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HomeMy WebLinkAboutAgreement A-15-259 with Fresno County Hispanic Commission on Alcohol and Drug Abuse Services Inc..pdf Agreement No. 15-259 1 AGREEMENT 2 3 THIS AGREEMENT is made and entered into this 1st day of July 2015, by and between the 4 COUNTY OF FRESNO, a political subdivision of the State of California, hereinafter referred to as 5 "COUNTY", and FRESNO COUNTY HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE 6 SERVICES, INC., whose service address is 1414 West Kearney Boulevard, Fresno, CA 93706, and remit to 7 address is 1803 Broadway Street, Fresno, CA 93 72 1, hereinafter referred to as "PROVIDER". 8 WITNESSETH: 9 WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), Contracts Division- 10 Substance Use Disorder (SUD) Services, has determined there is a need for certain Fresno County 11 residents to receive residential alcohol and substance use disorder treatment services for monolingual 12 Spanish-speaking men; and 13 WHEREAS, COUNTY is authorized to contract with privately operated agencies for the 14 provision of alcohol and substance use disorder treatment services, pursuant to Title 9, Division 4 of the 15 California Code of Regulations and Division 10.5 (commencing with section 11750) of the California 16 Health and Safety Code; and 17 WHEREAS, PROVIDER is willing and able to provide these services required by COUNTY, 18 pursuant to the terms and conditions of this Agreement. 19 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties 20 hereto agree as follows: 21 1. SERVICES 22 PROVIDER shall perform all services and fulfill all responsibilities for the provision of long- 23 term residential substance use disorder services for adult males, as identified in COUNTY's Request for 24 Proposal (RFP)No. 952-5338, dated March 6,2015,Addendum No. One (1) dated April 1, 2015, 25 hereinafter collectively referred to as COUNTY's revised RFP No. 952-5338 and PROVIDER's response to 26 said RFP, dated April 3, 2015, all incorporated herein by reference and made part of this Agreement. 27 28 I Additionally, PROVIDER shall perform all services and fulfill all responsibilities in a 2 manner consistent with the objectives and client outcomes identified in Exhibit A, "Scope of Work", 3 attached hereto and by this reference incorporated herein. 4 In the event of any inconsistency among these documents, the consistency shall be resolved 5 by giving precedence in the following priority: 1) to this Agreement, including all Exhibits; 2)to the revised 6 RFP No. 952-5338; 3)to the response to the revised RFP No. 952-5338. 7 PROVIDER must provide all necessary data to allow the COUNTY to bill Medi-Cal and/or 8 any other third-party source, for services and meet State and Federal reporting requirements. The necessary 9 data can be provided by a variety of means, including but not limited to: 1)direct data entry into 10 COUNTY's information system, 2)providing an electronic file compatible with COUNTY's information 11 system, or 3) integration between COUNTY's information system and PROVIDER's information system(s). 12 COUNTY encourages PROVIDER to adopt and maintain Electronic Health Records(EHR) 13 that meet the requirements of the Health Infortnation Technology for Economic and Clinical Health Act 14 (HITECH),part of the American Recovery and Reinvestment Act(ARRA) of 2009. PROVIDER shall bear 15 the costs associated with penalties and/or fines for non-compliance with the regulation. 16 2. TERM 17 This Agreement shall become effective on the 1 st day of July, 2015, and shall terminate on 18 the 30th day of June, 2018. This Agreement shall automatically be extended for two (2)twelve (12) month 19 periods, upon the terms and conditions herein set forth, unless written notice of non-renewal is given by 20 either PROVIDER or COUNTY no later than thirty (30) days prior to the renewal period. 21 3. TERMINATION 22 A. NON-ALLOCATION OF FUNDS—The terms of this Agreement, and the services 23 to be provided thereunder, are contingent on the approval of funds by the appropriating government agency. 24 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement 25 terminated, at any time by giving the PROVIDER thirty (30) days advance written notice. 26 B. BREACH OF CONTRACT—COUNTY may immediately suspend or terminate this 27 Agreement in whole or in part, where in the determination of COUNTY there is: 28 1) An illegal or improper use of funds; -2- 1 2) A failure to comply with any term of this Agreement; 2 3) A substantially incorrect or incomplete report submitted to COUNTY; 3 4) Improperly performed service. 4 In no event shall any payment by COUNTY constitute a waiver by COUNTY of any breach 5 of this Agreement or any default which may then exist on the part of the PROVIDER. Neither shall such 6 payment impair or prejudice any remedy available to COUNTY with respect to the breach or default. 7 COUNTY shall have the right to demand of the PROVIDER the repayment to COUNTY of any funds 8 disbursed to the PROVIDER under this Agreement, which in the judgment of COUNTY were not expended 9 in accordance with the terms of this Agreement. The PROVIDER shall promptly refund any such funds 10 upon demand. 11 C. WITHOUT CAUSE—Under circumstances other than those set forth above, this 12 Agreement may be terminated by COUNTY upon giving thirty (30) days advance written notice of an 13 intention to terminate to PROVIDER. 14 4. COMPENSATION 15 COMPENSATION — For claims submitted for services rendered under this Agreement, 16 COUNTY agrees to pay PROVIDER and PROVIDER agrees to receive Seventy-Six and 08/100 Dollars 17 ($76.08) per bed day for a daily allocated bed average of 7 beds per twelve (12) month period. The daily 18 allocated bed average is defined as the number of beds allocated to this Agreement on a daily basis or is 19 also defined as the number of participants that can be served per day. Annual reimbursement per bed per 20 day shall not exceed the above-stated daily rate regardless of the total maximum compensation of this 21 Agreement. Annual increases of no more than 1.5% of the previous year's cost per daily bed rate will be 22 reimbursed to PROVIDER per Exhibit B. 23 A. For the period July 1, 2015 through June 30, 2016, in no event shall the maximum 24 compensation under this Agreement for Substance Use Disorder Services exceed One Hundred Ninety- 25 Four Thousand Three Hundred Ninety-Three and No/100 Dollars ($194,393.00). 26 1) For the period July 1, 2016 through June 30, 2017, in no event shall the 27 maximum compensation under this Agreement for Substance Use Disorder Services exceed One 28 Hundred Ninety-Seven Thousand Three Hundred Nine and No/100 Dollars ($197,309.00). 1 2) For the period July 1, 2017 through June 30, 2018, in no event shall the 2 maximum compensation under this Agreement for Substance Use Disorder Services exceed Two 3 Hundred Thousand Two Hundred Sixty-Nine and No/100 Dollars ($200,269.00). 4 3) For the period July 1, 2018 through June 30, 2019, in no event shall the 5 maximum compensation under this Agreement for Substance Use Disorder Services exceed Two 6 Hundred Three Thousand Two Hundred Seventy-Three and No/100 Dollars ($203,273.00). 7 4) For the period July 1, 2019 through June 30, 2020, in no event shall the 8 maximum compensation under this Agreement for Substance Use Disorder Services exceed Two 9 Hundred Six Thousand Three Hundred Twenty-Two and No/100 Dollars ($206,322.00). 10 B. The contract maximum amount ($1,001,566.00) as identified in this agreement and I I in Exhibit B may be reduced based upon State, Federal, and local funding availability. In the event of 12 such action, the COUNTY's DBH Director or designee shall notify the PROVIDER in writing of the 13 reduction in the maximum amount within thirty (30) days. 14 In the event that funding for these services is delayed by the State Controller, COUNTY 15 may defer payment to PROVIDER. The amount of the deferred payment shall not exceed the amount of 16 funding delayed by the State Controller to the COUNTY. The period of time of the deferral by 17 COUNTY shall not exceed the period of time of the State Controller's delay of payment to COUNTY 18 plus forty-five (45) days. 19 C. PAYMENTS—PROVIDER may not exceed the above stated maximum allocated 20 bed days for the department. PROVIDER shall complete the year end cost report in accordance to 21 Section Thirty-seven (37), RECORDS, Subsection C of this Agreement at the end of the fiscal year to 22 reflect the actual cost and reimbursement for services provided. Regardless of the contract maximum, 23 PROVIDER will be reimbursed only for costs up to the negotiated bed day rate herein. Within forty-five 24 (45) days of the reconciliation by COUNTY. PROVIDER shall make payment to COUNTY or 25 COUNTY shall reimburse PROVIDER as appropriate. 26 Payment by COUNTY shall be in arrears, based on PROVIDER's monthly invoices 27 submitted for services provided during the preceding month, within forty-five (45) days after receipt and 28 -4- I verification of PROVIDER's monthly invoices by COUNTY's DBH, Contracts Division— SUD 2 Services. 3 For services rendered herein, PROVIDER shall assure that an on-going quality assurance 4 component is in place and is occurring. PROVIDER shall assure that clinical records for each participant 5 are of such detail and length that a review of said record will verify that appropriate services were 6 provided. If the record is unclear, incomplete, and/or indicates that appropriate services were not 7 provided, COUNTY reserves the right to withhold payment for the applicable unit(s) of service. It is 8 understood that all expenses incidental to PROVIDER's performance of services under this Agreement 9 shall be borne by PROVIDER. If PROVIDER should fail to comply with any provision of this 10 Agreement, COUNTY shall be relieved of its obligation for further compensation. PROVIDER'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 D. PUBLIC INFORMATION— PROVIDER shall disclose its funding source in all 15 public information; however, this requirement of disclosure of funding source shall not be required in 16 spot radio or television advertising. 17 E. LOBBYING ACTIVITY — PROVIDER shall not directly or indirectly use any of 18 the funds provided under this Agreement for publicity, lobbying, or propaganda purposes designed to 19 support or defeat legislation pending before the Congress of the United States or the Legislature of the 20 State of California. 21 F. POLITICAL ACTIVITY — PROVIDER shall not directly or indirectly use any of 22 the funds under this Agreement for any political activity or to further the election or defeat of any 23 candidate for public office. 24 G. FUNDING SOURCES — It shall be the obligation of PROVIDER to determine and 25 claim all revenue possible from private pay sources and third party payers. PROVIDER shall not use any 26 funds under this Agreement for services covered by Drug Medi-Cal or other health insurance for eligible 27 beneficiaries. PROVIDER shall claim all Drug Medi-Cal covered services for eligible beneficiaries 28 -5- I through the Drug Medi-Cal claiming process. COUNTY will only reimburse PROVIDER for services 2 rendered that are not covered by Drug Medi-Cal, other insurance or other revenue sources. 3 PROVIDER shall not use any funds under this Agreement to the extent that a 4 participant is eligible for Medi-Cal, insurance or other revenue reimbursement for services rendered. 5 Any revenues generated by PROVIDER in excess of the amounts budgeted in this 6 Agreement may be utilized to expand/enhance the services during COUNTY's fiscal years in which 7 revenues are collected or in the following COUNTY fiscal year. Additional revenues will be considered 8 separate and distinct from COUNTY's payment to PROVIDER. The manner and means of service 9 expansion/enhancement shall be subject to the prior written approval of COUNTY's DBH Director or 10 her designee. PROVIDER shall disclose all sources of revenue to COUNTY. Under no circumstances 11 will COUNTY funded staff time be used for fund-raising purposes. 12 H. COST OF LIVING ADJUSTMENT— PROVIDER shall not utilize any funds 13 provided under this Agreement for cost of living adjustments to PROVIDER's employee compensation 14 in excess of what is approved in the budget submitted with the RFP response. 15 I. PROVIDER agrees to limit annual administrative costs paid through this 16 Agreement to a maximum of fifteen percent (15%) of the total annual program budget. Administrative 17 costs include all non-direct service personnel such as executive directors, clerical staff and fiscal staff 18 and identified corporate overhead. Employee benefits shall not exceed twenty percent (20%) of total 19 salaries for those employees working under this Agreement. Benefits shall include health insurance, 20 retirement, life insurance, and other optional benefits. Failure to conform to this provision will be 21 grounds for contract termination at the option of the County of Fresno, DBH Director or her designee. 22 This Section Four(4) shall in no way be construed to classify PROVIDER or PROVIDER's officers, agents 23 and employees as an officer, agent, servant, employee,joint venture, partner, or associate of COUNTY, 24 pursuant to Section Seven (7). 25 5. INVOICING 26 PROVIDER shall invoice COUNTY by the twentieth (201") day of each month for actual 27 services rendered in the previous month in accordance with the budget projections specified in Exhibit B, 28 attached hereto and incorporated herein by this reference. -6- I Invoices shall be submitted via email to SAS@co.fresno.ca.us, Subject: Attn: Staff Analyst, 2 as indicated in Section Seventeen (17), hereinbelow. Invoices shall be accompanied by a monthly 3 participant roster and other reports and documentation as indicated in Section Seventeen(17). These will be 4 in a form and in such detail as acceptable to COUNTY's DBH=SUD Services. No reimbursement for 5 services shall be made until the invoice is received, reviewed and approved by COUNTY's DBH-SUD 6 Services. 7 If an invoice is incorrect or is otherwise not in proper form or substance, COUNTY's DBH, 8 Director or designee shall have the right to withhold payment as to only that portion of the invoice that is 9 incorrect or improper after five (5) days prior notice to PROVIDER. PROVIDER agrees to continue to 10 provide services for a period of ninety(90) days after notification of an incorrect or improper invoice. If 11 after said ninety (90) day period said invoice(s) is still not corrected to COUNTY's DBH, Director's or 12 designee's satisfaction, COUNTY's DBH, Director or designee may elect to terminate this Agreement, 13 pursuant to the termination provisions stated in Section Three (3) of this Agreement. In addition, 14 PROVIDER shall submit all invoices to COUNTY's DBH, for services provided within ninety (90) days 15 after each twelve(12) month period expires or this Agreement is terminated. If invoices are not submitted 16 within ninety(90) days after each twelve (12) month period expires or this Agreement is terminated, 17 COUNTY's DBH shall have the right to deny payment on such invoices. 18 General ledgers for services provided during each twelve (12) month period must be received 19 within sixty(60) days. If general ledgers are not submitted within sixty(60) days after each twelve (12) 20 month period expires, or this Agreement is terminated, COUNTY's DBH shall have the right to deny 21 payment on such invoices. 22 6. PROHIBITION ON PUBLICITY 23 None of the funds, materials, property or services provided directly or indirectly under this 24 Agreement shall be used for PROVIDER's advertising, fundraising, or publicity (i.e.,purchasing of 25 tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. Notwithstanding the above, 26 publicity of the services described in Section One (1) of this Agreement shall be allowed as necessary to 27 raise public awareness about the availability of such specific services when approved in advance by the 28 Director or designee, and at a cost as provided in Exhibit B for such items as written/printed materials, the -7- I use of media (i.e., radio, television, newspapers) and any other related expense(s). 2 7. INDEPENDENT CONTRACTOR 3 In performance of the work, duties and obligations assumed by PROVIDER under this 4 Agreement, it is mutually understood and agreed that PROVIDER, including any and all of the 5 PROVIDER'S officers, agents, and employees will at all times be acting and performing as an independent 6 contractor, and shall act in an independent capacity and not as an officer, agent, servant, employee,joint 7 venturer, partner, or associate of the COUNTY. Furthennore, COUNTY shall have no right to control or 8 supervise or direct the manner or method by which PROVIDER shall perform its work and function. 9 However, COUNTY shall retain the right to administer this Agreement so as to verify that PROVIDER is 10 performing its obligations in accordance with the teens and conditions thereof. 11 PROVIDER and COUNTY shall comply with all applicable provisions of law and the rules 12 and regulations, if any, of governmental authorities having jurisdiction over matters the subject thereof. 13 Because of its status as an independent contractor, PROVIDER shall have absolutely no right 14 to employment rights and benefits available to COUNTY employees. PROVIDER shall be solely liable and 15 responsible for providing to, or on behalf of, its employees all legally-required employee benefits. In 16 addition, PROVIDER shall be solely responsible and save COUNTY harmless from all matters relating to 17 payment of PROVIDER's employees, including compliance with Social Security withholding and all other 18 regulations governing such matters. It is acknowledged that during the tern of this Agreement,PROVIDER 19 may be providing services to others unrelated to the COUNTY or to this Agreement. 20 8. CONFLICT OF INTEREST 21 No officer, agent, or employee of COUNTY who exercises any function or responsibility for 22 planning and carrying out the services provided under this Agreement shall have any direct or indirect 23 personal financial interest in this Agreement. PROVIDER shall comply with all Federal, State of 24 California, and local conflict of interest laws, statutes, and regulations, which shall be applicable to all 25 parties and beneficiaries under this Agreement and any officer, agent, or employee of COUNTY. 26 9. DISCLOSURE OF SELF-DEALING TRANSACTIONS 27 This provision is only applicable if the PROVIDER is operating as a corporation (a for-profit 28 or non-profit corporation)or if during the term of this agreement, the PROVIDER changes its status to -8- I operate as a corporation. 2 Members of the PROVIDER's Board of Directors shall disclose any self-dealing 3 transactions that they are a party to while PROVIDER is providing goods or performing services under this 4 agreement. A self-dealing transaction shall mean a transaction to which the PROVIDER is a party and in 5 which one or more of its directors has a material financial interest. Members of the Board of Directors shall 6 disclose any self-dealing transactions that they are a party to by completing and signing a Self-Dealing 7 Transaction Disclosure Form (Exhibit C) and submitting it to the COUNTY prior to commencing with the 8 self-dealing transaction or immediately thereafter. 9 10. PROPERTY OF COUNTY 10 PROVIDER shall submit purchase invoices for the purchase of any fixed assets with their 11 monthly invoices. All purchases over Five Thousand and No/100 Dollars ($5,000.00), and certain purchases 12 under Five Thousand and No/100 Dollars ($5,000.00) such as fans, calculators, cameras, VCRs, DVDs and 13 other sensitive items as determined by COUNTY's DBH Director, or designee, made during the life of this 14 Agreement shall be identified as fixed assets with an assigned COUNTY Accounting Inventory Number. 15 These fixed assets shall be retained by COUNTY, as COUNTY property, in the event this Agreement is 16 terminated or upon expiration of this Agreement. PROVIDER agrees to participate in an annual inventory 17 of all COUNTY fixed assets and shall be physically present when fixed assets are returned to COUNTY's 18 possession at the termination or expiration of this Agreement. PROVIDER is responsible for returning to 19 COUNTY all COUNTY owned fixed assets, or the monetary value of said fixed assets if unable to produce 20 the fixed assets at the expiration or tennination of this Agreement. 21 11. MODIFICATION 22 Any matters of this Agreement may be modified from time to time by the written consent of 23 all the parties without, in any way, affecting the remainder. 24 In addition, changes to this Agreement, in whole or in part, which are necessary for 25 compliance with State of California and Federal law, shall be made by written amendment and executed by 26 COUNTY's DBH Director or designee and PROVIDER. 27 The COUNTY's DBH Director or designee may modify the maximum amount to be 28 consistent with available State and Federal funding, as stated in Section Four(4) in this agreement. -9- 1 12. NON-ASSIGNMENT 2 Neither party shall assign, transfer or sub-contract this Agreement nor their rights or duties 3 under this Agreement without the prior written consent of the other party. 4 13. HOLD HARMLESS 5 PROVIDER agrees to indemnify, save, hold harmless, and at COUNTY'S request,defend 6 the COUNTY, its officers, agents, and employees from any and all costs and expenses, damages, liabilities, 7 claims, and losses occurring or resulting to COUNTY in connection with the performance, or failure to 8 perform, by PROVIDER, its officers, agents, or employees under this Agreement, and from any and all 9 costs and expenses, damages, liabilities, claims, and losses occurring or resulting to any person, firm, or 10 corporation who may be injured or damaged by the perfonnance, or failure to perform, of PROVIDER, its 11 officers, agents, or employees under this Agreement. 12 14. INSURANCE 13 Without limiting the COUNTY's right to obtain indemnification from PROVIDER or any 14 third parties, PROVIDER, at its sole expense, shall maintain in full force and effect, the following insurance 15 policies or a program of self-insurance, including but not limited to, an insurance pooling arrangement or 16 Joint Powers Agreement(JPA)throughout the tern of the Agreement: 17 A. COMMERCIAL GENERAL LIABILITY 18 Commercial General Liability Insurance with limits of not less than One Million 19 Dollars ($1,000,000.00)per occurrence and an annual aggregate of Two Million Dollars ($2,000,000.00). 20 This policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including 21 completed operations,products liability, contractual liability, Explosion-Collapse-Underground, fire legal 22 liability or any other liability insurance deemed necessary because of the nature of this contract. 23 B. AUTOMOBILE LIABILITY 24 Comprehensive Automobile Liability Insurance with limits for bodily injury of not 25 less than Two Hundred Fifty Thousand Dollars ($250,000.00)per person, Five Hundred Thousand Dollars 26 ($500,000.00)per accident and for property damages of not less than Fifty Thousand Dollars ($50,000.00), 27 or such coverage with a combined single limit of Five Hundred Thousand Dollars ($500,000.00). Coverage 28 should include owned and non-owned vehicles used in connection with this Agreement. -10- I C. PROFESSIONAL LIABILITY 2 If PROVIDER employs licensed professional staff, (e.g., Ph.D., R.N., L.C.S.W.,L 3 M.F.T.)in providing services, Professional Liability Insurance with limits of not less than One Million 4 Dollars ($1,000,000.00)per occurrence, Three Million Dollars ($3.000,000.00) annual aggregate. 5 PROVIDER agrees that it shall maintain, at its sole expense, in full force and effect for a period of three(3) 6 years following the termination of this Agreement, one or more policies of professional liability insurance 7 with limits of coverage as specified herein. 8 D. WORKER'S COMPENSATION 9 A policy of Worker's Compensation insurance as may be required by the California 10 Labor Code. 11 PROVIDER shall obtain endorsements to the Commercial General Liability insurance 12 naming the County of Fresno, its officers, agents, and employees, individually and collectively, as additional 13 insured, but only insofar as the operations under this Agreement are concerned. Such coverage for 14 additional insured shall apply as primary insurance and any other insurance, or self-insurance, maintained by 15 COUNTY, its officers, agents and employees shall be excess only and not contributing with insurance 16 provided under PROVIDER's policies herein. This insurance shall not be cancelled or changed without a 17 minimum of thirty(30) days advance written notice given to COUNTY. 18 Within thirty(30) days from the date PROVIDER signs this Agreement, PROVIDER shall 19 provide certificates of insurance and endorsements as stated above for all of the foregoing policies, as 20 required herein,to the County of Fresno, Department of Behavioral Health, Contracts Division - Substance 21 Use Disorder Services at 3133 N. Millbrook Ave., Fresno, California, 93703. Attention: SUD Services Staff 22 Analyst, stating that such insurance coverages have been obtained and are in full force; that the County of 23 Fresno, its officers, agents and employees will not be responsible for any premiums on the policies;that such 24 Commercial General Liability insurance names the County of Fresno, its officers, agents and employees, 25 individually and collectively, as additional insured, but only insofar as the operations under this Agreement 26 are concerned; that such coverage for additional insured shall apply as primary insurance and any other 27 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, shall be excess 28 only and not contributing with insurance provided under PROVIDER's policies herein; and that this -11- I insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written notice 2 given to COUNTY. 3 In the event any PROVIDER fails to keep in effect at all times insurance coverage as herein 4 provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this Agreement 5 with PROVIDER upon the occurrence of such event. 6 All policies shall be with admitted insurers licensed to do business in the State of California. 7 Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of A FSC VIII or 8 better. 9 15. SUBCONTRACTS 10 PROVIDER shall be required to assume full responsibility for all services and activities 11 covered by this Agreement, whether or not PROVIDER is providing services directly. Further, 12 PROVIDER shall be the sole point of contact with regard to contractual matters, including payment of any 13 and all charges resulting from this Agreement. 14 If PROVIDER should propose to subcontract with one or more third parties to carry out a 15 portion of services covered by this Agreement, any such subcontract shall be in writing and approved as to 16 form and content by COUNTY's DBH Director or designee prior to execution and implementation. 17 COUNTY's DBH Director or designee shall have the right to reject any such proposed subcontract. Any 18 such subcontract together with all activities by or caused by PROVIDER shall not require compensation 19 greater than the total budget contained herein. An executed copy of any such subcontract shall be received 20 by COUNTY before any implementation and shall be retained by COUNTY. PROVIDER shall be 21 responsible to COUNTY for the proper performance of any subcontract. Any subcontractor shall be subject 22 to the same terns and conditions that PROVIDER is subject to under this Agreement. 23 It is expressly recognized that PROVIDER cannot engage in the practice of medicine. If any 24 medical services are to be provided in connection with the services under this Agreement, such medical 25 services shall be performed by an independent contract physician. In this instance, the requirements of the 26 Confidential Medical Information Act(Civil Code 56 et seq.) shall be met. 27 If PROVIDER hires an independent contract physician, PROVIDER shall require and 28 ensure that such independent contract physician carries Professional Liability(Medical Malpractice) -12- I Insurance, with limits of not less than One Million Dollars ($1,000,000.00)per occurrence, Three Million 2 Dollars($3,000,000.00) annual aggregate. 3 16. NO THIRD PARTY BENEFICIARIES 4 It is understood and agreed by and between the parties that the services provided by 5 PROVIDER for COUNTY herein are solely for the benefit of the COUNTY, and that nothing in this 6 Agreement is intended to confer on any person other than the parties hereto any right under or by reason of 7 this Agreement. 8 17. REPORTS—SUBSTANCE USE DISORDER SERVICES 9 PROVIDER shall submit all information and data required by State, including, but not 10 limited to the following: 11 A. Drug and Alcohol Treatment Access Report (DATAR) and Provider Waiting List 12 Record (WLR) in an electronic format provided by the State and due no later than five(5) days after the 13 preceding month; and 14 B. CALOMS TREATMENT—Submit CalOMS treatment admission, discharge, annual 15 update, and"provider activity report" record in an electronic format through COUNTY's SAIS system, and 16 on a schedule as determined by the COUNTY which complies with State requirements for data content, data 17 quality,reporting frequency, reporting deadlines, and report method and due no later than five (5) days after 18 the conclusion of the preceding month. All CalOMS admissions, discharges, and annual updates must be 19 entered into the COUNTY's CalOMS system within twenty-four(24) hours of occurrence; and 20 C. PROVIDER shall submit to COUNTY monthly fiscal and all program reports within 21 twenty(20)days of the end of each month. PROVIDER shall submit a complete and accurate year-end cost 22 report for each fiscal year affected by this Agreement, following the end of each fiscal year affected by this 23 Agreement. If the cost report indicates an amount due COUNTY, PROVIDER shall submit payment with 24 the report. If an amount is due PROVIDER, COUNTY shall reimburse PROVIDER within forty-five (45) 25 days of receiving and accepting the year-end cost report. PROVIDER shall also furnish to COUNTY such 26 statements,records,reports, data, and information as COUNTY may request pertaining to matters covered 27 by this Agreement. All reports submitted by PROVIDER to COUNTY must be typewritten. 28 D. COST REPORTS—On an annual basis for each fiscal year ending June 30tn -13- I PROVIDER shall submit a complete and accurate detailed cost report(s). Cost reports must be submitted to 2 the COUNTY as a hard copy with a signed cover letter and an electronic copy by the due date. Submittal 3 must also include any requested support documents such as general ledgers. All reports submitted by 4 PROVIDER to COUNTY must be typewritten. COUNTY will issue instructions for completion and 5 submittal of the annual cost report, including the relevant cost report template(s) and due dates. All cost 6 reports must be prepared in accordance with Generally Accepted Accounting Principles. Unallowable costs 7 such as lobbying or political donations must be deducted from the cost report and all invoices. If the 8 PROVIDER does not submit the cost report by the due date, including any extension period granted by the 9 COUNTY,the COUNTY may withhold payment of pending invoices until the cost report(s) has been 10 submitted and clears COUNTY desk audit for completeness and accuracy. 11 1) NON-DMC FUNDING SOURCES —PROVIDER will be required to submit 12 a cost report on a form(s)approved by the COUNTY to reflect actual costs and reimbursement for services 13 provided through funding sources other than DMC. Contracts that include a negotiated rate per unit of 14 service will be reimbursed only for the costs of approved units of service up to the negotiated unit of service 15 rate approved in the Agreement, regardless of the contract maximum. If the cost report indicates an amount 16 due to COUNTY, PROVIDER shall submit payment with the report. If an amount is due to PROVIDER 17 COUNTY shall reimburse PROVIDER within forty-five (45) days of receiving and accepting the year-end 18 cost report. 19 2) MULTIPLE FUNDING SOURCES—PROVIDER who has multiple 20 agreements for the same services provided at the same location where at least one of the Agreements is 21 funded through DMC and the other funding is other federal or county realignment funding will be required 22 to complete DMC cost reports and COUNTY approved cost reports. Such Agreements will be settled for 23 actual costs in accordance with Medicaid reimbursement requirements as specified in Title XIX or Title XXI 24 of the Social Security Act; Title 22, and the State's Medicaid Plan. 25 During the teen of this Agreement and thereafter, COUNTY and PROVIDER agree to settle 26 dollar amounts disallowed or settled in accordance with DHCS and COUNTY audit settlement findings 27 related to the DMC and realignment reimbursements. DHCS audit process is approximately eighteen (18)to 28 thirty-six (36)months following the close of the State fiscal year. COUNTY may choose to appeal DHCS -14- I settlement results and therefore reserves the right to defer payback settlement with PROVIDER until 2 resolution of the appeal. 3 In the event that PROVIDER fails to provide such reports or other information required 4 hereunder, it shall be deemed sufficient cause for the COUNTY to withhold monthly payments until there is 5 compliance. In addition,the PROVIDER shall provide written notification and explanation to the 6 COUNTY within fifteen (15) days of any funds received from another source to conduct the same services 7 covered by this Agreement. 8 18. EVALUATION—MONITORING 9 OUTCOMES—COUNTY's DBH Director, or designee, and the California Department of 10 Health Care Services (DHCS) or their designees shall monitor and evaluate the performance of PROVIDER 11 under this Agreement to determine to the best possible degree the success or failure of the services provided 12 under this Agreement. At the discretion of the COUNTY, a subcontractor may be obtained by the 13 COUNTY to independently evaluate and monitor the performance of the PROVIDER. PROVIDER shall 14 participate in the evaluation of the program as needed, at the discretion of COUNTY. 15 COUNTY shall recapture from PROVIDER the value of any services or other expenditures 16 determined to be ineligible based on the COUNTY or State monitoring results. At the discretion of the 17 COUNTY, recoupment can be made through a future invoice reduction or reimbursement by the 18 PROVIDER. 19 PROVIDER shall participate in a program review of the program at least yearly or more 20 frequently, or as needed, at the discretion of COUNTY. The PROVIDER agrees to supply all information 21 requested by the COUNTY, DHCS, and/or the subcontractor during the program evaluation, monitoring, 22 and/or review. 23 19. DATA SECURITY 24 For the purpose of preventing the potential loss, misappropriation or inadvertent access, 25 viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of 26 COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter into a 27 contractual relationship with the COUNTY for the purpose of providing services under this Agreement must 28 employ adequate data security measures to protect the confidential information provided to PROVIDER by -15- I the COUNTY, including but not limited to the following: 2 A. PROVIDER-OWNED MOBILE. WIRELESS OR HANDHELD DEVICES 3 PROVIDER may not connect to COUNTY networks via personally-owned mobile, 4 wireless or handheld devices, unless the following conditions are met: 5 1) PROVIDER has received authorization by COUNTY for telecommuting 6 purposes; 7 2) Current virus protection software is in place; 8 3) Mobile device has the remote wipe feature enabled; and 9 4) A secure connection is used. 10 B. PROVIDER-OWNED COMPUTERS OR COMPUTER PERIPHERALS 11 PROVIDER may not bring PROVIDER-owned computers or computer peripherals 12 into the COUNTY for use without prior authorization from the COUNTY's Chief Information Officer, 13 and/or designee(s), including but not limited to mobile storage devices. If data is approved to be transferred, 14 data must be stored on a secure server approved by the COUNTY and transferred by means of a Virtual 15 Private Network(VPN)connection, or another type of secure connection. Said data must be encrypted. 16 C. COUNTY-OWNED COMPUTER EQUIPMENT 17 PROVIDER or anyone having an employment relationship with the COUNTY may 18 not use COUNTY computers or computer peripherals on non-COUNTY premises without prior 19 authorization from the COUNTY's Chief Information Officer, and/or designee(s). 20 D. PROVIDER may not store COUNTY's private, confidential or sensitive data on any 21 hard-disk drive, portable storage device, or remote storage installation unless encrypted. 22 E. PROVIDER shall be responsible to employ strict controls to ensure the integrity and 23 security of COUNTY's confidential information and to prevent unauthorized access, viewing, use or 24 disclosure of data maintained in computer files, program documentation, data processing systems, data files 25 and data processing equipment which stores or processes COUNTY data internally and externally. 26 F. Confidential client information transmitted to one party by the other by means of 27 electronic transmissions must be encrypted according to Advanced Encryption Standards (AES)of 128 BIT 28 or higher. Additionally, a password or pass phrase must be utilized. -16- I G. PROVIDER is responsible to immediately notify COUNTY of any violations. 2 breaches or potential breaches of security related to COUNTY's confidential information, data maintained in 3 computer tiles, program documentation, data processing systems, data files and data processing equipment 4 which stores or processes COUNTY data internally or externally. 5 H. COUNTY shall provide oversight to PROVIDER's response to all incidents arising 6 from a possible breach of security related to COUNTY's confidential client information provided to 7 PROVIDER. PROVIDER will be responsible to issue any notification to affected individuals as required 8 by law or as deemed necessary by COUNTY in its sole discretion. PROVIDER will be responsible for all 9 costs incurred as a result of providing the required notification. 10 20. INTERIM SERVICES l 1 PROVIDER must adhere to the Negotiated Net Amount contract requirement to provide 12 Interim Services in the event that an individual must wait to be placed in treatment. 13 Interim Substance Abuse Services means services that are provided until an individual is 14 admitted to a substance abuse treatment program. The purposes of the services are to reduce the adverse 15 health effects of such abuse, promote the health of the individual, and reduce the risk of transmission of 16 disease. At a minimum, interim services include counseling and education about HIV and tuberculosis(TB), 17 about the risks of needle-sharing, the risks of transmission to sexual partners and infants, and about steps that 18 can be taken to ensure the HIV and TB transmission does not occur, as well as referral for HIV or TB 19 treatment services if necessary. For pregnant women, interim services also include counseling on the effects 20 of alcohol and drug use on the fetus, as well as referral for prenatal care. 21 Records must indicate evidence that Interim Services have been provided and documentation 22 will be reviewed for compliance. 23 21. REFERENCES TO LAWS AND RULES 24 In the event any law, regulation, or policy referred to in this Agreement is amended during 25 the term thereof, the parties hereto agree to comply with the amended provision as of the effective date of 26 such amendment. 27 22. STATE ALCOHOL AND DRUG REQUIREMENTS 28 A. INDEMNIFICATION -17- I The PROVIDER agrees to indemnify, defend and save hannless the State, its 2 officers, agents and employees from any and all claims and losses accruing or resulting to any and all 3 contractors, subcontractors, materialmen, laborers and any other person, firm or corporation furnishing or 4 supplying work, services, materials or supplies in connection with the perfonnance of this Agreement and 5 from any and all claims and losses accruing or resulting to any person, firm or corporation who may be 6 injured or damaged by the PROVIDER in the performance of this Agreement. 7 B. INDEPENDENT CONTRACTOR 8 The PROVIDER and the agents and employees of PROVIDER, in the performance 9 of this Agreement, shall act in an independent capacity and not as officers or employees or agents of State of 10 California. 11 C. CONTROL REQUIREMENTS 12 This Agreement is subject to all applicable Federal and State laws and regulations. 13 The provisions of this Agreement are not intended to abrogate any provisions of law or regulation existing or 14 enacted during the term of this Agreement. 15 D. NON - DISCRIMINATION PROVISION 16 1) Eligibility for Services 17 PROVIDER shall prepare and make available to COUNTY and to the public 18 all eligibility requirements to participate in the program plan set forth in PROVIDER's response to the RFP. 19 No person shall, because of ethnic group identification, age, sex, color, disability, medical condition, 20 national origin,race, ancestry, marital status, religion, religious creed,political belief or sexual preference be 21 excluded from participation, be denied benefits of, or be subject to discrimination under any program or 22 activity receiving Federal or State of California assistance. 23 2) Employment Opportunity 24 PROVIDER shall comply with COUNTY policy, and the Equal Employment 25 Opportunity Commission guidelines, which forbids discrimination against any person on the grounds of 26 race, color, national origin, sex,religion, age, disability status, or sexual preference in employment practices. 27 Such practices include retirement, recruitment advertising, hiring, layoff,tennination, upgrading, demotion, 28 transfer, rates of pay or other forms of compensation, use of facilities, and other terms and conditions of -18- I employment. 2 3) Suspension of Compensation 3 If an allegation of discrimination occurs, COUNTY may withhold all further 4 funds, until PROVIDER can show clear and convincing evidence to the satisfaction of COUNTY that funds 5 provided under this Agreement were not used in connection with the alleged discrimination. 6 4) NEPOTISM 7 Except by consent of COUNTY's Department of Behavioral Health Director, 8 or designee, no person shall be employed by PROVIDER who is related by blood or marriage to, or who is 9 a member of the Board of Directors or an officer of PROVIDER. 10 E. CONFIDENTIALITY 11 PROVIDER shall conform to and COUNTY shall monitor compliance with all State 12 of California and Federal statutes and regulations regarding confidentiality, including but not limited to 13 confidentiality of information requirements at Part 2, Title 42, Code of Federal Regulations; California 14 Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the 15 California Health and Safety Code; Title 22, California Code of Regulations, section 51009; and Division 1, 16 Part 2.6, Chapters 1-7 of the California Civil Code. 17 F. REVENUE COLLECTION POLICY 18 PROVIDER shall conform to all policies and procedures regarding revenue 19 collection issued by the State under the provisions of the Health and Safety Code, Division 10.5. 20 G. EXPENDITURE OF STATE GENERAL AND FEDERAL FUNDS 21 PROVIDER agrees that all funds paid out by the State shall be used exclusively for 22 providing alcohol and/or drug program services, administrative costs, and allowable overhead. 23 H. ACCESS TO SERVICES 24 PROVIDER shall provide accessible and appropriate services in accordance with 25 Federal and State statutes and regulations to all eligible persons. 26 I. REPORTS 27 PROVIDER agrees to participate in surveys related to the performance of this 28 Agreement and expenditure of funds and agrees to provide any such information in a mutually agreed upon -19- I format. 2 J. AUDITS 3 All State and Federal funds furnished to the PROVIDER(S)pursuant to this 4 Agreement along with related patient fees, third party payments, or other related revenues and funds 5 commingled with the foregoing funds are subject to audit by the State. The State may audit all alcohol and 6 drug program revenue and expenditures contained in this Agreement for the purpose of establishing the basis 7 for the subsequent year's negotiation. 8 K. RECORDS MAINTENANCE 9 1) PROVIDER shall maintain books, records, documents, and other evidence 10 necessary to monitor and audit this Agreement. 11 2) PROVIDER shall maintain adequate program and fiscal records relating to 12 individuals served under the terms of this Agreement, as required, to meet the 13 needs of the State in monitoring quality, quantity, fiscal accountability, and 14 accessibility of services. Information on each individual shall include, but not 15 be limited to, admission records, patient and participant interviews and 16 progress notes, and records of service provided by various service locations, 17 in sufficient detail to make possible an evaluation of services provided and 18 compliance with this Agreement. 19 23. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT 20 COUNTY and PROVIDER each consider and represent themselves as covered entities as 21 defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104- 22 191(HIPAA) and agree to use and disclose protected health information as required by law. 23 COUNTY and PROVIDER acknowledge that the exchange of protected health 24 information between them is only for treatment, payment, and health care operations. 25 COUNTY and PROVIDER intend to protect the privacy and provide for the security of 26 Protected Health Information (PHI) pursuant to the Agreement in compliance with HIPAA, the Health 27 Information Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH), and 28 -20- I regulations promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA 2 Regulations) and other applicable laws. 3 As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require 4 PROVIDER to enter into a contract containing specific requirements prior to the disclosure of PHI, as set 5 forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) of the Code of 6 Federal Regulations (CFR). 7 24. CONFIDENTIALITY 8 All services performed by PROVIDER under this Agreement shall be in strict conformance 9 with all applicable Federal, State of California and/or local laws and regulations relating to confidentiality, 10 including but not limited to, California Civil Code section 56 et seq., California Welfare and Institutions 11 Code sections 5328, 10850 and 14100.2, Health and Safety Code sections 11977 and 11812, 22 California 12 Code of Regulations section 51009, and 42 Code of Federal Regulations sections 2.1 et seq. PROVIDER 13 shall submit to COUNTY's monitoring of said compliance with all State and Federal statutes and 14 regulations regarding confidentiality. PROVIDER shall ensure that no list of persons receiving services 15 under this contract is published, disclosed, or used for any other purpose except for the direct administration 16 of the program or other uses authorized by law that are not in conflict with requirements for confidentiality. 17 Except as otherwise provided in this Agreement, PROVIDER, as a Business Associate of 18 COUNTY, may use or disclose protected health information ("PHI") to perfonn functions, activities or 19 services for or on behalf of COUNTY, as specified in this Agreement, provided that such use or disclosure 20 shall not violate the Health Insurance Portability and Accountability Act(HIPAA), U.S.C. 1320d et seq., and 21 its implementing regulations including but not limited to 45 C.F.R. Parts 142, 160, 162, and 164 (hereafter 22 known as"the Privacy and Security Rules"). The uses and disclosures of PHI may not be more expansive 23 than those applicable to COUNTY, as the ``Covered Entity"under the Privacy Rule, except as authorized for 24 management, administrative or legal responsibilities of the Business Associate. 25 PROVIDER shall not use or further disclose PHI other than as pennitted or required by this 26 Agreement, or as required by law. 27 PROVIDER shall implement administrative,physical and technical safeguards that 28 reasonably and appropriately protect the confidentiality, integrity and availability of PHI that it creates, -21- I receives, maintains, or transmits on behalf of COUNTY. 2 PROVIDER shall ensure that any agent, including a subcontractor to whom PROVIDER 3 provides PHI received from COUNTY, or to whom PROVIDER provides PHI which is created on behalf of 4 COUNTY, agrees to the same restrictions and conditions that apply to PROVIDER with respect to such 5 information. 6 PROVIDER shall report to COUNTY's Department of Behavioral Health (DBH) Director 7 or designee in writing within five (5) working days of any security incident of which PROVIDER becomes 8 aware. It is understood that if the security incident is not corrected within sixty (60) days of PROVIDER's 9 written notification to COUNTY's DBH Director, PROVIDER acknowledges that the COUNTY's DBH 10 Director or designee may terminate this Agreement in accordance to Section. Three(3) of this Agreement if 11 COUNTY's DBH Director, or designee, determines that PROVIDER has violated a material tenn of this 12 Agreement. 13 PROVIDER shall provide access, at the request of COUNTY, and in the time and manner 14 designated by COUNTY, to PHI in a designated record set (as defined in 45 C.F.R. § 164.501), to an 15 individual or to COUNTY in order to meet the requirements of 45 C.F.R. §164.524 regarding access by 16 individuals to their PHI. 17 PROVIDER shall make any amendment(s)to PHI in a designated record set at the request of 18 COUNTY, and in the time and manner designated by COUNTY in accordance with 45 C.F.R. § 164.526. 19 PROVIDER shall provide to COUNTY or to an individual, in a time and manner designated 20 by COUNTY, information collected in accordance with 45 C.F.R. § 164.528,to pen-nit COUNTY to 21 respond to a request by the individual for an accounting of disclosures of PHI in accordance with 45 C.F.R. 22 §164.528. 23 PROVIDER shall make internal records related to the use,disclosure, and privacy protection 24 of PHI received from COUNTY, or created/received by PROVIDER on behalf of COUNTY, available to 25 COUNTY or to the Secretary of the United States Department of Health and Human Services for purposes 26 of investigating or auditing COUNTY's compliance with the Health Insurance Portability and 27 Accountability Act, in a time and manner designated by COUNTY or the Secretary. 28 PROVIDER shall, if feasible,return or destroy all PHI received from COUNTY's DBH, or -22- I created or received by PROVIDER on behalf of COUNTY's DBH upon expiration or termination of this 2 Agreement. In the event that PROVIDER deems this infeasible, PROVIDER shall notify COUNTY's 3 DBH of the conditions that make return or destruction infeasible, and upon mutual agreement of the parties 4 that return or destruction is infeasible, extend the protections of this Agreement to the PHI in order to limit 5 future disclosures of PHI by PROVIDER. 6 The parties agree to take such action as is necessary to amend this Agreement as necessary 7 for COUNTY's DBH to comply with the requirements of the Privacy and Security Rules and the 8 implementing regulations. Any such changes may be made with the written approval of COUNTY's 9 Compliance Privacy Officer or designee, and/or the Security Officer or designee should the Security Officer 10 obtain such authority from the Board of Supervisors. I 1 PROVIDER shall mitigate, to the extent practicable, any harmful effect that is known to 12 PROVIDER of a use or disclosure of PHI by PROVIDER in violation of the requirements of this 13 Agreement. 14 25. CULTURAL COMPETENCY 15 As related to Cultural and Linguistic Competence: 16 A. Compliance with Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Section 2000d, 17 and 45 C.F.R. Part 80)and Executive Order 12250 of 1979 which prohibits recipients of federal financial 18 assistance from discriminating against persons based on race, color, national origin, sex, disability or 19 religion. This is interpreted to mean that a limited English proficient(LEP) individual is entitled to equal 20 access and participation in federally funded programs through the provision of comprehensive and quality 21 bilingual services. 22 B. Policies and procedures for ensuring access and appropriate use of trained 23 interpreters and material translation services for all LEP consumers, including, but not limited to, assessing 24 the cultural and linguistic needs of its consumers, training of staff on the policies and procedures, and 25 monitoring its language assistance program. The PROVIDER's procedures must include ensuring 26 compliance of any sub-contracted providers with these requirements. 27 C. PROVIDER assurances that minors shall not be used as interpreters. 28 D. PROVIDER shall provide and pay for interpreting and translation services to persons -23- I participating in PROVIDER's services who have limited or no English language proficiency, including 2 services to persons who are deaf or blind. Interpreter and translation services shall be provided as necessary 3 to allow such participants meaningful access to the programs, services and benefits provided by 4 PROVIDER. Interpreter and translation services, including translation of PROVIDER's"vital documents" 5 (those documents that contain information that is critical for accessing PROVIDER's services or are 6 required by law) shall be provided to participants at no cost to the participant. PROVIDER shall ensure that 7 any employees, agents, subcontractors, or partners who interpret or translate for a program participant,or 8 who directly communicate with a program participant in a language other than English, demonstrate 9 proficiency in the participant's language and can effectively communicate any specialized terms and 10 concepts peculiar to PROVIDER's services. 11 E. In compliance with the State mandated Culturally and Linguistically Appropriate 12 Services standards as published by the Office of Minority Health, PROVIDER must submit to COUNTY 13 for approval, within 60 days from date of contract execution,PROVIDER's plan to address all fifteen 14 national cultural competency standards as set forth in the "National Standards on Culturally and 15 Linguistically Appropriate Services"(CLAS), attached hereto as Exhibit D, and incorporated herein by this 16 reference. County's annual on-site review of PROVIDER shall include collection of documentation to 17 ensure all national standards are implemented. PROVIDER may solicit complimentary assistance from 18 OnTrack Consulting (http://ontrackconsultiiig.org/news/culturally-linguistically-appropriate-services) for 19 training in plan development. As the national competency standards are updated, PROVIDER's plan must 20 be updated accordingly. 21 26. SINGLE AUDIT CLAUSE 22 A. If PROVIDER expends Seven Hundred Fifty Thousand Dollars($750,000.00)or 23 more in Federal and Federal flow-through monies,PROVIDER agrees to conduct an annual audit in 24 accordance with the requirements of the Single Audit Standards as set forth in Office of Management and 25 Budget(OMB) Circular A-133. PROVIDER shall submit said audit and management letter to COUNTY. 26 The audit must include a statement of findings or a statement that there were no findings. If there were 27 negative findings, PROVIDER must include a corrective action plan signed by an authorized individual. 28 PROVIDER agrees to take action to correct any material non-compliance or weakness found as a result of -24- I such audit. Such audit shall be delivered to COUNTY's Department of Behavioral Health, Business Office 2 for review within nine (9) months of the end of any fiscal year in which funds were expended and/or 3 received for the program. Failure to perform the requisite audit functions as required by this Agreement may 4 result in COUNTY performing the necessary audit tasks, or at COUNTY's option, contracting with a public 5 accountant to perform said audit, or, may result in the inability of COUNTY to enter into future agreements 6 with PROVIDER. All audit costs related to this Agreement are the sole responsibility of PROVIDER. 7 B. A single audit report is not applicable if PROVIDER's Federal contracts do not 8 exceed the Seven Hundred Fifty Thousand Dollars ($7501.000.00) requirement or PROVIDER's only 9 funding is through Drug related Medi-Cal. If a single audit is not applicable, a program audit must be 10 performed and a program audit report with management letter shall be submitted by PROVIDER to 11 COUNTY as a minimum requirement to attest to PROVIDER's solvency. Said audit report shall be 12 delivered to COUNTY's Department of Behavioral Health, Business Office for review, no later than nine 13 (9) months after the close of the fiscal year in which the funds supplied through this Agreement are 14 expended. Failure to comply with this Act may result in COUNTY performing the necessary audit tasks or 15 contracting with a qualified accountant to perform said audit. All audit costs related to this Agreement are 16 the sole responsibility of PROVIDER who agrees to take corrective action to eliminate any material 17 noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under this 18 section shall be billed to the PROVIDER at COUNTY's cost, as determined by COUNTY's Auditor- 19 Controller/Treasurer-Tax Collector. 20 C. PROVIDER shall make available all records and accounts for inspection by 21 COUNTY,the State of California, if applicable, the Comptroller General of the United States, the Federal 22 Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a period of at 23 least three (3) years following final payment under this Agreement or the closure of all other pending 24 matters, whichever is later. 25 27. TAX EQUITY AND FISCAL RESPONSIBILITY ACT 26 To the extent necessary to prevent disallowance of reimbursement under section 1861(v) (1) 27 (1) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[1]), until the expiration of four(4)years after 28 the furnishing of services under this Agreement, PROVIDER shall make available,upon written request of -25- I the Secretary of the United States Department of Health and Human Services, or upon request of the 2 Comptroller General of the United States General Accounting Office, or any of their duly authorized 3 representatives, a copy of this Agreement and such books, documents, and records as are necessary to certify 4 the nature and extent of the costs of these services provided by PROVIDER under this Agreement. 5 PROVIDER further agrees that in the event PROVIDER carries out any of its duties under this Agreement 6 through a subcontract, with a value or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over 7 a twelve (12) month period, with a related organization, such Agreement shall contain a clause to the effect 8 that until the expiration of four(4) years after the furnishing of such services pursuant to such subcontract, 9 the related organizations shall make available, upon written request of the Secretary of the United States 10 Department of Health and Human Services, or upon request of the Comptroller General of the United States 11 General Accounting Office, or any of their duly authorized representatives, a copy of such subcontract and 12 such books, documents, and records of such organization as are necessary to verify the nature and extent of 13 such costs. 14 28. COMPLIANCE WITH LAWS AND POLICIES 15 PROVIDER shall comply with all applicable rules and regulations set forth in Titles 9 and 16 22 of the California Code of Regulations, and California Health and Safety Code section 11750 et seq. 17 PROVIDER shall comply with any other Federal and State laws or guidelines applicable to PROVIDER's 18 performance under this Agreement or any local ordinances,regulations, or policies applicable. Such 19 provisions include, but are not restricted to: 20 A. PROVIDER agrees to limit administrative cost to a maximum of fifteen percent 21 (15%) of the total program budget and to limit employee benefits to a maximum of twenty percent(20%)of 22 total salaries for those employees working under this Agreement during the terns of this Agreement. Failure 23 to conform to this provision will be grounds for contract tennination at the option of COUNTY. 24 B. PROVIDER shall provide that each client's ability to pay for services is detennined 25 by the use of the method approved by COUNTY. 26 C. PROVIDER shall establish and use COUNTY's approved method of determining 27 and collecting fees from clients. 28 -26- I D. PROVIDER shall furnish client records in accordance with the applicable Federal 2 and State regulations, and with the Standards for Alcohol and Drug Treatment Programs set forth by the 3 State Department of Alcohol and Drug Programs, including in such records a treatment plan for each client, 4 and evidence of each service rendered. 5 E. PROVIDER shall submit accurate, complete and timely claims and cost reports, 6 reporting only allowable costs. 7 F. PROVIDER shall comply with statistical reporting and program evaluation systems 8 as provided in State of California regulations and in this Agreement. 9 G. PROVIDER shall comply with requirements contained in the COUNTY's Net 10 Negotiated Amount (NNA) Agreement with the State of California, Department of Alcohol and Drug I 1 Programs, by this reference incorporated herein, until such time that a new NNA Agreement is established. 12 Upon amendment of the County NNA Agreement by the County and the State, the terms of the amended 13 NNA Agreement shall automatically be incorporated into this Agreement. 14 29. FEDERAL CERTIFICATIONS 15 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion 16 Lower Tier Covered Transactions. 17 A. DBH and PROVIDER recognize that Federal assistance funds will be used under the 18 terms of this Agreement. For purposes of this section, DBH will be referred to as the "prospective recipient". 19 B. This certification is required by the regulations implementing Executive Order 20 12549, Debarment and Suspension, 29 CFR Part 98, section 98.510, Participants'responsibilities. The 21 regulations were published as Part VII of the May 26, 1988 Federal Register(pages 19160-19211). 22 1) The prospective recipient of Federal assistance funds certifies by entering this 23 Agreement, that neither it nor its principals are presently debarred, suspended, proposed for debarment, 24 declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department 25 or agency. 26 2) The prospective recipient of funds agrees by entering into this Agreement, 27 that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, 28 suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless -27- I authorized by the Federal department or agency with which this transaction originated. 2 3) Where the prospective recipient of Federal assistance funds is unable to 3 certify to any of the statements in this certification, such prospective participant shall attach an explanation 4 to this Agreement. 5 4) The prospective recipient shall provide immediate written notice to DBH if at 6 any time prospective recipient learns that its certification in this clause of this Agreement was erroneous 7 when submitted or has become erroneous by reason of changed circumstances. 8 5) The prospective recipient further agrees that by entering this Agreement, it 9 will include a clause identical to this clause of this Agreement, and titled "Certification Regarding 10 Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions", in all 11 lower tier covered transactions and in all solicitations for lower tier covered transactions. 12 6) The certification in this clause of this Agreement is a material representation 13 of fact upon which reliance was placed by COUNTY when this transaction was entered into. 14 30. CLEAN AIR AND WATER 15 In the event funding under this Agreement exceeds one hundred thousand dollars 16 ($100,000.00), the PROVIDER must comply with all applicable standards, orders, or requirements issued 17 under section 306 of the Clean Air Act(42 U.S.C. 1857 (h)), section 506 of the Clean Water Act(33 U.S.C. 18 1368), Executive Order 11738, and Environmental Protection Agency Regulations (40 CFR part 32). 19 31. SMOKING PROHIBITION REQUIREMENTS 20 PROVIDER shall comply with Public Law 103-227, also known as the Pro-Children Act of 21 1994 (20 USC Section 6081, et seq.), and with California Labor Code Section 6404.5,the California Smoke- 22 Free Workplace Law. 23 32. ENERGY EFFICIENCY 24 The PROVIDER must comply with the mandatory standards and policies relating to energy 25 efficiency which are contained in the state energy conservation plan issued in compliance with Energy 26 Policy and Conservation Act (Pub. L. 94 163). 27 33. REPORTING REQUIREMENTS, COPYRIGHT AND PATENTS 28 The awarding agency's reporting requirements are stated in this Agreement. The awarding -28- I agency's requirements and regulations pertaining to copyright and rights in data, and patent rights with 2 respect to any discovery or invention which arise or is developed in the course of or under this Agreement (if 3 any), are likewise stated in this Agreement. 4 34. NON-DISCRIMINATION PROVISION 5 A. ELIGIBILITY FOR SERVICES —PROVIDER shall prepare,prominently post in its 6 facility, and make available to the DBH Director or designee and to the public all eligibility requirements to 7 participate in the program funded under this Agreement. PROVIDER shall not unlawfully discriminate in 8 the provision of services because of race, color, creed, national origin, gender, age, or physical or mental 9 disability as provided by State of California and Federal law in accordance with Title VI of the Civil Rights 10 Act of 1964 (42 USC section 2000(d)); Age Discrimination Act of 1975 (42 USC section 1681); 11 Rehabilitation Act of 1973 (29 USC section 794); Education Amendments of 1972 (20 USC section 1681); 12 Americans with Disabilities Act of 1990 (42 USC section 12132); Title 45, Code of Federal Regulations, 13 Part 84; provisions of the Fair Employment and Housing Act(California Government Code section 12900); 14 and regulations promulgated thereunder(Title 2. CCR, section 7285.0); Title 2, Division 3, Article 9.5 of the 15 California Government Code commencing with section 11135; and Title 9, Division 4, Chapter 6 of the 16 California Code of Regulations commencing with section 10800. 17 B. EQUAL OPPORTUNITY—PROVIDER shall comply with California Government 18 Code, section 12990 and California Code of Regulations, Title 11, Division 4, Chapter 5, in matters related to 19 the development, implementation, and maintenance of a nondiscrimination program. PROVIDER shall not 20 discriminate against any employee or applicant for employment because of race, religion, color, national 21 origin,physical or mental disability, marital status, gender, or age. Such practices include retirement, 22 recruitment, advertising, hiring, layoff, termination, upgrading, demotion, transfer, rates of pay or other 23 forms of compensation, use of facilities, and other terms and conditions of employment. PROVIDER 24 agrees to post in conspicuous places, notices available to all employees and applicants for employment 25 setting forth the provisions of the Equal Opportunity Act (42 USC section 2000(e)) in conformance with 26 Federal Executive Order No. 11246. PROVIDER agrees to comply with the provisions of the 27 Rehabilitation Act of 1973 (29 USC Section 794). 28 C. SUSPENSION OF COMPENSATION— If an allegation of discrimination occurs, -29- I DBH may withhold all further funds, until PROVIDER can show by clear and convincing evidence to the 2 satisfaction of DBH that funds provided under this Agreement were not used in connection with the alleged 3 discrimination. 4 D. NEPOTISM —Except by consent of the DBH Director or designee, no person shall 5 be employed by PROVIDER who is related by blood or marriage to or who is a member of the Board of 6 Directors or an officer of PROVIDER. 7 E. NEW FACILITIES AND DISABILITY ACCESS—New facilities shall be 8 wheelchair accessible and provide access to the disabled, consistent with Title 9, California Code of 9 Regulations, section 10820. If a new facility will be utilized, a plan ensuring accessibility to the disabled 10 must be developed. DBH shall assess, monitor, and document PROVIDER'S compliance with the 11 Rehabilitation Act of 1973 and Americans with Disabilities Act of 1990 to ensure that 12 recipients/beneficiaries and intended recipients/beneficiaries of services are provided services without regard 13 to physical or mental disability and that PROVIDER has provided a facility accessible to the physically 14 disabled. 15 35. ASSURANCES 16 In entering into this Agreement, PROVIDER certifies that it is not currently excluded, 17 suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs: that it has 18 not been convicted of a criminal offense related to the provision of health care items or services; nor has it 19 been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension, 20 debanment, or ineligibility. If COUNTY learns, subsequent to entering into a contract, that PROVIDER is 21 ineligible on these grounds, COUNTY will remove PROVIDER from responsibility for, or involvement 22 with, COUNTY's business operations related to the Federal Health Care Programs and shall remove such 23 PROVIDER from any position in which PROVIDER's compensation, or the items or services rendered, 24 ordered or prescribed by PROVIDER may be paid in whole or part, directly or indirectly, by Federal Health 25 Care Programs or otherwise with Federal Funds at least until such time as PROVIDER is reinstated into 26 participation in the Federal Health Care Programs. Further the PROVIDER agrees to the Disclosure of 27 Criminal History and Civil Actions and Certification regarding debarment suspension and other 28 responsibility matters primary covered transactions; PROVIDER must sign an appropriate Certification -30- I regarding debarment, suspension, and other responsibility matters, attached hereto as Exhibit E, incorporated 2 herein by reference and made part of this Agreement. 3 A. If COUNTY has notice that PROVIDER has been charged with a criminal offense 4 related to any Federal Health Care Program, or is proposed for exclusion during the term on any contract, 5 PROVIDER and COUNTY shall take all appropriate actions to ensure the accuracy of any claims submitted 6 to any Federal Health Care Program. At its discretion given such circumstances, COUNTY may request 7 that PROVIDER cease providing services until resolution of the charges or the proposed exclusion. 8 B. PROVIDER agrees that all potential new employees of PROVIDER or 9 subcontractors of PROVIDER who, in each case, are expected to perform professional services under this 10 Agreement, will be queried as to whether(1) they are now or ever have been excluded, suspended, debarred, 11 or otherwise ineligible to participate in the Federal Health Care Programs; (2)they have been convicted of a 12 criminal offense related to the provision of health care items or services; and or(3)they have been reinstated 13 to participation in the Federal Health Care Programs after a period of exclusion, suspension, debarment, or 14 ineligibility. 15 1) In the event the potential employee or subcontractor informs PROVIDER 16 that he or she is excluded, suspended, debarred or otherwise ineligible, or has been convicted of a criminal 17 offense relating to the provision of health care services, and PROVIDER hires or engages such potential 18 employee or subcontractor, PROVIDER will ensure that said employee or subcontractor does no work, 19 either directly or indirectly relating to services provided to COUNTY. 20 2) Notwithstanding the above, COUNTY at its discretion may terminate this 21 Agreement in accordance with Section Three (3) of this Agreement, or require adequate assurance (as 22 defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of 23 PROVIDER will perform work, either directly or indirectly, relating to services provided to COUNTY. 24 Such demand for adequate assurance shall be effective upon a time frame to be determined by COUNTY to 25 protect the interests of COUNTY consumers. 26 C. PROVIDER shall verify(by asking the applicable employees and subcontractors) 27 that all current employees and existing subcontractors who, in each case, are expected to perform 28 professional services under this Agreement (1) are not currently excluded, suspended, debarred, or otherwise -31- I ineligible to participate in the Federal Health Care Programs; (2) have not been convicted of a criminal 2 offense related to the provision of health care items or services; and (3) have not been reinstated to 3 participation in the Federal Health Care Program after a period of exclusion, suspension, debarment, or 4 ineligibility. In the event any existing employee or subcontractor informs PROVIDER that he or she is 5 excluded, suspended, debarred or otherwise ineligible to participate in the Federal Health Care Programs, or 6 has been convicted of a criminal offense relating to the provision of health care services, PROVIDER will 7 ensure that said employee or subcontractor does no work, either direct or indirect, relating to services 8 provided to COUNTY. 9 1) PROVIDER agrees to notify COUNTY immediately during the term of this 10 Agreement whenever PROVIDER learns that an employee or subcontractor who, in each case,is providing 11 professional services under this Agreement is excluded, suspended, debarred or otherwise ineligible to 12 participate in the Federal Health Care Programs, or is convicted of a criminal offense relating to the 13 provision of health care services. 14 2) Notwithstanding the above, COUNTY at its discretion may terminate this 15 Agreement in accordance with the Termination Section of this Agreement, or require adequate assurance (as 16 defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or subcontractor of 17 PROVIDER will perform work, either directly or indirectly, relating to services provided to COUNTY. 18 Such demand for adequate assurance shall be effective upon a time frame to be detennined by COUNTY to 19 protect the interests of COUNTY consumers. 20 D. PROVIDER agrees to cooperate fully with any reasonable requests for information 21 from COUNTY which may be necessary to complete any internal or external audits relating to 22 PROVIDER's compliance with the provisions of this Section. 23 E. PROVIDER agrees to reimburse COUNTY for the entire cost of any penalty 24 imposed upon COUNTY by the Federal Govermnent as a result of PROVIDER's violation of 25 PROVIDER's obligations as described in this Section. 26 36. AUDITS AND INSPECTIONS 27 The PROVIDER shall at any time during business hours, and as often as the COUNTY may 28 deem necessary, make available to the COUNTY for examination all of its records and data with respect to -32- I the matters covered by this Agreement. The PROVIDER shall, upon request by the COUNTY, permit the 2 COUNTY to audit and inspect all of such records and data necessary to ensure PROVIDER's compliance 3 with the teens of this Agreement. 4 If this Agreement exceeds ten thousand dollars ($10,000.00), PROVIDER shall be subject to 5 the examination and audit of the Auditor General for a period of three(3) years after final payment under 6 contract (Government Code Section 8546.7). 7 Notwithstanding the provisions stated in Section Two (2) of this Agreement, it is 8 acknowledged by the parties hereto that this Agreement shall continue in full force and effect until all audit 9 procedures and requirements as stated in this Agreement have been completed to the review and satisfaction 10 of COUNTY. PROVIDER shall bear all costs in connection with or resulting from any audit and/or 11 inspections including, but not limited to, actual costs incurred and the payment of any expenditures 12 disallowed by either COUNTY, State, or Federal governmental entities, including any assessed interest and 13 penalties. 14 37. RECORDS 15 A. RECORD ESTABLISHMENT AND MAINTENANCE—PROVIDER shall 16 establish and maintain records in accordance with State and Federal rules and regulations in addition to those 17 requirements prescribed by COUNTY with respect to all matters covered by this Agreement. Except as 18 otherwise authorized by COUNTY, PROVIDER shall retain all other records for a period of five (5)years 19 after receiving the final payment under this Agreement or the earlier termination of this Agreement, or until 20 State and/or Federal audit findings applicable to such services are resolved, whichever is later. 21 B. DOCUMENTATION—PROVIDER shall maintain adequate records in sufficient 22 detail to make possible an evaluation of services, and contain all the data necessary in reporting to the State 23 of California and/or Federal agency. All client records shall be maintained pursuant to applicable State of 24 California and Federal requirements concerning confidentiality. 25 C. REPORTS —PROVIDER shall submit to COUNTY monthly fiscal and all program 26 reports as further described in Section Seventeen (17). PROVIDER shall submit a complete and accurate 27 year-end cost report for each fiscal year affected by this Agreement, following the end of each fiscal year 28 affected by this Agreement. PROVIDER shall also furnish to COUNTY such statements, records, reports, -33- I data, and information as COUNTY may request pertaining to matters covered by this Agreement. All 2 reports submitted by PROVIDER to COUNTY must be typewritten. 3 D. SUSPENSION OF COMPENSATION—In the event that PROVIDER fail to 4 provide reports specified in this Agreement, it shall be deemed sufficient cause for COUNTY to withhold 5 payments until there is compliance. 6 E. DISALLOWANCES—Payments by COUNTY shall be in arrears, for services 7 provided during the preceding month, within forty-five (45) days after receipt, verification and approval of 8 PROVIDER invoices by COUNTY'S DBH-SAS. If payment for services are denied or disallowed by 9 State; and subsequently resubmitted to COUNTY by PROVIDER, the disallowed portion will be withheld 10 from the next reimbursement to the PROVIDER until COUNTY has received reimbursement from State for 11 said services. 12 F. CLIENT CONFIDENTIALITY—PROVIDER shall conform to and COUNTY shall 13 monitor compliance with all State and Federal statutes and regulations regarding confidentiality, including 14 but not limited to confidentiality of information requirements of 42 Code of Federal Regulations § 2.1 et 15 seq., Welfare and Institutions Code §§ 5328, 10850 and 14100.2, Health and Safety Code §§ 11977 and 16 11812, Civil Code, Division 1, Part 2.6, and 22 California Code of Regulations § 51009. 17 38. NOTICES 18 The persons and their addresses having authority to give and receive notices under this 19 Agreement include the following: 20 COUNTY PROVIDER 21 Director, Fresno County Executive Director 22 Department of Behavioral Health Fresno County Hispanic Commission 4441 East Kings Canyon 1803 Broadway St. 23 Fresno, CA 93702 Fresno, CA 93721 24 25 Any and all notices between the COUNTY and the PROVIDER provided for or permitted 26 under this Agreement or by law shall be in writing and shall be deemed duly served when personally 27 delivered to one of the parties, or in lieu of such personal services, when deposited in the United States Mail, 28 postage prepaid, addressed to such party. -34- 1 39. CHANGE OF LEADERSHIP 2 In the event of any change in the status of PROVIDER's leadership or management, 3 PROVIDER shall provide written notice to COUNTY within thirty (30) days from the date of change. Such 4 notification shall include any new leader or manager's name, address and qualifications. "Leadership or 5 management" shall include any employee, member, or owner of PROVIDER who either a) directs 6 individuals providing services pursuant to this Agreement,b) exercises control over the manner in which 7 services are provided, or c) has authority over PROVIDER's finances. 8 40. CHARITABLE CHOICE 9 PROVIDER may not discriminate in its program delivery against a client or potential client 10 on the basis of religion or religious belief, a refusal to hold a religious belief, or a refusal to actively 11 participate in a religious practice. Any specifically religious activity or service made available to individuals 12 by the PROVIDER must be voluntary as well as separate in time and location from County funded activities 13 and services. PROVIDER shall inform County as to whether it is faith-based. If PROVIDER identifies as 14 faith-based it must submit to Substance Abuse Services a copy of its policy on referring individuals to 15 alternate treatment PROVIDER, and include a copy of this policy in its client admission forms. The policy 16 must inform individuals that they may be referred to an alternative provider if they object to the religious 17 nature of the program, and include a notice to Substance Abuse Services. Adherence to this policy will be 18 monitored during annual site reviews, and a review of client files. If PROVIDER identifies as faith-based, 19 by July 1 of each year PROVIDER will be required to report to Substance Abuse Services the number of 20 individuals who requested referrals to alternate providers based on religious objection. 21 41. LICENSING-CERTIFICATES 22 Throughout each term of this Agreement, PROVIDER and PROVIDER's staff shall 23 maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions necessary for the 24 provision of the services hereunder and required by the laws and regulations of the United States of 25 America, State of California, the County of Fresno, and any other applicable governmental agencies. 26 PROVIDER shall notify COUNTY immediately in writing of its inability to obtain or maintain such 27 licenses, permits, approvals, certificates, waivers and exemptions irrespective of the pendency of any appeal 28 related thereto. Additionally, PROVIDER and PROVIDER's staff shall comply with all applicable laws, -3 5- I rules or regulations, as may now exist or be hereafter changed. 2 42. AOD CERTIFICATION 3 A. The COUNTY requires all COUNTY contracted providers of Alcohol and Other 4 Substance Use Disorder treatment services to obtain the California Department of Alcohol and Drug 5 Program's (ADP) Alcohol and Other Drug Program (AOD) Certification. The AOD Certification Standards 6 will apply to all residential and outpatient treatment modalities. The purpose of the AOD Certification 7 Standards is to ensure an acceptable level of service quality is provided to program participants. 8 B. PROVIDER shall provide proof of a completed application for AOD Certification to 9 the County within Thirty (30) days from the execution date of this Agreement with the COUNTY. A copy 10 of the AOD Certification shall be submitted to the COUNTY when approved by the California Department 11 of Alcohol Drug Programs. 12 C. This AOD Certification requirement applies to every primary treatment facility 13 operated by the PROVIDER. PROVIDER is not required to obtain a separate AOD Certification for 14 satellite sites associated with PROVIDER's primary treatment facility. Satellite sites are expected to operate 15 within the same AOD Certification guidelines and maintain the same standards as the PROVIDER's related 16 primary site. PROVIDERS whose agencies are nationally accredited with the Joint Commission on 17 Accreditation of Health Care Organizations (JCAHO) or the Commission on Accreditation of Rehabilitative 18 Facilities (CARF) are exempt from this requirement of AOD Certification. PROVIDER shall submit a copy 19 of their JCAHO or CARF accreditation to the COUNTY within Thirty (30) days from the date this 20 Agreement is executed. PROVIDER shall notify COUNTY if at any time their JCAHO or CARF 21 accreditation lapses or becomes invalid due to any reason during the term of this Agreement. PROVIDER 22 shall apply with State ADP for AOD Certification if their JAHCO or CARF accreditation lapses or becomes 23 invalid and shall submit a copy of the completed application for AOD Certification to the COUNTY within 24 Thirty (30) days from the date the JAHCO or CARF accreditation lapses or becomes invalid. 25 D. COUNTY shall tenninate this Agreement immediately in the event any of the 26 following occurs: 27 1) PROVIDER fails to submit a copy of the completed application for AOD 28 Certification, or a copy of either their JCAHO or CARF accreditation within Thirty (30) days from the -36- I execution date of this Agreement with the COUNTY. 2 2) PROVIDER's application for AOD Certification is denied by the California 3 Department of Alcohol and Drug Programs. 4 3) PROVIDER fails to submit to the COUNTY a copy of the AOD Certification 5 within Thirty (30) days after being approved by the California Department of Alcohol and Drug Programs, 6 or certification is not maintained throughout the contract period. 7 4) PROVIDER fails to apply for AOD Certification with State ADP or fails to 8 submit to the COUNTY a copy of the completed application for AOD Certification within Thirty(30)days 9 after the JAHCO or CARF accreditation lapses or becomes invalid. 10 43. COMPLAINTS 11 PROVIDER shall log complaints and the disposition of all complaints from a consumer or a 12 consumer's family. PROVIDER shall provide a summary of the complaint log entries concerning 13 COUNTY-sponsored consumers to COUNTY at monthly intervals by the fifteenth(15th) day of the 14 following month, in a format that is mutually agreed upon. PROVIDER shall post signs informing 15 consumer of their right to file a complaint or grievance. PROVIDER shall notify COUNTY of all incidents 16 reportable to state licensing bodies that affect COUNTY consumers within twenty-four(24) hours of receipt 17 of a complaint. 18 Within fifteen (15) days after each incident or complaint affecting COUNTY-sponsored 19 consumers, PROVIDER shall provide COUNTY with information relevant to the complaint, investigative 20 details of the complaint, the complaint and PROVIDER's disposition of, or corrective action taken to resolve 21 the complaint. 22 44. DRUG FREE WORKPLACE 23 PROVIDER shall comply with the requirements of the Drug-Free Work Place Act of 1990 24 (California Government Code section 8350). 25 45. CHILD ABUSE REPORTING 26 PROVIDER shall utilize a procedure acceptable to the COUNTY to ensure that all of 27 PROVIDER's employees, volunteers, consultants. subcontractors or agents performing services under this 28 Agreement shall report all known or suspected child abuse or neglect to one or more of the agencies set forth -37- I in Penal Code section 11165.9. This procedure shall include having all of PROVIDER's employees, 2 volunteers, consultants, subcontractors or agents performing services under this Agreement sign a statement 3 that he or she knows of and will comply with the reporting requirements set forth in Penal Code section 4 11166. The statement to be utilized by PROVIDER for reporting is set forth in Exhibit F, attached hereto 5 and by this reference incorporated herein. 6 46. GOVERNING LAW: 7 Venue for any action arising out of or related to this Agreement shall only be in Fresno 8 County, California. 9 The rights and obligations of the parties and all interpretation and performance of this 10 Agreement shall be governed in all respects by the laws of the State of California. 11 47. ENTIRE AGREEMENT: 12 This Agreement, including all Exhibits, COUNTY's Revised RFP No. 952-5338_and 13 PROVIDER's responses thereto, constitutes the entire Agreement between PROVIDER and COUNTY 14 with respect to the subject matter hereof and supersedes all previous agreement negotiations, proposals, 15 commitments, writings, advertisements, publications, and understandings of any nature whatsoever unless 16 expressly included in this Agreement. 17 /// 18 19 20 21 HI 22 HI 23 24 25 26 HI 27 28 -38- 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day 2 and year first hereinabove written. 3 ATTEST: 4 5 CONTRACTOR: FRESNO C UNTY HISPANIC COMMISSION, INC. 6 7 By: 8 Print Name: 9 Title: C�A A t t2IAA 10 Chairman of Board, or President, I 1 or any Vice President 12 13 By: 14 15 Print Name: ��y�g ✓l a D 16 Title: E(e ut f i u,.e &j �f Secretary(of Corporation), or 17 any Assistant Secretary, or 18 Chief Financial Officer, or any Assistant Treasurer 19 20 21 Mailing Address: 22 1803 Broadway Street 23 Fresno, CA 93721 Contact: Executive Director 24 25 26 PLEASE SEE ADDITIONAL SIGNATURE PAGE ATTACHED 27 28 -39- I APPROVED AS TO ACCOUNTING FORM: COUNTY OF FRESNO VICKI CROW, C.P.A., AUDITOR-CONTROLLER/ 2 TREASURER-TAX COLLECTOR 3 4 w 5 By By. 416-rj�/O" DEBORAH A. POOCHIGIAN, C irman 6 Board of Supervisors 7 8 APPROVED AS TO LEGAL FORM: BERNICE E. SEIDEL, Clerk DANIEL C. CEDERBORG, COUNTY COUNSEL Board of Supervisors 9 10 11 By: By: . 12 13 REVIEWED AND RECOMMENDED FOR 14 APPROVAL: 15 16 By: 17 DAWAN UTECHT, Director Department of Behavioral Health 18 19 The following is for COUNTY's use: 20 Fund/Subclass: 0001/10000 21 22 Organization: 56302081 23 FY 2015-16 $194,393.00 FY 2016-17 $197,309.00 24 FY 2017-18 $200,269.00 25 FY 2018-19 $203,273.00 FY 2019-20 $206,322.00 26 Account/Program: 7294/0 27 28 yl -40- Exhibit A—Scope of Work Page 1 of 17 SCOPE OF WORK A. Service Expectations Over more than a quarter century the Hispanic Commission has adhered to its mission to rid the incidence of substance and it consequences among the at risk population in Fresno County despite opportunities and invitations to do otherwise. The goal remains to provide currently licensed long-term residential alcohol/drug free oriented/participant driven services to individuals and their families residing in Fresno County affected by the consequences of alcohol and drug abuse. These services are designed to: • Identify and develop an understanding of the Substance Use Disorder (SUD) and how it leads to relapse. • Provide individual and group treatment and psycho-educational sessions that will assist monolingual clients. • Explore family/support system dynamics and how they relate to addiction, recovery and relapse potential. • Incorporate personal and community support systems supporting a productive, alcohol/drug-free lifestyle. • Approximately 90% of the clients will have an understanding of how addition manifests itself in his life. • Assist clients prior to discharge in to the community by developing a continuing care plan that includes support and mutual help groups and other ancillary services such as housing, access to vocational training, employment, child care, family reunification, medical care, mental health care legal aid, welfare services and other supportive services designed to help in the recovery process. The outcomes of these services are designed to bring: • Approximately 90% of clients will, when interviewed by a counselor, be able to identify the emotional, social, and/or other issues that increase his vulnerability to relapse. • Approximately 70% or more of the clients and their families will be able to identify and practice healthy forms of interaction that can support long term sobriety. • Approximately 99% of clients who complete the program will receive a continuous care plan and referrals so that all required supportive sources can be accessed. • Approximately 60 % or more of clients who complete the program will report themselves to be substance free within I year of the completing of the residential services. Developing a healthy recreational schedule is an important element of recovery which helps clients become involved in activities that are not associated with their addictions. The Hispanic Commission's programs address this through daily exercises and recreational activities Exhibit A—Scope of Work Page 2 of 17 at the treatment center. Equally important, in terms of recreational activities, is the establishment of good leisure time habit. Once clients have stopped using substances, individuals in the early stages of recovery frequently have difficulty adjusting to extended periods of time on the hands in which they have nothing to do and boredom is a frequent precursor to lapses and relapses. The Hispanic Commission helps clients plan leisure time so that exercise and sober social activities become regular parts of their lives. Sober social activities are structured through AA/NA, and other alumni groups. B. General Requirements 1. Structured Activities Used to Support Stated Objectives The Hispanic Commission currently offers residential treatment services to Latinos in Fresno County at Nuestra Casa, a nonprofit recovery home that facilitates the recovery process through highly structured services delivered in a home environment. This program takes place in three Phases: • Phase I is designed to introduce the client to the nature of addiction. This phase also explores culture and gender as these two forces interact to produce addiction. • Phase lI begins after the client has completed the first 30-day treatment component. The program seeks to stabilize the client and begins to address his life forces which can have an impact upon the recovery process. • Phase III prepares the client for his transition out of the safety of the program into an outpatient program at which point he is expected to function independently within his home and community while maintaining a substance free life utilizing his support system. 2. Residential Program Services Offered are delivered within a gender and culture specific framework. They include: • Comprehensive assessment using ASI. • Short-term therapy to address current and/or impending crises. • Individual, group and family sessions (both process and education). • Comprehensive case management and active referral. • Transportation, food, and housing. • Nutrition Education. • HIV education and testing. • Other services as needed. Exhibit A—Scope of Work Page 3 of 17 The Hispanic Commission is currently licensed to provide 16 beds for this residential program. Staffing levels will be monitored to ensure that they meet the CA Code of Regulations, Title 9, Chapter 11; Division 4, Chapter 5; and/or State of CA Health and Human Services Agency's Department of Health Care Services, Alcohol and/or other Drugs Certification Standards for Residential and Outpatient Services. The agency utilizes targeted case management in order to coordinate schedules. The Care Schedule includes "free" time slots that have been specifically created in order to allow time for the inclusion and integration of additional support services. Electronic case management technology is used to assist in the coordination of multiple schedules. Utilizing a culture and gender specific curriculum individual, group and family counseling is provided to clients in our residential program. Each of these sessions are designed to address enduring aspects of the recovery process from different perspectives. The individual counseling sessions allow the client and the counselor to uncover antecedents of the abuse problem from the perception of the client. In contrast, the group counseling sessions provide an objective, more holistic view of addiction based on multiple perspectives. Lastly, the family sessions provide an opportunity for the client and his family to begin the process of reunification and rebuilding. Fresno County Hispanic Commission provides a range of services that are designed to identify and address not merely intra-psychic forces that provoke and sustain drug use, but also the environmental forces that can challenge the recovery process as well. Thus, the program offers crisis intervention services with trained counselors who can provide temporary resolution to immediate crises. Additionally, the Commission assists each client in qualifying for and receiving all supportive services for which he is eligible. Counselors very critically begin planning for the release of the client to an outpatient program at least one month before discharge. The client is also assisted in finding housing and in obtaining other needed resources. Finally, aftercare services are provided to assist each client in obtaining employment and in remaining sober. During the treatment process, the client's vocation and educational interests are explored. By the end of the 90-day residential program, the men are either linked to education and training programs or are gainfully employed. During the course of the residential program, highly selective recreational and socialization experiences are introduced to support the overall treatment process. The Hispanic Commission includes socializing and recreational activities such as volleyball, soccer, basketball, walks, table games and other low impact physical activities to reinforce the concepts of discipline, teamwork, and excellence. While in residential treatment, the clients are provided full room and board. All meals are nutritious in content and balanced to the major food groups. Drug screening is used to ensurecompliance with the recovery process. Program staff screens saliva and urine specimens to insure clients are drug free. Exhibit A—Scope of Work Page 4 of 17 3. The Hispanic Commission's Intake Procedures: • Clients may call or walk into the agency from 8:00 am and 5:00 pm seven days a week, as the agency is open 24/7. • A triage form is completed on all clients to collect pertinent data to determine of he meets criteria for services. If he does not fall into the target population or meet the program guidelines, a referral will be made to appropriate service. If the client qualities, he will be admitted and a file will be opened. Clients who do not qualify are those who exhibit dangerous behavior, are not ambulatory, or need immediate medical attention. Clients will be scheduled for an initial interview appointment to assess needs and qualifications. An intake is done at a later time when it has been determined this is the appropriate program for the participant. • A person experiencing a crisis (suicidal, homicidal, acutely, psychotic, or severely depressed/anxious) will be treated immediately or referred to a crisis stabilization team depending on the severity of the crisis. • The intake process will give priority access to the target population, which are those monolingual men experiencing a predominant involvement with alcohol or other drugs. • Admission or placement on waiting list is based on the availability of beds for county sponsored residents. This process does not apply to insurance or private pay clients. • Throughout the period between intake and commencement of services, the client will maintain weekly contact with case manager or primary therapist. • The intake process will include: a comprehensive assessment interview (ASI), a psycho-social assessment, a psychiatric evaluation, physical/health, STDs, HIV screening, and financial assessment to determine ability to pay. • A Treatment Plan and a Coordination Plan will be developed as well as Progress Notes to monitor participant. • Unless crisis intervention is required, all intake forms will be completed within 24 hours. Signatures on consent forms and other intake forms will be obtained and a client file initiated. • A TB test will be done for all participants within three days of admission and physical exam will be completed for those clients applying for disability. • Clients needing mental health services will be referred for mental health evaluations as appropriate and appointments made. A physical screening and a mental health examination will be scheduled. Qualified staff will evaluate the results. Exhibit A—Scope of Work Page 5 of 17 All data from physical screenings will be reviewed and all medical problems will be referred to a physician. All data from the mental health assessments will be reviewed and signed by a mental health professional. 4. Admission Criteria • Admission is voluntary. • Clients must be alcohol and drug free for 72 hours prior to admission. • Clients must be ambulatory. • Clients must be 18 years old or older. • Primary problem is substance use disorder. • Clients must be Spanish speaking. • Clients must be willing to accept program rules. • Clients must have no history of excessive violence. • Physical or mental disabilities must not prevent clients from participation in program. • Pending legal problems must not prevent client's participation in treatment. The Hispanic Commission will admit all men that wish to be admitted who are capable and willing to abide by the program's requirements. Persons with communicable diseases must provide a letter of recommendation from a physician. Injection drug users and all other drug users will be viewed as priority clients. 5. SUD MHS or Medical Referrals The Nuestra Casa program links clients with other related services as needed. The services may include a culturally appropriate residential/inpatient care program, medical service, co-occurring disorders and mental health care. These referrals are active referrals and include follow-up. The Hispanic Commission will also include referrals to physicians for physical diagnoses. 6. Residential Services The Hispanic Commission's residential services will be organized in accordance with the requirements set forth in the RFP. Approximately 16 beds are available at the Nuestra Casa Recovery home for referred clients, with 7 proposed for County use. Nuestra Casa will provide twenty (20) hours per week of group and individual interventions (Monday through Friday) and Exhibit A—Scope of Work Page 6 of 17 an additional six (6) hours on weekends. Residential treatment will consist of the following service components. 7. Assessment and Treatment Planning The Counselor and Clinical Supervisor will consider the totality of all participants' needs (substance use, legal, family, social, psychological, health, housing, education, vocational, and safety) and develop individual service plans that provide the competencies each client requires in order to achieve and maintain abstinence and live a healthy, productive life in their community. Treatment planning begins at the time that participant is assessed and admitted into the program. The Senior Counselor will conduct a psych000ccal assessment, Addiction Severity Index (ASI) and the Hispanic Commission interview protocol. Following the assessment and a review of records provided by the referring entity, program staff will meet with participant and develop and individual treatment plan. The initial treatment plan will become the guide for each client's treatment, recovery service and eventual discharge plan. Plans will contain measurable goals, time limited objectives, and activities designed to help clients meet their individual goals and objectives. Service plans will evolve and staff and clients amend them to reflect changing conditions resulting from each individual's treatment process, meeting objective, the appearance of new information arising from ongoing assessment, change in treatment status, and changing living situation or employment. Plan amendments will address any lack of progress, any lapse or relapse, or other situations which may require new directions in services and supervision. Each resident will have a plan containing: • The treatment plan and signed release of information form. • Plan amendments to be reviewed at least bi-weekly by the Senior Counselor and the client. • Authorization of communications (ROI) between treatment staff, family members, superior court, probation, and other service providers. • A record of services to which clients are referred, including whether appointments are kept and when available, the results of these referrals. • Counseling notes— notes from probation contacts, a record of transfers to other settings. • Record of transfers to other settings- re-incarcerations, program terminations, etc. • Discharge plans that summarize progress made and recommendation s for the future treatment including continued 12-step meetings, alumni activities and legal compliance. Exhibit A—Scope of Work Page 7 of 17 The Senior Counselor and participant will sign all treatment, aftercare, exit plans and amendments. The original documents will remain in the master file and a copy will be given to the client. Nuestra Casa treatment features include case management, coordination with other Fresno County services, residential therapeutic treatment, vocational services, job search and referrals to counseling. Staff also coordinates with local service providers to ensure participants with mental health and other issues schedule and keep appointments as scheduled. Many clients also require parenting training, domestic violence or anger management counseling, all of which are provider through referral to other agencies. Twelve step or other peer support activities will complement treatment. Nuestra Casa offers onsite AA/NA meetings 3 days per week. Counselors will also discuss other needs and forms of support clients might benefit from. This may include referrals for cultural specific services like LGBTQ or HIV/AIDS support groups, prevention, education, confidential testing, counseling, HIV, or spiritual counseling. 8. Case Management_ The overarching program goal is to provide participants with knowledge, emotional and spiritual growth, life skills, and competencies that clients will need to maintain abstinence and lead healthy productive, self-sufficient lives. Case management will bring all of the necessary supportive elements together to ensure that each participant receives the services required to succeed in his recovery. The case management provided will include a holistic view of the participant, addressing not only substance abuse, but educational, family, social, housing, and other needs to help participants achieve self-sufficiency. Counselors will intervene, when appropriate, utilizing a strength-based orientation that considers an individual's and a family's strengths to help participants remain abstinent and direct resources to address their needs. Improvisation, community collaboration, and resource coordination are the cornerstones of successful case management and our program will utilize these tools. Case management activities will include evaluation, assessment, service planning, review, coordination with other providers, and encouraging client feedback on the effectiveness of treatment. 9. Coordination The Hispanic Commission will work closely with the County and others providers to coordinate clients' treatment planning and services. Copies of Treatment Plans and modification, discharge, and continuing care plans will be sent to all required stakeholders. At intake collaborators will be involved to provide insight into client needs, risks, and behaviors to complete treatment plans. In the event a client's drug test comes back positive or he leaves treatment, the referring entity will be notified within 24 hours. Other areas in which coordination is essential include: Exhibit A—Scope of Work Page 8 of 17 • Coordination with appropriate services to ensure clients with co-occurring disorders or other issues schedule and attend counseling sessions; • Coordination with the other Fresno County program services; • Coordination with mental health counseling groups for clients; • Coordination with organizations to ensure individuals with HIV/AIDS, Hepatitis C, TB, and other communicable diseases receive the care and medication required for their condition. • Coordination of step-ups and step-downs in treatment with other stakeholders; • Coordination of discharge planning and community care. 10. Drug Testing The Hispanic Commission will provide random drug testing to all clients utilizing DOT approved instant drug screening devices manufactured by MedTox Diagnostic. These devices test for Amphetamine, Cocaine, Opiates, Benzodyazepines and Marijuana and other drugs. Results are documented in each client's file. Positive findings are reported immediately to the referring agency followed by a staffing with program personnel and representatives from the referring agency. Once recommendations are received appropriate action is taken. 11. Crisis Intervention Staff of the Hispanic Commission's programs receive initial and annual follow-up training in evaluating and providing crisis intervention. Staff is trained to evaluate situations to determine the nature of the crises (emotional, physical, or spiritual) and to intervene appropriately. They are trained to know when and how to intervene directly and when outside intervention is needed. Staff is fully trained when to call 911, crisis hotlines, as well as on-call staff and therapists. Training also teaches staff how to avoid making a situation worse or creating additional harm through a failed intervention. 12. Referrals Referrals for other services are integrated into the residential treatment program. Clients will take part in the standard residential program, as well as specialized groups and individual counseling designed for substance abusers at risk of criminal activity. These include: During the substance abuse services, Counselors will refer clients to service providers indicated in their treatment plans and make follow-up contacts to ensure that they keep their appointments and, when indicated, discuss the services (subject to confidentiality limits) with the other providers. In some cases, referrals will be arranged and carried out by the Hispanic Commission. Referrals will include: benefits eligibility and application, housing, vocational counseling, education (i.e., Exhibit A—Scope of Work Page 9 of 17 community college or university enrollments), domestic violence and anger management counseling, financial assistance, legal counsel, family services, medical and mental health services. Clients with Co-occurring disorders will be referred to a Clinical Psychologist and other mental health professionals in the community. The Hispanic Commission will place heavy emphasis on vocational preparation to help participants find work because clients often have poor work histories. Most referrals will also be enrolled in anger management, domestic violence, and parenting skills workshops. 13. Treatment Program Accessibility and Compliance with the Americans for Disability Act All of the Hispanic Commission's programs will continue to comply with the ADA requirements. C. Target Population: The clients served by the Hispanic Commission include the following: • Monolingual Spanish-speaking men with substance use disorders; • Spanish-speaking clients who have co-occurring substance abuse/dependence and mental health disorders; • Residents of Fresno County; and • Underserved populations such as the disabled and low-income individuals. E. Minimum Duration and Intensity The Hispanic Commission will provide a minimum of twenty (20) hours SUD-focused face-to-face individual and group activity for each client scheduled from Mondays through Fridays and a minimum of six (6) hours of face-to-face individual and group activity scheduled on Saturday and/or Sunday for a total of 26 hours per week. Face-to-face individual sessions are one-on-one (counselor/client). Group sessions include a minimum of 2 and a maximum of 12 individuals. Records will be kept to clearly identify the hours of SUD-focused individual and group activity for clients each week. A large amount of research documents that any delay in the treatment process can have serious consequences for the entire recovery path. While this is true for all substance-dependent populations, it is particularly relevant for Latinos. Consequently the Hispanic Commission will systematically manage enrollment levels in order to reduce waiting lists. The treatment program is specifically designed with a Latino cultural orientation. As such, the activities are primarily geared to assist Latinos with their recovery from any substance-related problems and prepare Exhibit A—Scope of Work Page 10 of 17 them to challenge other life problems. Any individual experiencing a predominate involvement with alcoholism or drug use or related problems and who is willing to comply with the program's requirements will be eligible for participation in the program. No individual will be admitted who, in the judgment of personnel: • Exhibits behavior dangerous to staff or others, • Is not ambulatory; • Requires immediate medical evaluation and medical or nursing care; • Has a history of felony charges related to bodily harm or assault; All individuals screened by the Counselor or Clinical Supervisor that meet the criteria will be accepted and listed in the Hispanic Commission's manual files and in an electronic database after the screening process is complete and they have been found eligible. The intake process focuses on an assessment of the participant's service needs. Participants will be provided with all forms, financial agreements, rules and regulations, person rights, etc., which specify conditions under which they may be terminated from the program. The grounds for termination include arriving at the program while under the influence of drugs or alcohol, violence or threats of violence against other participants or staff, and possession or concealment of firearms, explosives or other weapons. After the screening process the log/file will be generated and those placed on the waiting list are asked to call the Hispanic Commission on a daily basis. The Hispanic Commission follows the protocols recommended by the DBH Provider Waiting List as required by Title 45, Code of Federal Regulations, §96.126 (C). Specific forms are completed to track the person's name, telephone, first letter of the applicants name, gender of applicant (1 for male, 2 for female), and the birth date of the applicant MMDDYY. Other information includes status specific to dreg and alcohol usage, Medi-Cal eligibility and SSI/SSP benefits, services requested, date entered or removed from the waiting list, days on the waiting list, referral to interim services, and reason removed from waiting list. Completed forms will be submitted to the County on a monthly basis and copies will be retained at the program site. Waiting list priorities are the same as the admission priorities indicated above. The Case Manager and/or Counselors not only ask applicants to call in daily, staff also call them weekly to update them regarding their status and to keep them interested. The agency will serve all persons Exhibit A—Scope of Work Page 11 of 17 deemed eligible for the program and who are committed to the treatment program. An individual is removed from the waiting list only after he enters into treatment or indicates that treatment is no longer desired. F. Counseling Services The Fresno Hispanic Commission's treatment approach provides residential treatment services to Latino males following these guidelines: 1. Outreach must be intensive and persuasive in order to convince clients that a residential program can benefit them. Potential clients must be at a point in their substance abuse cycle that they feel a need for help in overcoming their dependency. 2. The residential staff should be primarily male since Latino males are sometimes hesitant to accept assistance from a female. 3. Services offered must be designed to address multiple Substance Use Disorders (SUD), with alcohol which is often the primary substance. The treatment program must be structured to allow men to discuss their feelings, believes, attitudes, and opinions without fear of censor. 4. Group sessions encourage participants to identify and resolve alcohol and other drug related problems, to examine personal attitudes and behaviors and provide support for positive change in lifestyle leading to recovery. 5. Private counseling is available on a scheduled basis and as needed for each client. 6. Family members and significant others will be required to participate in family sessions. Under the direction of Program Director and Clinical Supervisor, the Fresno Hispanic Commission's program for Latino clients is designed to place trained counselors and clients into a therapeutic climate that totally moves the client away from SUD's for a period of up to 90 days. During this time period, the program addresses all physical needs of the client from food and shelter to medical needs. The cognitive behavioral program employs professionals and paraprofessionals who are nurturing, caring and yet disciplined and structured. The treatment environment includes individual and group therapy sessions that openly and honestly address critical, social and cultural values. All paraprofessionals involved receive training so that they can use cognitive behavioral counseling techniques, complete a treatment plan and, facilitate group interaction. The program also provides a range of support services. These include medical and mental health consultation, educational training, recreational therapy, career and job training and Exhibit A—Scope of Work Page 12 of 17 other services such as self-help groups (12-step program and or church support systems) as critical components of the services offered. Individual counseling sessions play an important role in the treatment system. They provide a forum in which to discuss critical issues, manage short-term crises, and explore personal resources such as family issues. Sessions are both regularly scheduled and impromptu. Independent of format, these sessions help keep participants focused on recovery or issues clients may be reluctant to bring up in groups. Each client receives a minimum of one half-hour of individual counseling per month. Clients with urgent needs, as well as those preparing to be discharged, generally receive additional counseling as needed. Job preparation is important to help clients with little if any formal employment experience to develop realistic work expectations and identify jobs or careers they enjoy and in which they can take excel. Vocational assistance challenges poor behaviors such as helplessness, dishonesty, and criminality by helping clients understand the connection between work and self-determination. The agency believes that regular wages lead to security and dignity. Vocational services begin with an assessment of the client's interests, work history, educational level, hobbies and aptitudes. The process helps clients develop occupational plans and mediate behaviors such as lack of punctuality, poor work habits and personal motivation, which are associated with substance abuse. The Hispanic Commission also addresses basics such as the need to get a driver's license and proper identification, how to find jobs, fill out applications, schedule appointment, how to dress for an interview, how to conduct oneself at an interview (verbal language, i.e., the need to make eye contact, how to sit, how to address the interviewer). These subjects are followed by more advanced concepts: how to construct a budget and manage money, securing an apartment, subscribing to utilities and opening a bank account. Mock interviews and role-play simulations play a major role in helping residents acquire new skills. Participants are assigned tasks and responsibilities in the process like setting up and breaking down group meeting spaces, cleaning and maintenance, helping in the kitchen, ant other tasks which help to build self-esteem, address interpersonal problem solving, and aide in team building. Once clients master the basics, they are referred to key community programs. G. Psycho Educational Groups Individual and group sessions will be scheduled to provide for a wide variety of psycho educational counseling designed to meet the needs of individual clients. These sessions may address issues like physical, emotional, social, psychological and cultural effects of co-occurring substance abuse/dependence and mental health disorders; life skills and resources; domestic violence; self-help philosophy and how to develop peer support. The activities of the staff and volunteers consist of effective intervention on behalf of the targeted monolingual Hispanic population at the points of crisis within the alcohol and drug abuse cycle. These points of impact include the courts and the justice system, detox and emergency facilities, impacted families, employment related agencies and church organizations. Exhibit A—Scope of Work Page 13 of 17 Education groups are conducted by the counselor in a lecture format following the culture-specific treatment curriculum. These materials explore substance abuse from a biological, psychological, family, social, and spiritual perspective. The groups address the physical, social, psychological, emotional and cultural effects of alcohol and drug use on the well-being of not only the clients, but also, their families. Relations with others are discussed as a path to recovery or relapse depending on the nature of the relationship. The role of stress and anger management is presented as a tool to advance recovery. Both self-help philosophy and peer support are discussed as critical elements of recovery. Educational/vocational training are integrated into the curriculum. The curriculum is supplemented by a journal book, which contains written exercises that clients complete away from the group. Participants present their exercises and discuss them with group members. The Hispanic Commission uses Spanish language of the journal exercises that enable individuals with limited literacy skills in either language to formulate verbal responses that they can then present to the group. Peer groups provide a supportive environment in which participants can collectively bring about changes in their attitudes and behaviors. Peer groups rely on the group process to promote openness as well as insight among participants. Groups are direct, but not confrontational, and no participants or staff is allowed to belittle another client. Peer groups feature joint problem-solving exercises and can be very flexible, enabling staff to structure them to meet emerging needs, move forward or backward, to respond to changes in the emotional dynamics of the group. Peer groups provide an opportunity for members to serve as role models, and the process helps participants share the personal impact of substance abuse on themselves and their families Peer associations are a strong force in the initiation of drug use. Similarly, treatment programs support the recovery process through the use of peer associations. Staff will utilize group treatment plans in order to integrate peer support into the treatment program. Space will be shared with AA and NA in order to make peer support and self-help easily available. Cultural competency is not merely a program component for the Hispanic Commission but an operational principal expressed by the phrase "La Cultura Cura". At its roots, alcoholism and drug addiction destroys the web of solidarity that nurtures and maintains individuals, families and communities. Alcoholism drowns the values and behavior characteristics of a culture. The Hispanic Commission services are designed to lead clients to the harmony of a sober life style by bringing about restoration and healing in a culturally specific context. Cultural Principles: The Hispanic Commission team has integrated five basic cultural principles into its treatment approach: Family: The extended network of blood and fraternal relations. This traditional support system is weakened by addiction related behavior and requires mending and restoration. Exhibit A—Scope of Work Page 14 of 17 Respect: The reciprocal difference and appreciative inquiry for mutual wellbeing. It is a truism within the Hispanic culture that "respect" for self and the rights of others is the basis of peace. Respeco is the ointment for interpersonal conflicts, which are one of the most damaging consequences of addiction. Education: Education is not limited to schooling, but includes traditional "knowledge" acquired from elders and mentors. Respected elders are frequently referred to as "maestro" and their advice is solicited respectfully. Work: The obligation that one should be involved in activities generating value, helping others, creating beauty, fostering life, and providing for ones charges. This is not limited to employment, although that is a significant component for most adults. Spirituality: Best described as a sense of the individual's relationship to all creation and all beings - a reverence for all life. This is not limited to formal religion which is merely an expression of spirituality. Relapse Relapse is part of the recovery process. In a controlled environment such as this program, the Hispanic Commission does not normally encounter alcohol and other drug use by clients. Clients may at times encounter opportunities for alcohol or drug use when they leave the treatment facilities to apply for work or receive other services. The Hispanic Commission addresses relapse prevention in individual and group counseling throughout the course of treatment. Relapse prevention is addressed not only in prevention groups, but also in education, health, re-entry and virtually any group or individual session in which it is relevant. Staff helps participants identify the circumstances and behaviors that lead to substance use and develop new positive responses to these events. The Hispanic Commission helps clients develop clean and sober social support networks and participate in AA, NA and alumni groups in addition to treatment and recovery services to help them remain abstinent following discharge. Relapse prevention activities at discharge focuses on jobs, housing, family issues, and independent living. Exhibit A—Scope of Work Page 15 of 17 H. Length of Treatment Phase L• Probation- 30 Dam • Assessment; Orientation; Individual treatment plan: Family history. • No phone calls for 30 days or visitors. • Steps to recover; Introduction to AA/NA; Self—Acceptance, Change; Discovering your comfort zone. Phase I1: Transitional: Blackout Period -30-40 dam • Passes are issued in accompaniment with family members; three phone calls per week;job search after 30 days include phone calls and mailing resumes. • Cultural stresses and conflict; communication; the physical effects of alcohol and drugs; problem solving; bad influences; stress management; living sober; violence and abuse; refusal skills; alternatives to drugs; self assertion; incest; responsibility; health impacts of drugs and alcohol; parents, children and siblings STDs and HIV/AIDS; Relapse Prevention; AA/NA. Phase III: Transitional: 40-60 Days. • Four hour passes issued on Saturdays; one daily phone call to family or job search. • Self-discipline; peer influence; spirituality, co-dependency; personal recovery planning; trust and mistrust; nutrition; strategies for ameliorating relapse triggers; life and coping skills; assignment to aftercare treatment modality; coordination with parole; identification of social service needs; family issues. The Hispanic Commission utilizes the American Society of Addition Medicine (ASAM) criteria with it clients at Nuestra Casa. The ASAM criteria provide separate placement criteria for adolescents and adults to create comprehensive and individualized treatment plans. The treatment plans are developed through a multidimensional patient assessment over five broad levels of treatment that are based on the degree of direct medical management. the structure, safety and security provided, and the intensity of treatment services provided. The six dimensions of multidimensional assessment are: 1. Acute Intoxication and/or Withdrawal Potential. 2. Biomedical Conditions and Complications. 3. Emotional, Behavioral, or Cognitive Conditions and Complications. 4. Readiness to Change 5. Relapse, Continued Use, or Continued Problem Potential. Exhibit A—Scope of Work Page 16 of 17 6. Recovery Living Environment, The Hispanic Commission is proposing 60 days of residential treatment to clients divided into a three-phase program. Peers and staff will review progress and make their decisions based upon the client's attitude toward others, progress on therapeutic issues, honesty in dealing with issues, and openness in the group discussion. The requirements of program graduation are to have completed the curriculum, to be in good standing with one's peers and staff, and have completed the requirements of each phase. A graduation ceremony will be held at the end of the program to commemorate each client's completion of treatment. The minimum length of primary treatment will not be less then one day and the treatment plan will be designed not to exceed 60 days. During the first 45 days discharge planning will developed and if additional days are needed beyond 60 days a request will be made to the Behavioral Health Contracts Division prior to the client's 45`" day of service. A daily census will be maintained for all clients including all the statistics required by Fresno County and the State of California including complete records of services, referral services, and progress notes of all counseling services. In addition the Commission has established and will continue to adhere to its Continuous Quality Improvement, Utilization Review and Cultural Competence Plans copies of each are included in this proposal. A continuing care plan will be drawn up for each client. The plan will list each client's unmet needs, risks, and strengths and weave them into a blueprint for the client to follow and remain abstinent. All clients will participate in AA/NA and other peer support/self help activities during treatment and will be expected to continue activities during care. The Hispanic Commission will attempt to integrate unemployed clients and those with little ability to pay for services into continuing care treatment slots supported by other funding sources. The agency will work with other outpatient providers to find accessible treatment slots. The Hispanic Commission will coordinate discharge planning and have copies of each client's signed discharge plan. For Services other that AOD treatment, staff will contact providers of those services (subject to signed client consent forms and/or Qualified Service Agreements) to let them know that the client is leaving treatment effective on a certain date and to make sure that other providers begin to work with participants to insure their continued participation in physical and mental health, educational, social and other services. 1. Outcomes Given that the agency serves a high-risk population with serious addiction, physical and mental health, and vocational problems, the Hispanic Commission is proposing the following performance outcome objections: • Ninety percent of clients will remain in treatment for a minimum of 60 days. • Eighty percent of clients will successfully complete the 60-day treatment program. Exhibit A—Scope of Work Page 17 of 17 • Seventy-five percent of clients will be employed at the time they complete treatment. The Hispanic Commission will work closely with other providers to transition clients from the residential level of service to a lower level of outpatient service. Contact will be maintained with the outpatient service provider to monitor the client's success in terms of abstinence from AOD use, criminal involvement, employment, social support, treatment needs, and CFS involvement. Required outcomes will be measured at intake, discharge and post treatment (one year follow-up). Data will be collected and reported to the County as required. Timeline: Outcomes for each client will be measured 1. At intake 2. At discharge—either 60-90 days. 3. 12 months after discharge. Measured outcomes will include: • Abstinence from AOD use. • Criminal involvement. • Employement status. • CPS involvement. • Social support/connections. • Treatment of co-occurring disorders. J. Key Staffing Requirement Staffing: All staffing requirements called for in the RFP are met by the Commission staff. Language: All staff associated with the Residential Service will be fluent in Spanish which is their "Language of Comfort" as well as that of the clients. This ability provides staff with cultural awareness of the meaning, idioms, slang usage, and various contexts in which the Spanish language is used and avoids the confusion and miscommunication associated with direct translation of English into Spanish. Exhibit B Page 1 of 20 FRESNO COUNTY FY 2015-2016 BUDGET BUDGET JUSTIFICATION NARRATIVE PERSONNEL/SALARIES Annual Salary and FTE equivalence as in budget. Annual(12 Month) %of FTE dedicated Budget Categories-Line Item Description Salary for this to this program Executive Director $4,500 7% Office Manager $3,500 7% Clinical Supervisor $15,000 70% Counselor $15,000 70% Attendant $8,500 70% Attendant $8,500 70% Attendant $8,500 70% Attendant $8,500 70% Attendant $10,000 70% Position descriptions submitted with proposal. PAYROLL TAXES TOTAL EMPLOYEE BENEFITS TOTAL INSURANCE List the following insurance categories: 0251 -Workers Compensation Insurance- 0252 - Liability Insurance- 0253 - Insurance Other- COMMUNICATIONS 0301 -Telecommunications/data lines- 0302-Answering Service- OFFICE EXPENSE 0351-Office Supplies: Includes Items necessary to carry out the daily activities to accomplish the program goals and objectives including paper, filing supplies, pens, pencils, scissors, and other supplies. 0352- Social/Rec, Workbooks.- 0353-Printing/Reproduction includes items such as the printing of business cards, program pamphlets, position vacancy advertising and other materials related to the program. 0354- Publications- 0355- Legal Notices/Advertising- EQUIPMENT List the following equipment categories and provide a brief description for each category: 0401 - Purchase of Equipment- 0402- Equipment Rent/Lease- 0403-Equipment Maintenance: minor equipment repair for copier and vehicle maintenance. FACILITIES List the following facilities categories and provide a brief description for each category: 0451 - Rent/Lease Building - 0452 - Facilities Maintenance- 0453- Utilities- Exhibit B Page 2 of 20 FRESNO COUNTY FY 2015-2016 BUDGET BUDGET JUSTIFICATION NARRATIVE TRAVEL List the following travel categories and provide a brief description for each category: 0501 - Staff Mileage- 0502-Staff Travel (Out of County) - 0503- Staff Training/Registration- 0504-Transportation - PROGRAM SUPPLIES List the following program supplies categories and provide a brief description for each category: 0551 - Program Supplies-Client Incentives 0552 - Program Supplies-Curriculum 0553- Program Supplies- Food CONSULTANCY List the following consulting categories and provide a brief description for each category: 0601 - Consultant Services- 0602 - Contracted Services- FISCAL AND AUDITS List the following fiscal and audits categories and provide a brief description for each category: 0651 -Accounting/Bookkeeping- 0652 - External Audit- OTHER COSTS List the following categories and provide a brief description for each category: 0701 - Indirect Costs- 0702- Licenses/Taxes- 0703- County Administration Fee- 0749-Other Costs- Other business services such as applicant TB tests, drug screens, and other program-related items that don't necessarily fit into another line item. REVENUE/MATCH Please identify all anticipated funding sources and distinguish whether the revenue offsets expenditures for the existing/proposed program: 3120- Drug Medi-Cal - Mental Health Medi-Cal - 3130- State Grant- 3140 - Private Donations- 3150 - Client Fees- O O t!? O O Lrno n 1- O O OnD o = M 0 N 00 00 c0 00 00 Q1 tN t rn 00 00 h M LL a) co w ww ww w caw w w ernnw•- m m o a o o a` m 000 0 o n m 0 0 rn o f LO LnO O O Orn N O ONo F--o V M co N M M 01 00 Q w w w w w w w Nw d � 7 � m E m c t m O ff O Q 0 a 9 mU o �o aLL d O Q y 0 d m 0 E 9 0 0 0 0 0 0 0 0 rn m w 0 0 > c 3� 5 0000000 0 rnn r. 0 0 O Ol z Q �C Lo Lo Lo to O 0 to N 00 O O C. �n m— C o ��� vi (D Oi O 3 d L7'm =p w 69 fA w w w w w N Q LL � c w LL H a Uc 0 0 0 O 0 0 m 0 0 0 o O 0 n E n n o O o o rn N 0 0 rn W Q aMv �'w w » w O Z 0 O m m o 0 0 0 0 0 0 U J 0 0 0 0 0 0 0 LU Q)O � 00000 � OZ Z Z Z W O to o E o c LL Z o o a W o o O 0 0 0 N N a a U N p w E� m LL p o 0 0 p 0 0 0 0 0 0 Q ^ o 0 0 0 0 o 0 o N N a t-. 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CO _I d 0 0 0 0 o 0 o o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 to G. 00 0 0 d W o 0 0 0 1- F Exhibit B FRESNO COUNTY Page 4 of 20 FY 2015-2016 BUDGET Provider Name: Program: Approved by: Date: Date: Budget Categories-Line Item Description SAPT Funding Other Funding Other Funding Proposed Program (Must Be Itemized) Budget Budget Budget Budget SALARY,PAYROLL TAX,AND EMPLOYEE BENEFITS TOTAL $100,173 $0 $0 $100,173 INSURANCE 0251 Worker's Compensation Insurance $6,700 $6,700 0252 Liability Insurance $2,500 $2,500 0253 Insurance Other-Specify $0 INSURANCE TOTAL $9,200 $0 $0 $9,200 COMMUNICATIONS 0301 Telecommunications/data lines $4,200 $4,200 0302 Answering Service $0 COMMUNICATIONS TOTAL $4,200 $0 $0 $4,200 OFFICE EXPENSE 0351 Office Supplies $1,000 $1,000 0352 Soc Rec.,Workbooks $0 0353 Printing/Reproduction $500 $500 0354 Publications $0 0355 Legal Notices/Advertising $0 OFFICE EXPENSE TOTAL $1,500 $0 $0 $1,500 EQUIPMENT 0401 Purchase of Equipment $0 0402 Equipment Rent/Lease $5,200 $5,200 0403 Equipment Maintenance $1,000 $1,000 EQUIPMENT TOTAL $6,200 $0 $0 $6,200 FACILITIES 0451 Rent/Lease Building $14,700 $14,700 0452 Facilities Maintenance $7,350 $7,350 0453 Utilities $6,000 $6,000 FACILITIES TOTAL $28,050 $0 $0 $28,050 TRAVEL COSTS 0501 Staff Mileage $750 $750 0502 Staff Travel(Out of County) $0 0503 Staff Training/Registration $1,000 $1,000 0504 Transportation $1,250 $1,250 TRAVEL COSTS TOTAL $3,000 $0 $0 $3,000 PROGRAM SUPPLIES 0551 Program Supplies-Client Incentives $0 0552 Program Supplies-Curriculum $4,200 $4,200 0553 Program Supplies-Food $28,000 $28,000 PROGRAM SUPPLIES TOTAL $32,200 $0 $0 $32,200 CONSULTANCY 0601 Consultant Services $500 $500 0602 Contracted Services $2,500 $2,500 CONSULTANCY TOTAL $3,000 $0 $0 $3,000 FISCAL AND AUDITS 0651 Accounting/Bookkeeping $1,500 $1,500 0652 External Audit $1,000 $1,000 FISCAL AND AUDITS TOTAL $2,500 $0 $0 $2,500 OTHER COSTS 0701 Indirect Costs $4,000 $4,000 0702 Licenses/Taxes $0 0703 County Administration Fee $2,500 $2,500 0749 Other Business Services $500 $500 OTHER COSTS TOTAL $7,000 $0 $0 $7,000 TOTAL PROGRAM EXPENDITURES $197,023 $0 $0 $197,023 REVENUE/MATCH 3120 Medi-Cal $0 3130 State Grant $0 3140 Private Donations $0 3150 Client Fees $2,630 1 1 $2,630 REVENUE/MATCH TOTAL $2,630 $0 $0 $2,630 NET PROGRAM BUDGET $194,393 $0 $0 $194,393 Exhibit B Page 5 of 20 FRESNO COUNTY FY 2016-2017 BUDGET BUDGET JUSTIFICATION NARRATIVE PERSONNEL/SALARIES Annual Salary and FTE equivalence as in budget. Annual(12 Month) %of FTE dedicated Budget Categories-Line Item Description Salary for this to this program Executive Director $4,500 7% Office Manager $3,500 7% Clinical Supervisor $15,000 70% Counselor $15,000 70% Attendant $9,000 70% Attendant $9,000 70% Attendant $9,000 70% Attendant $9,000 70% Attendant $10,500 70% Position descriptions submitted with proposal. PAYROLL TAXES TOTAL EMPLOYEE BENEFITS TOTAL INSURANCE List the following insurance categories: 0251 -Workers Compensation Insurance- 0252 - Liability Insurance- 0253- Insurance Other- COMMUNICATIONS 0301 -Telecommunications/data lines- 0302 -Answering Service- OFFICE EXPENSE 0351-Office Supplies: Includes Items necessary to carry out the daily activities to accomplish the program goals and objectives including paper, filing supplies, pens, pencils, scissors, and other supplies. 0352 - Social/Rec, Workbooks.- 0353-Printing/Reproduction includes items such as the printing of business cards, program pamphlets, position vacancy advertising and other materials related to the program. 0354- Publications- 0355 - Legal Notices/Advertising - EQUIPMENT List the following equipment categories and provide a brief description for each 0401 - Purchase of Equipment- 0402 - Equipment Rent/Lease- 0403-E ui ment Maintenance: minor equipment repair for copier and FACILITIES List the following facilities categories and provide a brief description for each 0451 - Rent/Lease Building- Exhibit B Page 6 of 20 FRESNO COUNTY FY 2016-2017 BUDGET BUDGET JUSTIFICATION NARRATIVE 0452 - Facilities Maintenance- 0453 - Utilities- TRAVEL List the following travel categories and provide a brief description for each 0501 - Staff Mileage- 0502 - Staff Travel (Out of County) - 0503- Staff Training/Registration - 0504-Transportation - PROGRAM SUPPLIES List the following program supplies categories and provide a brief description 0551 - Program Supplies-Client Incentives 0552- Program Supplies-Curriculum 0553 - Program Supplies- Food CONSULTANCY List the following consulting categories and provide a brief description for each 0601 - Consultant Services- 0602 - Contracted Services- FISCAL AND AUDITS List the following fiscal and audits categories and provide a brief description for 0651 -Accounting/Bookkeeping - 0652- External Audit- OTHER COSTS List the following categories and provide a brief description for each category: 0701 - Indirect Costs- 0702 - Licenses/Taxes- 0703- County Administration Fee- 0749-Other Costs- Other business services such as applicant TB tests, drug screens, and other program-related items that don't necessarily fit into another line item. 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N a Q j@(n c c c � F W c y in W W c o W w Z d y i/i M cL— N m m m m m X d y d o ci N yaaaa-a O X =Q 0 4 m Y c w`y m z W Aa a�o'i ayi E W U 'c � a�i m aai a�i a�i ~ N 2 U N Y`o !- w �u c W m Rz as @o_ z x = or 0 � J Jw � ._ omw w d EQaz v E o zwOt�cJaQQQ ¢ w _ju)LL m� J >= JXm YaSa a,a0 0 00 ov, J > rn o � � N ( r o promo m - o O Nmo } N o� v >- cL N ( d d XF y 0 0'R L C 7 w O o o 0 0 0 0 o o .- .- N N N N N N N M Q Q u7 to u) Lo Q O O o 0 a- 0 N N N N Q iLaa � �a m ��d0000000000000000000Na o0 oon W o0oo W P F- Exhibit B FRESNO COUNTY Page 8 of 20 FY 2016-2017 BUDGET Provider Name: Program: Approved by: Date: Date: Budget Categories-Line Item Description SAPT Funding Other Funding Other Funding Proposed Program (Must Be Itemized) Budget Budget Budget Budget SALARY,PAYROLL TAX,AND EMPLOYEE BENEFITS TOTAL $102,864 $0 $0 $102,864 INSURANCE 0251 Worker's Compensation Insurance $6,801 $6,801 0252 Liability Insurance $2,500 $2,500 0253 Insurance Other-Specify $0 INSURANCE TOTAL $9,301 $0 $0 $9,301 COMMUNICATIONS 0301 Telecommunications/data lines $4,263 $4,263 0302 Answering Service $0 COMMUNICATIONS TOTAL $4,263 $0 $0 $4,263 OFFICE EXPENSE 0351 Office Supplies $1.000 $1,000 0352 Soc Rec.,Workbooks $0 0353 Printing/Reproduction $500 $500 0354 Publications $0 0355 Legal Notices/Advertising $0 OFFICE EXPENSE TOTAL $1,500 $0 $0 $1,500 EQUIPMENT 0401 Purchase of Equipment $0 0402 Equipment Rent/Lease $5,200 $5,200 0403 Equipment Maintenance $1,000 $1,000 EQUIPMENT TOTAL $6,200 $0 $0 $6,200 FACILITIES 0451 Rent/Lease Building $14,700 $14,700 0452 Facilities Maintenance $7,350 $7,350 0453 Utilities $6,090 $6,090 FACILITIES TOTAL $28,140 $0 $0 $28,140 TRAVEL COSTS 0501 Staff Mileage $750 $750 0502 Staff Travel(Out of County) $0 0503 Staff Training/Registration $1,000 $1,000 0504 Transportation $1,269 $1269 TRAVEL COSTS TOTAL $3,019 $0 $0 $3,019 PROGRAM SUPPLIES 0551 Program Supplies-Client Incentives $0 0552 Program Supplies-Curriculum $4,200 $4,200 0553 Program Supplies-Food $28.454 $28,454 PROGRAM SUPPLIES TOTAL $32,654 $0 $0 $32,654 CONSULTANCY 0601 Consultant Services $500 $500 0602 Contracted Services $2,538 $2,538 CONSULTANCY TOTAL $3,038 $0 $0 $3,038 FISCAL AND AUDITS 0651 Accounting/Bookkeeping $1,500 $1,500 0652 External Audit $1,000 $1,000 FISCAL AND AUDITS TOTAL $2,500 $0 $0 $2,500 OTHER COSTS 0701 Indirect Costs $3,500 $3,500 0702 Licenses/Taxes $0 0703 County Administration Fee $2,500 $2,500 0749 Other Business Services $500 $500 OTHER COSTS TOTAL $6,500 $0 $0 $6,500 TOTAL PROGRAM EXPENDITURES $199,979 $0 $0 $199,979 REVENUE/MATCH 3120 Medi-Cal $0 3130 State Grant $0 3140 Private Donations $0 3150 Client Fees $2,670 1 $2,670 REVENUE/MATCH TOTAL $2,670 $0 $0 $2,670 NROGRAM BUDGET $197,309 $0 $0 $197,309 Exhibit B Page 9 of 20 FRESNO COUNTY FY 2017-2018 BUDGET BUDGET JUSTIFICATION NARRATIVE PERSONNEL/SALARIES Annual salary and FTE equivalence as in bud et. Annual(12 Month) %of FTE dedicated Budget Categories-Line Item Description Salary for this to this proqram Executive Director $4,500 7% Office Manager $3,500 7% Clinical Supervisor $15,000 70% Counselor $15,000 70% Attendant $9,500 70% Attendant $9,500 70% Attendant $9,500 70% Attendant $9,500 70% Attendant $11,000 70% Position descriptions submitted with proposal. PAYROLL TAXES TOTAL EMPLOYEE BENEFITS TOTAL INSURANCE List the following insurance categories: 0251 -Workers Compensation Insurance- 0252 - Liability Insurance- 0253 - Insurance Other- COMMUNICATIONS 0301 -Telecommunications/data lines- 0302-Answering Service- OFFICE EXPENSE 0351-Office Supplies: Includes Items necessary to carry out the daily activities to accomplish the program goals and objectives including paper, filing supplies, pens, pencils, scissors, and other supplies. 0352 - Social/Rec, Workbooks.- 0353-Printing/Reproduction includes items such as the printing of business cards, program pamphlets, position vacancy advertising and other materials related to the program. 0354- Publications- 0355 - Legal Notices/Advertisin - EQUIPMENT List the following equipment categories and provide a brief description for each category: 0401 - Purchase of Equipment- 0402 - Equipment Rent/Lease- 0403-Equipment Maintenance: minor equipment repair for copier and vehicle maintenance. Exhibit B Page 10 of 20 FRESNO COUNTY FY 2017-2018 BUDGET BUDGET JUSTIFICATION NARRATIVE FACILITIES List the following facilities categories and provide a brief description for each category: 0451 - Rent/Lease Building - 0452 - Facilities Maintenance- 0453- Utilities- TRAVEL List the following travel categories and provide a brief description for each 0501 - Staff Mileage- 0502 - Staff Travel (Out of County) - 0503- Staff Training/Registration - 0504-Transportation - PROGRAM SUPPLIES List the following program supplies categories and provide a brief description 0551 - Program Supplies- Client Incentives 0552 - Program Supplies- Curriculum 0553- Program Supplies- Food CONSULTANCY List the following consulting categories and provide a brief description for each 0601 -Consultant Services - 0602 - Contracted Services- FISCAL AND AUDITS List the following fiscal and audits categories and provide a brief description for 0651 -Accounting/Bookkeeping - 0652 - External Audit- OTHER COSTS List the following categories and provide a brief description for each category: 0701 - Indirect Costs- 0702- Licenses/Taxes- 0703- County Administration Fee- 0749-Other Costs-Other business services such as applicant TB tests, drug screens, and other program-related items that don't necessarily fit into another line item. 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W O O NO NO W F- V- Exhibit B P FRESNO COUNTY age 12 of 20 FY 2017-2018 BUDGET Provider Name: Program: Approved by: Date: Date: Budget Categories-Line Item Description SAPT Funding Other Funding Other Funding Proposed Program (Must Be Itemized) Budget Budget Budget Budget SALARY,PAYROLL TAX,AND EMPLOYEE BENEFITS TOTAL $105,556 $0 $0 $105,556 INSURANCE 0251 Worker's Compensation Insurance $6,903 $6,903 0252 Liability Insurance $2,500 $2,500 0253 Insurance Other-Specify $0 INSURANCE TOTAL $9,403 $0 $0 $9,403 COMMUNICATIONS 0301 Telecommunications/data lines $4,327 $4,327 0302 Answering Service $0 COMMUNICATIONS TOTAL $4,327 $0 $0 $4,327 OFFICE EXPENSE 0351 Office Supplies $1,000 $1,000 0352 Soc Rec.,Workbooks $o 0353 Printing/Reproduction $500 $500 0354 Publications $0 0355 Legal Notices/Advertising $0 OFFICE EXPENSE TOTAL $1,500 $0 $0 $1,500 EQUIPMENT 0401 Purchase of Equipment $0 0402 Equipment Rent/Lease $5,200 $5,200 0403 Equipment Maintenance $1,000 $1,000 EQUIPMENT TOTAL $6,200 $0 $0 $6,200 FACILITIES 0451 Rent/Lease Building $14,700 $14,700 0452 Facilities Maintenance $7,350 $7,350 0453 Utilities $6,181 $6,181 FACILITIES TOTAL $28,231 $0 $0 $28,231 TRAVEL COSTS 0501 Staff Mileage $750 $750 0502 Staff Travel(Out of County) $0 0503 Staff Training/Registration $1,000 $1,000 0504 Transportation $1,288 $1,288 TRAVEL COSTS TOTAL $3,038 $0 $0 $3,038 PROGRAM SUPPLIES 0551 Program Supplies-Client Incentives $0 0552 Program Supplies-Curriculum $4,200 $4,200 0553 Program Supplies-Food $28,949 $28,949 PROGRAM SUPPLIES TOTAL $33,149 $0 $0 $33,149 CONSULTANCY 0601 Consultant Services $500 $500 0602 Contracted Services $2,576 $2,576 CONSULTANCY TOTAL $3,076 $0 $0 $3,076 FISCAL AND AUDITS 0651 Accounting/Bookkeeping $1,500 $1,500 0652 External Audit $1.000 $1,000 FISCAL AND AUDITS TOTAL $2,500 $0 $0 $2,500 OTHER COSTS 0701 Indirect Costs $3,000 $3,000 0702 Licenses/Taxes $0 0703 County Administration Fee $2,500 $2,500 0749 Other Business Services $500 $500 OTHER COSTS TOTAL $6,000 $0 $0 $6,000 TOTAL PROGRAM EXPENDITURES $202,980 $0 $0 $202,980 REVENUE/MATCH 3120 Medi-Cal $0 3130 State Grant $0 3140 Private Donations $0 3150 Client Fees 1 $2,711 1 $2,711 REVENUEIMATCH TOTAL $2,711 $0 $0 $2,711 NET PROGRAM BUDGET $200,269 $0 $0 $200,269 Exhibit B FRESNO COUNTY Page 13 of 20 FY 2018-2019 BUDGET BUDGET JUSTIFICATION NARRATIVE PERSONNEL/SALARIES Annual Salary and FTE equivalence as in budget. Annual(12 Month) %of FTE dedicated Budget Categories-Line Item Description Salary for this to this program Executive Director $4,500 7% Office Manager $3,500 7% Clinical Supervisor $15,000 70% Counselor $15,000 70% Attendant $10,000 70% Attendant $10,000 70% Attendant $10,000 70% Attendant $10,000 70% Attendant $11,500 70% Position descriptions submitted with proposal, PAYROLL TAXES TOTAL EMPLOYEE BENEFITS TOTAL INSURANCE List the following insurance categories: 0251 -Workers Compensation Insurance- 0252 - Liability Insurance- 0253- Insurance Other- COMMUNICATIONS 0301 -Telecommunications/data lines- 0302 -Answering Service- OFFICE EXPENSE 0351-Office Supplies: Includes Items necessary to carry out the daily activities to accomplish the program goals and objectives including paper, filing supplies, pens, pencils, scissors, and other supplies. 0352- Social/Rec, Workbooks.- 0353-Printing/Reproduction includes items such as the printing of business cards, program pamphlets, position vacancy advertising and other materials related to the program. 0354- Publications- 0355- Legal Notices/Advertising - EQUIPMENT List the following equipment categories and provide a brief description for each category: 0401 - Purchase of Equipment- 0402 - Equipment Rent/Lease- 0403-Equipment Maintenance: minor equipment repair for copier and vehicle maintenance. FACILITIES List the following facilities categories and provide a brief description for each category: 0451 - Rent/Lease Building - 0452 - Facilities Maintenance- 0453 - Utilities- TRAVEL List the following travel categories and provide a brief description for each 0501 -Staff Mileage- 0502 -Staff Travel (Out of County) - 0503- Staff Training/Registration - 0504-Transportation- Exhibit B FRESNO COUNTY Page 14 of20 FY 2018-2019 BUDGET BUDGET JUSTIFICATION NARRATIVE PROGRAM SUPPLIES List the following program supplies categories and provide a brief description 0551 - Program Supplies- Client Incentives 0552 - Program Supplies-Curriculum 0553- Program Supplies- Food CONSULTANCY List the following consulting categories and provide a brief description for each 0601 - Consultant Services- 0602- Contracted Services- FISCAL AND AUDITS List the following fiscal and audits categories and provide a brief description for 0651 -Accounting/Bookkeeping - 0652 - External Audit- OTHER COSTS List the following categories and provide a brief description for each category: 0701 - Indirect Costs- 0702 - Licenses/Taxes- 0703- County Administration Fee- 0749-Other Costs- Other business services such as applicant TB tests, drug screens, and other program-related items that don't necessarily fit into another line item. 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J w O N_ NCJ CIO u' 5Z oQ c QC)L • � `nmOm mm v7 ZE0t c m F LL c EQ a oPLL = c LLL � 0 NLu m a cn O c c c c c Q W c 0 N N W Z c aci O Z LL z d w a N N 2 a� m m m m m F- x Q Q W E w W W ` m •o ` E W V 0 n a a s O Q m Q N Y m c m� m W U m c � a) a) m m a) F- U F W m - c W is Z 'O m Q Z x IE_ O 7✓ N J r0_ (0 0 J w O d a) W m w i EQaZ U E zwODU¢ ¢ Q ¢ Q w JU) n� J }x=�m > eA a. n T c N 0) 00 RO 00 lu J V 0 y o ,� N N M V to cn U) n a� W O .-- N M '7 t0 CD m O r N M V u') (O I� W O� O J N M O >- a. N M v0"A L C O w 0 0 0 0 o o 0 0 0 r r r r r r r r r r N N N N N N N N N N M a Q N Ul O Q ra 0 0 0 0LL d d S'V)a. m J a. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 U) a. 0 0 0 0 a. W NO NO 00 Exhibit B FRESNO COUNTY Page 16 of 20 FY 2018-2019 BUDGET Provider Name: Program: Approved by: Date: Date: Budget Categories-Line Item Description SAPT Funding Other Funding Other Funding Proposed Program (Must Be Itemized) Bud et Budget Budget Budget SALARY,PAYROLL TAX,AND EMPLOYEE BENEFITS TOTAL $108,247 $0 $0 $108,247 INSURANCE 0251 Worker's Compensation Insurance $7,006 $7,006 0252 Liability Insurance $2,500 $2,500 0253 Insurance Other-Specify $0 INSURANCE TOTAL $9,506 $0 $0 $9,506 COMMUNICATIONS 0301 Telecommunications/data lines $4,392 $4,392 0302 Answering Service $0 COMMUNICATIONS TOTAL $4,392 $0 $0 $4,392 OFFICE EXPENSE 0351 Office Supplies $1,000 $1,000 0352 Soc Rec,Workbooks $0 0353 Printing/Reproduction $500 $500 0354 Publications $0 0355 Legal Notices/Advertising $0 OFFICE EXPENSE TOTAL $1,500 $0 $0 $1,500 EQUIPMENT 0401 Purchase of Equipment $0 0402 Equipment Rent/Lease $5,200 $5,200 0403 Equipment Maintenance $1,000 $1,000 EQUIPMENT TOTAL $6,200 $0 $0 $6,200 FACILITIES 0451 Rent/Lease Building $14,700 $14,700 0452 Facilities Maintenance $7,350 $7,350 0453 Utilities $6,274 $6,274 FACILITIES TOTAL $28,324 $0 $0 $28,324 TRAVEL COSTS 0501 Staff Mileage $750 $750 0502 Staff Travel(Out of County) $0 0503 Staff Training/Registration $1,000 $1,000 0504 Transportation $1,307 $1,307 TRAVEL COSTS TOTAL $3,057 $0 $0 $3,057 PROGRAM SUPPLIES 0551 Program Supplies-Client Incentives $0 0552 Program Supplies-Curriculum $4,200 $4,200 0553 Program Supplies-Food $29,483 $29,483 PROGRAM SUPPLIES TOTAL $33,683 $0 $0 $33,683 CONSULTANCY 0601 Consultant Services $500 $500 0602 Contracted Services $2,614 $2,614 CONSULTANCY TOTAL $3,114 $0 $0 $3,114 FISCAL AND AUDITS 0651 Accounting/Bookkeeping $1,500 $1,500 0652 External Audit $1,000 $1,000 FISCAL AND AUDITS TOTAL $2,500 $0 $0 $2,500 OTHER COSTS 0701 Indirect Costs $2,500 $2,500 0702 Licenses/Taxes $0 0703 County Administration Fee $2,500 $2,500 0749 Other Business Services $500 $500 OTHER COSTS TOTAL $5,500 $0 $0 $5,500 TOTAL PROGRAM EXPENDITURES $206,023 $0 $0 $206,023 REVENUE/MATCH 3120 Medi-Cal $0 3130 State Grant $0 3140 Private Donations $0 3150 Client Fees 1 $2,750 $2,750 REVENUE/MATCH TOTAL $2,750 1 $0 1 $0 $2,750 NET PROGRAM BUDGET $203,273 1 $0 1 $0 $203,273 Exhibit B Page 17 of 20 FRESNO COUNTY FY 2019-2020 BUDGET BUDGET JUSTIFICATION NARRATIVE PERSONNEL/SALARIES Annual Salary and FTE equivalence as in bud et. Annual(12 Month) %of FTE dedicated Budget Categories-Line Item Description Salary for this to this prowarn Executive Director $4,500 7% Office Manager $3,500 7% Clinical Supervisor $15,000 70% Counselor $15,000 70% Attendant $10,500 70% Attendant $10,500 70% Attendant $10,500 70% Attendant $10,500 70% Attendant $12,000 70% Position descriptions submitted with proposal. PAYROLL TAXES TOTAL EMPLOYEE BENEFITS TOTAL INSURANCE List the following insurance categories: 0251 -Workers Compensation Insurance- 0252- Liability Insurance- 0253- Insurance Other- COMMUNICATIONS 0301 -Telecommunications/data lines- 0302 -Answering Service- OFFICE EXPENSE 0351-Office Supplies: Includes Items necessary to carry out the daily activities to accomplish the program goals and objectives including paper, filing supplies, pens, pencils, scissors, and other supplies. 0352 - Social/Rec, Workbooks.- 0353-Printing/Reproduction includes items such as the printing of business cards, program pamphlets, position vacancy advertising and other materials related to the program. 0354- Publications- 0355- Legal Notices/Advertising - EQUIPMENT List the following equipment categories and provide a brief description for each category: 0401 - Purchase of Equipment- 0402 - Equipment Rent/Lease- 0403-Equipment Maintenance: minor equipment repair for copier and vehicle maintenance. Exhibit B Page 18 of 20 FRESNO COUNTY FY 2019-2020 BUDGET BUDGET JUSTIFICATION NARRATIVE FACILITIES List the following facilities categories and provide a brief description for each category: 0451 - Rent/Lease Building- 0452 - Facilities Maintenance- 0453- Utilities- TRAVEL List the following travel categories and provide a brief description for each 0501 - Staff Mileage- 0502- Staff Travel (Out of County) - 0503- Staff Training/Registration - 0504 -Transportation - PROGRAM SUPPLIES List the following program supplies categories and provide a brief description 0551 - Program Supplies- Client Incentives 0552- Program Supplies- Curriculum 0553- Program Supplies- Food CONSULTANCY List the following consulting categories and provide a brief description for each 0601 - Consultant Services- 0602 - Contracted Services - FISCAL AND AUDITS List the following fiscal and audits categories and provide a brief description for 0651 -Accounting/Bookkeeping - 0652 - External Audit- OTHER COSTS List the following categories and provide a brief description for each category: 0701 - Indirect Costs - 0702 - Licenses/Taxes- 0703- County Administration Fee- 0749-Other Costs- Other business services such as applicant TB tests, drug screens, and other program-related items that don't necessarily fit into another line item. 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V LLLy0 in N o.a Q O M<A C) E E E E E Q W c o '4 h W Z c " N O Z �+- Z y O N N !n 2 N M M M M M ~ X 3 p x W D E N W W W E `a rnN.E � Uu oaccc Qma °YQm sd CoWU • R 'O N N W M C 7 N N N N N Y- U F- W M - C W Q' R Z •O a j E O Z x 0 - O fn J :6 _ 6>> J W M d N N W m W } `w QQ2 U E M Z WODUQQQQQ W_ JNLLV)> J } ='tz >w lG. 9 c y a 0 a O 00 O J U >_ N C 01- N w .- N M V' 'o O h CO D) O N M V � tD h T O O N M 'V to (D h m O O J N M a N M R p. yr O y 0 0.- 0 C W 0 0 0 0 0 0 0 0 0 s- N N N N N N N N N N M Q Q to u� to N Q a 0 0 0 0 C 'VJ LL n. d 2 to n. m J-d o o o O o 0 o 0 O O O 0 O 0 O O 0 0 0 O O 0 O 0 0 O 0 O 0 O fn d 0 0 00 d W O O O O W (-- I-- Exhibit B P FRESNO COUNTY age 20 of 20 FY 2019-2020 BUDGET Provider Name: Program: Approved by: Date: Date: Budget Categories-Line Item Description SAPT Funding Other Funding Other Funding Proposed Program (Must Be Itemized) Budget Budget Budget Budget SALARY,PAYROLL TAX,AND EMPLOYEE BENEFITS TOTAL $110,938 $0 $0 $110,938 INSURANCE 0251 Worker's Compensation Insurance $7,111 $7,111 0252 Liability Insurance $2,500 $2,500 0253 Insurance Other-Specify $0 INSURANCE TOTAL $9,611 $0 $0 $9,611 COMMUNICATIONS 0301 Telecommunications/data lines $4,458 $4,458 0302 Answering Service $0 COMMUNICATIONS TOTAL $4,458 $0 $0 $4,458 OFFICE EXPENSE 0351 Office Supplies $1,000 $1,000 0352 Soc Rec.,Workbooks $0 0353 Printing/Reproduction $500 $500 0354 Publications $0 0355 Legal Notices/Advertising $0 OFFICE EXPENSE TOTAL $1,500 $0 $0 $1,500 EQUIPMENT 0401 Purchase of Equipment $0 0402 Equipment Rent/Lease $5,200 $5,200 0403 Equipment Maintenance $1,000 $1,000 EQUIPMENT TOTAL $6,200 $0 $0 $6,200 FACILITIES 0451 Rent/Lease Building $14,700 $14,700 0452 Facilities Maintenance $7,350 $7,350 0453 Utilities $6,368 $6,368 FACILITIES TOTAL $28,418 $0 $0 $28,418 TRAVEL COSTS 0501 Staff Mileage $750 $750 0502 Staff Travel(Out of County) $0 0503 Staff Training/Registration $1,000 $1,000 0504 Transportation $1,327 $1,327 TRAVEL COSTS TOTAL $3,077 $0 $0 $3,077 PROGRAM SUPPLIES 0551 Program Supplies-Client Incentives $0 0552 Program Supplies-Curriculum $4,200 $4,200 0553 Program Supplies-Food $30,058 $30,058 PROGRAM SUPPLIES TOTAL $34,258 $0 $0 $34,258 CONSULTANCY 0601 Consultant Services $500 $500 0602 Contracted Services $2,653 $2,653 CONSULTANCY TOTAL $3,153 $0 $0 $3,153 FISCAL AND AUDITS 0651 Accounting/Bookkeeping $1,500 $1,500 0652 External Audit $1,000 $1,000 FISCAL AND AUDITS TOTAL $2,500 $0 $0 $2,500 OTHER COSTS 0701 Indirect Costs $2,000 $2,000 0702 Licenses/Taxes $0 0703 County Administration Fee $2,500 $2,500 0749 Other Business Services $500 $500 OTHER COSTS TOTAL $5,000 $0 $0 $5,000 TOTAL PROGRAM EXPENDITURES $209,113 $0 $0 $209,113 REVENUE/MATCH 3120 Medi-Cal $0 3130 State Grant $0 3140 Private Donations $0 3150 Client Fees 1 $2,791 1 $2,791 REVENUE/MATCH TOTAL $2,791 $0 $0 $2,791 NET PROGRAM BUDGET $206,322 $0 $0 $206,322 Exhibit C 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). Exhibit C Page 2 of 2 (1)Company Board Member Information: Name: Date: 2 Job Title: er re -k r (2)Company/Agency Name and Address: F:7re5N0 C0 U N4-1 (cv N ( C— I S D3 roa d vva v, (3)Disclosure(Please describe the nature of the self-dealing transaction you are a party to): , 111q (4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a): (5)Authorized Signature Signature: qOI (4, ( ,_ Date: Q � Exhibit D Page lof2 -F� National' /-| 8 � Standards ,J / / /�� `~�m^� _/��[lu�[us The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CbASStandnvds) ainn \o innprove health care quality and advance health equity by establishing a fraroework for organizations to serve the nation's increasingly diverse connro(inities. [} | Standard / [|[l�|[)�3/ r I) Provide efhecdve, equitable, understandable ond nespectfu| quality care and se/vices that are responsive to dive/se cultural health beliefs and Pnactices, preferred languages, health literacy and other con)rnuniration need`. ,� Leadership' � VV ��� `�{}V��[D�[l�{�, �Du v, (�[murcp 2) Advance and sustain organizational governance and leadership that promotes [L4S and health equity through po|icy, p/ocdce.sand allocated resomces. 3) Recruit, pnznno1e and support a cu!tu»aUy and hngusL/caUy diverse gove/nunce' |eadenh/p and workforce that are respons/vetothe population, inthe semiceanea. 4) Educate and train governance, |eade/d`ip and workforce in culturally and linguistically appropriate policies and practices onanongoing basis. /-{J�1�lU[l'���f'(l[l �]U/1 | �30(]Lj��O(� 'Communication - Language c/ Assistance 5) Offer language assistance to individuals who have limited English proficiency and/or othe/ communication needs, at no cost kzthern' to iao|itate timely accesstoall hea|th care and services, 6) ]nhzrrn all individuals of the avaJabihiy o| |anguaye xe/vices dea/|y and in their prefe//ed language' verbally and in writing 7) Ensure 1he connpetence of individuals providing |aoyuage assistance, vecognizing that the use of untrained individuals and/or nninors as interp/e(e/s Jhou|d be avoided. D) Provide easy to understand print and rnu|tirnedia materials and signage m the languages curnrnon|y used by the populations in the service area. ��{]a(lf�[���nf /-{lUf �U{]U� TM0O[{Jyf�Dl��n� �Or! 8��(}U����`'|'to Engagement,�r `' Continuous Improvement` `^ ' `Accountability 9) Establish culturally and linguistically apprupriate goals, policies and coanagernerA accountability, and infuSe thenn thmughout the organizations' planning and operations. Exhibit Page 2uf 2 IO) Conduct ongoing assessnnentsof the ong.mizatm"'sCLAS related aciivAiesand integrate CL4S related measures into assessment measuren'ient arid continuous quality improvement activities. lI) [oUpc( and maintain accurate and reliable demographic data to monitor and evaluate the impact ot [L4Son health equity and outconocsond to inform service delivery. 12) Conduct regular- assessments of community health assets an(] needs and use the results to plan and irnp|ernentservices that respond to the cultural and linguistic diversity of populations in the service area. 13) Partner with the connrnunityto design, inop|ennentand evaluate policies, p/acticesand services to ensure (u|1ura| and linguistic appropriateness. I4) Create conflict andg//evance resolution pmcesses that are culturally and linguistically appropriate to idendh( p/eventond nzso|ve conflicts or --ornp|ainb. 15) Communicate the organizatmn's progres` in imp}ernendng and sustaining CLAStoall �\akeho|ders' constituents and the general public. Exhibit E Page 1 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://www/epls/qov); 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. C:IUSERSISTATION4IDOCUMENTSIEXHIBITC-SELF-DEALINGTRANSACTIONDISCLOSUREFORMIEXHIBITE-DISCLOSU RESTATEMENT,DOC Exhibit E 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. CAUSERSISTATIOWDOCUMENTSIEXHIB ITC-SE LF-DEALINGTRANSACTIONDISCLOSUREFORMIEXHIBITE-DISCLOSURESTATEMENT.DOC Exhibit E 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: e ©Z ere f F(-esw0 C 0 -, N kL COnkwt (Printed Name & Title) (Name of Agency •r ComN ny) C:WSERSISTATION4IDOCUMENTSIEXHIB ITC-SE LF-DEAL INGTRANSACTION DISC LOSUREFORMIEXHI BITE-DISC LOSU RESTATEMENT.DOC Exhibit F 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 PROVIDERS) 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 (§) H 165.9. 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. §I 1165.1, 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. §1 1 165.4. 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 §11 166.) The child abuse report shall be made to any police department or sheriffs 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. §I I I66(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