with limits of not less than One 23 Million Dollars ($1,000,000.00) per accident for bodily injury and for property damages. Coverage should 24 include any auto used in connection with this Agreement. 25 C. Professional Liability 26 If CONTRACTOR employs licensed professional staff, (e.g., Ph.D., R.N., L.C.S.W., 27 M.F.C.C.) in providing services, Professional Liability Insurance with limits of not less than One Million 28 Dollars ($1,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00) annual aggregate. DMC Master Agreement -16- 1 D. Worker's Compensation 2 A policy of Worker's Compensation insurance as may be required by the California Labor 3 Code. 4 E. Molestation 5 Sexual abuse/ molestation liability insurance with limits of not less than One Million Dollars 6 ($1,000,000.00) per occurrence, Two Million Dollars ($2,000,000.00) annual aggregate. This policy shall be 7 issued on a per occurrence basis. 8 F. Cyber Liability 9 Cyber Liability Insurance, with limits not less than $2,000,000 per occurrence or claim, 10 $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to the duties and obligations as is 11 undertaken by CONTRACTOR in this Agreement and shall include, but not be limited to, claims involving 12 infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade 13 dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, 14 release of private information, alteration of electronic information, extortion and network security. The policy 15 shall provide coverage for breach response costs as well as regulatory fines and penalties as well as credit 16 monitoring expenses with limits sufficient to respond to these obligations. 17 CONTRACTOR shall obtain endorsements to the Commercial General Liability insurance 18 naming the County of Fresno, its officers, agents, and employees, individually and collectively, as additional 19 insured, but only insofar as the operations under this Agreement are concerned. Such coverage for 20 additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained 21 by COUNTY, its officers, agents and employees shall be excess only and not contributing with insurance 22 provided under CONTRACTOR's policies herein. This insurance shall not be cancelled or changed without 23 a minimum of thirty(30) days advance written notice given to COUNTY. 24 CONTRACTOR hereby waives its right to recover from COUNTY, its officers, agents, and 25 employees any amounts paid by the policy of worker's compensation insurance required by this 26 Agreement. CONTRACTOR is solely responsible to obtain any endorsement to such policy that may be 27 necessary to accomplish such waiver of subrogation, but CONTRACTOR's waiver of subrogation under 28 this paragraph is effective whether or not CONTRACTOR obtains such an endorsement. DMC Master Agreement -17 1 Within thirty (30) days from the date CONTRACTOR signs and executes this Agreement, 2 CONTRACTOR shall provide certificates of insurance and endorsement as stated above for all of the 3 foregoing policies, as required herein, to the assigned analyst at the County of Fresno, Department of 4 Behavioral Health, Contracts Division —SUD Services at 3133 N Millbrook Avenue, Fresno, California, 5 93703, stating that such insurance coverages have been obtained and are in full force; that the County of 6 Fresno, its officers, agents and employees will not be responsible for any premiums on the policies; that for 7 such worker's compensation insurance the CONTRACTOR has waived its right to recover from the 8 COUNTY, its officers, agents, and employees any amounts paid under the insurance policy and that waiver 9 does not invalidate the insurance policy; that such Commercial General Liability insurance names the 10 County of Fresno, its officers, agents and employees, individually and collectively, as additional insured, but 11 only insofar as the operations under this Agreement are concerned; that such coverage for additional 12 insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by 13 COUNTY, its officers, agents and employees, shall be excess only and not contributing with insurance 14 provided under CONTRACTOR's policies herein; and that this insurance shall not be cancelled or changed 15 without a minimum of thirty (30) days advance, written notice given to COUNTY. 16 In the event CONTRACTOR fails to keep in effect at all times insurance coverage as herein 17 provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate this 18 Agreement upon the occurrence of such event. 19 All policies shall be issued by admitted insurers licensed to do business in the State of 20 California, and such insurance shall be purchased from companies possessing a current A.M. Best, Inc. 21 rating of A FSC VII or better. 22 19. HOLD HARMLESS 23 CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY'S request, 24 defend the COUNTY, its officers, agents, and employees from any and all costs and expenses (including 25 attorney's fees and costs), damages, liabilities, claims, and losses occurring or resulting to COUNTY in 26 connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents, or 27 employees under this Agreement, and from any and all costs and expenses (including attorney's fees and 28 costs), damages, liabilities, claims, and losses occurring or resulting to any person, firm, or corporation who DMC Master Agreement -18 1 may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, 2 agents, or employees under this Agreement. 3 CONTRACTOR agrees to indemnify COUNTY for Federal, State of California audit 4 exceptions resulting from noncompliance herein on the part of the CONTRACTOR. 5 The provisions of this Section Nineteen (19), HOLD HARMLESS, shall survive 6 termination of this Agreement. 7 20. SINGLE AUDIT 8 A. If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars ($750,000.00) or 9 more in Federal and Federal flow-through monies, CONTRACTOR agrees to conduct an annual audit in 10 accordance with the requirements of the Single Audit Standards as set forth in 2 Code of Federal 11 Regulations (CFR) Part 200. CONTRACTOR shall submit said audit and management letter to COUNTY. 12 The audit must include a statement of findings or a statement that there were no findings. If there were 13 negative findings, CONTRACTOR must include a corrective action plan signed by an authorized individual. 14 CONTRACTOR agrees to take action to correct any material non-compliance or weakness found as a 15 result of such audit. Such audit shall be delivered to COUNTY's Department of Behavioral Health, Business 16 Office for review within nine (9) months of the end of any fiscal year in which funds were expended and/or 17 received for the program. Failure to perform the requisite audit functions as required by this Agreement may 18 result in COUNTY performing the necessary audit tasks, or at COUNTY's option, contracting with a public 19 accountant to perform said audit, or may result in the inability of COUNTY to enter into future agreements 20 with CONTRACTOR. All audit costs related to this Agreement are the sole responsibility of 21 CONTRACTOR. 22 B. A single audit report is not applicable if CONTRACTOR's Federal contracts do not 23 exceed the Seven Hundred Fifty Thousand Dollars ($750,000.00) requirement or CONTRACTOR's only 24 funding is through Drug Medi-Cal. If a single audit is not applicable, a program audit must be performed and 25 a program audit report with management letter shall be submitted by CONTRACTOR to COUNTY as a 26 minimum requirement to attest to CONTRACTOR's solvency. Said audit report shall be delivered to 27 COUNTY's Department of Behavioral Health, Business Office for review, no later than nine (9) months after 28 the close of the fiscal year in which the funds supplied through this Agreement are expended. Failure to DMC Master Agreement -19 1 comply with this Act may result in COUNTY performing the necessary audit tasks or contracting with a 2 qualified accountant to perform said audit. All audit costs related to this Agreement are the sole 3 responsibility of CONTRACTOR who agrees to take corrective action to eliminate any material 4 noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under this 5 section shall be billed to the CONTRACTOR at COUNTY's cost, as determined by COUNTY's Auditor- 6 Controller/Treasurer-Tax Collector. 7 C. CONTRACTOR shall make available all records and accounts for inspection by 8 COUNTY, the State of California, if applicable, the Comptroller General of the United States, the Federal 9 Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a minimum of 10 ten (10) years, in accordance with 42 CFR Part 438.3(h), from the finalized cost settlement process or, if an 11 audit by the Federal government or DHCS has been started before the expiration of the ten (10) year 12 period, records shall be maintained until completion of the audit and final resolution of all findings. 13 21. AUDITS AND INSPECTIONS 14 The CONTRACTOR shall at any time during business hours, and as often as the COUNTY 15 may deem necessary, make available to the COUNTY for examination all of its records and data with 16 respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request by the 17 COUNTY, permit the COUNTY to audit and inspect all electronic or print books and records as well as 18 inspection of the premises, physical facilities and equipment where Medicaid-related activities are 19 conducted to ensure CONTRACTOR'S compliance with the terms of this Agreement. 20 The refusal of CONTRACTOR to permit access to, and inspection of, electronic or print 21 books and records, physical facilities, and/or refusal to permit interviews with employees, as described in 22 this part, constitutes an express and immediate material breach of this Agreement and will be sufficient 23 basis to terminate the Agreement for cause or default. 24 The right to audit under this section exists for ten (10) years from the final date of the 25 agreement period or from the date of completion of any audit, whichever is later. 26 Notwithstanding the provisions stated in Section Three (3), TERM, of this Agreement, it is 27 acknowledged by the parties hereto that this Agreement shall continue in full force and effect until all audit 28 procedures and requirements as stated in this Agreement have been completed to the review and DMC Master Agreement -20 1 satisfaction of COUNTY. CONTRACTOR shall bear all costs in connection with or resulting from any audit 2 and/or inspections including, but not limited to, actual costs incurred and the payment of any expenditures 3 disallowed by either COUNTY, State, or Federal governmental entities, including any assessed interest and 4 penalties. 5 If CONTRACTOR, through an audit by the STATE or COUNTY, is found to be in violation of 6 this contract which results in the recoupment of funds paid to CONTRACTOR, COUNTY may, upon mutual 7 consent between CONTRACTOR and COUNTY, enter into a repayment agreement with the 8 CONTRACTOR, with total monthly payments not to exceed twelve (12) months from the date of the 9 repayment agreement, to recover the amount of funds to be recouped. The monthly repayment amounts 10 shall be netted against the CONTRACTOR's monthly billing for services rendered during the month. 11 COUNTY reserves the right to forgo a repayment agreement and recoup all funds immediately. 12 If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR shall be 13 subject to the examination and audit of the California State Auditor for a period of three (3) years after final 14 payment under contract (Government Code Section 8546.7). 15 22. EVALUATION — MONITORING 16 CONTRACTOR shall participate in a review of the program at least yearly or more 17 frequently, or as needed, at the discretion of COUNTY. The CONTRACTOR agrees to supply all 18 information requested by the COUNTY, DHCS, and/or the subcontractor during the program evaluation, 19 monitoring, and/or review. 20 COUNTY's DBH Director, or his or her designee, and DHCS or their designees shall 21 monitor and evaluate the performance of CONTRACTOR under this Agreement to determine to the best 22 possible degree the success or failure of the services provided under this Agreement. At the discretion of 23 the COUNTY, a subcontractor may be obtained by the COUNTY to independently evaluate and monitor the 24 performance of the CONTRACTOR. CONTRACTOR shall participate in the evaluation of the program as 25 needed, at the discretion of COUNTY. 26 COUNTY shall recapture from CONTRACTOR the value of any services or other 27 expenditures determined to be ineligible based on the COUNTY or State monitoring results. At the 28 discretion of the COUNTY, CONTRACTOR shall enter into a repayment agreement with the COUNTY, with DMC Master Agreement -21 1 total monthly payments not to exceed twelve (12) months from the date of the repayment agreement, to 2 recover the amount of funds to be recouped. The monthly repayment amounts shall be netted against the 3 CONTRACTOR's monthly billing for services rendered during the month. COUNTY reserves the right to 4 forgo a repayment agreement and recoup all funds immediately. 5 23. REPORTS—SUBSTANCE USE DISORDER SERVICES 6 CONTRACTOR(S) shall submit all information and data required by COUNTY and State 7 in accordance with Exhibit F — Provider Reporting Requirements, incorporated in this Agreement and 8 also available on the DBH website at: https://www.co.fresno.ca.us/departments/behavioral- 9 health/home/for-providers/contract-providers/substance-use-disorder-providers. Reporting requirements 10 may be revised periodically to reflect changes to State mandated reporting. CONTRACTOR(S) that are 11 not in compliance with reporting deadlines are subject to payment withholding until reporting compliance 12 is achieved. Reporting requirements include, but are not limited to, the following: 13 A. Drug and Alcohol Treatment Access Report (DATAR) in an electronic format 14 provided by the State and due no later than five (5) days after the preceding month; 15 B. CalOMS Treatment— Submit CalOMS treatment admission, discharge, annual 16 update, and "provider activity report" record in an electronic format through COUNTY's information 17 system, and on a schedule as determined by the COUNTY which complies with State requirements for 18 data content, data quality, reporting frequency, reporting deadlines, and report method and due no later 19 than five (5) days after the preceding month. All CalOMS admissions, discharges, and annual updates 20 must be entered into the COUNTY's CalOMS system within twenty-four (24) hours of occurrence; 21 C. ASAM Level of Care (LOC) — Submit ASAM LOC data in a format determined by 22 DBH, on a schedule as determined by the COUNTY which complies with State requirements; 23 D. Access Form — CONTRACTOR shall enter access information into COUNTY's 24 EHR at time of first contact with person served; 25 E. Ineligible Person Screening Report—format provided by COUNTY DBH and due 26 by the fifteenth (15th) day of each month to comply with State requirements; 27 F. Logic Manager Incident Reporting —as needed, when incidents occur and as 28 instructed in Exhibit J, Protocol for Completion of Incident Report. DMC Master Agreement -22 1 G. Monthly Status Report—format provided by COUNTY DBH and due by the fifteen 2 (15th) day of each month; 3 H. Wait list— required by residential providers only and due by the fifteen (15th) day 4 of each month; 5 I. Grievance Log - due by the fifteen (15th) day of each month; 6 J. Missed appointments — CONTRACTOR shall enter all missed appointments into 7 COUNTY's EHR by the fifteenth (15th) of the following month; 8 K. Cultural Competency Survey — completed annually in a format to be determined 9 by DBH; 10 L. Americans with Disabilities (ADA) —Annually, upon request by COUNTY DBH, 11 CONTRACTOR(S) shall complete a system-wide accessibility survey in a format determined by DBH for 12 each service location and modality and shall submit an ADA Accessibility Certification and Self- 13 Assessment, including an Implementation Plan, for each service location; 14 M. Culturally and Linguistically Appropriate Services (CLAS) -Annually, upon request 15 by COUNTY DBH, CONTRACTOR(S) shall complete an agency CLAS survey in a format determined by 16 COUNTY DBH and shall submit a CLAS Self-Assessment, including an Implementation Plan; 17 N. Risk Assessment—Annually, upon request by COUNTY DBH, CONTRACTOR shall 18 submit a Risk Assessment on a form and in a format to be provided by DBH. The Assessment must be 19 submitted to the COUNTY in hard copy as well as electronically by the due date set by COUNTY; 20 O. Network Adequacy Certification Tool (NACT)—Annually, upon request, 21 CONTRACTOR shall submit NACT data as requested by COUNTY DBH; 22 P. Operating Expense Report— CONTRACTOR shall submit expenses by the 25th of 23 each month on a form provided by COUNTY DBH, including a general ledger, payroll register and other 24 supporting documentation as request; and 25 Q. Cost Reports— On an annual basis for each fiscal year ending June 30th non- 26 NTP CONTRACTOR(S) shall submit a complete and accurate detailed cost report(s). Refer to Section 27 Twenty-four (24), Cost Reporting, for cost reporting requirements. 28 DMC Master Agreement -23 1 24. COST REPORTING 2 Cost reports must be submitted to the COUNTY as a hard copy with a signed cover letter 3 and an electronic copy by the due date. Submittal must also include any requested support documents 4 such as general ledgers and detailed electronic (e.g. Excel) schedules demonstrating how costs were 5 allocated both within programs, if provider has multiple funding sources (e.g. DMC and SABG), and 6 between programs, if CONTRACTOR provides multiple SUD treatment modalities. Provider shall 7 maintain general ledgers that reflect the original transaction amounts where each entry in their 8 accounting records represents one-hundred percent (100%) of the total transaction cost and can be 9 supported with the original source documentation (i.e. receipts, bills, invoices, payroll registers, etc.). 10 Bank statements reflecting purchases are not original source documents and will not be accepted as 11 such. All costs found to not be supported by original source documentation will be disallowed. Total 12 unallowable costs shall be allocated their percentage share of the indirect Costs along with the 13 Contractor's direct costs. All reports submitted by CONTRACTOR(S) to COUNTY must be typewritten. 14 COUNTY will issue instructions for completion and submittal of the annual cost report, including the 15 relevant cost report template(s) and due dates within forty-five (45) days of each fiscal year end. All cost 16 reports must be prepared in accordance with Generally Accepted Accounting Principles. Unallowable 17 costs such as those denoted in 2 CFR 200 Subpart E, Cost Principles, 41 U.S.C. 4304, and the Center for 18 Medicare and Medicaid Studies (CMS) Provider Reimbursement Manual (PRM) 15-1, must not be 19 included as an allowable cost on the cost report and all invoices. Unallowable costs must be kept in the 20 provider's General Ledger in accounts entitled Unallowable followed by name of the account (e.g. 21 Unallowable— Food) or in some other appropriate form of segregation in the provider's accounting 22 records. For further information on unallowable costs refer to regulations provided above. If the 23 CONTRACTOR(S) does not submit the cost report by the due date, including any extension period 24 granted by the COUNTY, the COUNTY may withhold payment of pending invoices until the cost 25 report(s) has been submitted and clears COUNTY desk audit for completeness and accuracy. Once the 26 cost reports have been approved by the County, originally-executed signed certification pages attesting 27 to the accuracy of the information contained in cost reports shall be submitted to the County. 28 DMC Master Agreement -24 1 1) DMC - A DMC cost report must be submitted in a format prescribed by the 2 DHCS for the purposes of Short Doyle Medi-Cal reimbursement of total costs for all programs. 3 CONTRACTOR(S) shall report costs under their approved legal entity number established during the 4 DMC certification process. Total units of service reported on the cost report will be compared to the units 5 of services entered by CONTRACTOR(S) into COUNTY's data system. CONTRACTOR(S) will be 6 required to correct discrepancies and resubmit to COUNTY prior to COUNTY's final acceptance of the 7 cost report. 8 2) OTHER FUNDING SOURCES — CONTRACTOR(S) will be required to 9 submit a cost report on a form approved and provided by the COUNTY to reflect actual costs and 10 reimbursement for services provided through funding sources other than DMC. Contracts that include a 11 negotiated rate per unit of service will be reimbursed for actual costs incurred (the sum of both direct 12 costs as defined in 2 CFR 200.413, and allocated indirect costs as defined in 2 CFR 200.414) not to 13 exceed the contract maximum. If the cost report indicates an amount due to COUNTY, 14 CONTRACTOR(S) shall submit payment with the report. If an amount is due to CONTRACTOR(S) 15 COUNTY shall reimburse CONTRACTOR within forty-five (45) days of receiving and accepting the year- 16 end cost report. 17 3) MULTIPLE FUNDING SOURCES — CONTRACTOR(S) with multiple 18 agreements for the same services (e.g. Outpatient, Residential) provided at the same location where at 19 least one of the Agreements is funded through DMC and the other funding is other federal or county 20 realignment funding will be required to complete DMC cost reports and COUNTY approved cost reports. 21 Such Agreements will be settled for actual allowable costs in accordance with Medicaid reimbursement 22 requirements as specified in Title XIX or Title XXI of the Social Security Act; Title 22, and the State's 23 Medicaid Plan. Within forty-five (45) days of the reconciliation by COUNTY, CONTRACTOR shall make 24 payment to COUNTY or COUNTY shall reimburse CONTRACTOR as appropriate. 25 During the term of this Agreement and thereafter, COUNTY and CONTRACTOR(S) 26 agree to settle dollar amounts disallowed or settled in accordance with DHCS and COUNTY audit 27 settlement findings. DHCS audit process is approximately eighteen (18) to thirty-six (36) months 28 following the close of the State fiscal year. COUNTY may choose to appeal DHCS settlement results DMC Master Agreement -25 1 and therefore reserves the right to defer payback settlement with CONTRACTOR(S) until resolution of 2 the appeal. 3 CONTRACTOR shall furnish to COUNTY such statements, records, reports, data, and 4 information as COUNTY may request pertaining to matters covered by this Agreement. All reports 5 submitted to the COUNTY must be typewritten. 6 In the event that CONTRACTOR(S) fails to provide such reports or other information 7 required hereunder, it shall be deemed sufficient cause for the COUNTY to withhold monthly payments 8 until there is compliance. In addition, the CONTRACTOR shall provide written notification and 9 explanation to the COUNTY within fifteen (15) days of any funds received from another source to 10 conduct the same services covered by this Agreement. 11 25. PROPERTY OF COUNTY 12 A. CONTRACTOR shall submit purchase invoices for the purchase of any fixed assets 13 with their monthly invoices. All purchases over Five Thousand and No/100 Dollars ($5,000.00), and certain 14 purchases under Five Thousand and No/100 Dollars ($5,000.00) such as fans, calculators, cameras, 15 VCRs, DVDs and other sensitive items as determined by COUNTY's DBH Director, or his or her designee, 16 made during the life of this Agreement shall be identified as assets that can be inventoried and maintained 17 in COUNTY's DBH Asset Inventory System. These assets shall be retained by COUNTY, as COUNTY 18 property, in the event this Agreement is terminated or upon expiration of this Agreement. CONTRACTOR 19 agrees to participate in an annual inventory of all COUNTY fixed assets and shall be physically present 20 when fixed assets are returned to COUNTY's possession at the termination or expiration of this Agreement. 21 CONTRACTOR is responsible for returning to COUNTY all COUNTY owned fixed assets, or the monetary 22 value of said fixed assets if unable to produce the fixed assets at the expiration or termination of this 23 Agreement. 24 B. The purchase of any equipment by CONTRACTOR with funds provided 25 hereunder shall require the prior written approval of COUNTY's DBH Director or his or her designee, 26 shall fulfill the provisions of this Agreement as appropriate, and must be directly related to 27 CONTRACTOR's services or activity under the terms of this Agreement. COUNTY's DBH Director, or 28 DMC Master Agreement -26 1 his or her designee, may refuse reimbursement for any costs resulting from equipment purchased, 2 which are incurred by CONTRACTOR, if prior written approval has not been obtained from COUNTY. 3 C. The terms and conditions described in this Section are not applicable to the 4 leasing of vehicles by CONTRACTOR with the funds provided under this Agreement. 5 26. RECORDS 6 A. RECORD ESTABLISHMENT AND MAINTENANCE —CONTRACTOR shall 7 establish and maintain records in accordance with State and Federal rules and regulations in addition to 8 those requirements prescribed by COUNTY with respect to all matters covered by this Agreement. 9 Except as otherwise authorized by COUNTY, CONTRACTOR shall retain all other records for a period 10 of ten (10) years from the finalized cost settlement process, or from the date of completion of any audit, 11 whichever is later. 12 B. DOCUMENTATION — CONTRACTOR shall maintain adequate records in 13 sufficient detail to make possible an evaluation of services and contain all the data necessary in 14 reporting to the State of California and/or Federal agency. All persons served records shall be 15 maintained pursuant to applicable State of California and Federal requirements concerning 16 confidentiality. In the event of contract termination or expiration, all original copies of clinical records, 17 including clinical charts, group sign-in sheets, and fiscal records, including original receipts, for a period 18 of ten (10) years shall be delivered to COUNTY. 19 C. REPORTS — CONTRACTOR shall submit to COUNTY periodic fiscal and all 20 program reports as further described in Section Twenty-Three (23) REPORTS — Substance Use 21 Disorder Services. CONTRACTOR shall submit a complete and accurate year-end cost report for each 22 fiscal year affected by this Agreement, following the end of each fiscal year affected by this Agreement. 23 CONTRACTOR shall also furnish to COUNTY such statements, records, reports, data, and information 24 as COUNTY may request pertaining to matters covered by this Agreement. All reports submitted by 25 CONTRACTOR to COUNTY must be typewritten. 26 D. SUSPENSION OF COMPENSATION — In the event that CONTRACTOR fails to 27 provide reports specified in this Agreement, it shall be deemed sufficient cause for COUNTY to withhold 28 payments until there is compliance. DMC Master Agreement -27 1 E. PERSON SERVED CONFIDENTIALITY— CONTRACTOR shall conform to and 2 COUNTY shall monitor compliance with all State and Federal statutes and regulations regarding 3 confidentiality, including but not limited to confidentiality of information requirements of 42 CFR § 2.1 et 4 seq., Welfare and Institutions Code §§ 5328, 10850 and 14100.2, Health and Safety Code §§ 11977 5 and 11812, Civil Code, Division 1, Part 2.6, and CCR Title 22 § 51009. 6 27. DATA SECURITY 7 For the purpose of preventing the potential loss, misappropriation or inadvertent access, 8 viewing, use or disclosure of COUNTY data including sensitive or personal person served information; 9 abuse of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that 10 enter into a contractual relationship with the COUNTY for the purpose of providing services under this 11 Agreement must employ adequate data security measures to protect the confidential information provided 12 to CONTRACTOR by the COUNTY, including but not limited to the following: 13 A. CONTRACTOR-OWNED MOBILE, WIRELESS, OR HANDHELD DEVICES 14 CONTRACTOR may not connect to COUNTY networks via personally-owned 15 mobile, wireless or handheld devices, unless the following conditions are met: 16 1) CONTRACTOR has received authorization by COUNTY for telecommuting 17 purposes; 18 2) Current virus protection software is in place; 19 3) Mobile device has the remote wipe feature enabled; and 20 4) A secure connection is used. 21 B. CONTRACTOR-OWNED COMPUTERS OR COMPUTER PERIPHERALS 22 CONTRACTOR may not bring CONTRACTOR-owned computers or computer 23 peripherals into the COUNTY for use without prior authorization from the COUNTY's Chief Information 24 Officer, and/or designee(s), including but not limited to mobile storage devices. If data is approved to be 25 transferred, data must be stored on a secure server approved by the COUNTY and transferred by means of 26 a Virtual Private Network (VPN) connection, or another type of secure connection. Said data must be 27 encrypted. 28 DMC Master Agreement -28 1 C. COUNTY-OWNED COMPUTER EQUIPMENT 2 CONTRACTOR or anyone having an employment relationship with the COUNTY 3 may not use COUNTY computers or computer peripherals on non-COUNTY premises without prior 4 authorization from the COUNTY's Chief Information Officer, and/or designee(s). 5 D. CONTRACTOR may not store COUNTY's private, confidential or sensitive data on 6 any hard-disk drive, portable storage device, or remote storage installation unless encrypted. 7 E. CONTRACTOR shall be responsible to employ strict controls to ensure the integrity 8 and security of COUNTY's confidential information and to prevent unauthorized access, viewing, use or 9 disclosure of data maintained in computer files, program documentation, data processing systems, data 10 files and data processing equipment which stores or processes COUNTY data internally and externally. 11 F. Confidential person served information transmitted to one party by the other by 12 means of electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) 13 of 128 BIT or higher. Additionally, a password or pass phrase must be utilized. 14 G. CONTRACTOR is responsible to immediately notify COUNTY of any violations, 15 breaches or potential breaches of security related to COUNTY's confidential information, data maintained in 16 computer files, program documentation, data processing systems, data files and data processing 17 equipment which stores or processes COUNTY data internally or externally. 18 H. COUNTY shall provide oversight to CONTRACTOR's response to all incidents 19 arising from a possible breach of security related to COUNTY's confidential person served information 20 provided to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected 21 individuals as required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR 22 will be responsible for all costs incurred as a result of providing the required notification. 23 28. EHR CERTIFICATION 24 CONTRACTOR shall obtain certification from the Certification Commission for Healthcare 25 Information Technology (CCHIT) for Security Access Control, Audit, and Authentication if using a non- 26 Avatar electronic health record (EHR) and shall provide a copy of the certification to COUNTY. 27 Additionally, CONTRACTOR shall recertify their EHR annually and provide a copy of the recertification 28 to COUNTY. CONTRACTOR shall ensure all employees who use an EHR other than Avatar sign an DMC Master Agreement -29 1 Electronic Signature Agreement (See example, Exhibit K) and maintain a copy in the employee's 2 personnel file. 3 29. COMPLIANCE WITH LAWS, POLICIES AND RULES 4 CONTRACTOR shall comply with all applicable rules and regulations set forth in CCR Titles 5 9 and 22, and California Health and Safety Code § 11750 et seq., with the exception of regulations waived 6 by the Centers for Medicare and Medicaid Services and DHCS, as stated within the DMC-Organized 7 Delivery System (ODS) Special Terms and Conditions (STCs) and the DMC Intergovernmental Agreement. 8 CONTRACTOR shall comply with any other Federal and State laws or guidelines applicable to 9 CONTRACTOR's performance under this Agreement or any local ordinances, regulations, or policies 10 applicable. Such provisions include, but are not restricted to: 11 A. CONTRACTOR shall comply with 42 CFR Part 438. 12 B. CONTRACTOR shall comply with Early and Periodic Screening, Diagnostic and 13 Treatment (EPSDT) statutes and regulations. 14 C. CONTRACTOR shall ensure that each person served's ability to pay for services is 15 determined by the use of the method approved by COUNTY. 16 D. CONTRACTOR shall establish and use COUNTY's approved method of 17 determining and collecting fees from persons served. 18 E. CONTRACTOR shall furnish person served records in accordance with the 19 applicable Federal, State and local regulations and requirements, including in such records a treatment 20 plan for each person served, and evidence of each service rendered. 21 F. CONTRACTOR shall submit accurate, complete and timely claims and cost reports, 22 reporting only allowable costs. 23 G. CONTRACTOR shall comply with statistical reporting and program evaluation 24 systems as provided in State of California regulations and in this Agreement. 25 H. CONTRACTOR shall comply with requirements contained in the DMC 26 Intergovernmental Agreement with DHCS by this reference incorporated herein, until such time that a new 27 DMC Intergovernmental Agreement is established. Upon amendment of the DMC Intergovernmental 28 Agreement, the terms of the amended Contract shall automatically be incorporated into this Agreement. DMC Master Agreement -30- 1 I. CONTRACTOR shall inform every person served of their rights regarding Grievance 2 and Appeals as described in the Provider Manual, attached hereto and by this reference incorporated. 3 J. CONTRACTOR shall file an incident report for all incidents involving persons served 4 and CONTRACTOR staff, using COUNTY's Incident Reporting System, following the Protocol for 5 Completion of Incident Report described in the Provider Manual, attached hereto and by this reference 6 incorporated. 7 K. In the event any law, regulation, or policy referred to in this Agreement is amended 8 during the term thereof, the parties hereto agree to comply with the amended provision as of the effective 9 date of such amendment. Exhibits will be updated as needed and no formal amendment of this contract is 10 required for new rules to apply. 11 30. NON-DISCRIMINATION PROVISION 12 ELIGIBILITY FOR SERVICES — CONTRACTOR shall prepare, prominently post in its 13 facility, and make available to the DBH Director, or his or her designee, and to the public all eligibility 14 requirements to participate in the program funded under this Agreement. CONTRACTOR shall not 15 unlawfully discriminate in the provision of services because of sex, race, religion, color, national origin, 16 ancestry, ethnic group identification, physical disability, mental disability, medical condition, genetic 17 information, sexual orientation, marital status, age, gender, gender identity, gender expression, or 18 military or veteran status as provided by State of California and Federal law in accordance with Title VI 19 of the Civil Rights Act of 1964 (42 USC § 2000(d)); Age Discrimination Act of 1975 (42 USC § 1681); 20 Rehabilitation Act of 1973 (29 USC § 794); Education Amendments of 1972 (20 USC § 1681); 21 Americans with Disabilities Act of 1990 (42 USC § 12132); 45 CFR, Part 84; provisions of the Fair 22 Employment and Housing Act (California Government Code § 12900); and regulations promulgated 23 thereunder (CCR Title 2, § 7285.0); Title 2, Division 3, Article 9.5 of the California Government Code 24 commencing with section 11135; and CCR Title 9, Division 4, Chapter 6 commencing with section 25 10800. 26 A. EQUAL OPPORTUNITY— CONTRACTOR shall comply with California Government 27 Code, § 2990 and CCR Title 2, Division 4, Chapter 5, in matters related to the development, 28 implementation, and maintenance of a nondiscrimination program. CONTRACTOR shall not discriminate DMC Master Agreement -31- 1 against any employee or applicant for employment because sex, race, religion, color, national origin, 2 ancestry, ethnic group identification, physical disability, mental disability, medical condition, genetic 3 information, sexual orientation, marital status, age, gender, gender identity, gender expression, or military 4 or veteran status. Such practices include retirement, recruitment, advertising, hiring, layoff, termination, 5 upgrading, demotion, transfer, rates of pay or other forms of compensation, use of facilities, and other terms 6 and conditions of employment. CONTRACTOR agrees to post in conspicuous places, notices available to 7 all employees and applicants for employment setting forth the provisions of the Equal Opportunity Act (42 8 USC § 2000(e)) in conformance with Federal Executive Order No. 11246. CONTRACTOR agrees to 9 comply with the provisions of the Rehabilitation Act of 1973 (29 USC § 794). 10 B. SUSPENSION OF COMPENSATION — If an allegation of discrimination occurs, 11 DBH may withhold all further funds, until CONTRACTOR can show by clear and convincing evidence to the 12 satisfaction of DBH that funds provided under this Agreement were not used in connection with the alleged 13 discrimination. 14 C. NEPOTISM — Except by consent of the DBH Director, or his or her designee, no 15 person shall be employed by CONTRACTOR who is related by blood or marriage to or who is a member of 16 the Board of Directors or an officer of CONTRACTOR. 17 D. NEW FACILITIES AND DISABILITY ACCESS— New facilities shall be wheelchair 18 accessible and provide access to the disabled, consistent with CCR Title 9, § 10820. If a new facility will be 19 utilized, a plan ensuring accessibility to the disabled must be developed. DBH shall assess, monitor, and 20 document CONTRACTOR's compliance with the Rehabilitation Act of 1973 and Americans with Disabilities 21 Act of 1990 to ensure that recipients/persons served and intended recipients/beneficiaries of services are 22 provided services without regard to physical or mental disability and that CONTRACTOR has provided a 23 facility accessible to the physically disabled. 24 31. COMPLIANCE 25 CONTRACTOR(S) shall comply with all requirements of the "Fresno County Behavioral 26 Health Compliance Program Contractor Code of Conduct and Ethics" as set forth in Exhibit L. Within 27 thirty (30) days of entering into this Agreement with the COUNTY, new CONTRACTOR(S) shall have all 28 of CONTRACTOR(S) employees, agents and subcontractors providing services under this Agreement DMC Master Agreement -32 1 complete General Compliance training and certify in writing, that they have received, read, understood, 2 and shall abide by the requirements set forth in Exhibit L. CONTRACTOR(S) shall ensure that within 3 thirty (30) days of hire, all new employees, agents and subcontractors providing services under this 4 Agreement complete General Compliance training and certify in writing that they have received, read, 5 understood, and shall abide by the requirements set forth in Exhibit L. 6 CONTRACTOR(S) will require all employees, agents and subcontractors providing 7 services under this Agreement to complete General Compliance training annually thereafter and 8 appropriate employees, agents and subcontractors shall complete Substance Use Disorder 9 Documentation Billing or billing/reimbursement training. CONTRACTOR(S) understands that the 10 promotion of and adherence to such requirements is an element in evaluating the performance of 11 CONTRACTOR(S) and its employees, agents and subcontractors. 12 CONTRACTOR(S) employees, agents and subcontractors will submit written 13 certifications upon completion of General Compliance training to the COUNTY's Compliance Officer. 14 CONTRACTOR(S) and its employees, agents and subcontractors will promptly report 15 any suspected violation(s) of the Code of Conduct and Ethics or report any activity that they believe may 16 violate the standards of the Compliance Program through the DBH Compliance Hotline: (888) 262-4174. 17 CONTRACTOR(S) agrees to reimburse COUNTY for the entire cost of any penalty 18 imposed upon COUNTY by the Federal Government as a result of CONTRACTOR(S) violation of the 19 terms of this Agreement. 20 32. COMPLAINTS 21 CONTRACTOR shall log complaints and the disposition of all complaints from a persons 22 served or a person served's family. CONTRACTOR shall provide a summary of the complaint log entries 23 concerning COUNTY-sponsored persons served to COUNTY at monthly intervals by the fifteenth (15th) 24 day of the following month, in a format that is mutually agreed upon. CONTRACTOR shall post signs 25 informing person served of their right to file a complaint or grievance. CONTRACTOR shall notify COUNTY 26 of all incidents reportable to state licensing bodies that affect COUNTY persons served within twenty-four 27 (24) hours of receipt of a complaint. 28 Within fifteen (15) days after each incident or complaint affecting COUNTY-sponsored DMC Master Agreement -33- 1 persons served, CONTRACTOR shall provide COUNTY with information relevant to the complaint, 2 investigative details of the complaint, the complaint and CONTRACTOR's disposition of, or corrective 3 action taken to resolve the complaint. 4 33. CULTURAL COMPETENCY 5 As related to Cultural and Linguistic Competence: 6 A. Compliance with Title 6 of the Civil Rights Act of 1964 (42 U.S.C. § 2000d, and 45 7 CFR Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance 8 from discriminating against persons based on race, color, national origin, sex, disability or religion. This is 9 interpreted to mean that a limited English proficient (LEP) individual is entitled to equal access and 10 participation in federally funded programs through the provision of comprehensive and quality bilingual 11 services. 12 B. Policies and procedures for ensuring access and appropriate use of trained 13 interpreters and material translation services for all LEP persons served, including, but not limited to, 14 assessing the cultural and linguistic needs of its persons served, training of staff on the policies and 15 procedures, and monitoring its language assistance program. The CONTRACTOR's procedures must 16 include ensuring compliance of any sub-contracted providers with these requirements. 17 C. CONTRACTOR assurance that minors shall not be used as interpreters. 18 D. CONTRACTOR shall provide and pay for interpreting and translation services to 19 persons participating in CONTRACTOR's services who have limited or no English language proficiency, 20 including services to persons who are deaf or blind. Interpreter and translation services shall be provided as 21 necessary to allow such participants meaningful access to the programs, services and benefits provided by 22 CONTRACTOR. Interpreter and translation services, including translation of CONTRACTOR's "vital 23 documents" (those documents that contain information that is critical for accessing CONTRACTOR's 24 services or are required by law) shall be provided to participants at no cost to the participant. 25 CONTRACTOR shall ensure that any employees, agents, subcontractors, or partners who interpret or 26 translate for a program participant, or who directly communicate with a program participant in a language 27 other than English, demonstrate proficiency in the participant's language and can effectively communicate 28 any specialized terms and concepts peculiar to CONTRACTOR's services. DMC Master Agreement -34- 1 E. In compliance with the State-mandated Culturally and Linguistically Appropriate 2 Services standards as published by the Office of Minority Health, new CONTRACTOR must submit to 3 COUNTY for approval, within 60 days from date of contract execution, CONTRACTOR's plan to address 4 all fifteen national cultural competency standards as set forth in the "National Standards on Culturally and 5 Linguistically Appropriate Services" (CLAS), attached hereto as Exhibit M, and incorporated herein by this 6 reference. County's annual on-site review of CONTRACTOR shall include collection of documentation to 7 ensure all national standards are implemented. As the national competency standards are updated, 8 CONTRACTOR's plan must be updated accordingly. 9 F. CONTRACTOR shall complete and submit county-issued CLAS self-assessment 10 annually. CONTRACTOR shall update CLAS plan as necessary. 11 34. CLEAN AIR AND WATER 12 In the event funding under this Agreement exceeds one hundred thousand dollars 13 ($100,000.00), the CONTRACTOR must comply with all applicable standards, orders, or requirements 14 issued under section 306 of the Clean Air Act (42 U.S.C. 1857 (h)), section 506 of the Clean Water Act (33 15 U.S.C. 1368), Executive Order 11738, and Environmental Protection Agency Regulations (40 CFR part 32). 16 35. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT 17 COUNTY and CONTRACTOR each consider and represent themselves as covered 18 entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 19 104-191(HIPAA) and agree to use and disclose protected health information as required by law. 20 COUNTY and CONTRACTOR acknowledge that the exchange of protected health 21 information between them is only for treatment, payment, and health care operations. 22 COUNTY and CONTRACTOR intend to protect the privacy and provide for the security of 23 Protected Health Information (PHI) pursuant to the Agreement in compliance with HIPAA, the Health 24 Information Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH), and 25 regulations promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA 26 Regulations) and other applicable laws. 27 As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require 28 CONTRACTOR to enter into a contract containing specific requirements prior to the disclosure of PHI, DMC Master Agreement -35- 1 as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) of the Code 2 of Federal Regulations (CFR). 3 Additionally, CONTRACTOR shall comply with the HIPAA requirements stated in Exhibit 4 C, "Drug Medi-Cal Specific Requirements." 5 36. CHILD ABUSE REPORTING 6 CONTRACTOR shall utilize a procedure acceptable to the COUNTY to ensure that all of 7 CONTRACTOR's employees, volunteers, consultants, subcontractors or agents performing services under 8 this Agreement shall report all known or suspected child abuse or neglect to one or more of the agencies 9 set forth in Penal Code § 11165.9. This procedure shall include having all of CONTRACTOR's employees, 10 volunteers, consultants, subcontractors or agents performing services under this Agreement sign a 11 statement that he or she knows of and will comply with the reporting requirements set forth in Penal Code § 12 11166. The statement to be utilized by CONTRACTOR for reporting is set forth in Exhibit N, "Notice of 13 Child Abuse Reporting," attached hereto and by this reference incorporated herein. 14 37. RESTRICTION ON DISTRIBUTION OF STERILE NEEDLES 15 CONTRACTOR shall adhere to the requirement that no funds shall be used to carry out any 16 program of distributing sterile needles or syringes for the hypodermic injection of any illegal drug unless 17 DHCS chooses to implement a demonstration syringe services program for intravenous drug users. 18 38. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST 19 INFORMATION 20 This provision is only applicable if CONTRACTOR is a disclosing entity, fiscal agent, or 21 managed care entity as defined in 42 CFR § 455.101, 455.104, and 455.106(a)(1)(2). 22 In accordance with 42 CFR §§ 455.101, 455.104, 455.105 and 455.106(a)(1)(2), the 23 following information must be disclosed by CONTRACTOR by completing Exhibit O "Disclosure of 24 Ownership and Control Interest Statement," attached hereto and by this reference incorporated herein. 25 CONTRACTOR shall submit this form to COUNTY DBH within thirty (30) days of the effective date of 26 this Agreement and at any time in which the status changes. Submissions shall be scanned pdf copies 27 and are to be sent via email to SAS(o-)fresnocountyca.gov and the assigned analyst at the County of 28 DMC Master Agreement -36- 1 Fresno, Department of Behavioral Health, Contracts Division. 2 A. Name and address of any person(s) whether it be an individual or corporation with 3 an ownership or controlling interest in the disclosing entity or managed care entity. 4 1) Address must include the primary business address, every business 5 location and P.O. Box address(es). 6 2) Date of birth and Social Security Number for individuals. 7 3) Tax identification number for other corporations or entities with ownership 8 or controlling interest in the disclosing entity. 9 B. Any subcontractor(s) in which the disclosing entity has five (5) percent or more 10 interest. 11 C. Whether the person(s) with an ownership or controlling interest of the disclosing 12 entity is related to another person having ownership or controlling interest as a parent, spouse, sibling or 13 child. Including whether the person(s) with ownership or controlling interest of the disclosing entity is 14 related to a person (parent, spouse, sibling or child) with ownership or has five (5) percent or more 15 interest in any of its subcontractors. 16 D. Name of any other disclosing entity in which an owner of the disclosing entity has 17 an ownership or control interest. 18 E. The ownership of any subcontractor with whom CONTRACTOR has had business 19 transactions totaling more than twenty-five thousand dollars ($25,000) during the 12-month period 20 ending on the date of the request; and 21 F. Any significant business transactions between CONTRACTOR and any wholly 22 owned supplier, or between CONTRACTOR and any subcontractor, during the five (5) year period 23 ending on the date of the request. 24 G. Any person(s) with an ownership or control interest in CONTRACTOR, or agent or 25 managing employee of CONTRACTOR; and 26 1) Has been convicted of a criminal offense related to that person's 27 involvement in any program under Medicare, Medicaid, or the Title XX services program since the 28 inception of those programs. DMC Master Agreement -37 1 H. The ownership of any subcontractor with whom CONTRACTOR has had 2 business transactions totaling more than twenty-five thousand dollars ($25,000) during the 12-month 3 period ending on the date of the request; and 4 I. Any significant business transactions between CONTRACTOR and any wholly 5 owned supplier, or between CONTRACTOR and any subcontractor, during the five (5) year period 6 ending on the date of the request. 7 39. CHANGE OF LEADERSHIP/MANAGEMENT 8 Any and all notices between COUNTY and CONTRACTOR(S) provided for or permitted 9 under this Agreement or by law, shall be in writing and shall be deemed duly served when personally 10 delivered to one of the parties, or in lieu of such personal service, when deposited in the United States Mail, 11 postage prepaid, addressed to such party. 12 In the event of any change in the status of CONTRACTOR's leadership or management, 13 CONTRACTOR shall provide written notice to COUNTY within thirty (30) days from the date of change. 14 Such notification shall include any new leader or manager's name, address and qualifications. "Leadership 15 or management" shall include any employee, member, or owner of CONTRACTOR who either a) directs 16 individuals providing services pursuant to this Agreement; b) exercises control over the manner in which 17 services are provided; or c) has authority over CONTRACTOR's finances. 18 40. NOTICES 19 The persons and their addresses having authority to give and receive notices under this 20 Agreement include the following: 21 COUNTY CONTRACTOR Director, Fresno County See Exhibit A 22 Department of Behavioral Health 23 1925 E Dakota Ave Fresno, CA 93726 24 All notices between the COUNTY and CONTRACTOR provided for or permitted under this 25 Agreement must be in writing and delivered either by personal service, by first-class United States mail, by 26 an overnight commercial courier service, or by telephonic facsimile transmission. A notice delivered by 27 personal service is effective upon service to the recipient. A notice delivered by first-class United States 28 mail is effective three COUNTY business days after deposit in the United States mail, postage prepaid, DMC Master Agreement -38 1 addressed to the recipient. A notice delivered by an overnight commercial courier service is effective one 2 COUNTY business day after deposit with the overnight commercial courier service, delivery fees prepaid, 3 with delivery instructions given for next day delivery, addressed to the recipient. A notice delivered by 4 telephonic facsimile is effective when transmission to the recipient is completed (but, if such transmission is 5 completed outside of COUNTY business hours, then such delivery shall be deemed to be effective at the 6 next beginning of a COUNTY business day), provided that the sender maintains a machine record of the 7 completed transmission. For all claims arising out of or related to this Agreement, nothing in this section 8 establishes, waives, or modifies any claims presentation requirements or procedures provided by law, 9 including but not limited to the Government Claims Act (Division 3.6 of Title 1 of the Government Code, 10 beginning with section 810). 11 41. SEPARATE AGREEMENT 12 It is mutually understood by the parties that this Agreement does not, in any way, create 13 a joint venture among CONTRACTOR(S). By execution of this Agreement, CONTRACTOR(S) 14 understands that a separate Agreement is formed between each individual CONTRACTOR and 15 COUNTY. 16 42. GOVERNING LAW 17 Venue for any action arising out of or related to this Agreement shall only be in Fresno 18 County, California. 19 The rights and obligations of the parties and all interpretation and performance of this 20 Agreement shall be governed in all respects by the laws of the State of California. 21 43. SEVERABILITY 22 The provisions of this Agreement are severable. The invalidity or unenforceability of 23 any one provision in the Agreement shall not affect the other provisions. 24 44. ELECTRONIC SIGNATURE 25 The parties agree that this Agreement may be executed by electronic signature as 26 provided in this section. An "electronic signature" means any symbol or process intended by an 27 individual signing this Agreement to represent their signature, including but not limited to (1) a 28 digital signature; (2) a faxed version of an original handwritten signature; or (3) an electronically DMC Master Agreement -39 1 scanned and transmitted (for example by PDF document) of a handwritten signature. Each 2 electronic signature affixed or attached to this Agreement (1) is deemed equivalent to a valid 3 original handwritten signature of the person signing this Agreement for all purposes, including but 4 not limited to evidentiary proof in any administrative or judicial proceeding, and (2) has the same 5 force and effect as the valid original handwritten signature of that person. The provisions of this 6 section satisfy the requirements of Civil Code section 1633.5, subdivision (b), in the Uniform 7 Electronic Transaction Act (Civil Code, Division 3, Part 2, Title 2.5, beginning with section 1633.1). 8 Each party using a digital signature represents that it has undertaken and satisfied the 9 requirements of Government Code section 16.5, subdivision (a), paragraphs (1) through (5), and 10 agrees that each other party may rely upon that representation. This Agreement is not conditioned 11 upon the parties conducting the transactions under it by electronic means and either party may 12 sign this Agreement with an original handwritten signature. 13 45. ENTIRE AGREEMENT 14 This Agreement, including all Exhibits, constitutes the entire agreement between the 15 CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes all previous 16 Agreement negotiations, proposals, commitments, writings, advertisements, publications, and 17 understanding of any nature whatsoever unless expressly included in this Agreement. 18 // 19 // 20 21 22 // 23 // 24 25 26 27 // 28 // DMC Master Agreement -40- 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day 2 and year first hereinabove written. 3 4 CONTRACTOR COYNT,Y OF FRESNO 5 _ L VQ - 6 SEE EXHIBIT A Brian Pacheco Chairman of the Board of Supervisors of the 7 County of Fresno 8 9 10 ATTEST: 11 Bernice E. Seidel 12 Clerk of the Board of Supervisors County of Fresno, State of California 13 14 15 16 FOR ACCOUNTING USE ONLY: 17 18 ORG No.: 56302081 19 Account No.: 7295/0 20 Fund/Subclass: 0001/10000 Requisition No.: N/A 21 By: �d Deputy 22 23 24 25 26 27 28 -41- DMC Master Agreement 1 Provider: AEGIS TREATMENT CENTERS, LLC. 2 3 By 4 5 Print Name: Susan D. Hoeflich 6 Title: Vice President, Managed Care 7 Chairman of the Board, President, or Vice President 8 9 Date: 4/6/2022 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 DMC Master Agreement -42 1 Provider: BAKERSFIELD RECOVERY SERVICE, INC. 2 3 By 4 5 Print Na 6 7 Title: _ N Chairman of the Board, President, or Vice President 8 9 Date: 3 —31 10 11 12 By 13 14 Print Name: K lM q zt) Cva�s 15 16 Title: _ j-c j k r-t r` Secretary (of Corporation), Assistant Secretary, 17 Chief Financial Officer, or Assistant Treasurer 18 19 Date: 20 21 22 23 24 25 26 27 28 DMC Master Agreement -43- 1 Provider: BAYMARK HEALTH SERVICES, INC. 2 ADDICTION RESEARCH AND TREATMENT, INC. 3 MEDMARK TREATMENT CENTERS — FRESNO WEST, INC. 4 5 By 6 7 Print Name: Frank Baumann 8 Vice President 9 Title: Chairman of the Board, President, or Vice President 10 11 Date: 12 13 14 By O 15 16 Print Name: Gilbert D'Andria 17 18 Title: VP Treasurer Secretary (of Corporation), Assistant Secretary, 19 Chief Financial Officer, or Assistant Treasurer 20 21 Date: y/ 8/2 o Z Z 22 23 24 25 26 27 28 DMC Master Agreement -44- 1 Provider: CENTRAL CALIFORNIA RECOVERY, INC. 2 3 By 1 4 5 Print Name: 6 Title: 7 dairman oft1be Board, President, or Vice President 8 9 Date- 10 c. 11 12 ByQ6at&�� 6 6d�etzz 13 14 Print Name: 15 16 Title: 64,<-e-l?- Secretary (of Corporation), Assistant Secretary, 17 Chief Financial Officer, or Assistant Treasurer 18 Date: Z/4//--�0 19 V 20 21 22 K' 23 24 25 26 27 28 -45- DMC Master Agreement 1 Provider: DELTA CARE, INC. 2 3 By 4 5 Print Name: G - 6 7 Title: Chairman of the Board, President, or Vice President 8 9 Date: 10 r 11 12 By 13 14 Print Name:�'r . 15 16 Title: Secretary (o orporation), Assistant Secretary, 17 Chief Financial Officer, or Assistant Treasurer 18 19 Date: 20 21 22 23 24 25 26 27 28 -46- DMC Master Agreement 1 Provider: FRESNO COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG 2 ABUSE SERVICES, INC. 3 4 BY _ 5 6 Print Name: C 7 8 Title: d-fkXt A-AAAN Chairman of the Board, President, or Vice President 9 10 Date: •2d�� 11 12 13 By At 14 15 Print Name: L o&1r,Q,. � �,, 16 17 Title: �cP[ u Au.e _hrvieG�ny- Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 20 Date: 4I 4 /Z2. 21 22 23 24 25 26 27 28 DMC Master Agreement -47 1 Provider: FRESNO NEW CONNECTIONS, INC. 2 3 By 4 5 Print Name: ( h SLf) 6 J 11++ 7 Title: �-� C .�U I��{' 1�1(-e t-)C' Chairman of the Board, President, or Vice President 8 9 Date: 10 11 12 By 13 I I 14 Print Name: 1 )L"CkAA C 15 ` 16 Title: &L y \ Secretary (of Corporation), Assistant Secretary, 17 Chief Financial Officer, or Assistant Treasurer 18 19 Date: Z 20 21 22 23 24 25 26 27 28 DMC Master Agreement -48 ii DocuSign Envelope ID:54020EB0-58E3-4D2F-99D2-9A5009164C53 1 Provider: KINGS VIEW 2 DocuSigned by: 4 By A04F817F73914D5... 5 Print Name: Amanda Nugent Divine, PhD 6 7 Title: Chief Executive Officer 8 Chairman of the Board, President, or Vice President 9 10 Date: 3/29/2022 11 12 DocuSigned by: 13 By — 79925D1G4D6C40B . 14 Print Name: Michael Kosareff 15 16 Title: Chief Financial Officer 17 Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 Date: 3/29/2022 20 21 22 23 24 25 26 27 28 DMC Master Agreement -49 1 Provider: MENTAL HEALTH SYSTEMS, INC. 2 3 4 �i 5 James C.Cafla h Print Name: g an, fr• 6 7 Title: P*Sidear&CEO 8 Chairman of the Board, President, or Vice President 9 / 10 Date: 13U/�D . 11 12 r\ 13 By 14 � yC�Oca�. Print Name: 15 16 Title: 0 17 Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 Date: 20 21 22 23 24 25 26 27 28 DMC Master Agreement _50- 1 Provider: PRODIGY HEALTHCARE, INC. 2 By 3 ` 4 Prin ame: 5 6 Title: 7 Chairman of the Board, President, or Vice President 9 Date: l 10 11 12 B _ Y 13 14 Print Name: \cwf,)p 15 16 Title: FO Secretary (of Corporation), Assistant Secretary, 17 Chief Financial Officer, or Assistant Treasurer 18 19 Date: Z�- 20 21 22 23 24 25 26 27 28 -51- DMC Master Agreement 1 Provider: PROMESA BEHAVIORAL HEALTH, INC. 2 3 By 4 5 Print Name:/'l�Cf1R(?� '� /�/i9NOKG-L, 6 7 Title: Ar 8 C airman of the Board, President, or Vice President 9 10 Date: y A-A Z 11 12 13 By 14 15 Print Name: Z UN I',A 16 17 Title: C F-0 Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 20 Date: +J`— 1 L 21 22 23 24 25 ' 26 27 28 -52- DMC Master Agreement 1 Provider: TURNING POINT OF CENTRAL CALIFORNIA, INC. 2 3 �le U'a�� By 4 61 5 Print Name: Raymond R. Banks 6 7 Title: Chief Executive Officer 8 Chairman of the Board, President, or Vice President 9 10 Date: 4/20/2022 11 12 13 B wl 40aa y 14 15 Print Name: William Goodall 16 17 Title: Chief Financial Officer Secretary (of Corporation), Assistant Secretary, 18 Chief Financial Officer, or Assistant Treasurer 19 20 Date: 4/19/2022 21 22 23 24 25 26 27 28 DMC Master Agreement -53- I i i I Provider: WESTCARE CALIFORNIA, INC. 2 By 5 I Print Name: 6 7 Title: C C:>Q3 i i 8 Chairman of the Board, President, or Vice President 9 10 Date: 11 ��i-�.a-a'►..iV.� -btu o�,�t-�,z 3�,. � C.c.S rJ -}ta i 12 �vi.r..a v� z>' t 13 By i 14 Cit-Na 15 16 Title: 17 Secretary (of Corporation), Assista Secretary, Chief Financial Officer, or Assistant Treasurer 18 19 Date: 20 21 22 23 24 25 26 27 28 -54- DMC Master Agreement 1 2 THIS PAGE INTENTIONALLY LEFT BLANK 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 DMC Master Agreement -55- 1 THIS PAGE INTENTIONALLY LEFT BLANK 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 DMC Master Agreement -56- 1 THIS PAGE INTENTIONALLY LEFT BLANK 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 DMC Master Agreement -57 1 THIS PAGE INTENTIONALLY LEFT BLANK 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 DMC Master Agreement -58 Fresno County Department of Behavioral Health Exhibit A Drug Medi-Cal Services Vendor List VENDOR CONTACT PHONE NUMBER TYPE OF BUSINESS BayMark Health Services,Inc. Addiction Research and Treatment,Inc. Regional Vice President (707)290-0670 For Profit Corporation MedMark Treatment Centers—Fresno West,Inc. Dawn Groendyke Remit to: 1720 Lakepointe Drive#117 Lewisville,Tx 75057 Aegis Treatment Centers,I.I.C. Regional Director (818)206-0360 Limited Liability Company Remit to: Sarah Khawaja-Laljiani 7246 Remmet Ave. Canoga Park,Ca 91303 Bakersfield Recovery Services Inc. Executive Director (661)325-1817 501(c)3 Non-Profit Corporation Remit to: Eric Sanders PO Box 3218 Bakersfield,CA 93385 Central California Recovery,Inc. President (559)273-2942 501(c)3 Non-Profit Corporation Remit to: Dale White (559)681-1947 1204 W.Shaw Ave.#102 Fresno,CA 93711 Delta Care,Inc. Executive Director (559)276-7558 501(c)3 Non-Profit Corporation Remit to: 4705 N.Sonora Ave#113 Fresno,Ca 93722 Fresno County Hispanic Commission on Alcohol and Drug Abuse Services,Inc. Executive Director (559)268-6480 501(c)3 Non-Profit Corporation Remit to: Domingo Zapata 1803 Broadway St. Fresno,Ca 93721 Fresno New Connections,Inc. Executive Director (559)248-1548 501(c)3 Non-profit Corporation Remit to: Carrie Christensen 4411 N.Cedar Ave.#108 Fresno,CA 93726 Kings View Chief Financial Officer (559)251-0100 x3011 501(c)3 Non-profit Corporation Remit to: 7170 N.Financial Drive,#110 Fresno,CA 93720 Mental Health Systems,Inc. CEO (858)573-2600 501(c)3 Non-profit Corporation Remit to: James Callaghan 9465 Farnham St. CFO San Diego,CA 92123 Joelle Verbestel Prodigy Healthcare,Inc. President (559)892-9452 For Profit Corporation Remit to: J.D.Dhanda P.O.Box 820 Fowler,Ca 93625 Promesa Behavioral Health CEO (559)439-5437 501(c)3 Non-profit Corporation Remit to: Lisa Weigant 7120 N.Marks Ave,#110 Fresno,Ca 93711 Turning Point of Central California,Inc. Chief Executive Officer (559)732-8086 501(c)3 Non-profit Corporation Remit to: PO Box 7447 Visalia,CA 93290 WestCare California,Inc. Chief Operating Officer (559)251-4800 501(c)3 Non-profit Corporation Remit to: Shawn A.Jenkins 1900 N.Gateway Blvd,100 Fresno,CA 93727 **A list of current provider sites can be found at: httos://www.co.fresno.ca.us/departments/behaviora I-health/substance-use-d isorder-service: DMC Master Agreement Revised 7/01/2022 1 of 1 Exhibit B Fresno County,Department of Behavioral Health Drug Medi-Cal Organized Delivery System Modality of Service Descriptions Covered services under the Drug Medi-Cal Organized Delivery System(DMC-ODS) shall be furnished in an amount, duration, and scope that is no less than the amount, duration, and scope for the same services furnished to persons served under fee-for-service Medicaid, as set forth in 42 CFR 440.230. Contractors shall ensure that the services are sufficient in amount, duration, or scope to reasonably be expected to achieve the purpose for which the services are furnished. Contractors may not arbitrarily deny or reduce the amount duration, or scope of a required service solely because of diagnosis, type of illness, or condition of the person served. Contractors are required to ensure services are provided timely as further described in the Fresno County Substance Use Disorder Provider Manual. In all levels of care, contractors are required to either offer medications for addiction treatment (MAT) directly or demonstrate effective referral mechanisms in place to the most clinically appropriate MAT services. Providing a person served the contact information for a MAT program is insufficient. Placement in an appropriate level of care must be determined through an assessment based on the American Society of Addiction Medicine (ASAM) criteria and prescribed by the contractor's medical director. DRUG MEDI-CAL SERVICES: EARLY INTERVENTION SERVICES (ASAM LEVEL 0.5) Early intervention services (EIS) are available to persons served under 21 who are screened and determined to be at risk of developing an SUD. At risk persons served may receive any service component covered under the outpatient level of care (ASAM 1.0) as early intervention services. An SUD diagnosis is not required for early intervention services. A full assessment utilizing the ASAM criteria is not required for a person served under the age of 21 to receive EIS. EIS services may be delivered in a wide variety of settings and can be provided in person, by telehealth, or by telephone. EIS services do not limit or modify the Early Periodic Screening, Diagnostic and Treatment (EPSDT)mandate. OUTPATIENT SERVICES (ASAM LEVEL 1.0) Outpatient services consist of up to nine (9)hours per week of medically necessary services for adults and up to six (6) hours per week of services for adolescents. Services may exceed the maximum hours based on individual medical necessity. Revised 07/01/2022 1 DMC Master Agreement Exhibit B Services can be provided by an LPHA or registered/certified counselor in-person, by telephone, or telehealth in any appropriate setting in the community, in accordance with HIPAA and 42 CFR Part 2. Group size is limited to no less than two (2) and no more than twelve (12)persons served. Outpatient services include the following service components: • Assessment • Care Coordination • Counseling (individual/group) • Family Therapy • Medication Services • MAT for opioid use disorders • MAT for alcohol use disorders and non-opioid SUDs • Patient Education • Recovery Services • SUD Crisis Intervention Services INTENSIVE OUTPATIENT SERVICES (ASAM LEVEL 2.1) Intensive outpatient involves structured programming provided to persons served as medically necessary for a minimum of nine (9)hours and a maximum of nineteen(19) hours for adults and a minimum of six(6)hours and a maximum of nineteen(19) for adolescents. Providers may exceed maximum treatment hours when determined to be medically necessary. Intensive outpatient treatment services include the same service components listed under Outpatient 1.0. Services can be provided by an LPHA or registered/certified counselor in-person, by telephone, or telehealth in any appropriate setting in the community, in accordance with HIPAA and 42 CFR Part 2. Group size is limited to no less than two (2) and no more than twelve (12)persons served. OPIOID (NARCOTIC) TREATMENT PROGRAMS (ASAM LEVEL 1.0) Narcotic treatment program services shall be provided in accordance with Title 9, Chapter 4, Division 4 and CFR 42. Narcotic Treatment Programs (NTP), also known as Opioid Treatment Programs (OTP), are outpatient programs that provide Food and Drug Administration (FDA)-approved medications and biological products to treat SUDs when ordered by a physician as medically necessary. NTPs are required to administer, dispense, or prescribe medications to persons served covered under the DMC-ODS formulary including methadone,buprenorphine (transmucosal and long- acting injectable), naltrexone (oral and long-acting injectable), disulfiram, and naloxone. NTPs may also prescribe the medication for dispensing at a pharmacy. The medical evaluation for methadone treatment must be conducted in-person. Revised 07/01/2022 2 DMC Master Agreement Exhibit B Persons served in OTP/NTP settings shall receive no less than fifty(50)minutes of treatment services per calendar month although additional services may be provided based on medical necessity. Counseling services provided in the NTP modality can be provided in person, by telehealth or by telephone. NTP services include the following service components: • Assessment • Care Coordination • Counseling (individual/group) • Family Therapy • Medical Psychotherapy • Medication Services • MAT for opioid use disorders • MAT for alcohol use disorders and non-opioid SUDs • Patient Education • Recovery Services • SUD Crisis Intervention Services PERINATAL/NON-PERINATAL RESIDENTIAL SUBSTANCE USE DISORDER TREATMENT SERVICES (EXCLUDING ROOM AND BOARD) (ASAM LEVELS 3.1, 3.3 and 3.5) Residential treatment services are provided in facilities licensed by the California Department of Health Care Services (DHCS) or the California Department of Social Services for adolescents that also have DMC certification and a DHCS Level of Care Designation or an ASAM LOC Certification demonstrating ability to delivery care consistent with ASAM treatment criteria. There is no bed capacity limit for residential facilities.The Contactor must provide 24-hour care with trained personnel, including awake staff on the overnight shift to address persons served needs. Adults (21 and over): The length of stay in a short-term residential setting shall be determined by individualized clinical need. Services must include preparation for a step down to a less intensive level of care, when clinically appropriate. The statewide goal for the average length of stay for residential treatment services is 30 days. Adolescents (under the age of 21): The length of stay in a short-term residential setting shall be determined by individualized clinical need. Services must include preparation for step down to a less intensive level of care as soon as clinically appropriate. Adolescent beneficiaries receiving residential treatment shall be stabilized as soon as possible and moved down to a less intensive level of treatment. Nothing in the DMC-ODS or in this paragraph overrides any EPSDT requirements. Revised 07/01/2022 3 DMC Master Agreement Exhibit B Residential contractor(s) must seek prior authorization for residential treatment services upon admission and prior to the expiration of each authorized treatment period. Treatment authorization request processes can be found in the Fresno County SUD Provider Manual. Residential services include the following service components: • Assessment • Care Coordination • Counseling (individual/group) • Family Therapy • Medication Services • MAT for opioid use disorders • MAT for alcohol use disorders and non-opioid SUDs • Patient Education • Recovery Services • SUD Crisis Intervention Services WITHDRAWAL MANAGEMENT (Level 1-WM,Level 2-WM and Level 3.2-WM) Withdrawal management (WM) services are prescribed based on an individual assessment using the ASAM criteria. Contractor(s) shall ensure persons served receiving both residential and outpatient WM services are monitored during the detoxification process. Withdrawal Management Services may be provided in an outpatient or residential setting. Withdrawal management services are urgent and provided on a short-term basis. When provided as part of withdrawal management services, service activities such as the assessment, focus on the stabilization and management of psychological and physiological symptoms associated with withdrawal, engagement in care and effective transitions to a level of care where comprehensive treatment services are provided. A full ASAM assessment shall not be required as a condition of admission to a withdrawal management program. ASAM 3.7-WM and 4-WM services are part of the DMC-ODS continuum of care but are offered through the Medi-Cal Managed Care Plans, Anthem Blue Cross and CalViva Health. If a person served is determined to be in need of this level of care, the provider should provide care coordination to the Managed Care Plans for treatment. Withdrawal Management services include the following service components: • Assessment • Care Coordination • Medication Services • MAT for opioid use disorders • MAT for alcohol use disorders and non-opioid SUDs • Observation • Recovery Services Revised 07/01/2022 4 DMC Master Agreement Exhibit B ADDITIONAL MEDICATION ASSISTED TREATMENT (MAT) Medication for addiction treatment include all FDA-approved medications and biological products to treat Alcohol Use Disorders (AUD), Opioid Use Disorders (OUD) and any SUD. MAT may be provided in clinical or non-clinical settings and can be delivered as a standalone service or as a service delivered as part of another level of care. Persons served who decline counseling services shall not be denied access to MAT or administratively discharged. Additional MAT involves the ordering, prescribing, administering, and monitoring of medications for substance use disorders. All DMC-ODS providers, at all levels of care, must demonstrate that they either directly offer or have an effective referral mechanism/process to MAT for persons served with SUD diagnoses. MAT services may be provided in conjunction with the following service components: • Assessment • Care Coordination • Counseling (individual/group) • Family Therapy • Medication Services • Patient Education • Recovery Services • SUD Crisis Intervention Services • Withdrawal Management Services CARE COORDINATION SERVICE (formerly Case Management) Care Coordination services are defined as a service that assists persons served to access needed medical, educational, social, prevocational, vocational, rehabilitative, or other community services. Care coordination consists of activities to provide coordination of SUD care, mental health care, and medical care, and to support the person served with linkages to services and supports designed to restore the person served to their best possible functional level. Care Coordination services are provided to a person served in conjunction with all levels of treatment and may also be claimed as a standalone service. Care Coordination services may be provided by an LPHA or certified counselor. Contractors shall use care coordination services to coordinate with physical and/or mental health systems of care. Care coordination can be provided in clinical or nonclinical settings (including the community) and can be provided face-to-face,by telehealth, or by telephone. Revised 07/01/2022 5 DMC Master Agreement Exhibit B Care Coordination shall include one or more of the following components: • Coordination with medical and mental health providers to monitor and support comorbid health conditions. • Discharge planning, including coordinating with SUD treatment providers to support transitions between levels of care and to recovery resources, referrals to mental health providers, and referrals to primary or specialty medical providers. • Coordinating with ancillary services, including individualized connection, referral, and linkages to community-based services and supports including but not limited to educational, social, prevocational, vocational, housing, nutritional, criminal justice, transportation, childcare, child development, family/marriage education, cultural sources, and mutual aid support groups. Care Coordination shall be consistent with and shall not violate confidentiality of persons served as set forth in 42 CFR Part 2, and California law. PEER SUPPORT SERVICES (Available following completion of Fresno County opt-in) Peer support services promote recovery, resiliency, engagement, socialization, self-sufficiency, self-advocacy, development of natural supports, and identification of strengths through structured activities such as group and individual coaching to set recovery goals and identify steps to reach the goals. Peer support services may be provided with the person served or significant support person(s) and may be provided in a clinical or non-clinical setting. Peer support services can include contact with family members or other people (collaterals) supporting the person served if the purpose of the collateral's participation is to focus on the treatment needs of the person served. Peer support services are delivered and claimed as a standalone service. Peer support services can be provided concurrently with other levels of care and are based on a plan of care approved by a Behavioral Health Professional. Peer support services consist of Education Skill Building Groups, Engagement services and Therapeutic Activity services. Peer Support Specialists are individuals in recovery with a current State-approved Medi-Cal Peer Support Specialist Certification Program certification and working under the direction of a Behavioral Health Professional. Behavioral Health Professionals must be licensed, waivered, or registered in accordance with applicable State of California licensure requirements and listed in the California Medicaid State Plan as a qualified DMC provider. RECOVERY SERVICES Recovery Services are designed to support recovery and prevent relapse with the objective of restoring the person served to their best possible functional level. Revised 07/01/2022 6 DMC Master Agreement Exhibit B Recovery services can be utilized when the person served is triggered, when the person served has relapsed or simply as a measure to prevent relapse. Persons served do not need to be diagnosed as being in remission to access Recovery Services. Persons served may receive Recovery Services while receiving MAT services, including NTP services. Persons served may receive Recovery Services immediately after incarceration with a prior diagnosis of SUD. Services may be provided in person, by telehealth, or by telephone. Recovery Services can be delivered and claimed as a standalone service, concurrently with the other levels of care or as a service delivered as part of other levels of care. Contractors that do not opt to make recovery services available must refer persons served to a contractor that provides recovery services. Recovery Services shall include the following service components: • Assessment • Care Coordination • Counseling (individual and group) • Family Therapy Recovery Monitoring, which includes recovery coaching and monitoring designed for the maximum reduction of the person served's SUD • Relapse Prevention which includes interventions designed to teach persons served with SUD how to anticipate and cope with the potential for relapse for the maximum reduction of the person served's SUD. CLINICIAN CONSULTATION (formerly Physician Consultation) Clinician Consultation consists of LPHAs consulting with LPHAs, such as addiction medicine physicians, addiction psychiatrists, licensed clinicians, or clinical pharmacists, to support the provision of care. Clinician Consultation is designed to support licensed clinicians with complex cases and may address medication selection, dosing, side effect management, adherence, drug-drug interactions, or level of care considerations. It includes consultations between clinicians designed to assist clinicians with seeking expert advice on treatment needs for specific persons served. These consultations can occur in person,by telehealth,by telephone, or by asynchronous telecommunication systems. NON-DMC FUNDED SERVICES: Non-DMC eligible persons served will have access to the same services as DMC-eligible persons served with costs reimbursed through other sources. These services, available to all perinatal and non-perinatal adults and adolescents, include: • Early Intervention Services • Outpatient • Intensive Outpatient • Additional Medication Assisted Treatment • Residential treatment, including Withdrawal Management Revised 07/01/2022 7 DMC Master Agreement Exhibit B • Care Coordination • Peer Support Services • Recovery Services • Clinician Consultation Room and Board for Residential Treatment and Withdrawal Management services is not eligible for reimbursement through DMC. These costs will be covered with other non-DMC funding sources. Revised 07/01/2022 8 DMC Master Agreement Exhibit C DRUG MEDI-CAL INTERGOVERNMENTAL AGREEMENT REQUIREMENTS Fresno County, through the Department of Behavioral Health, makes substance use disorder treatment services available throughout the county to Medi-Cal eligible persons served 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. 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 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. Revised 01/31/2022 DMC Master Agreement Exhibit C 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 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. 2. 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 Revised 01/31/2022 DMC Master Agreement Exhibit C 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. 3. 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. 4. 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 an individual to an organization that are provided in 2 C.F.R. Revised 01/31/2022 DMC Master Agreement Exhibit C 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 A, incorporated herein by reference and made part of this Agreement and must require all employees to complete annual TVPA training. 5. 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. 6. CONFIDENTIALITY OATH CONTRACTOR shall ensure that all of its employees sign a written confidentiality oath, attached hereto as Attachment C, 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. 7. CONTROL REQUIREMENTS Performance under this Agreement is subject to all applicable Federal and State laws, regulations and standards. 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 failure 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, commencing with Section 11760; B. California Code of Regulations (CCR), Title 9, Division 4, Chapter 8, commencing with Section 13000; C. Government Code Section 16367.8 Revised 01/31/2022 DMC Master Agreement Exhibit C D. 42, CFR, Sections 8.1 through 8.6. E. Title 21, CFR, Sections 1301.01 through 1301.93, Department of Justice, Controlled Substances. F. State Administrative Manual (SAM), Chapter 7200 (General Outline of Procedures). G. 31 U.S.C. sections 7501-7507 (Single Audit Act of 1984; Single Audit Act Amendments of 1996); H. 2CFR Part 200 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards); and CONTRACTOR shall be familiar with the above requirements and must incorporate these requirements into written policies and procedures, as applicable. 8. 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's policies, procedures, and practices must be consistent with the principles outlined and are embedded in the organizational structure, as well as being upheld in day-to-day operations. CONTRACTOR shall promote the delivery of services in a culturally competent manner to all persons served, including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity. 9. ADA CONSIDERATIONS CONTRACTOR shall ensure that physical access, reasonable accommodations, and accessible equipment are available for Medicaid persons served with physical or mental disabilities in accordance with CFR Title 45, Part 84 and the Americans with Disabilities Act. 10. ADDITIONAL INTERGOVERNMENTAL AGREEMENT RESTRICTIONS This Agreement is subject to any additional restrictions, limitations, conditions, or statutes enacted or amended by the federal or state governments, which may affect the provisions, terms, or funding of this Agreement in any manner. 11. NULLIFICATION OF DMC-ODS SERVICES The parties agree that failure of COUNTY, or CONTRACTOR, to comply with W&I section 14124.24, the Special Terms and Conditions, and this Agreement, shall be deemed a breach that results in the termination of the State-County Intergovernmental Agreement for cause. In the event of a breach, the DMC-ODS services shall terminate. The COUNTY shall immediately begin providing DMC services to the person served in accordance with the State Plan. 12. 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. Revised 01/31/2022 DMC Master Agreement Exhibit C 13. LIMITATION ON USE OF FUNDS FOR PROMOTION OF LEGALIZATION OF CONTROLLED SUBSTANCES CONTRACTOR is prohibited from using funds made available through this Agreement 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). 14. NONDISCRIMINATION IN EMPLOYMENT AND SERVICES CONTRACTOR certifies that under the laws of the United States and the State of California, incorporated into this Agreement by reference and made a part hereof as if set forth in full, CONTRACTOR shall not unlawfully discriminate against any person. 15. FEDERAL LAW REQUIREMENTS CONTRACTOR 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 IX of the Education Amendments of 1972 (regarding education and programs and activities), if applicable. C. 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. D. Age Discrimination Act of 1975 (45 CFR Part 90), as amended (42 USC Sections 6101 —6107), which prohibits discrimination on the basis of age. E. Age Discrimination in Employment Act (29 CFR Part 1625). F. Title I of the Americans with Disabilities Act (29 CFR Part 1630) prohibiting discrimination against the disabled in employment. G. Americans with Disabilities Act (28 CFR Part 35) prohibiting discrimination against the disabled by public entities. H. Title III of the Americans with Disabilities Act (28 CFR Part 36) regarding access. I. Rehabilitation Act of 1973, as amended (29 USC Section 794), prohibiting discrimination on the basis of individuals with disabilities. J. 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. K. Executive Order 13166 (67 FR 41455) to improve access to federal services for those with limited English proficiency. L. The Drug Abuse Office and Treatment Act of 1972, as amended, relating to nondiscrimination on the basis of drug abuse. Revised 01/31/2022 DMC Master Agreement Exhibit C M. 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. 16. 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 under this Agreement or terminate all, or any type, of funding provided hereunder. 17. INVESTIGATIONS AND CONFIDENTIALITY OF ADMINISTRATIVE ACTIONS COUNTY acknowledges that if a DMC provider is under investigation by DHCS or any other state, local or federal law enforcement agency for fraud or abuse, DHCS may temporarily suspend CONTRACTOR from the DMC program, pursuant to W&I Code, Section 14043.36(a). Information about CONTRACTOR's administrative sanction status is confidential until such time as the action is either completed or resolved. The DHCS may also issue a Payment Suspension to a provider pursuant to W&I Code, Section 14107.11 and Code of Federal Regulations, Title 42, section 455.23. The COUNTY is to withhold payments from a DMC provider during the time a Payment Suspension is in effect. COUNTY has executed a Confidentiality Agreement that permits DHCS to communicate with COUNTY concerning CONTRACTOR(S) that are subject to administrative sanctions. 18. 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 CCR Title 9, Division 4, Chapter 8. 19. ADMISSION DISCRIMINATION CONTRACTOR shall accept individuals eligible for admission in the order in which they apply without restriction, up to the limits set under the State-County Intergovernmental Agreement. CONTRACTOR shall not, based on health status or need for health care services, discriminate against individuals eligible for admission. CONTRACTOR shall follow all Federal and State civil rights laws. CONTRACTOR shall not unlawfully discriminate, exclude people, or treat Revised 01/31/2022 DMC Master Agreement Exhibit C them differently, on any ground protected under Federal or State law, including sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status„ gender, gender identity, or sexual orientation and will not use any policy or practice that has the effect of discriminating on the basis of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. CONTRACTOR shall ensure that persons served that meet medical necessity for Medication Assisted Treatment (MAT) receive the same access to care as non-MAT persons served. CONTRACTOR shall provide information on how to file a Discrimination Grievance with COUNTY or DHCS if there is a concern of discrimination based on sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. CONTRACTOR shall also provide information on how to file a Discrimination Grievance with the United States Department of Health and Human Services Office of Civil Rights if there is a concern of discrimination based on race, color, national origin, sex, age, or disability. 20. SUBCONTRACTUAL REQUIREMENTS CONTRACTOR shall fulfill contractual requirements of delegated services or activities in accordance with 42 CFR §438.230 and shall perform the delegated activities and reporting responsibilities in compliance with COUNTYs State-County Intergovernmental Agreement obligations. CONTRACTOR shall comply with all applicable Medicaid laws and regulations, including applicable sub-regulatory guidance and contract provisions. CONTRACTOR shall not bill persons served for covered services under this agreement in excess of the amount that would be owed by the individual if the COUNTY had directly provided the services (42 U.S.C. 1396u-2(b)(6)(C)). 21. INSPECTION AND AUDIT OF RECORDS AND ACCESS TO FACILITIES CONTRACTOR agrees that COUNTY, DHCS, CMS, the HHS Inspector General, the Comptroller General, or their designees have the right to audit, evaluate, and inspect any books, records, contracts, computer or other electronic systems of CONTRACTOR, or of the CONTRACTOR's sub-contractor, that pertain to any aspect of services and activities performed, or determination of amounts payable under COUNTY's contract with DHCS. CONTRACTOR shall make available, at any time, for purposes of an audit, evaluation, or inspection, its premises, physical facilities, equipment, books, records, contracts, computer or other electronic systems relating to its Medicaid enrollees. The right to audit will exist through 10 years from the final date of the contract period or from the date of completion of any audit, whichever is later. 22. GRIEVANCE CONTRACTOR shall comply with Grievance procedures set forth in the State- County Intergovernmental Agreement, the Provider Manual and the Member Handbook. CONTRACTOR shall make the following grievance information available to all persons served: A. Perons Served's right to a State Fair Hearing and how to obtain a hearing as well as representation rules. Revised 01/31/2022 DMC Master Agreement Exhibit C B. Person Served's right to file grievances and appeals, including the requirements and timeframes for filing. C. Person Served's right to give written consent to allow CONTRACTOR or legal representative, acting on behalf of the person served, to file an appeal. D. Person Served may file a grievance orally or in writing to DHCS or COUNTY. E. The availability of assistance with filing grievances and appeals. F. The toll-free number to file oral grievances and appeals. G. Person Served's right to request continuation of benefits during an appeal or state fair hearing filing although the person served may be liable for the cost of any continued benefits if the action is upheld. H. Any state determined contractor's appeal rights to challenge the failure of the COUNTY to cover a service. 23. GREIVANCE AND APPEALS RECORDKEEPING REQUIREMENTS CONTRACTOR shall retain person served grievance and appeal records as referenced in 42 CFR §438.416, for a period of no less than ten (10) years. Person served grievance and appeal data shall include a general description of the reason for the grievance or appeal, the date the grievance or appeal was received, the date of each review or, if applicable, review meeting, the resolution and date of resolution at each level of the grievance or appeal and the name of the covered person for whom the grievance or appeal was filed. The record must be accurately maintained in a manner accessible to DHCS and available upon request to CMS. 24. PERSON SERVED INFORMING AND TRANSLATION SERVICES CONTRACTOR shall make written and verbal information available to persons served in their language of choice. Written material: CONTRACTOR shall use COUNTY's written/translated materials that are critical to obtaining services, including the provider directory, member handbook, appeal and grievance notices, and denial and termination notices, available in the prevalent non—English languages. All other CONTRACTOR specific written materials must be made available in the prevalent non-English languages. CONTRACTOR shall ensure that written materials use easily understood language and format, use a font size no smaller than 12-point, and are made available in alternative formats upon request of the potential person served or person served at no cost. Written materials shall include taglines in the prevalent non-English languages in the state, as well as large print, explaining the availability of written translation or oral interpretation to understand the information provided and the toll-free and TTY/TDY telephone number of COUNTY's member/customer service unit. Written materials for potential and current persons served shall include language taglines in at least the top sixteen (16) non-English languages spoken by individuals with limited English proficiency of the State, as well as large print, explaining the availability of written translation or oral interpretation to understand the information provided. Large print means in a font size no smaller than 18 point. Auxiliary aids: CONTRACTOR shall ensure auxiliary aids and services in an appropriate manner that takes into consideration the special needs of persons served or potential 9 Revised 01/31/2022 DMC Master Agreement Exhibit C persons served with disabilities or limited English proficiency shall be made available upon request of the potential person served or person served at no cost. Interpretation services: CONTRACTOR shall make interpretation services available free of charge and in a timely manner to each person served. This includes oral interpretation and the use of auxiliary aids (such as TTY/TDY and American Sign Language) and services including qualified interpreters for individuals with disabilities. Oral interpretation requirements apply to all non—English languages, not just those that DHCS identifies as prevalent. Pursuant to WIC 14029.91(a)(1)(B), Oral interpretation services shall be provided by an interpreter that, at a minimum, meets all the following qualifications: A. Demonstrated proficiency in speaking and understanding both spoken English and the language spoken by the limited-English-proficient person served; B. The ability to interpret effectively, accurately, and impartially, both receptively and expressly, to and from the language spoken by the limited-English-proficient person served and English, using any necessary specialized vocabulary, terminology, and phraseology; and C. Adherence to generally accepted interpreter ethics principles, including client confidentiality. CONTRACTOR shall notify its persons served and prospective persons served that oral interpretation is available for any language and written translation is available in prevalent languages to individuals whose primary language is not English free of cost and how to access those materials. This may include, but is not limited to qualified interpreters and information written in other languages. CONTRACTOR shall notify persons served that auxiliary aids and services are available upon request, at no cost and in a timely manner for non-English speaking/reading/writing persons served and persons served with disabilities. Free aides and services to people with disabilities to help them communicate better may include, but are not limited to, qualified sign language interpreters and written information in other formats (e.g. large print, audio, accessible electronic formats, and other formats). CONTRACTOR shall notify persons served how to access these services. Pursuant to 14029.91(a)(1)(C), CONTRACTOR shall not require a person served with limited English proficiency to provide his or her own interpreter or rely on a staff member who does not meet the qualifications described above. CONTRACTOR shall not rely on an adult or minor child accompanying the limited- English-proficient person served to interpret or facilitate communication except under the circumstances described in WIC Section 14029.91(a)(1)(D) for emergencies and upon request that the accompanying adult provide assistance. Pursuant to 45 CFR 92.201, CONTRACTOR shall not require a person served with limited English proficiency to accept language assistance services. CONTRACTOR shall post a DHCS-approved nondiscrimination notice and language taglines in at least the top sixteen (16) non-English languages in the State (as determined by DHCS) as well as large print, explaining the availability of free language assistance services, including written translation and oral interpretation to understand the information provided, and the toll-free and TTY/TDY telephone number of CONTRACTOR's member/customer service unit, as follows: 10 Revised 01/31/2022 DMC Master Agreement Exhibit C A. In all conspicuous physical locations where CONTRACTOR interacts with the public; B. In a conspicuous location on CONTRACTOR's website that is accessible on CONTRACTOR's home page, and in a manner that allows persons served and prospective persons served to easily locate the information; and C. In all significant communications and significant publications targeted to persons served, enrollees, applicants, and members of the public, except for significant publications and significant communications that are small-sized, such as postcards and tri-fold brochures. CONTRACTOR shall post a DHCS-approved nondiscrimination statement and language taglines in a least the top two non-English languages in the State (as determined by DHCS), explaining the availability of free language assistance services, and the toll-free and TTY/TDY telephone number of CONTRACTOR's member/customer service unit, as follows: A. In all significant publications and significant communications that are small- sized, such as postcards and tri-fold brochures; and B. CONTRACTOR's nondiscrimination notice, nondiscrimination statement, and language taglines must be in a conspicuously visible font size no smaller than 12-point. Any large print tagline required must be in a font size no smaller than 18-point and must include information on how to request auxiliary aides and services, including the provision of the materials in alternative formats. 25. MEMBER HANDBOOK CONTRACTOR shall utilize COUNTY developed member handbook and issue to persons served at intake. Member handbooks can also be made available by mailing a printed copy of the information to the person served's mailing address, emailing after obtaining the person served's agreement to receive information by email, providing direction in paper or electronic form to the COUNTY website or any other method that can reasonably be expected to result in the person served receiving that information. 26. TIMELY ACCESS REQUIREMENTS CONTRACTOR shall meet DHCS and COUNTY standards for timely access to care and services, taking into account the urgency of the need for services. CONTRACTORs must offer hours of operation that are no less than the hours of operation offered to commercial persons served or comparable to Medicaid FFS, if CONTRACTOR services only Medicaid persons served. Timeliness standards include, but are not limited to: A. Initial contact to first face-to-face appointment— 10 business days B. Initial contact to first dose of NTP — 3 business days C. Timeliness of services for Urgent Conditions — 1 business day CONTRACTOR shall ensure that medical attention for emergency and crisis medical conditions are provided immediately. 11 Revised 01/31/2022 DMC Master Agreement Exhibit C 27. CARE COORDINATION CONTRACTOR and COUNTY shall comply with the care and coordination requirements of the State-County Intergovernmental Agreement, Exhibit A, Attachment I, II.E.3. CONTRACTOR shall ensure that each person served has an ongoing source of care appropriate to his or her needs and shall ensure a person or entity within their organization is formally designated as primarily responsible for coordinating the services accessed by the person served. The person served shall be provided information on how to contact their case manager. CONTRACTOR shall coordinate services between levels of care, with services the person served receives from any other managed care organization and the services the person served receives from community and social support providers. Care coordination efforts shall be accurately documented in person served's chart to be verified during COUNTY chart audits conducted at least annually. CONTRACTOR shall make a best effort to conduct an initial screening of each person served's ancillary needs, within thirty (30) calendar days of the effective date of admission for all new persons served, including subsequent attempts if the initial attempt to contact the person served is unsuccessful. CONTRACTOR shall ensure that it maintains and shares, as appropriate, a person served health record in accordance with professional standards. CONTRACTOR shall ensure that in the process of coordinating care, each person served's privacy is protected in accordance with the privacy requirements in 45 CFR parts 160 and 164 subparts A and E and 42 CFR Part 2, to the extent that they are applicable. CONTRACTOR shall ensure that persons served are aware of and are referred to, when appropriate, recovery supports and services immediately after discharge or upon completion of an acute care stay. 28. AUTHORIZATION OF SERVICES CONTRACTOR shall adhere to COUNTY's written policies and procedures, outlined in the Provider Manual, for authorization of services. 29. PERFORMANCE IMPROVEMENT PROJECTS CONTRACTOR shall assist, when requested by COUNTY, in developing and reviewing annual Performance Improvement Projects including but not limited to identifying a clinical and a non-clinical problem, brainstorming causes and barriers, implementation of interventions for the identified problems, and analysis of interventions. CONTRACTOR shall assist in planning and initiation of activities for increasing or sustaining improvement. 30. CONTRACTOR DMC CERTIFICATION DMC certified contractors must revalidate DMC certification with DHCS every five (5) years. Failure to revalidate DMC certification within 120 days following the expiration of every five (5) year period will result in contract termination. COUNTY shall terminate CONTRACTOR immediately upon notification from DHCS that the CONTRACTOR cannot be enrolled, or the expiration of one 120-day period without enrollment of CONTRACTOR and shall notify affected 12 Revised 01/31/2022 DMC Master Agreement Exhibit C person served. CONTRACTOR shall ensure enrollment with DHCS as a Medicaid provider consistent with the provider disclosure, screening and enrollment requirements. DMC certified CONTRACTORs shall be subject to continuing certification requirements at least once every five years. DHCS may allow the CONTRACTOR to continue delivering covered services to person served at a site subject to on-site review by DHCS as part of the recertification process prior to the date of the on-site review, provided the site is operational, the certification remains valid, and has all required fire clearances. DHCS shall conduct unannounced certification and recertification site visits at clinics pursuant to W&I Code, Section 14043.7. 31. PROGRAM INTEGRITY REQUIREMENTS CONTRACTOR shall implement and maintain arrangements or procedures that are designed to detect and prevent fraud, waste, and abuse. CONTRACTOR shall maintain written policies, procedures, and standards of conduct that articulate CONTRACTORs commitment to comply with all applicable requirements and standards under the State-County Intergovernmental Agreement, and all applicable Federal and State requirements. CONTRACTOR shall establish and implement procedures and a system with dedicated staff for routine internal monitoring and auditing of compliance risks, prompt response to compliance issues as they are raised, investigation of potential compliance problems as identified in the course of self-evaluation and audits, correction of such problems promptly and thoroughly (or coordination of suspected criminal acts with law enforcement agencies) to reduce the potential for recurrence, and ongoing compliance. CONTRACTOR shall provide reports to COUNTY within 60 calendar days when it has identified an overpayment. COUNTY shall provide a mechanism for reporting and collecting overpayment. CONTRACTOR shall retain information regarding data, information, and documentation for person served encounter data specified in 42 CFR §§438.604, 438.606, 438.608, and 438.610 for a period of no less than 10 years. CONTRACTOR shall ensure sites keep a record of persons served being treated at that location. CONTRACTOR shall not knowingly have a relationship with a director, officer or partner of CONTRACTOR, a subcontractor of CONTRACTOR, a person with beneficial ownership of five (5) percent or more of CONTRACTOR's equity or a network provider or person with an employment, consulting or other arrangement with the CONTRACTOR for the provision of items and services that are significant and material to the CONTRACTOR's obligations under this Agreement with the following: A. An individual or entity that is debarred, suspended, or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non-procurement activities under regulations issued under Executive Order No. 12549 or under guidelines implementing Executive Order No. 12549. B. An individual or entity who is an affiliate, as defined in the Federal Acquisition Regulation at 48 CFR 2, Section 101, of a person described above. Revised 01/31/2022 DMC Master Agreement Exhibit C CONTRACTOR shall not have a relationship with an individual or entity that is excluded from participation in any Federal Health Care Program under section 1128 or 1128A of the Act. 32. CONTRACTOR SPECIFICATIONS CONTRACTOR shall ensure that professional staff shall be licensed, registered, certified or recognized under California scope of practice statutes. Professional staff shall provide services within their individual scope of practice and receive supervision required under their scope of practice laws. CONTRACTOR shall ensure that professional staff(LPHAs) receive a minimum of five (5) hours of continuing education related to addiction medicine each year. Copies of these certifications and licenses shall be maintained in staff's personnel files and records shall be made available to COUNTY upon request. CONTRACTOR shall ensure that non-professional staff receive appropriate onsite orientation and training prior to performing assigned duties. A professional and/or administrative staff shall supervise non-professional staff. Professional and non-professional staff are required to have appropriate experience and any necessary training at the time of hiring. Documentation of trainings, certifications and licensure shall be contained in personnel files. Registered and certified SLID counselors shall adhere to all requirements in Title 9, Chapter 8. 33. CREDENTIALING/RECREDENTIALING CONTRACTOR shall follow the COUNTY's established credentialing and re- credentialing process for all licensed and/or certified staff. Initial credentialing must be completed prior to providing treatment services. Re-credentialing must be completed every three (3) years. 34. MEDICAL DIRECTOR REQUIREMENTS CONTRACTOR's Medical Director must, prior to the delivery of services under this Contract, be enrolled with DHCS under applicable state regulations, screened in accordance with 42 CFR 455.450(a) as a "limited" categorical risk within a year prior to serving as a Medical Director under this Agreement, and have a signed Medicaid provider agreement with DHCS as required by 42 CFR 431.107. Medical Directors shall receive a minimum of five (5) hours of continuing medical education related to addiction medicine annually. 35. ASAM REQUIREMENTS CONTRACTOR shall use COUNTY's American Society of Addiction Medicine (ASAM) criteria assessment and re-assessment tools to determine the person served's level of care. CONTRACTOR shall ensure that assessment of services for adolescents will follow the ASAM adolescent treatment criteria. CONTRACTOR and CONTRACTOR's staff shall comply with obtaining ASAM Criteria training prior to providing services. CONTRACTOR shall ensure that, at minimum, staff conducting assessments complete the two e-Training modules entitled "ASAM Multidimensional Assessment", "From Assessment to Service Planning and Level of Care" and "Introduction to the ASAM Criteria". CONTRACTOR shall maintain records of ASAM trainings in personnel files and will make these records available to COUNTY upon request. 14 Revised 01/31/2022 DMC Master Agreement Exhibit C Residential care CONTRACTORs must meet the established ASAM criteria for each level of residential care provided and receive an ASAM Designation prior to providing DMC-ODS services. 36. MEDICAL NECESSITY CONTRACTOR shall ensure that an initial medical necessity determination, for an individual to receive a DMC-ODS benefit, is performed through a face-to-face review or telehealth by a Medical Director or a LPHA. If a person served's assessment and intake information are completed by a counselor through a face-to-face review or telehealth, the Medical Director or LPHA shall evaluate each person served's assessment and intake information with the counselor to establish whether that person served meets medical necessity criteria. The ASAM Criteria shall be applied to determine placement into the level of assessed services. CONTRACTOR shall ensure that all ADULT persons served receive at least one diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM) Fifth Edition for Substance-Related and Addictive Disorders. After establishing a diagnosis and documenting the basis for diagnosis, the American Society of Addiction Medicine (ASAM) Placement Criteria shall be applied by the diagnosing individual to for placement into the correct level of care. CONTRACTOR shall periodically as directed by COUNTY, and at a minimum of every six (6) months, reassess for continued medical necessity of an ongoing treatment. The reassessment determination must be documented by the Medical Director, licensed physician or LPHA as clinically appropriate. OTP/NTP CONTRACTOR shall periodically as directed by COUNTY, and at a minimum within two (2) years from admission and annually thereafter, reassess for continued medical necessity of an ongoing treatment and determine that those services are still clinically appropriate for that individual. For Medical Necessity definition and Assessment and Reassessment timeframes CONTRACTOR shall refer to the Provider Manual. Individuals under age 21 are eligible to receive Medicaid services pursuant to the Early Periodic Screening, Diagnostic and Treatment (EPSDT) mandate. Under the EPSDT mandate, perons served under the age 21 are eligible to receive all appropriate and medically necessary services needed to correct and ameliorate health conditions that are coverable under section 1905(a) Medicaid authority. Nothing in the DMC-ODS shall override any EPSDT requirements. Medical necessity for an adolescent individual (an individual under the age of 21) is determined using the following criteria: A. The adolescent individual may be assessed to be at-risk for developing a SUD based on the following criteria: 1) Substance use does NOT meet the minimum diagnosis criteria per the DSM 5; and 2) Reports of experimental or early-phase substance use, associated biopsychosocial risk factors, and information gathered from the full ASAM assessment and the At-Risk Determination Tool indicate risk of developing an SUD. 1s Revised 01/31/2022 DMC Master Agreement Exhibit C B. The adolescent individual must meet the ASAM adolescent treatment criteria. 37. MEDI-CAL ELIGIBILITY VERIFICATION CONTRACTOR shall be responsible for verifying the Medi-Cal eligibility of each person served for each month of service prior to billing for DMC services for that month. Medi-Cal eligibility verification should be performed prior to rendering service, in accordance with and as described in the DHCS DMC Provider Billing Manual. Options for verifying the eligibility of a Medi- Cal person served are described in the DHCS DMC Provider Billing Manual at the following web address and by this reference incorporated herein. https://www.dhcs.ca.gov/services/Documents/SUD%20- %20DMC%20Billinq%20Manual/DMC Billing Manual 2019%20Final.pdf 38. OTHER HEALTH COVERAGE BILLING REQUIREMENTS In the event that a person served has Other Health Coverage (OHC), CONTRACTOR shall bill the OHC prior to billing DMC to receive either payment from the OHC, or a notice of denial from the OHC indicating that either the recipient's OHC coverage has been exhausted or that the specific service is not a benefit of the OHC. 39. DMC REIMBURSEMENT RATE SETTING CONTRACTOR shall submit financial and service data to COUNTY on an annual basis in a format provide by, and by a deadline set by, COUNTY for reimbursement rate setting purposes. COUNTY shall approve contractor-specific reimbursement rates for each modality except NTPs. CONTRACTORs that do not comply with the requirements of the rate setting process will be considered out of compliance with contractual requirements and will not receive annual reimbursement rates CONTRACTORs that are non-compliant are subject to contract termination. Annual reimbursement rates for NTP services shall be set by DHCS pursuant to the process set forth in W&I Code, Section 14021.51. NTP CONTRACTOR shall submit cost reports to DHCS. 40. DMC CERTIFICATION AND ENROLLMENT Prior to delivering SUD services CONTRACTOR shall obtain any licenses, registrations, DMC certifications or approval to operate a SUD program or provide a covered service in accordance with applicable laws and regulations. CONTRACTOR shall continuously maintain any licenses, registrations, DMC certifications or approval to operate a SUD program or provide a covered service in accordance with applicable laws and regulations for the duration of this Contract. CONTRACTOR and any subcontractors shall comply with the following regulations and guidelines: A. Title 21, CFR Part 1300, et seq., Title 42, CFR, Part 8; B. Title 22, Sections 51490.1(a); C. Exhibit A, Attachment I, Article III.PP — Requirements for Services; D. Title 9, Division 4, Chapter 4, Subchapter 1, Sections 10000, et seq.; and 16 Revised 01/31/2022 DMC Master Agreement Exhibit C E. Title 22, Division 3, Chapter 3, sections 51000 et. seq. 41. PERINATAL CERTIFICATION REQUIREMENTS CONTRACTORs of perinatal DMC services shall be properly certified to provide these services and comply with the applicable requirements below: A. Perinatal services shall address treatment and recovery issues specific to pregnant and postpartum women, such as relationships, sexual and physical abuse, and development of parenting skills. B. Perinatal services shall include: 1) Mother/child habilitative and rehabilitative services (i.e., development of parenting skills, training in child development, which may include the provision of cooperative child care pursuant to Health and Safety Code Section 1596.792); 2) Service access (i.e., provision of or arrangement for transportation to and from medically necessary treatment); 3) Education to reduce harmful effects of alcohol and drugs on the mother and fetus or the mother and infant; and 4) Coordination of ancillary services (i.e., assistance in accessing and completing dental services, social services, community services, educational/vocational training and other services which are medically necessary to prevent risk to fetus or infant). C. Medical documentation that substantiates the person served's pregnancy and the last day of pregnancy shall be maintained in the person served file. 42. 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. 43. CONTRACTOR CHANGE IN SERVICE OR LOCATION CONTRACTOR shall ensure that any reduction of covered services or relocations are not implemented until approval is issued by DHCS. CONTRACTOR must submit a new DMC certification application to the DHCS Provider Enrollment Division (PED). The DMC certification application shall be submitted to PED 60 days prior to the desired effective date of the reduction of covered services or relocation. CONTRACTOR shall notify COUNTY when its license, registration, certification, or approval to operate a SUD program or provide a covered service is revoked, suspended, modified, or not renewed by entities other than DHCS. Revised 01/31/2022 DMC Master Agreement Exhibit C 44. MEDICATION ASSISTED TREATMENT CONTRACTORs that do not provide medication assisted treatment shall have procedures for linkage/integration for persons served requiring medication assisted treatment. CONTRACTOR staff will regularly communicate with physicians of person served who are prescribed these medications unless the person served refuses to consent to sign 42 CFR part 2 Compliant Releases of Information for this purpose. 45. EVIDENCE BASED PRACTICES (EBP) CONTRACTOR shall implement Motivational Interviewing and at least two EBPs prescribed by DHCS based on the timeline established by COUNTY as outlined in the Provider Manual. The two additional required EBPs may be selected from the following: Cognitive- Behavioral Therapy, Relapse Prevention, Trauma-Informed Treatment and Psycho-Education. Three EBPs shall be utilized per service modality. COUNTY and DHCS will monitor the implementation and regular training of EBPs to staff during reviews. CONTRACTOR shall ensure that staff are internally monitored for training, quality of delivery and fidelity of Evidence Based Practices. 46. COORDINATION AND CONTINUITY OF CARE WITH MANAGED CARE PLANS CONTRACTOR shall coordinate with the Managed Care Plans, Anthem and CaIVIVA Health, when appropriate, for comprehensive physical and behavioral health screening and collaborative treatment planning. COUNTY shall maintain MOUs with the managed care plans to facility person served care coordination and will monitor CONTRACTORs with regard to the effectiveness of physical health care coordination. 47. POSTSERVICE POSTPAYMENT AND POSTSERVICE PREPAYMENT (PSPP) DHCS shall conduct Postservice Postpayment and Postservice Prepayment (PSPP) Utilization Reviews of contracted DMC providers to determine whether the DMC services were provided. DHCS shall issue the PSPP report to the COUNTY with a copy to CONTRACTOR. CONTRACTOR shall ensure any deficiencies are remediated and COUNTY shall attest the deficiencies have been remediated. All CONTRACTOR shall submit a COUNTY-approved corrective action plan (CAP) to DHCS within 60 days of the date of the PSPP report. CONTRACTOR(S) that do not comply with the CAP submittal requirements or fail to implement the approved CAP provisions within the designated timeline are subject to payment withholding until compliance is determined. 48. DRUG SCREENING Where drug screening by urinalysis is deemed medically appropriate, CONTRACTOR shall establish procedures which protect against the falsification and/or contamination of any urine sample and document urinalysis results in the person served's file. 49. TREATMENT RECORDING REQUIREMENTS CONTRACTOR shall comply with the requirements outlined in the Intergovernmental Agreement, Exhibit A, Attachment I, Section PP, regarding admission, 18 Revised 01/31/2022 DMC Master Agreement Exhibit C assessment, person served record, medical necessity and diagnosis, physical examination, treatment plan, sign-in sheets, progress notes, continuing services, and discharge. 50. 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 ensure 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)]. 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 enrolled 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. 19 Revised 01/31/2022 DMC Master Agreement Exhibit C E. Code Set Retention Both COUNTY and CONTRACTOR 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 COUNTY and CONTRACTOR 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 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. 51. PARITY IN MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS A. General Parity Requirement CONTRACTOR shall not impose any financial requirements, Quantitative Treatment Limitations, or Non-Quantitative Treatment Limitations in any classification of benefit (inpatient, outpatient, emergency care, or prescription drugs) other than those limitations permitted and outlined in the State-County Contract. CONTRACTOR shall not apply any financial requirement or treatment limitation to substance use disorder services in any classification of benefit that is more restrictive than the predominant financial requirement or treatment limitation of that type applied to substantially all medical/surgical benefits in the same classification of benefit furnished to person served (whether or not the benefits are furnished by the CONTRACTOR). (42 CFR 438.910(b)(1)) CONTRACTOR shall provide substance use disorder services to person served in every classification in which medical/surgical benefits are provided. (42 CFR 438.910(b)(2)) B. Quantitative Limitations CONTRACTOR shall not apply any cumulative financial requirement for substance use disorder services in a classification that accumulates separately from any established for medical/surgical services in the same classification. (42 CFR 438.910(c)(3)) C. Non-Quantitative Limitations CONTRACTOR shall not impose a non-quantitative treatment limitation for substance use disorder benefits in any classification unless, under the policies and procedures of CONTRACTOR as written and in operation, any processes, strategies, evidentiary standards, or other factors used in applying the non-quantitative treatment limitation to substance use disorder benefits in the classification are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, or other factors used in applying the limitation for medical/surgical benefits in the classification. (42 CFR §438.910(d)) 20 Revised 01/31/2022 DMC Master Agreement Exhibit C 52. CONTRACTOR shall use processes, strategies, evidentiary standards, or other factors in determining access to out-of-network providers for substance use disorder services that are comparable to, and applied no more stringently than, the processes, strategies, evidentiary standards, or other factors in determining access to out-of-network providers for medical/surgical benefits. (42 CFR §438.910(d)(3)). 53. ACCESSIBILITY CONSIDERATIONS CONTRACTOR shall ensure that their health programs or activities provided through electronic and information technology are accessible to person served with disabilities, unless doing so would result in undue financial and administrative burdens or a fundamental alteration in the nature of the health programs or activities. When undue financial and administrative burdens or a fundamental alteration exist, CONTRACTOR shall provide information in a format other than an electronic format that would not result in such undue financial and administrative burdens or a fundamental alteration but would ensure, to the maximum extent possible, that person served with disabilities receive the benefits or services of the health program or activity that are provided through electronic and information technology. CONTRACTOR shall make reasonable modifications to policies, practices, or procedures when such modifications are necessary to avoid discrimination on the basis of disability, unless CONTRACTOR can demonstrate that making the modifications would fundamentally alter the nature of the health program or activity. For the purposes of this section, the term "reasonable modifications" shall be interpreted in a manner consistent with the term as set forth in the ADA Title II regulation at 28 CFR 35.130(b)(7). 54. STATE PLAN COUNTIES OTP/NTP PERSONS SERVED OTP CONTRACTORs shall ensure that a person served that resides in a county that does not participate in DMC-ODS does not experience a disruption of OTP/NTP services. OTP CONTRACTORs shall provide any medically necessary NTP services covered by the California Medi-Cal State Plan to persons served that reside in a county that does not participate in DMC- ODS. OTP CONTRACTORs who provide services to an out-of-county person served shall submit claims for those services to the county in which the person served resides (according to MEDS). PERSON SERVED RIGHTS CONTRACTOR shall comply with any applicable Federal and state laws that pertain to person served rights and shall ensure that its employees observe and protect those rights. CONTRACTOR shall have written policies guaranteeing the person served's rights specified in 42 CFR 438.100. RECORD RETENTION CONTRACTORS shall maintain records for each service rendered, to whom it was rendered, and the date of service, pursuant to WIC 14124.1 and 42 CFR 438.3(h) and 438.3(u). 21 Revised 01/31/2022 DMC Master Agreement Exhibit C, Attachment A Page 1 of 1 TRAFFICKING VICTIMS PROTECTION ACT OF 2000 CERTIFICATION I, as an authorized agent of (Print Name) acknowledge the requirement to (Organization Name) comply with the Trafficking Victims Protection Act of 2000 (TVPA), specifically Section 106(g), which authorizes the County of Fresno to terminate a contract, without penalty, if this organization or its employees, or a subcontractor or its employees: • Engages in severe forms of trafficking in persons during the period of time that the award is in effect; • Procures a commercial sex act during the period of time that the award in in effect; or • Uses forced labor in the performance of the award or subawards under the award. I understand that the TVPA establishes human trafficking and related offenses as federal crimes and attaches severe penalties to them. I will immediately inform the County of Fresno, Department of Behavioral Health, Contracts Division — Substance Use Disorder (SUD) Services immediately of any information received from any source alleging a violation of the TVPA by either this organization or its employees, or a subcontractor or its employees during the term of this contract. I understand that this organization is obligated to ensure any subcontractors are informed of the requirements of the TVPA and, if found in violation, will be immediately terminated. I agree to submit this signed certification annually on behalf of the organization acknowledging requirements under the TVPA and attesting that all employees will receive annual TVPA training, and that documentation of training will be placed in personnel files. Signature: Date: Title: DMC Master Agreement Exhibit C, Attachment B Page 1 of 1 UNLAWFUL USE OF DRUGS AND ALCOHOL CERTIFICATION I, as an authorized agent of (Print Name) acknowledge the requirement to (Organization Name) comply with California HSC 11999-11999.3, which authorizes the County of Fresno to terminate a contract, without penalty, if this organization or its employees, or a subcontractor or its employees fail to ensure that: • The program contains a component that clearly explains in written materials that there shall be no unlawful use of drugs or alcohol. No aspect of a drug- or alcohol-related program shall include any message on the responsible use, if the use is unlawful, of drugs or alcohol; • All aspects of a drug- or alcohol-related program are consistent with the "no unlawful use" message, including, but not limited to, program standards, curricula, materials, and teachings; and • The "no unlawful use" of drugs and alcohol message contained in drug- or alcohol-related programs applies to the use of drugs and alcohol prohibited by law. I understand that the State of California enforces an Unlawful Use policy in which there is zero tolerance for promoting the unlawful use of and drugs or alcohol in an AOD treatment facility. If this organization fails to satisfy the guidelines adopted by the State of California, the drug or alcohol program shall not receive state funds and their contract with Fresno County will be terminated. I understand that this organization is obligated to ensure any subcontractors are informed of the requirements of HSC 11999-11999.3 and, if found in violation, will be immediately terminated. Signature: Date: Title: DMC Master Agreement Exhibit C,Attachment C Page 1 of 1 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: hllp://www.dhcs.ca.gov/fortnsandpubs/laws/priv/Pages/DHCSBusinessAssociates0nly.aspx and return the completed form to: privacyofficerndhcs.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: 3133 N Millbrook,Fresno,California 93703 FAX(559)600-7673 www.co.fresno.ca.us DMC Master Agreement The County of Fresno is an Equal Employment Opportunity Employer Exhibit D DBH VISION: Health and well-being for our community. DBH MISSION: DBH, in partnership with our diverse community, is dedicated to providing quality, culturally responsive, behavioral health services to promote wellness, recovery, and resiliency for individuals and families in our community. 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 2. Principle Two - Strengths-based 1 rev 01-02-2020 DMC Master Agreement Exhibit D 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 values and preferences of those we serve o Other clinically significant interventions such as innovative, promising, and emerging practices are embraced 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 2 rev 01-02-2020 DMC Master Agreement Exhibit D 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 person'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 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 3 rev 01-02-2020 DMC Master Agreement Exhibit D 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 4 rev 01-02-2020 DMC Master Agreement Exhibit E Fresno County Department of Behavioral Health Drug Medi-Cal Treatment Services Approved Rates by Provider Fiscal Year 2022-23 15-Minute Unit Day Rate OPT IOT Care Recovery Clinician MAT Withdrawal Residential Residential Coordination Services Consultation Management 3.1 3.5 APPROVED MAXIMUM UOS RATE 51.00 53.85 51.45 52.05 153.60 153.60 164.24 185.13 188.52 COUNTY APPROVED PROVIDER RATES: Bakersfield Recovery, Inc.-Jason's Retreat 164.24 Bakersfield Recovery, Inc.-Capistrano 164.24 Central California Recovery 45.00 46.35 153.60 153.60 Delta Care 40.50 51.45 33.00 153.60 153.60 Fresno County Hispanic Commission 1 43.07 1 153.60 153.60 111.05 Fresno New Connections 32.70 53.85 51.45 27.00 153.60 153.60 Kings View-Fresno 44.55 44.55 153.60 153.60 Mental Health Systems- FYA 39.00 38.55 37.20 153.60 153.60 Mental Health Systems- IMPACT 40.95 42.90 39.75 39.75 153.60 153.60 Mental Health Systems- Fresno First(Womens) 1 43.07 153.60 153.60 127.27 172.38 172.38 Mental Health Systems- Fresno First(Perinatal) 43.07 153.60 153.60 127.27 172.38 172.38 Prodigy 50.55 50.10 52.05 153.60 153.60 Promesa 48.90 46.80 49.50 153.60 153.60 Turning Point-First Street Center 36.60 35.55 153.60 153.60 Turning Point-Quest House 43.07 153.60 153.60 177.92 188.52 Turning Point-Visalia 43.07 153.60 153.60 106.00 WestCare Outpatient-Belmont 51.00 50.70 49.65 42.75 153.60 153.60 WestCare Bakersfield Residential 40.50 153.60 153.60 163.41 120.63 WestCare Fresno Residential Mens 35.25 153.60 153.60 164.24 156.84 163.66 Perinatal 35.251 153.601 153.60 164.241 170.781 175.84 Womens 35.251 153.601 153.601 164.241 158.831 173.87 07/01/2022 DMC Master Agreement 1 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 2 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 3 of 15 Exhibit E Fresno County Department of Behavioral Health Drug Medi-Cal Treatment Services Approved Rates by Provider Fiscal Year 2023-24 15-Minute Unit Day Rate OPT IOT Care Recovery Clinician MAT Withdrawal Residential Residential Coordination Services Consultation Management 3.1 3.5 APPROVED MAXIMUM UOS RATE COUNTY APPROVED PROVIDER RATES: Bakersfield Recovery, Inc.-Jason's Retreat Bakersfield Recovery, Inc.-Capistrano Central California Recover Delta Care Fresno County Hispanic Commission Fresno New Connections Kings View-Fresno Mental Health Systems- FYA Mental Health Systems- IMPACT Mental Health Systems- Fresno First(Womens) Mental Health Systems- Fresno First(Perinatal) Prodigy Promesa Turning Point-First Street Center Turning Point-Quest House Turning Point-Visalia WestCare Outpatient-Belmont WestCare Bakersfield Residential WestCare Fresno Residential Mens Perinatal Womens 07/01/2022 DMC Master Agreement 4 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 5 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 6 of 15 Exhibit E Fresno County Department of Behavioral Health Drug Medi-Cal Treatment Services Approved Rates by Provider Fiscal Year 2024-25 15-Minute Unit Day Rate OPT IOT Care Recovery Clinician MAT Withdrawal Residential Residential Coordination Services Consultation Management 3.1 3.5 APPROVED MAXIMUM UOS RATE COUNTY APPROVED PROVIDER RATES: Bakersfield Recovery, Inc.-Jason's Retreat Bakersfield Recovery, Inc.-Capistrano Central California Recover Delta Care Fresno County Hispanic Commission Fresno New Connections Kings View-Fresno Mental Health Systems- FYA Mental Health Systems- IMPACT Mental Health Systems- Fresno First(Womens) Mental Health Systems- Fresno First(Perinatal) Prodigy Promesa Turning Point-First Street Center Turning Point-Quest House Turning Point-Visalia WestCare Outpatient-Belmont WestCare Bakersfield Residential WestCare Fresno Residential Mens Perinatal Womens 07/01/2022 DMC Master Agreement 7 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 8 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 9 of 15 Exhibit E Fresno County Department of Behavioral Health Drug Medi-Cal Treatment Services Approved Rates by Provider Fiscal Year 2025-26 15-Minute Unit Day Rate OPT IOT Care Recovery Clinician MAT Withdrawal Residential Residential Coordination Services Consultation Management 3.1 3.5 APPROVED MAXIMUM UOS RATE COUNTY APPROVED PROVIDER RATES: Bakersfield Recovery, Inc.-Jason's Retreat Bakersfield Recovery, Inc.-Capistrano Central California Recover Delta Care Fresno County Hispanic Commission Fresno New Connections Kings View-Fresno Mental Health Systems- FYA Mental Health Systems- IMPACT Mental Health Systems- Fresno First(Womens) Mental Health Systems- Fresno First(Perinatal) Prodigy Promesa Turning Point-First Street Center Turning Point-Quest House Turning Point-Visalia WestCare Outpatient-Belmont WestCare Bakersfield Residential WestCare Fresno Residential Mens Perinatal Womens 07/01/2022 DMC Master Agreement 10 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 11 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 12 of 15 Exhibit E Fresno County Department of Behavioral Health Drug Medi-Cal Treatment Services Approved Rates by Provider Fiscal Year 2026-27 15-Minute Unit Day Rate OPT IOT Care Recovery Clinician MAT Withdrawal Residential Residential Coordination Services Consultation Management 3.1 3.5 APPROVED MAXIMUM UOS RATE COUNTY APPROVED PROVIDER RATES: Bakersfield Recovery, Inc.-Jason's Retreat Bakersfield Recovery, Inc.-Capistrano Central California Recover Delta Care Fresno County Hispanic Commission Fresno New Connections Kings View-Fresno Mental Health Systems- FYA Mental Health Systems- IMPACT Mental Health Systems- Fresno First(Womens) Mental Health Systems- Fresno First(Perinatal) Prodigy Promesa Turning Point-First Street Center Turning Point-Quest House Turning Point-Visalia WestCare Outpatient-Belmont WestCare Bakersfield Residential WestCare Fresno Residential Mens Perinatal Womens 07/01/2022 DMC Master Agreement 13 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 14 of 15 Exhibit E [This page intentionally left blank] 07/01/2022 DMC Master Agreement 15 of 15 PROVIDER REPORTS Fresno County Substance Use Disorder Services Department of Behavioral Health Exhibit F Report Purpose Submit to Notes weekly Monthly Annual As Needed ASAM Level of Care Tracks level of care determined at sas@ Submit reports by Monday for the (LOC) screening,assessment,and reassessment fresnocountyca.gov previous week; ensure that reports are Monday and actual LOC referred to. password protected or encrypted. Provides capacity and utilization 5th of DATAR information on publicly funded SUD DHCS Webpage following programs. month Template provided by DBH. • Provider shall enter information per modality. If provider offers multiple Managed care requirement. Used to levelsof care within a modality, provider is to use the program ID with 15th of Monthly Status Report monitor network adequacy standards. sas@ followin (MSR) Provides status on DMC programs and is fresnocountyca.gov the lowest LOC(e.g.,for residential, monthg used to update provider directory. enter info under 3.1 instead of 3.5). • Providers are asked to report departing counselors via MSR as soon asthey become aware of the upcoming change. Provides information on length of waittime 15th of Wait List* for admission into a residential sas@ Applicable to residential providers only following program. fresnocountyca.gov month Checks for clinicians'eligibility to provide 15th of Ineligible Persons services based on sanctions or exclusion sas@ Template provided by DBH current Screening status. fresnocountyca.gov month 15t"of Missed Appointments Collects missed appointment data. Avatar following month 15th of Grievance Log DHCS requirement.Collects grievances at mcare@ Template provided by DBH following SUD programs. fresnocountyca.gov month 25th of Operational Expense Tracks provider expenses and monitors sas@ Template provided by DBH following Review(OER)* whether reported costs are allowable. fresnocountyca.gov month 12/27/2021 DMC Master Agreement Page 1 PROVIDER REPORTS Fresno County Substance Use Disorder Services Department of Behavioral Health Exhibit F Report Purpose Submit to Notes weekly Monthly Annual As Needed Network Adequacy sas@ Certification Tool Used to monitor network adequacy Template provided by DBH Feb 1 (NACT) standards. fresnocountyca.gov Culturally and Used to monitor adherence to the Linguistically National CLAS Standards which are sas@ Appropriate Services intended to advance health equity, Template provided b DBH TBD fresnocountyca.gov p p Y (CLAS)self-assessment improve quality,and help eliminate and CLAS plan health care disparities. Americans with Used to monitor compliance with sas@ Disabilities Act(ADA) legislation that prohibits discrimination fresnocountyca.gov Template provided by DBH TBD self-assessment against people with disabilities. Identifies costs and charges related to sas@ Cost Report* program. fresnocountyca.gov Due annually; date set by DHCS and DBH TBD Electronic copy: sas@ fresnocountyca.gov Hard copy: Mandated questionnaire used to determine Department of Risk Assessment a provider's risk categoryclassification. Behavioral Health Due annually; date set by DBH TBD Substance Use Disorder Services Attn: Fiscal Analyst 3133 N Millbrook Ave Fresno, CA 93703 12/27/2021 DMC Master Agreement Page 2 PROVIDER REPORTS Fresno County Substance Use Disorder Services Department of Behavioral Health Exhibit F Additional Reports Report Purpose Submit to Notes weekly Monthly Annual As Needed • Providers are required to complete an online report of any incidents that compromise the health and Logic Manager Incident reporting system Logic Manager safety of clients, employees or X community members. • Reports must be submitted within 48 hours of an incident • Complete form at the time that an individual requests Access Form Collects timeliness data. Avatar SUD treatment X • Instructions are posted at our SUD Services Provider Page • Timeframes vary. Refer to MHSUDS IN #18-010E: https://www.dhcs.ca.gov/forms andpubs/Pages/Behavioral Heal Managed care requirement. NOABD letters th Information Notice.aspx Notice of Adverse Benefit provide information to Medi-Cal persons mcare@ • Templates provided by DBH, Determination (NOABD) served about their appeal rights and other fresnocountyca.gov available at the Provider page: X rights under the Medi-Cal program. https://www.co.fresno.ca.us/depar tments/behavioral- health/home/for- providers/contract- providers/substance-use-disorder- providers *Excluding NTP-only Providers 12/27/2021 DMC Master Agreement Page 3 Exhibit G Page 1 of 1 ELECTRONIC HEALTH RECORD SOFTWARE CHARGES CONTRACTOR(S) understand that COUNTY utilizes NetSmart's Avatar for its Electronic Health Records Management. CONTRACTOR(S) agree to reimburse COUNTY for all user license fees for accessing NetSmart's Avatar, as set forth below. Description FY 2018-19 FY 2019-20 FY 2020-21 FY 2021-22 FY 2022-23 General Users Avatar Named User Hosting (per active user per month; every Avatar"active" log on $37.00 $37.00 $37.00 $37.00 $37.00 ID is a named user) Avatar Named User Maintenance* $14.00 $14.00 $14.00 $14.00 (per active user per month) $14.00 Cloud Hosting- Perceptive Disaster Recovery (per active user per month) $4.66 $4.66 $4.66 $4.66 $4.66 eRx Users Full Suite Prescriber $104.00 $104.00 $104.00 $104.00 (per active user per month; applicable to an active $104.00 Prescriber user ePrescribing Controlled Substances Tokens $8.00 $8.00 $8.00 $8.00 (per active user per month; applicable to an active $8.00 Prescriber user of Controlled Substances Non-Prescribing User $13.00 $13.00 $13.00 $13.00 (per active user per month; applicable to an active Non- $13.00 Prescriber user Reaching Recovery Users Reaching Recovery (per adult client/person served per year; applicable to $10.00 $10.00 $10.00 $10.00 $10.00 adult treatment programs except contracted triage/CI, CSU or PHF ProviderConnect Users Individual Subscription' (per user per month; applicable to provider-user whose $41.25 $41.25 $41.25 $41.25 $41.25 claims are reviewed and posted by Managed Care) Should CONTRACTOR(S) choose not to utilize NetSmart's Avatar for its Electronic Health Records management, CONTRACTOR(S) will be responsible for obtaining its own system for Electronic Health Records management. *Annual Maintenance increases by 3%each FY on July 111 aI AA faxed pages peF MORth A R additiGRal fee of$0.20 peF faxed page will apply theFeafteF. DMC Master Agreement Exhibit H Page 1 of 2 SELF-DEALING TRANSACTION 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). DMC Master Agreement Exhibit H 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: DMC Master Agreement Exhibit I Pagel of 3 DISCLOSURE - CRIMINAL HISTORY & CIVIL ACTIONS: In their proposal, the bidder is required to disclose if any of the following conditions apply to them, their owners, officers, corporate managers and partners (hereinafter collectively referred to as "Bidder"): • Within the three-year period preceding the proposal, they have been convicted of, or had a civil judgment rendered against them for: o 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; o violation of a federal or state antitrust statute; o embezzlement, theft, forgery, bribery, falsification, or destruction of records; or o false statements or receipt of stolen property • Within a three-year period preceding their proposal, they have had a public transaction (federal, state, or local) terminated for cause or default. Disclosure of the above information will not automatically eliminate a Bidder from consideration. The information will be considered as part of the determination of whether to award the contract and any additional information or explanation that a Bidder elects to submit with the disclosed information will be considered. If it is later determined that the Bidder failed to disclose required information, any contract awarded to such Bidder may be immediately voided and terminated for material failure to comply with the terms and conditions of the award. Any Bidder who is awarded a contract must sign an appropriate Certification Regarding Debarment, Suspension, and Other Responsibility Matters, pages 2 and 3 of this Exhibit, Additionally, the Bidder awarded the contract must immediately advise the County in writing if, during the term of the agreement: (1) Bidder 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://sam.gov); or (2) any of the above listed conditions become applicable to Bidder. The Bidder will indemnify, defend and hold the County harmless for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or other matter listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility Matters. DMC Master Agreement Exhibit I Page 2 of 3 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. DMC Master Agreement Exhibit I Page 3 of 3 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; (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) DMC Master Agreement Exhibit J Page 1 of 1 INCIDENT REPORTING PROTOCOL FOR COMPLETION OF INCIDENT REPORT The Incident Report must be completed for all incidents involving individuals served through DBH's current incident reporting portal, Logic Manager, at https:Hfresnodbh.logicmanager.com/incidents/?t=9&p=1&k=182beOc5cdcd5072bb1864cdee 4d3d6e • The reporting portal is available 24 hours a day, every day. • Any employee of the CONTRACTOR can submit an incident using the reporting portal at any time. No login is required. • The designated administrator of the CONTRACTOR can add information to the follow up section of the report after submission. • When an employee submits an incident within 24 hours from the time of the incident or first knowledge of the incident, the CONTRACTOR's designated administrator, the assigned contract analyst and the Incident Reporting email inbox will be notified immediately via email from the Logic Manager system that there is a new incident to review. • Meeting the 24 hour incident reporting requirements will be easier as there are no signatures to collect. • The user guide attached identifies the reporting process and the reviewer process, and is subject to updates based on DBH's selected incident reporting portal system. • Employees involved in a crisis incident should be offered appropriate Employee Assistance Program (EAP) or similar related wellness and recovery assistance. In conjunction with the DBH's Guiding Principles of Care Delivery and wellness of the workforce, CONTRACTOR shall align their practices around this vision and ensure needed debriefing services are offered to all employees involved in a crisis incident. Employees shall be afforded all services to strengthen their recovery and wellness related to the crisis incident. Appropriate follow-up with the employee shall be carried out and a plan for workforce wellness shall be submitted to DBH. Questions about incident reporting, how to use the incident reporting portal, or designating/changing the name of the administrator who will review incidents for the CONTRACTOR should be emailed to DBHlncidentReporting@fresnocountyca.gov and the assigned contract analyst. DMC Master Agreement Mental Health Plan (MHP) and Substance Use Disorder(SUD) services Co Incident Reporting System Exhibit J t, 1 INCIDENT REVIEWER ROLE — User Guide Fresno County Department of Behavioral Health (DBH) requires all of its county-operated and contracted providers (through the Mental Health Plan (MHP) and Substance Use Disorder (SUD) services) to complete a written report of any incidents compromising the health and safety of clients, employees, or community members. Yes! Incident reports will now be made through an on online reporting portal hosted by Logic Manager. It's an easier way for any employee to report an incident at any time. A few highlights: • No supervisor signature is immediately required. • Additional information can be added to the report by the program supervisor/manager without having to resubmit the incident. • When an incident is submitted, the assigned contract analyst, program supervisor/manager, clinical supervisor and the DBHlncidentReporting mailbox automatically receives an email notification of a new incident and can log in any time to review the incident. Everything that was on the original paper/electronic form matches the online form. • Do away with submitting a paper version with a signature. • This online submission allows for timely action for the health and safety of the persons-served, as well as compliance with state reporting timelines when necessary. As an Incident Reviewer, your responsibility is to: • Log in to Logic Manager and review incident submitted within 48 hours of notification of incident. • Review incident for clarity, missing information and add in additional information deemed appropriate. • Notify DBHlncidentReporting@fresnocountyca.gov if there is addition information you need to report that you are unable to add in Logic Manager. • Contact.DBHlncidentReporting@fresnocountVca.gov if you have any concerns, questions or comments with Logic Manager or incident reporting. Below is the link to report incidents https://fresnodbh.logicmanager.com/incidents/?t=9&p=1&k=182be0c5cdcd5072bbl864cdee4d3d6e The link will take you to reporting screen and you may begin your incident submission: DMC Master Agreement Exhibit J E C 4 Y fresnodbh.logicmanagecmmlncidents/?t=9&p=18ik=182be0c5cdcd5072bbl864cdee4d3d6e LogicManager Incident Report Please complete this form Client Information Name of Facility' Name of Reporting Party' Facility Address' Enter to r Facility Phone Number' Mental Health or Substance Use Disorder Program?' Client First Name` Client Last Name E 4 C 4 ... .. t . . I .. :.. ..... .. i Client Date of Birth Client Address i ClientlD i Gender' County of origin' Summary Subject O Incident(check all that apply)' It Other-specify(i.e.fire,poisoning,epidemic outbreaks,other catastrophes/events that jeopardize the welfare and safety of clients,staff and/or members of the community): i Description of the incident' DMC Master Agreement Exhibit J Similar to the paper version, you can select multiple incident categories. I nci dent(check all that apply)' Medical Emergency X Death of Client X Homicide/Homicide Attempt AWOL/Elopement from locked facility V olence/Abuse/Assault(toward others,client and/or property Attempted Suicide(resulting in serious injury) Injury(self-inflicted or by accident) Medication Error E 4 C 4 A fresnodbh.logicmamgeccom/incidents/?t-9&p=1&k-182be0c5cdcd5072bbl864cdee4d3d6e Date of Incident* Time of Incident* Fner:cxi i Location of Incident' Key People Directly Involved in Incident(witnesses,staff)' Did the Injured Party seek Medical Attention? S�k-.t::oti- Attach any additional details B Add File or Drop File Here Reported By Name' Fnter.as Reported By Email' Geer:z i Reported On 10/30/2019 DMC Master Agreement Exhibit J As another bonus feature,you can either drag files (such as a copy of a UOR, additional statements/document) or click on Add File to upload a file. E C 0 i fresnodbh.logicmanagecco mcl tsRt_4&o=1&k=182beOc5cdcd5072bbl864cdee4d3d6e B Add File or Drop File Here Reported By Name' Reported By Email' I rater re a Reported On 10/30/2019 Follow Up Action Taken(check all that apply)' Please specify if other Description of Action Taken' ,rater te;;i Outcome' Similar to the paper version, you can select multiple Action Taken categories. - Follow Up Action Taken(check all that apply)' Law Enforcement Contacted X Called 911/EMS% Consulted with Physician First Aid/CPR Administered Client removed from building Parent/Legal Guardian Contacted Other When you are done entering all information simply click submit. Any fields that have a red asterisk require information and will prevent you from submitting the form. A "Thank you for your submission" statement will pop up if an incident is successfully submitted. You can click "Reload the F " to submit another incident. LogicManager Thank you for your submission) RELOADe• DMC Master Agreement Exhibit J You will receive a Notification email when a new incident is reported, or a new comment has been made regarding an incident. Click on "Open this incident in Logic Manager" and this will take you to the Logic Manager login screen. Wed'!G,3G/21,�9.u.40 AM SL SYSTEM LogicManager via custom r.support@logicmanager.com <customer.support@logicmanager.com> O Notification- To DBH Incident Reporting OI If there are problems with how this message is displayed,click here to view it in a web Click here to download pictures.To help protect your privacy,Outlook prevented autom oc�download of some pictures in this message. CAUTION!!!-EXTERNAL EMAIL-THINK BEFORE YOU CLICK x�NOFPcPk ��liaeba daw�i .,Wvrelan—Meaur �KH y�.rrc. Hi Mila Arevalo, You have received a notification through LogicManager.Please see the details below_ Type:Incident Report Subject:102: Notification To:Mila Arevalo Ocen this inciderd in LogicManager If using Internet Brplorer,click here to open the notification. This email was generated by LogicManager.If you have any technical issues, please email suDmrt(@Il icmanamr.com_ Enter in your email address and password. First time users will be prompted to set up a password. Q 6 fresnodbh.my.logicmanager.comjlogin LogicManager Forgot your password? DMC Master Agreement Exhibit J Once you log in,the main screen will show your task(incidents to review). Click on analyst/supervisor follow up to view the incident. Your Task List TASK NAME SOURCE STATUS ASSIGNEDTO ASSIGNED BY DUE DATE. Analyrt Follow Up In Progi 11d cell SYSTEM L.,c nager This screen below will then pop up. There are 5 tabs to navigate through. Client information will show you the client and facility information. No edits can be made to this section. Analyst Follow Up Tasty Delalls CllentlnfarmMlon xameof facility• xamenmpodinewxy F 111y Redress• sapliry Pnone xumber xemal xeakh or mbaun«u:e pl:omer proeomr alenuaxwmr The next tab is Sum ary: This section can be edited. You can add on to the areas below or make corrections to these fields. Be sur to click SAVE when you made edits.Then Cancel to exit out of the incident. Analyst Follow Up Task Detalls Cllentlnform ,,,, 5ummary r.)low Up Documents —j-0 Incleenl(<heckall that apply)' 0-h of Cllent st - If Otherzpecify(1,(re,p.—I,S,epidemic outbreaks,ether<ataxmphes/events that leopaMUA the welh«and safety of clients,slax and/--b—f the cpmmpmry) Descrlpt—dthein<ident' f Daepf m<m.nr to/3onm9 rime pnn<leenr f LRahon..—d.- f Tssk ID:311 Source:103:null « < 3 > CANCEL DMC Master Agreement Exhibit J The next tab is Follow up: This section can be edited. You can a d on to the areas below or make corrections to these fields. Be sure to click SAVE when you made edits.Th Cancel to Exit out of the incident. Analyst Follow Up Task Details Clientlnform ahon Summary Follow Up Documents Action Taken(check all thatapply)' Law Enforcement Co—d N Pleases fyifother Descnphon mAction Taken' f Outcome' f added information cause of death-renter per corona 10-31-0 Task ID:313 Sourte:303:null �� �� CANCEL The next tab is Documents: You can view and add attachments to the incident. Be sure to click SAVE when adding documents.Then Cancel to Exit out of the incident. Analyst Follow Up Task Details Client Information Summary Follow Up Documents Add Document " Name Type Source Upload Date Uploaded By ,j No Documents yet. Drop files here or click on the Add Document dropch-n. « < 5 1 » CANCEL SAVE Task ID:313 Source:103:null If all tasks are followed up with and the incident no longer needs further review/information,you will click SUBMIT. Once you click Submit the incident will be removed from your task list and no further edits can be made. Notice the SUBMIT button is on every tab. DMC Master Agreement Exhibit K ELECTRONIC SIGNATURE AGREEMENT This Agreement governs the rights, duties, and responsibilities of County in the use of an electronic signature in County. The undersigned understands that this Agreement describes my obligations to protect my electronic signature, and to notify appropriate authorities if it is stolen, lost, compromised, unaccounted for, or destroyed. I agree to the following terms and conditions: 1 agree that my electronic signature will be valid for one year from date of issuance or earlier if it is revoked or terminated per the terms of this agreement. • I will be notified and given the opportunity to renew my electronic signature each year prior to its expiration. The terms of this Agreement shall apply to each such renewal. I will use my electronic signature to establish my identity and sign electronic documents and forms. • I am solely responsible for protecting my electronic signature. • If I suspect or discover that my electronic signature has been stolen, lost, used by an unauthorized party, or otherwise compromised, then I will immediately notify the County Alcohol and Drug Administrator or his/her designee and request that my electronic signature be revoked. • I will then immediately cease all use of my electronic signature. • I agree to keep my electronic signature secret and secure by taking reasonable security measures to prevent it from being lost, modified or otherwise compromised, and to prevent unauthorized disclosure of, access to, or use of it or of any media on which information about it is stored. • I will immediately request that my electronic signature be revoked if I discover or suspect that it has been or is in danger of being lost, disclosed, compromised or subjected to unauthorized use in any way. 1 understand that I may also request revocation at any time for any other reason. • If I have requested that my electronic signature be revoked, or I am notified that someone has requested that my electronic signature be suspended or revoked, and I suspect or discover that it has been or may be compromised or subjected to unauthorized use in any way, I will immediately cease using my electronic signature. I will also immediately cease using my electronic signature upon termination of employment or termination of this Agreement. • 1 further agree that, for the purposes of authorizing and authenticating electronic health records, my electronic signature has the full force and effect of a signature affixed by hand to a paper document. Requestor Signature Date Requestor Printed Name Approver Signature Date Title DMC Master Agreement Exhibit L FRESNO COUNTY BEHAVIORAL HEALTH COMPLIANCE PROGRAM CONTRACTOR CODE OF CONDUCT AND ETHICS Fresno County is firmly committed to full compliance with all applicable laws, regulations, rules and guidelines that apply to the provision and payment of behavioral health services. Behavioral health contractors and the manner in which they conduct themselves are a vital part of this commitment. Fresno County has established this Contractor Code of Conduct and Ethics with which contractor, contractor's employees and subcontractors shall comply. Contractor shall require its employees and subcontractors to attend a compliance training that will be provided by Fresno County DBH. After completion of this training, each contractor, contractor's employee and subcontractor must sign the Behavioral Health Compliance Training Acknowledgment and Agreement form and return this form to the Compliance officer or designee. Contractor and its employees and subcontractor shall: 1. Comply with all applicable laws, regulations, rules or guidelines when providing and billing for behavioral health services. 2. Conduct themselves honestly, fairly, courteously and with a high degree of integrity in their professional dealing related to their contract with the County and avoid any conduct that could reasonably be expected to reflect adversely upon the integrity of the County. 3. Treat County employees, beneficiaries, and other behavioral health contractors fairly and with respect. 4. NOT engage in any activity in violation of the County's Compliance Program, nor engage in any other conduct which violates any applicable law, regulation, rule or guideline 5. Take precautions to ensure that claims are prepared and submitted accurately, timely and are consistent with all applicable laws, regulations, rules or guidelines. 6. Ensure that no false, fraudulent, inaccurate or fictitious claims for payment or reimbursement of any kind are submitted. 7. Bill only for eligible services actually rendered and fully documented. Use billing codes that accurately describe the services provided. 8. Act promptly to investigate and correct problems if errors in claims or billing are discovered. 9. Promptly report to the Compliance Officer any suspected violation(s) of this Code of Conduct and Ethics by County employees or other behavioral health contractors, or report any activity that they believe may violate the standards of the Compliance Program, or any other applicable Revised 09/20/18 DMC MasterAgreement 1 Exhibit L law, regulation, rule or guideline. Fresno County prohibits retaliation against any person making a report. Any person engaging in any form of retaliation will be subject to disciplinary or other appropriate action by the County. Contractor may report anonymously. 10. Consult with the Compliance Officer if you have any questions or are uncertain of any Compliance Program standard or any other applicable law, regulation, rule or guideline. 11. Immediately notify the Compliance Officer if they become or may become an Ineligible person and therefore excluded from participation in the Federal Health Care Programs. 12. Immediately contact the DBH Business Office inbox using the DBHADPBusinessOfficegfresnocountyca.gov and your assigned DBH analyst and report any overpayment. Revised 09/20/18 DMC Master Agreement 2 Exhibit M Page 1 of 2 CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES CONTRACTOR shall adhere to and develop written procedures in accordance with the below standards adapted from the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care: Culturally Competent Care: 1. Organizations must ensure that beneficiaries receive from all staff members effective, understandable, and respectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language. 2. Organizations must implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area. 3. Organizations must ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery. Language Access Services: 4. Organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to beneficiaries with limited English proficiency at all points of contact, in a timely manner during all hours of operation. 5. Organizations must provide to beneficiaries in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services. 6. Organizations must assure the competence of language assistance provided to limited English proficient beneficiaries by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on the request of the beneficiary). 7. Organizations must make available easily understood beneficiary-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area. Organizational Supports: 8. Organizations must develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services. DMC Master Agreement Exhibit M Page 2 of 2 9. Organizations must conduct initial and ongoing organizational self-assessments of CLAS related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, beneficiary satisfaction Assessments, and Outcomes-Based Evaluations. 10. Organizations must ensure that data on the individual beneficiary's race, ethnicity, and spoken and written language are collected in program records, integrated into the organizations management information systems, and periodically updated. 11. Organizations must maintain a current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area. 12. Organizations must develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and beneficiary involvement in designing and implementing CLAS-related activities. 13. Organizations must ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by beneficiaries. 14. Organizations must regularly make available to the public information about their progress and successful innovations in implementing these standards and to provide public notice in their communities about the availability of this information. 15. Organizations must ensure communication regarding the organization's progress in implementing and sustaining CLAS to all stakeholders, constituents, and general public. CONTRACTOR shall develop written procedures in accordance with the above standards. 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. DMC Master Agreement Exhibit N 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 PROVIDER(S) related to provision of alcohol and drug abuse treatment services for Fresno County residents, 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.0 §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 department head or designee. I have read and understand the above statement and agree to comply with the child abuse reporting requirements. SIGNATURE DATE 0980fadx DMC Master Agreement Exhibit O 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)/Social Security Number /Telephone Number ) II. Answer the following questions by checking "Yes" or "No." If any of the questions are answered "Yes," list all names and addresses (primary, every business location, and P.O. Box address)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 YES No 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 byTitles XVIII, XIX, or XX? ......................................................................................................................... o 0 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 XVI II, XIX, or XX? ...................................................................................... o 0 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)........... o 0 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 (primary, every business location, and P.O. Box address) 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 DOB ADDRESS EIN B. Type of entity: o Sole proprietorship o Partnership n Corporation o Unincorporated Associations o 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 DOB ADDRESS PROVIDER Page 1 of 3 DMC Master Agreement Exhibit O YES NO IV. A. Has there been a change in ownership or control within the last year? ....................................................... o 0 If yes, give date. B. Do you anticipate any change of ownership or control within the year?....................................................... o 0 If yes, when? C. Do you anticipate filing for bankruptcy within the year?................................................................................ o 0 If yes, when? V. Is the facility operated by a management company or leased in whole or part by another organization?.......... o 0 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?......... n n VII. A. Is this facility chain affiliated? ...................................................................................................................... n n 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 Page 2 of 3 DMC Master Agreement Exhibit O INSTRUCTIONS FOR COMPLETING DISCLOSURE OF CONTROL AND INTEREST STATEMENT Please answer all questions as of the current date.If the yes block for any item is checked,list requested additional information under the Remarks Section on page 2,referencing the item number to be continued.If additional space is needed use an attached sheet. DETAILED INSTRUCTIONS These instructions are designed to clarify certain questions on the form.Instructions are listed in question order for easy reference.No instructions have been given for questions considered self-explanatory. IT IS ESSENTIAL THAT ALL APPLICABLE QUESTIONS BE ANSWERED ACCURATELY AND THAT ALL INFORMATION BE CURRENT. Item I-Under"Identifying Information"specify in what capacity the entity is doing business as(DBA)(e.g.name of trade or corporation). Item II-Self-explanatory Item III-List the names of all individuals and organizations having direct or indirect ownership interests,or controlling interest separately or in combination amounting to an ownership interest of 5 percent or more in the disclosing entity. Direct ownership interest-is defined as the possession of stock,equity in capital or any interest in the profits of the disclosing entity. A disclosing entity is defined as a Medicare provider or supplier,or other entity that furnishes services or arranges for furnishing services under Medicaid or the Maternal and Child Health program,or health related services under the social services program. Indirect ownership interest-is defined as ownership interest in an entity that has direct or hospital-based home health agencies,are not indirect ownership interest in the disclosing entity. The amount of indirect ownership in the disclosing entity that is held by any other entity is determined by multiplying the percentage of ownership interest at each level.An indirect ownership interest must beds in the facility now and the previous be reported if it equates to an ownership interest of 5 percent or more in the disclosing entity.Example: if A owns 10 percent of the stock in a corporation that owns 80 percent of the stock of the disclosing entity,A's interest equates to an 8 percent indirect ownership and must be reported. Controlling interest-is defined as the operational direction or management of disclosing entity which may be maintained by any or all of the following devices:the ability or authority,expressed or reserved,to amend or change the corporate identity(i.e.,joint venture agreement,unincorporated business status)of the disclosing entity;the ability or authority to nominate or name members of the Board of Directors or Trustees of the disclosing entity;the ability or authority,expressed or reserved,to amend or change the by-laws, constitution,or other operating or management direction of the disclosing entity;the right to control any or all of the assets or other property of the disclosing entity upon the sale or dissolution of that entity;the ability or authority,expressed or reserved,to control the sale of any or all of the assets,to encumber such assets by way of mortgage or other indebtedness,to dissolve the entity or to arrange for the sale or transfer of the disclosing entity to new ownership or control. Item IV-VII-(Changes in Provider Status)For Items IV-VII,if the yes box is checked,list additional information requested under Remarks. Clearly identify which item is being continued. Change in provider status-is defined as any change in management control.Examples of such changes would include;a change in Medical or Nursing Director,a new Administrator,contracting the operation of the facility to a management corporation,a change in the composition of the owning partnership which under applicable State law is not considered a change in ownership,or the hiring or dismissing of any employees with 5 percent or more financial interest in the facility or in an owning corporation,or any change of ownership. Item IV-(A&B)If there has been a change in ownership within the last year or if you anticipate a change,indicate the date in the appropriate space. Item V-If the answer is yes,list name of the management firm and employer identification number(EIN),or the name of the leasing organization.A management company is defined as any organization that operates and manages a business on behalf of the owner of that business,with the owner retaining ultimate legal responsibility for operation of the facility. Item VI-If the answer is yes,identify which has changed(Administrator,Medical Director,or Director of Nursing)and the date the change was made.Be sure to include name of the new Administrator,Director of Nursing or Medical Director,as appropriate. Item VII-A chain affiliate is any free-standing health care facility that is either owned,controlled,or operated under lease or contract by an organization consisting of two or more free-standing health care facilities organized within or across State lines which is under the ownership or through any other device,control and direction of a common party. Chain affiliates include such facilities whether public,private,charitable or proprietary.They also include subsidiary organizations and holding corporations.Provider-based facilities,such as hospital-based home health agencies,are not considered to be chain affiliates. Page 3 of 3 DMC Master Agreement