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HomeMy WebLinkAboutAgreement A-16-294 with IMDSNFMHRC Placement Providers.pdf Agreement No. 16-294 1 MASTER AGREEMENT 2 THIS AGREEMENT is made and entered into this 7th day of June , 2016, by 3 and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, 4 hereinafter referred to as "COUNTY", and each contractor listed in Exhibit A, attached hereto and by 5 this reference incorporated herein, and collectively hereinafter referred to as "CONTRACTOR", and 6 such additional CONTRACTOR(S) as may, from time to time during the term of this Agreement, be 7 added by COUNTY. References in this Agreement to "party" or"parties" shall be understood to 8 refer to COUNTY and each CONTRACTOR, unless otherwise specified. 9 WITNESSETH: 10 WHEREAS, COUNTY, through its Department of Behavioral Health(DBH),pursuant to 11 various provisions of the California Welfare and Institutions Code and the California Code of 12 Regulations, must provide geropsychiatric skilled nursing care, locked skilled nursing care with 13 special mental health treatment programs, mental health rehabilitation center services, and other 14 enhanced treatment services and facilities to house and treat adults with severe and serious mental 15 health impairments; and 16 WHEREAS, each CONTRACTOR has the secured facilities, staff and expertise, and is licensed 17 by the State of California, to provide residential mental health services to severely and persistently 18 mentally disabled persons in appropriate skilled nursing or mental health rehabilitation center 19 facilities. 20 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties 21 hereto agree as follows: 22 1. SERVICES 23 A. CONTRACTOR(S) shall perform all services and fulfill all responsibilities 24 identified in COUNTY's RFSQ No. 952-5447, dated February 25, 2016 and CONTRACTOR(S) 25 responses to said RFSQ No. 952-5447, all incorporated by reference and herein made part of this 26 Agreement. In the event of any inconsistency among these documents the inconsistency shall be 27 resolved by giving precedence to the following order: 1) to this Agreement including all Exhibits, 28 and all amendments thereto; to CONTRACTOR(S) Responses to the RFSQ No. 952-5447. A copy of 1 - COUNTY OF FRESNO Fresno, CA 1 COUNTY's RFSQ No. 952-5447, and CONTRACTOR(S) Responses shall be retained and made 2 available during the term of this Agreement by COUNTY's Purchasing Department. 3 B. It is understood that each CONTRACTOR shall be providing residential mental 4 health treatment services at one (1) or more of the type of facilities as described in the Scope of Work 5 as identified in Exhibit B, attached hereto and by this reference incorporated herein. The types of 6 facilities include: Skilled Nursing Facilities (SNFs), Geropsychiatric Nursing Care Facilities 7 (GNCFs), Institutions of Mental Disease (IMDs), and Mental Health Rehabilitation Centers 8 (MHRCs). Each CONTRACTOR shall be fulfilling all responsibilities applicable to the provision of 9 the necessary residential mental health treatment services as identified for that respective facility as 10 described in each sub-part of Exhibit C "Description of Services &Rates", attached hereto and by 11 this reference incorporated herein. Additional facilities may be identified and added to Exhibits A 12 and C pursuant to Paragraph 14 herein,based on the need by COUNTY to provide appropriate 13 residential mental health treatment services to Fresno County clients. All references to Exhibit C 14 shall be to CONTRACTOR(S)' corresponding sub-part, Exhibit C-1, Exhibit C-2, Exhibit C-3, 15 Exhibit C-4, Exhibit C-5, Exhibit C-6, Exhibit C-7(a-g), Exhibit C-8(a-b), Exhibit C-9, and Exhibit 16 C-10, as indicated on Exhibit A. 17 C. Upon termination of this Agreement for any reason, each CONTRACTOR 18 agrees to assist COUNTY in the placement of COUNTY's clients who can no longer remain at 19 CONTRACTOR(S)' facilities. 20 D. COUNTY shall provide transportation services for its clients to and from each 21 CONTRACTOR's residential mental health service facility, as needed. 22 E. Each CONTRACTOR warrants that it possesses all licenses and certificates 23 required by local, State of California and/or Federal laws and regulations for the conduct of its 24 business and shall operate its business in accordance with all applicable laws and regulations. Each 25 CONTRACTOR further warrants that all of its personnel performing services under this Agreement 26 shall be licensed and certified where required, to lawfully perform their duties and shall maintain such 27 licensure and certifications throughout the term of this Agreement. 28 2 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTORS shall maintain copies of all licenses and certifications noted 2 above and shall allow COUNTY to review these documents upon request. 3 F. Each CONTRACTOR performing services under this Agreement shall execute a 4 "Description of Services & Rates"which will become part of this Agreement, as a sub-part of Exhibit 5 C. Each"Description of Services &Rates" shall specify the services to be provided by the individual 6 CONTRACTOR and the specific duties, rates, and responsibilities COUNTY requires of each 7 CONTRACTOR. Once the CONTRACTOR has signed, dated and returned the "Description of 8 Services &Rates"to COUNTY, COUNTY's DBH Director, or designee, shall review the 9 "Description of Services &Rates" and indicate approval by signing and dating the"Description of 10 Services &Rates". Upon the execution of the "Description of Services & Rates"by COUNTY's 11 DBH Director, or designee, as described herein, the CONTRACTOR shall be added to this 12 Agreement. After a CONTRACTOR is added to this Agreement, they will be processed through the 13 COUNTY's DBH Managed Care credentialing process. Once cleared and credentialed, the 14 CONTRACTOR(S) shall be eligible to provide residential mental health treatment services pursuant 15 to the terms and conditions set forth in this Agreement, Scope of Work(Exhibit B), and in that 16 CONTRACTOR's "Description of Services &Rates" (Exhibit Q. 17 2. TERM 18 This Agreement shall become effective on the lst day of July 1, 2016 and shall terminate 19 on the 30th day of June 30, 2019. CONTRACTOR(S) added to this Agreement after July 1, 2016, 20 shall become part of the Agreement effective upon the date the executed "Description of Services & 21 Rates" is received and approved by the COUNTY's DBH Director, or designee, as set forth in 22 Paragraph I.F. of this Agreement. 23 Effective July 1, 2019, this Agreement, subject to satisfactory performance, shall be 24 extended for two (2) additional twelve (12) month periods upon the same terms and conditions herein 25 set forth,unless written notice of non-renewal is given no later than thirty(30) days prior to the close 26 of the current Agreement term by COUNTY's DBH Director, or designee, or one (1) or more 27 CONTRACTOR(S). A CONTRACTOR's written notice of non-renewal shall be understood to 28 effect renewal only to the extent of that CONTRACTOR's involvement in this Agreement. - 3 - COUNTY OF FRESNO Fresno, CA 1 The June 30 termination date specified herein shall be the termination date for all 2 CONTRACTORS, regardless of when CONTRACTOR is added to this Agreement. Any 12-month 3 renewal period of this Agreement for any CONTRACTOR already providing services under this 4 Agreement shall commence on July I of 2019 and 2020, as appropriate. 5 3. TERMINATION 6 A. Non-Allocation of Funds - The terms of this Agreement, and the services to be 7 provided thereunder, are contingent on the approval of funds by the appropriating government 8 agency. Should sufficient funds not be allocated, the services provided may be modified, or this 9 Agreement terminated at any time by giving one (1) or all CONTRACTORS thirty(30) days advance 10 written notice. 11 B. Breach of Contract- COUNTY may immediately suspend or terminate this 12 Agreement in whole or in part, as to one (1) or all CONTRACTORS, where in the determination of 13 COUNTY there is: 14 1) An illegal or improper use of funds; 15 2) A failure to comply with any term of this Agreement; 16 3) A substantially incorrect or incomplete report submitted to the COUNTY; 17 4) Improperly performed service. 18 In no event shall any payment by COUNTY constitute a waiver by COUNTY of 19 any breach of this Agreement or any default which may then exist on the part of any 20 CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to COUNTY 21 with respect to the breach or default. COUNTY shall have the right to demand of each 22 CONTRACTOR the repayment to COUNTY of any funds disbursed to that CONTRACTOR under 23 this Agreement, which in the judgment of COUNTY were not expended in accordance with the terms 24 of this Agreement. Each CONTRACTOR shall promptly refund any such funds upon demand or, at 25 the COUNTY's option such repayment shall be deducted from future payments owing to that 26 CONTRACTOR under this Agreement. COUNTY shall provide notice to the CONTRACTOR of 27 such a breach or default prior to taking any action to suspend payments or terminate the Agreement. 28 4 - COUNTY OF FRESNO Fresno, CA 1 In addition, each CONTRACTOR shall have the right to terminate this Agreement upon 2 giving a written thirty(30) day notice to COUNTY, in the event COUNTY fails to comply with the 3 term of this Agreement or fails to perform its services as stated herein. 4 C. Without Cause -Under circumstances other than those set forth above, this 5 Agreement may be terminated by COUNTY's DBH Director, or designee, or one (1) or more 6 CONTRACTOR(S)upon the giving of thirty(30) days advance written notice of an intention to 7 terminate. 8 4. COMPENSATION 9 All parties acknowledge that COUNTY shall not pay for services for any client who has 10 not,pursuant to Paragraph 13 of this Agreement,been authorized in advance by COUNTY's DBH 11 Director, or designee, to receive residential mental health treatment services from 12 CONTRACTOR(S). All clients who have been authorized by the COUNTY's DBH Director will 13 hereinafter be referred to as "authorized COUNTY client". All parties further acknowledge that any 14 Enhanced Services provided to authorized COUNTY clients must have separate authorization as 15 described further in the Scope of Work(Exhibit B), if such separate authorization is required in the 16 CONTRACTOR(S)' "Description of Services &Rates" (Exhibit C) described in Paragraph I.F. 17 above. 18 COUNTY agrees to pay CONTRACTOR(S) and CONTRACTOR(S) agree to receive 19 compensation for each day for each authorized COUNTY client placed within the 20 CONTRACTOR(S)' facility, in accordance with the maximum daily rates identified by each 21 CONTRACTOR(S) within their respective "Description of Services &Rates", as set forth herein as 22 Exhibit C. For authorized COUNTY clients that do not qualify for Medi-Cal or are receiving non- 2 3 Medi-Cal billable services, COUNTY agrees to pay CONTRACTOR(S) and CONTRACTOR(S) 24 agree to receive compensation for additional physician services required. Physician services rates 25 shall be included in the "Description of Services &Rates" (Exhibit C) identified by each individual 26 CONTRACTOR and shall be included in an all-inclusive basic daily rate or included as an additional 27 line item to be billed on the invoice. 28 5 - COUNTY OF FRESNO Fresno, CA 1 The maximum amount of compensation to be paid to all CONTRACTORS collectively 2 for daily rate charges for the first 12-month period of the initial contract term, (July 1, 2016 through 3 June 30, 2017) shall not exceed the amount of Ten Million, One Hundred Fifty Thousand, and 4 No/100 Dollars ($10,150,000.00). 5 The maximum amount of compensation to be paid to all CONTRACTORS collectively 6 for daily rate charges for the second 12-month period of the initial contract term, (July 1, 2017 7 through June 30, 2018) shall not exceed the amount of Ten Million, Six Hundred Fifty-Seven 8 Thousand, Five Hundred and No/100 Dollars ($10,657,500.00). 9 The maximum amount of compensation to be paid to all CONTRACTORS collectively 10 for daily rate charges for the third 12-month period of the initial contract term, (July 1, 2018 through 11 June 30, 2019) shall not exceed the amount of Eleven Million, One Hundred Ninety Thousand, Three 12 Hundred Seventy-Five, and No/100 Dollars ($11,190,375.00). 13 The maximum amount of compensation to be paid to all CONTRACTORS collectively 14 for daily rate charges for the first 12-month period of the renewal contract term, (July 1, 2019 through 15 June 30, 2020) shall not exceed the amount of Eleven Million, Seven Hundred Forty-Nine Thousand, 16 Eight Hundred Ninety-Four, and No/100 Dollars ($11,749,894.00). 17 The maximum amount of compensation to be paid to all CONTRACTORS collectively 18 for daily rate charges for the second 12-month period of the renewal contract term, (July 1, 2020 19 through June 30, 2021) shall not exceed the amount of Twelve Million, Three Hundred Thirty-Seven 20 Thousand, Three Hundred Eighty-Eight, and No/100 Dollars ($12,337,388.00). 21 In no event shall the total maximum amount for the services provided by 22 CONTRACTOR(S) collectively under the terms and conditions of this Agreement for the entire five 23 (5) year term exceed Fifty-Six Million, Eighty-Five Thousand, One Hundred Fifty-Seven, and 24 No/100 Dollars ($56,085,157.00). 25 It is acknowledged by all parties hereto that the rate(s) specified in each 26 CONTRACTOR'S "Description of Services &Rates"may change during the term of this Agreement 27 and such rate changes must be approved by COUNTY's DBH Director, or designee, upon receipt of a 28 written application for such a rate increase. Any such approved rate change shall become a part of - 6 - COUNTY OF FRESNO Fresno, CA 1 this Agreement. It is also acknowledged that as additional CONTRACTORS are added to this 2 Agreement, Exhibit C shall be updated to include the specific "Description of Services &Rates" 3 which includes services, requirements and rates for each added CONTRACTOR, and shall be 4 effective upon approval and execution by COUNTY's DBH Director, or designee. 5 Commencing April I" of each term of this Agreement, each CONTRACTOR shall 6 provide a new "Description of Services &Rates"with the updated rates of services for the following V 12-month term of the Agreement (beginning with the new fiscal year). Said updated"Description of 8 Services &Rates" shall be reviewed for approval by COUNTY's DBH Director, or designee, as set 9 forth in Paragraph I.F. of this Agreement. 10 Adjustments for Basic, Special Treatment Program services, Enhanced Rate services for 11 SNFs, GNCFs, IMDs and MHRCs: COUNTY and CONTRACTORS acknowledge that the rates 12 recited in the"Description of Services &Rates" for each individual CONTRACTOR may be subject 13 to adjustment based upon rates set by the California State Department of Health Care Services for 14 such services, hereinafter referred to as the "Medi-Cal Rate". COUNTY agrees to pay the adjusted 15 Medi-Cal Rate for each and every unit of service provided after the effective date of such adjustment 16 as published by the California State Department of Health Care Services, and CONTRACTOR agrees 17 to accept such adjusted Medi-Cal Rate as of the effective date of such adjustment, whether or not the 18 cost of providing such services shall have exceeded the amount of the payments hereunder. 19 COUNTY and CONTRACTORS further acknowledge that tiered Enhanced Services rates per day, if 20 provided for in the respective CONTRACTOR(S)' "Description of Services &Rates", may apply 21 based on client need and may be adjusted during the term of this Agreement. Said tiered Enhanced 22 Services rates per day, if provided by CONTRACTOR(S), shall be indicated within the 23 CONTRACTOR(S)' respective Exhibit C. Adjustments to said Enhanced Services rates maybe 24 requested by CONTRACTOR only when accompanied by a comprehensive written justification of 25 the need for the rate increase. Such a rate change for the Enhanced Services may be approved by the 26 COUNTY's DBH Director, or designee, and the respective CONTRACTOR and shall become a part 27 of this Agreement. CONTRACTOR shall be responsible for billing Medi-Cal, Medi-Care and other 28 third party payers for the ancillary and secondary costs above COUNTY compensation for said - 7 - COUNTY OF FRESNO Fresno, CA 1 services. 2 The daily rate(s), times the number of days utilized by authorized COUNTY clients in 3 CONTRACTOR(S)' residential mental health treatment facility, less adjustments, if any, will 4 determine the actual reimbursement to CONTRACTOR(S). It is understood and agreed by the parties 5 that the foregoing is the total sum to be paid to all CONTRACTORS for the services to be provided 6 hereunder for each twelve (12) month period of this Agreement, irrespective of whether the cost of providing such services shall have exceeded the amount of the payments. 8 5. THIRD PARTY PAYMENTS 9 In the event any authorized COUNTY client is a recipient of income from any source, 10 including Supplemental Security Income/State Supplemental Program (SSI/SSP), Veterans 11 Administration benefits, retirement benefits, or annuities, and the authorized COUNTY client's 12 representative payee or the conservator of the client's estate is the Fresno County Public Guardian 13 (PG), COUNTY remains responsible to pay CONTRACTOR(S) the full amount for services rendered 14 under this Agreement. When PG is the representative payee or conservator of the estate, the 15 authorized COUNTY client's income shall be collected by PG and utilized to reimburse COUNTY 16 for the costs of services provided hereunder. 17 If a CONTRACTOR is informed that the authorized COUNTY client's representative 18 payee or conservator of the estate is a person or entity other than COUNTY's PG, said 19 CONTRACTOR shall attempt to obtain payment for the services (rendered by said CONTRACTOR) 20 directly from the client's representative payee or conservator of the estate. The amount 21 CONTRACTOR shall attempt to collect is the amount of the client's monthly income, less the 22 client's "personal needs" fund contribution of Forty-Five and No/100 Dollars ($45.00)per month for 23 clients placed within an IMD or Thirty and No/100 Dollars ($30.00)per month for clients placed 24 within a SNF. If CONTRACTOR is successful in collecting any amount from the client's 25 representative payee or conservator of the estate, CONTRACTOR shall deduct that amount from the 26 amount invoiced to COUNTY for the services provided to that client. All amounts actually collected 27 by CONTRACTOR shall be deducted from the amount otherwise payable to CONTRACTOR 28 pursuant to this Agreement. When any amount is collected by CONTRACTOR, that amount shall be - 8 - COUNTY OF FRESNO Fresno, CA 1 deducted from CONTRACTOR's next invoice to COUNTY regardless of the date the services for 2 which money was received were delivered. In the event that CONTRACTOR is paid for an 3 authorized COUNTY client from a third party source, CONTRACTOR shall not seek reimbursement 4 from COUNTY for any service provided, in whole or in part, and COUNTY shall not be liable to 5 CONTRACTOR therefore. 6 CONTRACTORS shall maintain and forward to COUNTY on a monthly basis a list of 7 all clients who have third-party payees or conservators of the estate, other than COUNTY's PG. 8 In the event CONTRACTOR(S) fails to comply with any provisions of this Agreement, 9 COUNTY shall withhold payment until such time as the non-compliance has been corrected. 10 6. INVOICING AND PAYMENTS 11 A. Invoicing 12 CONTRACTORS shall invoice COUNTY by the fifteenth(15th) day of each 13 month following the month in which the services were provided via email addressed to 14 DBHInvoices(c co.fresno.ca.us with a carbon copy(cc)to DBHLPSConservatorshiR(a),co.fresno.ca.us 15 and the assigned DBH Mental Health Contracts Staff Analyst. Invoices shall be summarized in a 16 statement format. All invoices submitted should include the following required information: name of 17 facility, facility address, invoice date range, client name, admit date, discharge date, number of days, 18 social security#, date of birth, case manager, daily rate and total. In no event shall CONTRACTORS 19 submit claims to COUNTY for clients that are not duly authorized by COUNTY to receive services. 20 B. Contract Payment Schedule 21 Payments by COUNTY shall be in arrears, within forty-five (45) days after 22 receipt and verification of CONTRACTOR(S)' invoices by COUNTY's DBH in an amount 23 equivalent to the daily rate times the total monthly utilization of beds under this Agreement, including 24 any rate adjustment provided for in Paragraph 4 herein. However, if invoice(s) is not received in 25 proper form or substance as stated in Paragraph 6.A. above, COUNTY may withhold subsequent 26 payment(s)until such invoice(s) is received. 27 C. Reconciliation of Payments to Invoices 28 COUNTY shall complete a reconciliation of payments made to costs invoiced. If - 9 - COUNTY OF FRESNO Fresno, CA 1 an adjustment to the payment is necessary, COUNTY shall notify CONTRACTOR(S) in writing 2 within five (5) working days after the completion of the reconciliation. Within forty-five (45) days 3 thereafter, COUNTY shall make payment to CONTRACTOR or CONTRACTOR shall reimburse 4 COUNTY as appropriate. In the event that CONTRACTOR(S)bills the COUNTY for supplemental 5 charges for a previous month's services, those charges shall be sent to the COUNTY for review via a 6 separate invoice and summarized statement and are not to be included within the next regular month's 7 invoice. 8 7. INDEPENDENT CONTRACTOR 9 In performance of the work, duties, and obligations assumed by CONTRACTOR(S) 10 under this Agreement, it is mutually understood and agreed that CONTRACTOR(S), including any 11 and all of CONTRACTOR(S)' officers, agents, and employees will at all times be acting and 12 performing as independent contractors, and shall act in an independent capacity and not as an officer, 13 agent, servant, employee,joint venturer, partner, or associate of the COUNTY. Furthermore, 14 COUNTY shall have no right to control or supervise or direct the manner or method by which 15 CONTRACTOR(S) shall perform its work and function. However, COUNTY shall retain the right to 16 administer this Agreement so as to verify that CONTRACTOR(S) is performing their obligations in 17 accordance with the terms and conditions thereof. CONTRACTOR(S) and COUNTY shall comply 18 with all applicable provisions of law and the rules and regulations, if any, of governmental authorities 19 having jurisdiction over matters which are directly or indirectly the subject of this Agreement. 20 Because of their status as independent contractors, CONTRACTOR(S) shall have 21 absolutely no right to employment rights and benefits available to COUNTY employees. 22 CONTRACTOR(S) shall be solely liable and responsible for providing to, or on behalf of, its 23 employees all legally-required employee benefits. In addition, CONTRACTOR(S) shall be solely 24 responsible and save COUNTY harmless from all matters relating to payment of CONTRACTOR(S)' 25 employees, including compliance with Social Security, withholding, and all other regulations 26 governing such matters. It is acknowledged that during the term of this Agreement, 27 CONTRACTOR(S)may be providing services to others unrelated to the COUNTY or to this 28 Agreement. - 10 - COUNTY OF FRESNO Fresno, CA 1 8. MODIFICATION 2 Any matters of this Agreement may be modified from time to time by the written 3 consent of all the parties without, in any way, affecting the remainder. 4 Notwithstanding the above, changes to the List of Contracted Providers (Exhibit A), 5 including changes to CONTRACTOR(S)' addresses, as well as changes to the "Description of 6 Services &Rates" (Exhibit C) for rate adjustments due to state-required facility rate increases for 7 each of CONTRACTOR(S)' facilities may be made with the written approval of the COUNTY's 8 DBH Director, or designee, and the individual CONTRACTOR. 9 In addition, non-material changes to the Scope of Work(Exhibit B) as needed to 10 accommodate revisions in the law relating to mental health treatment services may be made with the 11 signed written approval of COUNTY's DBH Director, or designee, and respective 12 CONTRACTOR(S)through an amendment approved by COUNTY's County Counsel and Auditor- 13 Controller/Treasurer-Tax Collector. Said changes shall not result in any change to the maximum 14 compensation amount payable by COUNTY to CONTRACTOR(S), as stated herein. 15 9. NON-ASSIGNMENT 16 COUNTY and CONTRACTOR(S) shall not assign, transfer or subcontract this 17 Agreement nor their rights or duties under this Agreement, without the prior written consent of 18 COUNTY and the individual CONTRACTOR seeking to make such assignment. 19 10. HOLD-HARMLESS 20 CONTRACTOR(S) agrees to indemnify, save, hold harmless, and at COUNTY's 21 request, defend COUNTY, its officers, agents and employees from any and all costs and expenses, 22 including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting 23 to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR(S), its 24 officers, agents or employees under this Agreement, and from any and all costs and expenses, 25 including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting 26 to any person, firm or corporation who may be injured or damaged by the performance, or failure to 27 perform, of CONTRACTOR(S), their officers, agents or employees under this Agreement. 28 11 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR(S) agrees to indemnify COUNTY for Federal and/or State of 2 California audit exceptions resulting from noncompliance herein on the part of CONTRACTOR(S). 3 11. INSURANCE 4 Without limiting the COUNTY's right to obtain indemnification from 5 CONTRACTOR(S) or any third parties, each CONTRACTOR, at its sole expense, shall maintain in 6 full force and effect the following insurance policies throughout the term of this Agreement: 7 A. Commercial General Liability 8 Commercial General Liability Insurance with limits of not less than One Million 9 Dollars ($1,000,000)per occurrence and an annual aggregate of Two Million Dollars ($2,000,000). This policy shall be issued on a per occurrence basis. 10 COUNTY may require specific coverage including completed operations, 11 product liability, contractual liability, Explosion, Collapse, and Underground 12 (XCU), fire legal liability or any other liability insurance deemed necessary because of the nature of the Agreement. 13 B. Automobile Liability 14 Comprehensive Automobile Liability Insurance with limits for bodily injury of not less than Two Hundred Fifty Thousand Dollars ($250,000)per person, Five 15 Hundred Thousand Dollars ($500,000)per accident and for property damages of 16 not less than Fifty Thousand Dollars ($50,000), or such coverage with a combined single limit of Five Hundred Thousand Dollars ($500,000). Coverage 17 should include owned and non-owned vehicles used in connection with this 18 Agreement. 19 C. Professional Liability 20 If CONTRACTOR(S) employs licensed professional staff(e.g. PH.D., R. N., L.C.S.W., M.F.T.) in providing services, Professional Liability Insurance with 21 limits of not less than One Million Dollars ($1,000,000)per occurrence, Three Million Dollars ($3,000,000) annual aggregate. CONTRACTOR(S) agree that it 2 2 shall maintain, at its sole expense, in full force and effect for a period of three (3) 23 years following the termination of this Agreement, one or more policies of professional liability insurance with limits of coverage as specified herein. 24 25 D. Worker's Compensation 26 A policy of Worker's Compensation Insurance as may be required by the California Labor Code. 27 28 12 - COUNTY OF FRESNO Fresno, CA 1 E. Child Abuse/Molestation and Social Services Coverage 2 CONTRACTOR shall have either separate policies or umbrella policy with 3 endorsements covering Child Abuse/Molestation and Social Services Liability coverage or have a specific endorsement on their General Commercial liability 4 policy covering Child Abuse/Molestation and Social Services Liability. The 5 policy limits for these policies shall be $1,000,000 per occurrence with $2,000,000 annual aggregate. The policies are to be on a per occurrence basis. 6 7 CONTRACTOR(S) shall obtain endorsements to the Commercial General Liability 8 insurance naming the County of Fresno, its officers, agents, and employees, individually and 9 collectively, as additional insured, but only insofar as the operations under this Agreement are 10 concerned. Such coverage for additional insured shall apply as primary insurance and any other 11 insurance, or self-insurance, maintained by the COUNTY, its officers, agents and employees shall be 12 excess only and not contributing with insurance provided under the CONTRACTOR(S)'policies 13 herein. This insurance shall not be cancelled or changed without a minimum of thirty(30) days 14 advance written notice given to COUNTY. 15 Within thirty(30) days from the date each CONTRACTOR signs this Agreement, 16 CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of 17 the foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 18 3133 N. Millbrook Avenue, Fresno, California 93703, Attn: Mental Health Contracted Services 19 Division, stating that such insurance coverages have been obtained and are in full force; that the 20 County of Fresno, its officers, agents and employees will not be responsible for any premiums on the 21 policies; that such Commercial General Liability insurance names the County of Fresno, its officers, 22 agents and employees, individually and collectively, as additional insured, but only insofar as the 23 operations under this Agreement are concerned; that such coverage for additional insured shall apply 24 as primary insurance and any other insurance, or self-insurance, maintained by COUNTY, its 25 officers, agents and employees, shall be excess only and not contributing with insurance provided 26 under CONTRACTOR(S)' policies herein; and that this insurance shall not be cancelled or changed 27 without a minimum of thirty(30) days advance, written notice given to COUNTY. 28 13 - COUNTY OF FRESNO Fresno, CA 1 In the event CONTRACTOR(S) fails to keep in effect at all times insurance coverage as herein 2 provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this 3 Agreement upon the occurrence of such event. 4 All policies shall be with admitted insurers licensed to do business in the State of California. 5 Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of A FSC 6 VII or better. 7 12. CONFLICT OF INTEREST 8 No officer, agent, or employee of the COUNTY who exercises any function or 9 responsibility for planning and carrying out the services provided under this Agreement shall have 10 any direct or indirect personal financial interest in this Agreement. CONTRACTORS shall comply 11 with all Federal, State of California, and local conflict of interest laws, statutes, and regulations, 12 which shall be applicable to all parties and beneficiaries under this Agreement and any officer, agent, 13 or employee of the COUNTY. 14 13. ADMISSION OF AUTHORIZED COUNTY CLIENTS 15 In order for proper reimbursement: 16 A. All referrals to CONTRACTORS must be authorized by the COUNTY's DBH 17 Director, or designee. Authorized COUNTY clients will be referred to CONTRACTORS from 18 COUNTY's DBH with the supporting documents identifying the level of care needed and treatment 19 that is desired by COUNTY. Upon acceptance of the referral by CONTRACTORS, COUNTY shall 20 authorize in writing the placement of the authorized COUNTY client at CONTRACTORS' facility. 21 Any Enhanced Rate services needed by the authorized COUNTY client will be mutually agreed upon 22 by both parties and approved by COUNTY's DBH Director, or designee. 23 B. CONTRACTORS and COUNTY shall work together to ensure the most 24 appropriate placement within the facility. 25 C. If admission is denied by CONTRACTOR(S), the COUNTY's DBH Director, or 26 designee, will be immediately notified in writing concerning the reasons for the denial. 27 D. Policies and procedures for admission shall be written by CONTRACTORS in 28 compliance with this Agreement. Policies shall include a provision that authorized COUNTY clients - 14 - COUNTY OF FRESNO Fresno, CA 1 are accepted for care without discrimination on the basis of race, color, religion, gender, national 2 origin, or disability or mental status. 3 14. ADDITIONS/DELETIONS OF CONTRACTORS 4 COUNTY's DBH Director, or designee, reserves the right at any time during the term of 5 this Agreement to add new CONTRACTOR(S) to those listed in Exhibit A. It is understood any such 6 additions will not affect compensation paid to any other CONTRACTOR, and therefore such 7 additions may be made by COUNTY without notice to or approval of the other CONTRACTOR(S) 8 under this Agreement. These same provisions shall apply to the deletion of any CONTRACTOR(S) 9 contained in Exhibit A, except that deletions shall be by written mutual agreement between the 10 COUNTY and the particular CONTRACTOR to be deleted, or shall be in accordance with the 11 provisions of Paragraph 3 of this Agreement. 12 15. LICENSES/CERTIFICATES 13 Throughout each term of this Agreement, CONTRACTOR(S) and CONTRACTOR(S)' 14 staff shall maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions 15 necessary for the provision of the services hereunder and required by the laws and regulations of the 16 United States of America, State of California, the County of Fresno, and any other applicable 17 governmental agencies. CONTRACTOR(S) shall notify COUNTY immediately in writing of its 18 inability to obtain or maintain such licenses,permits, approvals, certificates, waivers and exemptions 19 irrespective of the pendency of any appeal related thereto. Additionally, CONTRACTOR(S) and 20 CONTRACTOR(S)' staff shall comply with all applicable laws, rules or regulations, as may now 21 exist or be hereafter changed. 22 16. RECORDS 23 A. Medical Records: Clinical records of each client shall be the property of each 24 individual CONTRACTOR and shall be maintained for seven(7) years or until audit findings are 25 resolved. All such records shall be considered confidential client records in accordance with 26 California Welfare and Institutions Code, Section 5328. Clinical records shall include evaluative 27 studies and sufficient detail to make possible an evaluation by COUNTY's DBH Director, or 28 designee. - 15 - COUNTY OF FRESNO Fresno, CA 1 B. Financial Records: Each CONTRACTOR shall maintain financial records in the 2 manner provided by the State Health and Welfare Agency and make such records available to 3 COUNTY's DBH Director, or designee, and the California Health and Human Services Agency. 4 If COUNTY or CONTRACTOR(S) are requested to disclose any books, 5 documents or records relevant to this Agreement, for the purpose of an audit or investigation by an 6 entity authorized by law to conduct such an audit or investigation, COUNTY or CONTRACTOR(S) 7 shall notify the other party of the nature and scope of such request and shall make available to the 8 other party all such books, contracts, documents or records. By agreeing to the aforementioned, 9 COUNTY and CONTRACTORS do not waive any legal rights that they have with regard to 10 disclosure of documents or information. 11 CONTRACTORS shall maintain accurate accounting records of its costs and 12 operating expenses. Such records of costs and expenditures shall be maintained for at least four(4) 13 years, or until audit findings are resolved, and shall be open to inspection by COUNTY's DBH 14 Director, COUNTY's Auditor-Controller/Treasurer-Tax Collector, the Grand Jury, the State 15 Controller, the State Director of the Department of Health Care Services, or any of their deputies. 16 C. Other: CONTRACTOR(S) shall maintain and provide to COUNTY, with prior 17 notice, client information for purposes of trend studies conducted by COUNTY's Quality Assurance 18 Coordinator and other staff as appropriate, as authorized by COUNTY's DBH Director, or designee. 19 17. REPORTING 20 Each CONTRACTOR agrees to provide COUNTY with any reports which may be 21 required by State and/or Federal agencies for compliance with this Agreement. In addition, 22 COUNTY requires the submission of monthly and quarterly reports detailing the work accomplished 23 during the reporting period, work to be accomplished during the subsequent reporting period, and 24 problems, existing or anticipated, which should be brought to COUNTY's attention. At the expiration 25 of each twelve (12) month period of this Agreement, each CONTRACTOR shall submit a written 26 evaluation of its performance relative to this Agreement. 27 At the end of each quarter of this Agreement, each CONTRACTOR shall submit a 28 financial report listing the name of clients served, with dates when they were in the various programs - 16 - COUNTY OF FRESNO Fresno, CA 1 and the total expenditure based on actual usage by COUNTY for that quarter. 2 All such reports shall be sent attention to the Division Manager, Adult Services 3 Division, County of Fresno, Department of Behavioral Health, 4441 E. Kings Canyon Road, Fresno, 4 California 93702. 5 18. MONITORING 6 Each CONTRACTOR agrees to extend to COUNTY's staff, COUNTY's DBH Director, 7 and the State Department of Health Care Services, or their respective designees, the right to review 8 and monitor records,programs or procedures, at any time, in regard to clients, as well as the overall 9 operation of CONTRACTOR(S)' programs in order to ensure compliance with the terms and 10 conditions of this Agreement. 11 19. COMPLIANCE WITH STATE REQUIREMENTS 12 Each CONTRACTOR shall recognize that COUNTY operates its mental health 13 programs under an agreement with the State of California Department of Health Care Services, and 14 that under said agreement the State imposes certain requirements on COUNTY and its 15 subcontractors. CONTRACTORS shall adhere to the State requirements identified in this 16 Agreement. 17 20. CONFIDENTIALITY 18 All services performed by CONTRACTOR(S)under this Agreement shall be in strict 19 conformance with all applicable Federal, State of California and/or local laws and regulations relating 20 to confidentiality. 21 21. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT 22 COUNTY and CONTRACTOR(S) each consider and represent themselves as covered 23 entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public 24 Law 104-191(HIPAA) and agree to use and disclose Protected Health Information(PHI) as required 25 by law. 26 COUNTY and CONTRACTOR(S) acknowledge that the exchange of PHI between them 27 is only for treatment,payment, and health care operations. 28 17 - COUNTY OF FRESNO Fresno, CA 1 COUNTY and CONTRACTOR(S) intend to protect the privacy and provide for the 2 security of PHI pursuant to the Agreement in compliance with HIPAA, the Health Information 3 Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH), and regulations 4 promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA Regulations) 5 and other applicable laws. 6 As part of the HIPAA Regulations, the Privacy Rule and the Security Rule require V CONTRACTOR(S) to enter into a contract containing specific requirements prior to the disclosure of 8 PHI, as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) of the 9 Code of Federal Regulations (CFR). 10 22. DATA SECURITY 11 For the purpose of preventing the potential loss, misappropriation or inadvertent access, 12 viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse 13 of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that 14 enter into a contractual relationship with the COUNTY for the purpose of providing services under 15 this Agreement must employ adequate data security measures to protect the confidential information 16 provided to CONTRACTOR(S)by the COUNTY, including but not limited to the following: 1-7 A. CONTRACTOR(S)-Owned Mobile, Wireless, or Handheld Devices 18 CONTRACTOR(S)may not connect to COUNTY networks via personally- 19 owned mobile, wireless or handheld devices,unless the following conditions are met: 20 1) CONTRACTOR(S)has received authorization by 21 COUNTY for telecommuting purposes; 22 2) Current virus protection software is in place; 23 3) Mobile device has the remote wipe feature enabled; and 24 4) A secure connection is used. 25 B. CONTRACTOR(S)-Owned Computers or Computer Peripherals 26 CONTRACTOR(S) may not bring CONTRACTOR(S)-owned computers or 2-7 computer peripherals into the COUNTY for use without prior authorization from the COUNTY's 28 Chief Information Officer, and/or designee(s), including but not limited to mobile storage devices. If - 18 - COUNTY OF FRESNO Fresno, CA 1 data is approved to be transferred, data must be stored on a secure server approved by the COUNTY 2 and transferred by means of a Virtual Private Network(VPN) connection, or another type of secure 3 connection. Said data must be encrypted. 4 C. COUNTY-Owned Computer Equipment 5 CONTRACTOR(S), including its subcontractor(s) and employees, may not use 6 COUNTY computers or computer peripherals on non-COUNTY premises without prior authorization 7 from the COUNTY's Chief Information Officer, and/or designee(s). 8 D. CONTRACTOR(S)may not store COUNTY's private, confidential or sensitive 9 data on any hard-disk drive, portable storage device, or remote storage installation unless encrypted. 10 E. CONTRACTOR(S) shall be responsible to employ strict controls to ensure the 11 integrity and security of COUNTY's confidential information and to prevent unauthorized access, 12 viewing,use or disclosure of data maintained in computer files, program documentation, data 13 processing systems, data files and data processing equipment which stores or processes COUNTY 14 data internally and externally. 15 F. Confidential client information transmitted to one party by the other by means of 16 electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 17 128 BIT or higher. Additionally, a password or pass phrase must be utilized. 18 G. CONTRACTOR(S) is responsible to immediately notify COUNTY of any 19 violations,breaches or potential breaches of security related to COUNTY's confidential information, 20 data maintained in computer files, program documentation, data processing systems, data files and 21 data processing equipment which stores or processes COUNTY data internally or externally. 22 H. COUNTY shall provide oversight to CONTRACTOR(S)' response to all 23 incidents arising from a possible breach of security related to COUNTY's confidential client 24 information provided to CONTRACTOR(S). CONTRACTOR(S) will be responsible to issue any 25 notification to affected individuals as required by law or as deemed necessary by COUNTY in its sole 26 discretion. CONTRACTOR(S) will be responsible for all costs incurred as a result of providing the 27 required notification. 28 19 - COUNTY OF FRESNO Fresno, CA 1 23. NON-DISCRIMINATION 2 During the performance of this Agreement, CONTRACTOR(S) shall not unlawfully 3 discriminate against any employee or applicant for employment, or recipient of services, because of 4 race, religious creed, color, national origin, ancestry,physical disability, mental disability, medical 5 condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, 6 sexual orientation, or military or veteran status pursuant to all applicable State of California and V Federal statutes and regulations. 8 24. TAX EQUITY AND FISCAL RESPONSIBILITY ACT 9 To the extent necessary to prevent disallowance of reimbursement under section 1861(v) 10 (1) (I) of the Social Security Act, (42 U.S.C. § 1395x, sub. (v)(1)[I]), until the expiration of four(4) 11 years after the furnishing of services under this Agreement, CONTRACTOR(S) shall make available, 12 upon written request of the Secretary of the United States Department of Health and Human Services, 13 or upon request of the Comptroller General of the United States General Accounting Office, or any of 14 their duly authorized representatives, a copy of this Agreement and such books, documents, and 15 records as are necessary to certify the nature and extent of the costs of these services provided by 16 CONTRACTOR(S)under this Agreement. CONTRACTOR(S) further agrees that in the event 17 CONTRACTOR(S) carries out any of its duties under this Agreement through a subcontract, with a 18 value or cost of Ten Thousand and No/100 Dollars ($10,000.00) or more over a twelve (12)month 19 period, with a related organization, such Agreement shall contain a clause to the effect that until the 20 expiration of four(4) years after the furnishing of such services pursuant to such subcontract, the 21 related organizations shall make available, upon written request of the Secretary of the United States 22 Department of Health and Human Services, or upon request of the Comptroller General of the United 23 States General Accounting Office, or any of their duly authorized representatives, a copy of such 24 subcontract and such books, documents, and records of such organization as are necessary to verify 25 the nature and extent of such costs. 26 25. PUBLICITY PROHIBITION 27 None of the funds, materials,property or services provided directly or indirectly under 28 this Agreement shall be used for CONTRACTOR(S)' advertising, fundraising, or publicity(i.e., - 20 - COUNTY OF FRESNO Fresno, CA 1 purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. 2 26. CULTURAL COMPETENCY 3 As related to Cultural and Linguistic Competence, CONTRACTOR(S) shall comply 4 with: 5 A. Title 6 of the Civil Rights Act of 1964 (42 U.S.C. section 2000d, and 45 C.F.R. 6 Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial assistance 7 from discriminating against persons based on race, color, national origin, sex, disability or religion. 8 This is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal 9 access and participation in federally funded programs through the provision of comprehensive and 10 quality bilingual services. 11 B. Policies and procedures for ensuring access and appropriate use of trained 12 interpreters and material translation services for all LEP clients, including, but not limited to, 13 assessing the cultural and linguistic needs of its clients, training of staff on the policies and 14 procedures, and monitoring its language assistance program. CONTRACTOR(S)' procedures must 15 include ensuring compliance of any subcontracted providers with these requirements. 16 C. CONTRACTOR(S) shall not use minors as interpreters. 17 D. CONTRACTOR(S) shall provide and pay for interpreting and translation 18 services to persons participating in CONTRACTOR(S)' services who have limited or no English 19 language proficiency, including services to persons who are deaf or blind. Interpreter and translation 20 services shall be provided as necessary to allow such participants meaningful access to the programs, 21 services and benefits provided by CONTRACTOR(S). Interpreter and translation services, including 22 translation of CONTRACTOR(S)' "vital documents" (those documents that contain information that 23 is critical for accessing CONTRACTOR(S)' services or are required by law) shall be provided to 24 participants at no cost to the participant. CONTRACTOR(S) shall ensure that any employees, agents, 25 subcontractor(s), or partners who interpret or translate for a program participant, or who directly 26 communicate with a program participant in a language other than English, demonstrate proficiency in 27 the participant's language and can effectively communicate any specialized terms and concepts 28 peculiar to CONTRACTOR(S)' services. - 21 - COUNTY OF FRESNO Fresno, CA 1 E. In compliance with the State-mandated Culturally and Linguistically 2 Appropriate Services standards as published by the Office of Minority Health, CONTRACTOR(S) 3 must submit to COUNTY for approval, within sixty(60) days from date of contract execution, 4 CONTRACTOR(S)' plan to address all fifteen(15)national cultural competency standards as set 5 forth in the "National Standards on Culturally and Linguistically Appropriate Services (CLAS)" 6 http://minorityhealth.hhs.gov/assets/pdf/checked/finalreport.pdf COUNTY's annual on-site review 7 of CONTRACTOR(S) shall include collection of documentation to ensure all national standards are 8 implemented. As the national competency standards are updated, CONTRACTOR(S)' plan must be 9 updated accordingly. 10 27. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST 11 INFORMATION 12 This provision is only applicable if CONTRACTOR(S) is a disclosing entity, fiscal 13 agent, or managed care entity as defined in Code of Federal Regulations (C.F.R.). Title 42, Section 14 455.101, 455.104, and 455.106(a)(1),(2). 15 In accordance with C.F.R. Title 42 Sections 445.101, 455.104, 455.105, and 16 455.106(a)(1)(2), the following information must be disclosed by CONTRACTOR(S)by completing 17 Exhibit D, "Disclosure of Ownership and Control Interest Statement", attached hereto and by this 18 reference incorporated herein. CONTRACTOR(S) shall submit this form to the COUNTY's DBH 19 within thirty(30) days of the effective date of this Agreement. Additionally, CONTRACTOR(S) 20 shall report any changes to this information within thirty-five (35) days of occurrence by completing 21 Exhibit D, "Disclosure of Ownership and Control Interest Statement. Submissions shall be scanned 22 PDF copies and are to be sent via email to DBHAdministration(&,co.fresno.ca.us, attention: Mental 23 Health Contracted Services. 24 28. DISCLOSURE—CRIMINAL HISTORY AND CIVIL ACTIONS 25 CONTRACTOR(S) is required to disclose if any of the following conditions apply to 26 them, their owners, officers, corporate managers and partners (hereinafter collectively referred to as 27 "CONTRACTOR(S)"): 28 22 - COUNTY OF FRESNO Fresno, CA 1 A. Within the three (3) year period preceding the Agreement award, they have been 2 convicted of, or had a civil judgment rendered against them for: 3 1. Fraud or a criminal offense in connection with obtaining, attempting to 4 obtain, or performing a public (federal, state, or local) transaction or contract under a public 5 transaction; 6 2. Violation of a federal or state antitrust statute; 7 3. Embezzlement, theft, forgery, bribery, falsification, or destruction of 8 records; or 9 4. False statements or receipt of stolen property. 10 B. Within a three (3) year period preceding their Agreement award, they have had 11 a public transaction (federal, state, or local) terminated for cause or default. 12 Disclosure of the above information will not automatically eliminate 13 CONTRACTOR(S) from further business consideration. The information will be considered as 14 part of the determination of whether to continue and/or renew the Contract and any additional 15 information or explanation that a CONTRACTOR(S) elects to submit with the disclosed 16 information will be considered. If it is later determined that the CONTRACTOR(S) failed to 17 disclose required information, any contract awarded to such CONTRACTOR(S) may be 18 immediately voided and terminated for material failure to comply with the terms and conditions of 19 the award. 20 CONTRACTOR(S) must sign a"Certification Regarding Debarment, Suspension, and 21 Other Responsibility Matters- Primary Covered Transactions" in the form set forth in Exhibit E, 22 attached hereto and by this reference incorporated herein. Additionally, CONTRACTOR(S)must 23 immediately advise the COUNTY in writing if, during the term of this Agreement: (1) 24 CONTRACTOR(S)becomes suspended, debarred, excluded or ineligible for participation in federal 25 or state funded programs or from receiving federal funds as listed in the excluded parties' list system 26 (http://www.sam.gov); or(2) any of the above listed conditions become applicable to 27 CONTRACTOR(S). CONTRACTOR(S) shall indemnify, defend and hold the COUNTY harmless 28 for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or other matter - 23 - COUNTY OF FRESNO Fresno, CA 1 listed in the signed Certification Regarding Debarment, Suspension, and Other Responsibility 2 Matters. 3 29. COMPLAINTS 4 Each CONTRACTOR shall log complaints and the disposition of all complaints from a client or 5 a client's family. CONTRACTORS shall provide a copy of the detailed complaint log entries 6 concerning COUNTY-sponsored clients to COUNTY at monthly intervals by the fifteenth (15t') day V of the following month, in a format that is mutually agreed upon. In addition, CONTRACTORS shall 8 provide details and attach documentation of each complaint with the log. CONTRACTORS shall 9 post signs informing client of their right to file a complaint or grievance. CONTRACTORS shall 10 notify COUNTY of all incidents reportable to State licensing bodies that affect COUNTY clients 11 within twenty-four(24)hours of receipt of a complaint. 12 Within fifteen (15) days after each incident or complaint affecting COUNTY-sponsored 13 clients, CONTRACTORS shall provide COUNTY with information relevant to the complaint, 14 investigative details of the complaint, the complaint and CONTRACTOR's disposition of, or 15 corrective action taken to resolve the complaint. 16 30. DISCLOSURE OF SELF-DEALING TRANSACTIONS 17 This provision is only applicable if the CONTRACTOR(S) is operating as a corporation 18 (a for-profit or non-profit corporation) or if during the term of this agreement, the CONTRACTOR(S) 19 changes its status to operate as a corporation. 20 Members of the CONTRACTOR(S)' Board of Directors shall disclose any self-dealing 21 transactions that they are a party to while CONTRACTOR(S) is providing goods or performing 22 services under this agreement. A self-dealing transaction shall mean a transaction to which the 23 CONTRACTOR(S) is a party and in which one or more of its directors has a material financial 24 interest. Members of the Board of Directors shall disclose any self-dealing transactions that they are 25 a party to by completing and signing a Self-Dealing Transaction Disclosure Form, as identified in 26 Exhibit F, attached hereto and by this reference incorporated herein, and submitting it to the 27 COUNTY prior to commencing with the self-dealing transaction or immediately thereafter. 28 24 - COUNTY OF FRESNO Fresno, CA 1 31. SEVERABILITY 2 If any non-material term, provision, covenant, or condition of this Agreement is held by 3 a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions 4 shall remain in full force and effect, and shall in no way be affected, impaired or invalidated. 5 32. SEPARATE AGREEMENT 6 It is mutually understood by the parties that this Agreement does not, in any way, create 7 a joint venture among the individual CONTRACTORS. By execution of the Agreement, 8 CONTRACTORS understand that a separate Agreement is formed between each individual 9 CONTRACTOR and COUNTY. 10 33. AUDITS AND INSPECTIONS 11 CONTRACTOR(S) shall at any time during business hours, and as often as COUNTY 12 may deem necessary, make available to COUNTY for examination all of its records and data with 13 respect to the matters covered by this Agreement. CONTRACTOR(S) shall,upon request by 14 COUNTY, permit COUNTY to audit and inspect all such records and data necessary to ensure 15 CONTRACTOR(S)' compliance with the terms of this Agreement. 16 If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), 17 CONTRACTOR(S) shall be subject to the examination and audit of the State Auditor for a period of 18 three (3) years after final payment under contract(Government Code section 8546.7). 19 34. NOTICES 20 The persons having authority to give and receive notices under this Agreement and their 21 addresses include the following: 22 COUNTY CONTRACTOR(S) 23 Director, Fresno County SEE EXHIBIT A 24 Department of Behavioral Health 4441 E. Kings Canyon Road 25 Fresno, CA 93702 26 Any and all notices between the COUNTY and the CONTRACTOR(S)provided for or 27 permitted under this Agreement, or by law, shall be in writing and shall be deemed duly served when 28 personally delivered to one of the parties, or in lieu of such personal service, when deposited in the - 25 - COUNTY OF FRESNO Fresno, CA 1 United States Mail,postage prepaid, addressed to such party. 2 35. GOVERNING LAW 3 The parties agree that for the purposes of venue performance under this Agreement is to 4 be in Fresno County, California. 5 The rights and obligations of the parties and all interpretation and performance of this 6 Agreement shall be governed in all respects by the laws of the State of California. 7 36. ENTIRE AGREEMENT 8 This Agreement, including all Exhibits, RFSQ#952-5447 and Responses to RFSQ 9 #952-5447 constitutes the entire agreement between the CONTRACTOR(S) and COUNTY with 10 respect to the subject matter hereof and supersedes all previous agreement negotiations, proposals, 11 commitments, writings, advertisements,publications, and understandings of any nature whatsoever 12 unless expressly included in this Agreement. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 26 - COUNTY OF FRESNO Fresno, CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and 2 year first hereinabove written. 3 4 CONTRACTORS: COUNTY OF FRESNO 5 PLEASE SEE ADDITIONAL SIGNATURE PAGES ATTACHED 6 BY„ Chairman, Board of Supervisors 7 8 Date: Lo-1Ilp 9 10 11 BERNICE E. SEIDEL, Clerk 12 Board of Supervisors 13 14 BY 15 ZlxrA -71 oZ 1 Date: 16 17 18 19 20 21 22 23 24 25 26 27 28 - 27 - COUNTY OF FRESNO Fresno, CA 1 APPROVED AS TO LEGAL FORM: 2 DANIEL C. CEDERBORG, COUNTY COUNSEL 3 C 4 BY 5 6 APPROVED AS TO ACCOUNTING FORM: VICKI CROW, C.P.A.,AUDITOR-CONTROLLER/ 7 TREASURER-TAX COLLECTOR 8 9 By 10 11 REVIEWED AND RECOMMENDED FOR 12 APPROVAL: 13 14 44w_" k By 15 Dawan Utecht,Director 16 Department of Behavioral Health 17 18 19 20 Fund/Subclass: 0001/10000 Organization: 563 02175 21 Account/Program: 7295/0' 22 23 FY 2016-17 $10,150,000 FY 2017-18 $10,657,500 24 FY2018-19 $11,190,375 25 FY 2019-20 $11,749,894 FY 2020-21 $12,337,388 26 27 28 28 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR: 2 MENTAL HEALTH MANAGEMENT I,INC., 3 d.b.a. CANYON MANOR 4 5 By 6 y Print Name��`, 7 8 Title: �X e-( 0 �"s t/ e �� d'e c"toS- Chairman of the Board, or 9 President, or any Vice President or 10 Director of Operations 11 12 13 Print Nam 14 Title: Ate . l►r t.,[+6 r Secretary(of Corporation), or 15 any Assistant Secretary, or 16 Chief Financial Officer, or any Assistant Treasurer/Facility 17 Administrator 18 19 Mailine Address: 655 Canyon Manor Road 20 Novato, CA 94947 Phone: (415) 892-1628 21 Fax: (415) 892-8624 22 Email: REvatzCanyonM@aol.com Contact: Richard Evatz,Executive Director 23 24 25 26 27 28 - 29 - COUNTY OF FRESNO 1 CONTRACTOR: 2 CF MERCED BEHAVIORAL,LLC., 3 d.b.a. MERCED BEHAVIORAL CENTER 4 5 B ANY 6 Print N e: �ti% ✓�. C/ 1 � 7 8 itle: Ch irman of the Bo •d, or 9 President, or any Vice President or 10 Director of Operations 11 By 12 Print Name: 13 14 Title: Secretary (of Corporation), or 15 any Assistant Secretary, or 16 Chief Financial Officer, or any Assistant Treasurer/Facility 17 Administrator 18 19 Mailing Address: 1255 `B" Street 20 Merced, CA 95341 Phone: (209) 723-8814 21 Fax: (209) 384-3747 22 Email: Jeri.Allgood@mercedbehavioralhcc.com 23 Contact: Jeri Allgood, Administrator 24 25 26 27 28 - 30 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR: 2 CRESTWOOD BEHAVORIAL HEALTH, INC. 3 4 5 By 6 Print Name: �1 . 7 Title: 8 Chairman of the Board, or President, or any Vice President or 9 Director of Operations 10 11 By ,. �-'' v-- 12 13 Print Name: 14 Title: Cc;,- Secretary(of Corporation), or 15 any Assistant Secretary, or 16 Chief Financial Officer, or any Assistant Treasurer/Facility 17 Administrator 18 19 Mailing Address: 20 520 Capitol Mall, Suite 800 Sacramento, CA 95814 21 Phone: (916) 471-2240 Fax: (916) 471-2212 22 Email: gzeyen@cbhi.net cbhi.net 23 Contact: Gary Zeyen, Controller 24 25 26 27 28 - 31 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR: 2 GOLDEN STATE HEALTH CENTERS,INC. 3 d.b.a. SYLMAR HEALTH AND REHABILITATION CENTER 4 5 B 6 Print Name: �lyn�✓ jr ,/�/.�� 7 "crp 8 Title: N5r,back Chairman of the Board, or 9 President, or any Vice President or 10 Director of Operations 11 �� By 12 13 Print Name: H,,.K �tgM Weis 14 Title: Ser-rel-owl Secretary(of Corporation), or 15 any Assistant Secretary, or 16 Chief Financial Officer, or any Assistant Treasurer./Facility 17 Administrator 18 19 Mailine Address: 20 13347 Ventura Blvd. Sherman Oaks, CA 91423 21 Phone: (818) 385-3222 Email: mrmweiss@gmail.com 22 Contact: Martin Weiss, President 23 24 25 26 27 28 32 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR: 2 HELIOS HEALTHCARE, LLC, 3 d.b.a. IDYLWOOD CARE CENTER 4 5 6 Print Name: _,,t tit 7 8 Title: Chairman of the Board, or 9 President, or any Vice President or 10 Director of Operations 11 By 12 13 Print Name: ; 14 Title: C 4� ,v.� — Secretary(of Corporation), or 15 any Assistant Secretary, or 16 Chief Financial Officer, or any Assistant Treasurer/Facility 17 Administrator 18 19 Mailing Address: 520 Capitol Mall, Suite 800 20 Sacramento, CA 95814 Phone: (916)471-2266 21 Fax: (916) 471-2212 22 Email: gzeyen@cbhi.net Contact: Gary Zeyen, Controller 23 24 25 26 27 28 - 33 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR: 2 KF COMMUNITY CARE,LLC., 3 d.b.a. COMMUNITY CARE CENTER 4 5 By 6 _ Print Name: 7 8 Title: Chairman of the Board,or 9 President, or any Vice President or 10 Director of Operations 11 i 12 / 13 / --Pfint Nameetyt-lo 14 Title: ecretary(of Corporation ,or 15 any Assistant Secretary, or 16 Chief Financial Officer, or any Assistant Treasurer/Facility 17 Administrator 18 19 Mailiniz Address: 2335 S. Mountain Avenue 20 Duarte,CA 91010 Phone: (626) 357-3207 Ext 225 21 Email: boconnor@chms.us 22 Contact: Barbara O'Connor,Administrator 23 24 25 26 27 28 - 34 - COUNTY OF FRESNO Fresno, CA 1 CONTRACTOR: TELECARE CORPORATION: 3 MORTON BAKAR CENTER CORDILLERAS MENTAL HEALTH CENTER(MHRC) 4 GLADMAN MENTAL HEALTH REHABILITATION CENTER LA PAZ GEROPSYCHIATRIC CENTER GARFIELD NEUROBEHAVIORAL CENTER 6 VILLA FAIRMONT-MHRC VILLA FAIRMONT-MHRC FLEX UNIT 7 8 9 By � 'a'� l/\ v"� S l 1 o! Z J l 10 Print Name: F N'L T 1A Q't C. N t <✓ 11 Title: Sr OP1- 12 Chairman of the Board, or 13 President,or any Vice President or Director of Operations 14 15 By � I �� Ilot <o 16 print Name: ►\ N R S" N L L 17 Title: S VP o4 Ct:7 0 18 Secretary(of Corporation),or 19 any Assistant Secretary, or Chief Financial Officer, or 20 any Assistant Treasurer/Facility Administrator 21 22 Mailine Address: 23 1080 Marina Village Parkway, Suite 100 24 Alameda, CA 94501-1043 Phone: (510) 337-7950,Ext. 1183 25 Fax: (510) 337-7969 Email: dconnolly@telecarecorp.com 26 Contact: Dwain Connolly,Director of Financial 2 7 Planning&Analysis 28 - 35 - COUNTY OF FRESNO Fresno, CA 1 2 CONTRACTOR: 3 VISTA PACIFICA ENTERPRISES, INC., 4 d.b.a.VISTA PACIFICA CENTER AND d.b.a.VISTA PACIFICA CONVALESCENT 5 6 7 By 8 Print Name: ~` ' �' " "" f 9j��f 'l Title: 10 Chairman of the Board, or President, or any Vice President or 11 Director of Operations 12 13 By 14 Print Name: J 15 Title: 16 Secretary(of Corporation), or 17 any Assistant Secretary, or Chief Financial Officer, or 18 any Assistant Treasurer/Facility Administrator 19 20 Mailing Address: 21 Vista Pacifica Center 3674 Pacific Avenue 22 Jurupa Valley, CA 92509 23 Phone: (951) 682-4833 Ext. 106 Email: cjumonville@vistapacificaent.com 24 Contact: Cheryl Jumonville, President 25 26 27 28 - 36 - COUNTY OF FRESNO Fresno, CA 1 2 CONTRACTOR: 3 MEDICAL HILL REHAB CENTER, LLC., d.b.a. KINDRED NURSING AND REHABILITATION—MEDICAL HILL 4 5 1 6 By f 7 Print Name: 8 Title: \ ),d '�'0�nP�v tQ Y4_ i A u,—V 9 Chairman of the Board, or President, or any Vice President or 10 Director of Operations 11 12 By 13 J Print Name: i 14 Title: '(A )vy 15 Secretary(of Corporation),or 16 any Assistant Secretary, or Chief Financial Officer, or 17 any Assistant Treasurer/Facility Administrator 18 19 Mailing Address: 20 475 29' Street Oakland, CA 94609 21 Phone: (510) 832-3222 Ext 171 22 Email: april.liammock@kindred.com Contact: April Hammock, Admissions Coordinator 23 24 25 26 27 28 37 - COUNTY OF FRESNO Fresno, CA Exhibit A LIST OF CONTRACTORS CONTRACTOR NAME EXHIBIT REFERENCE 1. Mental Health Management I, Inc., d.b.a. Canyon Manor C-1 2. CIF Merced Behavioral, LLC., d.b.a. Merced Behavioral Center C-2 3. Crestwood Behavioral Health Inc. C-3 4. Golden State Health Centers, Inc., d.b.a. C-4 Sylmar Health and Rehabilitation Center 5. Helios Healthcare, LLC., d.b.a. Idylwood Care Center C-5 6. KF Community Care, LLC., d.b.a. Community Care Center C-6 7. Telecare Corporation C-7 (a-g) 8. Vista Pacifica Enterprises, Inc., d.b.a. Vista Pacifica Center C-8 (a-b) and d.b.a. Vista Pacifica Convalescent 9. Medical Hill Rehab Center, LLC., d.b.a. C-9 Kindred Nursing and Rehabilitation — Medical Hill 10. 7`" Avenue Center C-10 Exhibit B Page 1 of 15 SCOPE OF WORK I. GEROPSYCHIATRIC NURSING CARE SERVICES Fresno County Department of Behavioral Health (DBH) is responsible for the provision of appropriate Skilled Nursing Facility (SNF) and Geropsychiatric Nursing Care Facility (GNCF) services to Fresno County residents who are age 65 years or older, have serious and persistent psychiatric impairment and problems with their physical health. SNFs operate under Title 22, California Code of Regulations, sections 51335, 71443-724 75 and the California Department of Health Care Services' (DHCS) Policies and Directives. Title 22 of the California Code of Regulations describes and defines programs that serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. A. GOALS AND OBJECTIVES 1. Provide a safe and healthful living environment; 2. Control and modify the person's destructive behavior patterns; 3. Prevent or reduce acute psychiatric hospitalizations or long-term hospitalization; 4. Provide care as close to the client's home community(Fresno County) as possible; and 5. Provide high quality care and supervision at the lowest appropriate cost. B. LOCATION The location of the facility should be in relatively close proximity to Fresno County. This will help expedite the integration of these clients back into community living, decrease the travel expense required by court hearings and staff travel, and facilitate involvement by family and friends for client support. C. TYPES OF SERVICES The Department of Behavioral Health contracts for a number of SNF beds for both Basic and Enhanced levels of care. The rates for the Basic Services per bed per day are dictated by the State. Enhanced Services are described in Subsection 6.13 below. The following are the types of SNF beds needed, depending on a client's mental/physical health condition: 1. Basic Services: includes reasonable access to required medical treatment, up-to-date psychopharmacology and transportation to needed off-site services, and bilingual/bicultural programming, as appropriate. 2. Secured SNF: includes the services listed under "Basic Services" in a secured environment, but not in a locked facility. 3. Locked SNF with or without enhanced services: includes the services listed under "Basic Services" in a locked building. 4. Sub-Acute SNF: includes services that are non-acute 24-hour voluntary or involuntary care that is required for the provision of mental health services to clients with serious mental conditions who are not in need of acute mental health care, but who require general mental health evaluation, diagnostic assessment, treatment, nursing and/or related services, on a 24-hour per day basis in order to achieve stabilization and/or an optimal level of functioning. Such clients are those who, if in the community, would require the services of a licensed health facility providing 24-hour sub-acute mental health care. Such facilities include, but are not limited to, skilled nursing facilities with special treatment programs. Sub-acute has the same meaning as non- acute as defined in this section. Exhibit B Page 2 of 15 5. Special Treatment Program: therapeutic services provided to clients with serious mental conditions having special needs in one (1) or more of the following areas: self-help skills, behavioral adjustment, and interpersonal relationships. They also include pre-vocational preparation and pre-release planning. Contractor will provide a copy of the Policy or Procedure Guide (PPG) on agency's Special Treatment Program to the Department of Behavioral Health within ten (10) working days from the day the Agreement becomes effective. The PPG is to be sent to Department of Behavioral Health, Attn: Contracted Services Division — Mental Health, 3133 N. Millbrook Avenue, Fresno, California 93703. 6. SERVICES: A. Basic Services: i. Treatment Setting 1. A facility that provides reasonable security, supervision, and substantial compliance. Substantial compliance means conformity to regulations to be a licensee to such an extent that client safety, welfare, and quality of care is assured. 2. Development of an individual, written client care plan which indicates the care to be given, the objectives to be accomplished, and the professional discipline responsible for each element of care. Objectives shall be measurable and time limited. For specifics on supervision, refer to Title 22. 3. Safeguards for clients' monies and valuables. For specifics, refer to Title 22. 4. Activity Programs (Title 22, California Code of Regulations, and State DHCS' Policies and Directives): a. An activity program means a program that is staffed and equipped to encourage the participation of each client, meets the needs and interests of each client, and encourages self-care and resumption of normal activities. b. Clients shall be encouraged to participate in activities planned to meet their individual needs. An activity program shall have a written, planned schedule of social and other purposeful activities. c. The program shall be designed to make life more meaningful, to stimulate and support physical and mental capabilities to the fullest extent, to enable the client to maintain the highest attainable social, physical, and emotional functioning, but not necessarily to correct or remedy a disability. d. The activity program shall consist of individual, small and large group activities designed to meet the needs and interests of each client. 5. The provision for basic living needs includes, but is not limited to food, laundry, and care of resident's personal clothing, and security of personal items. Exhibit B Page 3 of 15 a. The dietetic service shall provide food of the quality and quantity to meet each client's needs in accordance with the physician's orders and meets "the recommended daily dietary allowance" as specified in the most current edition adopted by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences. For specifics, refer to Title 22. b. Laundry and care of residents' personal clothing - for specific information, refer to Title 22, for specifics. c. Security of personal items and safeguards for clients' monies and valuables - for specific information, refer to Title 22 for specifics. d. Resident Security - It is expected that these residents may be segregated from other residents of the facility to insure security. ii. Clinical 1. Pre-admission screening process. 2. Admission policy describing the extent of the facility's right of refusal. 3. Review process, if requested, for persons not accepted for admission or discharged as inappropriate for the facility. 4. Program designed to modify combative behavior, protect the client, prevent the breakage of property, and promote personal responsibility for behavior. 5. Use of restraints and postural supports. For specifics, refer to Title 22. 6. Provision of medical care with availability of physician services for treatment of any physical ailments of the clients housed at the facility. 7. Consultation and/or case staffing to be held with appropriate County assigned mental health professionals, as needed, but no less frequently than on a quarterly basis. Administration 1. Administrator will meet with the County's DBH Adult Services Division Manager, or designee, as required to monitor the Agreement. 2. Facility will immediately report all incidents involving Fresno County clients to the contract liaison. Notification will be made to Fresno County in cases of illegality, death, self-injury, absence without leave, property destruction and violence towards others. 3. Daily census records will be maintained and sent to the County's DBH Adult Services Division Manager. 4. Prepare reports as may be required to fulfill the terms of the agreement. 5. Occurrences such as epidemic outbreaks, poisoning, fires, major accidents, death from unnatural causes or other catastrophes and Exhibit B Page 4 of 15 unusual occurrences which threaten the welfare, safety, or health of clients, personnel, or visitors shall be reported by the facility within twenty-four (24) hours, either by telephone at (559) 600-9180, and confirmed in writing, or by fax at (559) 600-7674 to the Director, Department of Behavioral Health. An incident report shall be prepared by Contractor, on each occurrence. 6. Every incident report shall be retained on file by the facility for one (1) year. The facility shall furnish such other pertinent information related to such occurrences to the Director, Department of Behavioral Health 3133 N. Millbrook Avenue, Fresno, California 93703, upon request. 7. Every fire or explosion that occurs in or on the premises shall be reported within twenty-four (24) hours to the local fire authority or, in areas not having an organized fire service, to the State Fire Marshal. Contractor shall meet all fire safety requirements set by the local Fire Marshal and other requirements cited in the California Health and Safety Code. 8. All facilities shall have a placement contact person readily available to respond to requests for placements from the County. This is to prevent placement delays in placing a client at the appropriate level of care. 9. No notice is required to move a person to a different level of care or when there is a need to discharge the client because this is dependent on clinical prognosis. 10. The daily rate for the client will be commensurate with the level of care being provided at that facility. 11. All services, other than the Basic Services, must be pre-approved prior to placement utilizing Special Services Authorization Form (Exhibit G), attached hereto to this Agreement and by this reference incorporated herein. 12. For the purposes of this Agreement, the term "bed day" includes beds held vacant for patients who are temporarily (not more than seven (7) days) absent from a facility. Contractor will notify County in the event that a client has to be moved to an acute treatment facility and a bed hold needs to be made. County will approve any bed-hold days that may be required on a case-by-case basis. B. Enhanced Services: Enhanced Services augment the services of Basic and Special Treatment Programs. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The target population is adults with serious and persistent mental health conditions whose behavior requires more intensive programming than is available from Basic Services. It is anticipated that the intensive treatment and staffing provided by enhanced services will prevent State Hospital admissions. The target population may include persons who are often at risk of elopement and occasionally assaultive or self- destructive. They may have complicating medical problems. Additionally, they may require specialized services to insure successful transition to community living. Exhibit B Page 5 of 15 Clients needing these services are male or female; have a major psychiatric diagnosis, organic brain syndrome or major mental disorder; are a LPS conservatee of Fresno County; may be physically impaired, perhaps non-ambulatory; and present a special or unusual behavior management issue. The major objectives for these services are: to control and modify the client's destructive behavior; and, to prevent or reduce acute psychiatric hospitalization or long- term State hospitalization. D. REPORTING/OUTCOMES Contractor shall be required to submit monthly census reports detailing the number of County clients living in the facility on a daily basis. Contractor shall provide, at County's request, any required reports to County, which may include performance outcome measurement reports as communicated by the County to Contractor. Outcome measures may include, but are not limited to: • Successful program completion and transition to lower level of care placement • Reduced or no inpatient hospitalizations • Reduced or no incidents of self-injury, injury to others or property damage • Reduced or no incidents of medical emergency or hospitalization E. OBJECTIVES/EVALUATION A strong evaluation component will be required for these services. Contractor will be required to have an evaluation program that includes observable, measurable, time-limited outcome and process objectives. The evaluation program will be submitted in writing to the assigned DBH Mental Health Contracts Analyst for review and approval by the County within sixty (60) days after the Agreement is executed. Process objectives are defined as those describing or delineating the amount, frequency, and kinds of services to be provided. Outcome objectives are those indicators that describe the effect of program activities on client behavior or status. F. CORPORATIONS For incorporated businesses, the Contractor shall notify the Department of all facilities that the Department of Behavioral Health might use. G. INSURANCE Contractor will provide County with new certificates of insurance if there is any change in coverage. H. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT County and Contractor each consider and represent themselves as covered entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA) and agree to use and disclose protected health information as required by law. I. County reserves the right to revise and/or update the Scope the Work as needed, within the regulations of applicable CCR, CFR, and/or WIC codes. Exhibit B Page 6 of 15 SCOPE OF WORK (Continued) II. LOCKED SKILLED NURSING FACILITY CARE / INSTITUTIONS OF MEDICAL DISEASE SERVICES Fresno County Department of Behavioral Health is responsible for the provision of appropriate locked Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to Fresno County residents eighteen (18) to sixty-four (64) years of age, having serious and persistent psychiatric impairment, and are in need of Skilled Nursing Facility/Institutions for Mental Disease services (SNF/IMD) with Special Treatment Programs (STPs) and Enhanced Services. Skilled Nursing Facility/Special Treatment Program/Institutions for Mental Disease (SNF/STP/IMD) operate under Title 22, California Code of Regulations, Sections 51335, 71443-72475 and the California Department of Health Care Service's (DHCS) Policies and Directives. Title 22 of the California Code of Regulations describes and defines programs that serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. Contractor will provide "Basic Services", which include reasonable access to required medical treatment, up-to-date psychopharmacology and transportation to needed off-site services, and bilingual/bicultural programming as appropriate. A. GOALS AND OBJECTIVES 1. Provide a safe and healthful living environment; 2. Control and modify the person's destructive behavior patterns; 3. Prevent or reduce acute psychiatric hospitalizations or long-term hospitalization; 4. Provide care as close to the client's home community (Fresno County) as possible; and 5. Provide high quality care and supervision at the lowest appropriate cost. B. LOCATION The location of the facility should be in relatively close proximity to Fresno County. This will help expedite the integration of these clients back into community living, decrease the travel expense required for court hearings and staff travel, and facilitate involvement by family and friends for client support. C. TYPES OF SERVICES The Department of Behavioral Health contracts for a number of SNF/STP/IMD beds for both Basic and Enhanced levels of care. The distribution, types, and total number of beds depend on the facilities selected. The rates for the Basic services per bed per day are dictated by the State. Enhanced services are described in Subsection 3 below. 1. Basic Services: A. Treatment Setting i. A facility that provides reasonable security, supervision, and substantial compliance. Substantial compliance means conformity to regulations to be a licensee to such an extent that client safety, welfare, and quality of care is assured. ii. Development of an individual, written client care plan which indicates the care to be given, the objectives to be accomplished, and the professional discipline responsible for each element of care. Objectives shall be measurable and time limited. For further specifics on supervision, refer to Title 22. iii. Safeguards for clients' monies and valuables. For specifics, refer to Title 22. iv. Activity Programs (Title 22, California Code of Regulations, and State DHCS' Policies and Directives): Exhibit B Page 7 of 15 a. An activity program means a program that is staffed and equipped to encourage the participation of each client, meets the needs and interests of each client, and encourages self-care and resumption of normal activities. b. Clients shall be encouraged to participate in activities planned to meet their individual needs. An activity program shall have a written, planned schedule of social and other purposeful activities. c. The program shall be designed to make life more meaningful, to stimulate and support physical and mental capabilities to the fullest extent, to enable the client to maintain the highest attainable social, physical, and emotional functioning, but not necessarily to correct or remedy a disability. d. The activity program shall consist of individual, small and large group V. The provision for basic living needs includes, but is not limited to food, laundry, and care of resident's personal clothing, and security of personal items. a. The dietetic service shall provide food of the quality and quantity to meet each client's needs in accordance with the physician's orders and meets "the recommended daily dietary allowance" as specified in the most current edition adopted by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences. For specifics, refer to Title 22. b. Laundry and care of residents' personal clothing - refer to Title 22 for specific information. c. Security of personal items and safeguards for clients' monies and valuables- refer to Title 22 for specific information. vi. Resident Security - It is expected that these residents may be segregated from other residents of the facility to insure security. B. Clinical i. Pre-admission screening process. ii. Admission policy describing the extent of the facility's right of refusal. iii. Review process, if requested, for persons not accepted for admission or discharged as inappropriate for the facility. iv. Program designed to modify combative behavior, protect the client, prevent the breakage of property, and to promote personal responsibility for behavior. V. Use of restraints and postural supports. For specifics, refer to Title 22 related to these issues. vi. Consultation and/or case staffing to be held with appropriate County assigned mental health professionals, as needed, but no less frequently than on a quarterly basis. C. Administration i. Administrator will meet with the assigned DBH Mental Health Contracts Analyst, or designee, as required to monitor the contract. Exhibit B Page 8 of 15 ii. Facility will immediately report all incidents involving Fresno County clients to the contract liaison. Notification will be made to Fresno County in cases of illegality, death, self-injury, absence without leave, property destruction and violence towards others. iii. Daily census records will be maintained and sent to the County's DBH Adult Services Division Manager. iv. Prepare reports as may be required to fulfill the terms of the agreement. V. Occurrences such as epidemic outbreaks, poisoning, fires, major accidents, death from unnatural causes or other catastrophes and unusual occurrences which threaten the welfare, safety, or health of clients, personnel, or visitors shall be reported by the facility within twenty-four (24) hours, either by telephone at (559) 600-9180, and confirmed in writing, or by fax at (559) 600- 7674 to the Director, Department of Behavioral Health. An incident report shall be prepared by the Contractor on each occurrence. vi. Every incident report shall be retained on file by the facility for one (1)year. The facility shall furnish such other pertinent information related to such occurrences to the Director, Department of Behavioral Health 3133 N. Millbrook Avenue, Fresno, California 93703, upon request. vii. Every fire or explosion that occurs in or on the premises shall be reported within twenty-four (24) hours to the local fire authority or, in areas not having an organized fire service, to the State Fire Marshal. Contractor shall meet all fire safety requirements set by the local Fire Marshal and other requirements cited in the California Health and Safety Code. viii. All facilities shall have a placement contact person readily available to respond to requests for placements from the County.This is to prevent placement delays in placing a client at the appropriate level of care. ix. No notice is required to move a person to a different level of care or when there is a need to discharge the client because this is dependent on clinical prognosis. X. The daily rate for the client will be commensurate with the level of care being provided at that facility. xi. All services, other than the Basic Services, must be pre-approved prior to placement utilizing Special Services Authorization Form (Exhibit G). xii. For the purposes of this Agreement, the term "bed day" includes beds held vacant for patients who are temporarily (not more than seven (7) days) absent from a facility. Contractor will notify County in the event that a client has to be moved to an acute treatment facility and a bed hold needs to be made. County will approve any bed-hold days that may be required on a case-by-case basis. Exhibit B Page 9 of 15 2. Special Treatment Program Special Treatment Program (STP) services are those therapeutic services provided to clients with serious mental health conditions having special needs in one (1) or more of the following areas: self-help skills, behavioral adjustment, and interpersonal relationships. They also include pre- vocational preparation and pre-release planning. Contractor shall provide a copy of the Policy and Procedure Guide (PPG) on agency's Special Treatment Program/Approach to the Department of Behavioral Health within ten (10) working days from the day the Agreement becomes effective. The PPG is to be sent to the Department of Behavioral Health, Attn: Mental Health Contracted Services Division, 3133 N. Millbrook Avenue, Fresno, California 93703. 3. Enhanced Services Enhanced Services augment the services of Basic and Special Treatment Programs. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The target population is adults with serious and persistent mental health conditions whose behavior requires more intensive programming than is available from Basic Services. It is anticipated that the intensive treatment and staffing provided by Enhanced Services will prevent State Hospital admissions. The target population may include persons who are often at risk of elopement and occasionally assaultive or self-destructive. They may have complicating medical problems. Additionally, they may require specialized services to insure successful transition to community living. Clients needing these services may be male or female; have a major psychiatric diagnosis, organic brain syndrome or major mental disorder; are a LPS conservatee Fresno County; are physically impaired, perhaps non-ambulatory; and present a special or unusual behavior management issue. The major objectives for these services are: to control and modify the client's destructive behavior; provide a safe, secure, and healthful environment; provide adequate supervision; and, prevent or reduce acute psychiatric hospitalization or long-term State hospitalization. D. REPORTING/OUTCOMES Contractor shall be required to submit monthly census reports detailing the number of County clients living in the facility on a daily basis. Contractor shall provide, at County's request, any required reports to County, which may include performance outcome measurement reports as communicated by the County to Contractor. Outcome measures may include, but are not limited to: • Successful program completion and transition to lower level of care placement • Reduced or no inpatient hospitalizations • Reduced or no incidents of self-injury, injury to others or property damage • Reduced or no incidents of medical emergency or hospitalization E. OBJECTIVES/EVALUATION A strong evaluation component will be required for these services. Contractor will be required to have an evaluation program that will include observable, measurable, time-limited outcome and process objectives. The evaluation program will be submitted in writing to the assigned DBH Mental Health Contracts Analyst for review and approval by the County within sixty (60) days after the Agreement is executed. Process objectives are defined as those describing or delineating the amount, frequency, and Exhibit B Page 10 of 15 kinds of services to be provided. Outcome objectives are those indicators that describe the effect of program activities on client behavior or status. F. CORPORATIONS For incorporated businesses, the Contractor shall notify the Department of all facilities that the Department of Behavioral Health might use. G. INSURANCE Contractor will provide County with new certificates of insurance if there is any change in coverage. H. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT County and Contractor each consider and represent themselves as covered entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA) and agree to use and disclose protected health information as required by law. I. County reserves the right to revise and/or update the Scope the Work as needed, within the regulations of applicable CCR, CFR, and/or WIC codes. Exhibit B Page 11 of 15 SCOPE OF WORK (Continued) III. MENTAL HEALTH REHABILITATION CENTERS Mental Health Rehabilitation Centers (MHRCs) provide intensive support and rehabilitation to clients as an alternative to state hospital or other 24-hour care facilities. MHRCs help clients develop the skills to become self-sufficient and increase their levels of independent functioning. MHRCs operate under Title 9, California Code of Regulations, Division 1, and the California Department of Health Care Services' Policies and Directives. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Care Services Licensing and Certification Division. MHRCs are needed for clients upon discharge from an acute inpatient psychiatric facility or outpatient crisis stabilization program like the twenty-four (24) hour program providing intensive services to persons eighteen (18) years of age or older. These clients would otherwise be placed in a State hospital or another mental health facility to develop skills to become self-sufficient and increase their levels of independent functioning. The contracted MHRC(s) focus on mental health rehabilitation, rather than skilled nursing, and will include short-term, rehabilitative, individualized, goal-oriented programs. The length of stay for clients with serious mental health conditions will vary. A newly conserved client may reside in the facility for ninety (90) days, whereas, another client may reside in the facility from eight (8)to eleven (11) months.The target population may include clients who have an active temporary conservatorship; and, recently conserved Fresno County clients (no longer than three (3) years), or clients who are unsuccessful in transitioning from an IMD to a lower level of care. Specific "Basic Services" are outlined in Title 22, California Code of Regulations, which describes and defines programs that serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. It is expected that the Contractor will provide "Basic Services", which include reasonable access to required medical treatment, up-to-date psychopharmacology and transportation to needed off-site services, and bilingual/bicultural programming as appropriate A. GOALS AND OBJECTIVES 1. Offer early restorative interventions; 2. Avoid admissions of clients to acute level facilities who do not meet medical necessity criteria; 3. Decrease the average length of stay and administrative stay days in acute psychiatric facilities by providing a more appropriate treatment program; 4. Avoid extended hospital stays of clients waiting for placement at other sub-acute, long-term or out-of-County facilities; 5. Interrupt the cycle of increased dependence on the utilization of skilled nursing facilities as a placement option; 6. Decrease recidivism; and 7. Provide a safe and healthful living environment. B. LOCATION The location of the facility should be in relatively close proximity to Fresno County. This will help expedite the integration of these clients back into community living, decrease the travel expense required by court hearing and staff travel, and facilitate involvement by family and friends for client support. Exhibit B Page 12 of 15 C. TYPES OF SERVICES The Department of Behavioral Health contracts for a number of MHRC beds.The distribution, types, and total number of beds depend on the facilities available. 1. Basic Services: A. Treatment Setting i. A facility that provides reasonable security, supervision, and substantial compliance. Substantial compliance means conformity to regulations to be a licensee to such an extent that client safety, welfare, and quality of care is assured. ii. Development of an individual, written client care plan which indicates the care to be given, the objectives to be accomplished, and the professional discipline responsible for each element of care. Objectives shall be measurable and time limited. For further specifics on supervision, refer to Title 22. iii. Safeguards for clients' monies and valuables. For specifics, refer to Title 22.4. iv. Activity Programs (Title 9, Title 22, California Code of Regulations, and State DHCS' Policies and Directives): a. An activity program means a program that is staffed and equipped to encourage the participation of each client, to meet the needs and interests of each client, and encourage self-care and resumption of normal activities. b. Clients shall be encouraged to participate in activities planned to meet their individual needs. An activity program shall have a written, planned schedule of social and other purposeful activities. The program shall be designed to make life more meaningful and to stimulate and support physical and mental capabilities to the fullest extent, and enable the client to maintain the highest attainable social, physical, and emotional functioning but not necessarily to correct or remedy a disability. c. The activity program shall consist of individual, small and large group activities that are designed to meet the needs and interests of each client. V. The provision for basic living needs includes, but is not limited to food, laundry, and care of resident's personal clothing, and security of personal items. a. The dietetic service shall provide food of the quality and quantity to meet each client's needs in accordance with the physician's orders and meets "the recommended daily dietary allowance" as specified in the most current edition adopted by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences. For specifics, refer to Title 22. b. Laundry and care of residents' personal clothing. Refer to Title 22 for specific information. c. Security of personal items and safeguards for clients' monies and valuables. Refer to Title 22 for specific information. Exhibit B Page 13 of 15 vi. Resident Security - It is expected that these residents may be segregated from other residents of the facility to insure security. B. Clinical i. Pre-admission screening process. ii. Admission policy describing the extent of the facility's right of refusal. iii. Review process, if requested, for persons not accepted for admission or discharged as inappropriate for the facility. iv. Program designed to modify combative behavior; protect the client; prevent the breakage of property; and, promote personal responsibility for behavior. V. Use of restraints and postural supports. For specifics, refer to Title 22. vi. Consultation and/or case staffing to be held with appropriate County-assigned mental health professionals, as needed, on a quarterly basis. C. Administration i. Administrator will meet with the County's DBH Adult Services Division Manager, or designee, as required to monitor the contract. ii. Facility will immediately report all incidents involving Fresno County clients to the contract liaison. Notification will be made to Fresno County in cases of illegality, death, self-injury, absence without leave, property destruction and violence towards others. iii. Daily census records will be maintained and sent to the County's DBH Adult Services Division Manager. iv. Prepare reports as may be required to fulfill the terms of the agreement. V. Occurrences such as epidemic outbreaks, poisoning, fires, major accidents, death from unnatural causes or other catastrophes and unusual occurrences which threaten the welfare, safety, or health of clients, personnel, or visitors shall be reported by the facility within twenty-four (24) hours, either by telephone at (559) 600-9180, and confirmed in writing, or by fax at (559) 600- 7674 to the Director, Department of Behavioral Health. An incident report shall be prepared by the Contractor on each occurrence. vi. Every incident report shall be retained on file by the facility for one (1)year. The facility shall furnish such other pertinent information related to such occurrences to the Director, Department of Behavioral Health, 3133 N. Millbrook Avenue, Fresno, California 93703. vii. Every fire or explosion that occurs in or on the premises shall be reported within twenty-four (24) hours to the local fire authority or, in areas not having an organized fire service, to the State Fire Marshal. Contractor shall meet all fire safety requirements set by the local Fire Marshal and other requirements cited in the California Health and Safety Code. viii. All facilities shall have a placement contact person readily available to respond to requests for placements from the County.This is to prevent placement delays in placing a client at the appropriate level of care. Exhibit B Page 14 of 15 ix. No notice is required to move a person to a different level of care or when there is a need to discharge the client because this is dependent on clinical prognosis. X. The daily rate for the client will be commensurate with the level of care provided at that facility. xi. All services, other than the Basic Services, must be pre-approved prior to placement utilizing Special Services Authorization Form (Exhibit G) xii. For the purposes of this Agreement, the term "bed day" includes beds held vacant for patients who are temporarily (not more than seven (7) days) absent from a facility. Contractor will notify County in the event that a client has to be moved to an acute treatment facility and a bed hold needs to be made. County will approve any bed-hold days that may be required on a case-by-case basis. 2. Special Treatment Program: The MHRC(s) will focus on mental health rehabilitation, rather than skilled nursing, and will include short-term, rehabilitative, individualized, goal-oriented special treatment programs. The length of stay for clients with serious mental health conditions will vary. 3. Enhanced Services: Enhanced Services augment the services of Basic and Special Treatment Programs. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The target population is adults with serious and persistent mental health conditions whose behavior requires more intensive programming than is available from Basic Services. It is anticipated that the intensive treatment and staffing provided by enhanced services will prevent State Hospital admissions. The target population may include persons who are often at risk of elopement and occasionally assaultive or self-destructive. They may have complicating medical problems. Additionally, they may require specialized services to insure successful transition to community living. Clients needing these services may be male or female; have a major psychiatric diagnosis, organic brain syndrome, or major mental disorder; are a LPS conservatee of Fresno County; may be physically impaired; and present a special or unusual behavior management issue. The major objectives for these services are: to control and modify the client's destructive behavior; provide a safe, secure, and healthful environment; provide adequate supervision; and, prevent or reduce acute psychiatric hospitalization or long-term State hospitalization. D. TARGET POPULATION: 1. Clients who no longer are in need of acute hospital care. 2. Clients who have an active temporary conservatorship. 3. Recently conserved Fresno County clients (no longer than three (3)years). Exhibit B Page 15 of 15 E. REPORTING/OUTCOMES Contractor shall be required to submit monthly census reports detailing the number of County clients living in the facility on a daily basis. Contractor shall provide, at County's request, any required reports to County, which may include performance outcome measurement reports as communicated by the County to Contractor. Outcome measures may include, but are not limited to: • Successful program completion and transition to lower level of care placement • Reduced or no inpatient hospitalizations • Reduced or no incidents of self-injury, injury to others or property damage • Reduced or no incidents of medical emergency or hospitalization F. OBJECTIVES/EVALUATION A strong evaluation component will be required for these services. Contractor will be required to have an evaluation program that will include observable, measurable, time-limited outcome and process objectives. The evaluation program will be submitted in writing to the assigned DBH Mental Health Contracts Analyst for review and approval by the County within sixty (60) days after the Agreement is executed. Process objectives are defined as those describing or delineating the amount, frequency, and kinds of services to be provided. Outcome objectives are those indicators that describe the effect of program activities on client behavior or status. G. CORPORATIONS For incorporated businesses, the Contractor shall notify the Department of all facilities that the Department of Behavioral Health might use. H. INSURANCE Contractor will provide County with new certificates of insurance if there is any change in coverage. I. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT County and Contractor each consider and represent themselves as covered entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA) and agree to use and disclose protected health information as required by law. J. County reserves the right to revise and/or update the Scope the Work as needed, within the regulations of applicable CCR, CFR, and/or WIC codes. EXHIBIT C-1 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) MENTAL HEALTH MANAGEMENT I, INC., d.b.a. CANYON MANOR Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of this Agreement. The County does not guarantee any minimum number of beds. IV. RATES Program Services Rate Basic Daily Rate* $305.14 * The Basic Daily Rate shall be inclusive of all psychiatric services such as weekly visits, initial psychiatric assessment and two affidavits for LPS conservatorship renewal per year. EXHIBIT C-1 Page 2 of 3 **Any rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-1 Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By en ��- �' Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: MENTAL HEALTH MANAGEMENT 1, INC., d.b.a. CANYON MANOR By Print Name:: C-L'X�rcD,--�t Title: iE--)C e C-,)--lei V e- �" t- Chairman of the Board, or President, or any Vice President or Director of Operations Print Name: j Title: A s�. 11, r Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address. 655 Canyon Manor Road Novato, CA 94947 Phone: (415) 892-1628 Fax: (415) 892-8624 Email: REvatzCanyonM@aol.com Contact: Richard Evatz, Executive Director Fund: 0001/10000 Organization: 56302175 Account/Program: 7290 EXHIBIT C-2 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) CIF MERCED BEHAVIORAL, LLC, d.b.a. MERCED BEHAVIORAL CENTER Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES: Basic Daily Rate services consist of usual and customary SNF/IMD services to adults with mental health conditions, plus those services that are included in Special Treatment programs as contained in Title 22 of the California Code of Regulations, sections 72443-72475. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. SPECIAL TREATMENT PROGRAMS: Special Treatment Programs (STP) serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. These clients require continuous supervision and may be expected to benefit from an active rehabilitation program designed to improve their adaptive functioning or prevent any further deterioration of their adaptive functioning. Services are provided to individuals having special needs or deficits in one (1) or more of the following areas: self-help skills; behavioral adjustment; interpersonal relationships; pre-vocation preparation, alternative placement planning, and/or pre-release planning. II. ENHANCED SERVICES: Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. A charge in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor for Enhanced and STP services by using the Special Services Authorization Form (Exhibit G). The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. EXHIBIT C-2 Page 2 of 3 III. REQUIREMENTS: Contractor shall provide up to thirty-five (35) beds per day for authorized County clients during each term of the Agreement. In addition, Contractor shall provide additional beds as needed by the County, subject to availability of said beds by the Contractor. The County does not guarantee any minimum number of beds for all services provided by the Contractor and payment will be based on usage. IV. RATES: Program Services Rate Basic Daily Rate $191.69 Bed Hold Rate $184.61 Enhanced Services Rate* Negotiable with Pre-Authorization *All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time- limited and approval must be sought using the Special Services Authorization Form (Exhibit G). Rates are inclusive of psychiatric services. Rate is set at the State Medi-Cal rate and will be adjusted if the Medi-Cal rate changes. In the event a client is placed who does not have Medi-Cal and is under age 65, County will pay both the "with Medi-Cal" rate and the "without Medi-Cal" rate above to cover room and board charges. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-2 Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: CF MERCED BEHAVIORAL CENTER, LLC, d.b.a. MERCED BEHAVIORAL CENTER B) y y P trjintme: Title: Chairman of thk Board, or President, or any Vice President or Director of Operations By Print Name: Title: Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1255 "B" Street Merced, CA 95341 Phone: (209) 723-8814 Fax: (209) 384-3747 Email: Jeri.Aligood@mercedbehavioralhcc.com Contact: Jeri Allgood, Administrator Fund: 0001/10000 Organization: 56302175 Account/Program: 7290 EXHIBIT C-3 Page 1 of 9 DESCRIPTION OF SERVICES & RATES (FY 2016-17) CRESTWOOD BEHAVORIAL HEALTH, INC. Contractor has many facilities throughout the State of California providing all services listed in Exhibit B and agrees to provide County with the agreed upon services for adults with mental health conditions, pursuant to Welfare and Institutions Code, Section 5900 et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives, and other applicable statues and regulations at the following types of facilities: Skilled Nursing Facility (SNF), Institutions of Mental Disease (IMD), Geropsychiatric Nursing Care Facilities (GNCF), and Mental Health Rehabilitation Center (MHRC). For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES: Basic Daily Rate services are listed by facility listed in Exhibit C-3 pages 4 through 9. Services provided are itemized within the ""Scope of Work" (Exhibit B). SPECIAL TREATMENT PROGRAMS Special Treatment Programs (STP) serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. These clients require continuous supervision and may be expected to benefit from an active rehabilitation program designed to improve their adaptive functioning or prevent any further deterioration of their adaptive functioning. Services are provided to individuals having special needs or deficits in one (1) or more of the following areas: self-help skills; behavioral adjustment; interpersonal relationships; pre-vocation preparation, alternative placement planning, and pre-release planning. II. ENHANCED SERVICES: Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. A charge in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor for Enhanced and STP services by using the Special Services Authorization Form (Exhibit G). The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. EXHIBIT C-3 Page 2 of 9 III. REQUIREMENTS: Contractor shall provide available beds needed for authorized County clients during each term of this Agreement. The County does not guarantee any minimum number of beds for all services provided by the Contractor and payment will be based on usage. IV. RATES: Contractor's rates are identified in pages 4-9 of this Exhibit C-3. All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time- limited and approval must be sought using the Special Services Authorization Form (Exhibit G). Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-3 Page 3 of 9 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: CRESTWOOD BEHAVORIAL HEALTH, INC. By Print Name: -G'I(CVvc"o C Title: Chairman of the Board, or President, or any Vice President or Director of Operations By Print Name: Title: C-L.-',t 7-tq Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 520 Capitol Mail, Suite 800 Sacramento, CA 95814 Phone: (916) 471-2245 Fax: (916) 471-2212 Email: gzeyen@cbhi.net Contact: Gary Zeyen, Controller Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-3 GRE4TW4OD".0 RA,EHAVIOL"HEALTH, INC, Page 4 of 9 07/01/2016 TOTAL WITH ENHANCED SERVICES The following rates include room and board, nursing care,special treatment program services, activity program, OTC medications, dietary, etc. Physician services, pharmacy and other ancillary medical services are not included in the per diem rate and are separately billable in accordance with Title 22, CCR,section 51611 C. 1140RIM0 1:044:.. , ' j STOCKTON 32.00 32.00 34.00 34.00 53.00 53.00 79.00 79.00 105.00 105.00 SUB ACUTE NEGOTIABLE NON MEDI CAL **** MODESTO 37.00 37.00 53.00 53.00 79.00 79.00 105.00 105.00 SUB ACUTE NEGOTIABLE NON MEDI CAL **** FREMONT GTC NON MEDI CAL **** 124.00 NEURO-BEHAV 124.00 124.00 CONVERSION(REQUIRES PRIV ROOM) 270.20 CRESTWOOD MANOR FREMONT 0.00 29.00 29.00 0.00 53.00 53.00 84.00 84.00 124.00 124.00 **** Current Medi-cal rate EXHIBIT C-3 CRESTWOOD BEHAVIORAL HEALTH, INC. Page 5 of 9 07/01/2016 TOTAL WITH ENHANCED SERVICES The following rates include room and board, nursing care,special treatment program services, activity program, OTC medications, dietary, etc. Physician services, pharmacy and other ancillary medical services are not included in the per diem rate and are separately billable in accordance with Title 22, CCR,section 51511 C. IMD 18=64 BASIC ENHANCED TOTAL CRESTWOOD WELLNESS AND RECOVERY CTR-REDDING 198.82 21.00 219.82 198.82 42.00 240.82 198.82 53.00 251.82 198.82 105.00 303.82 EXHIBIT C-3 e6of9 Pa GRESTWOOD BEHAVIORAL HEALTH, INC. . 9 07/01/2016 The following rates include room and board, nursing care,special treatment program services, activity program,OTC medications, dietary, etc. Physician services, pharmacy and other ancillary medical services are not included in the per diem rate and are separately billable in accordance with Title 22, CCR,section 51511 C. PSYCHIAT"RIC;'HEALTH"FACILITIES SACRAMENTO 817.61 SAN DOSE 960.00 INDIGENT 1,069.00 SOLANO 845.00 KERN 937.00 AMERICAN RIVER 811.13 EXHIBIT C-3 :CRESTWO:OD BEHAVIORAL_HEALTH' INC. Page 7 of 9 07/01/2016 COMMUNITY;CARE CENTERS: BRIDGEHOUSE(EUREKA) RCFE Negotiated PATHWAY 168.00 OUR HOUSE 110.00 BRIDGE(KERN) 176.00 AMERICAN RIVER RESIDENTIAL 116.00 PLEASANT HILL BRIDGE 116.00 PLEASANT HILL PATHWAYS 171.00 FRESNO 176.00 VALLEJO RCFE 121.00 EXHIBIT C-3 CRESTWtJ.OD'BEHAV101 AL HEALTH, INC Page 8 of 9 07/01/2016 GERO,P$YCH'00, ENHANCED TOTAL STOCKTON 0 0.00 21.00 21.00 53.00 53.00 SPECIAL VALLEJO 0 0.00 21.00 21.00 53.00 53.00 SPECIAL MODESTO 0 0.00 21.00 21.00 53.00 53.00 SPECIAL REDDING GTC 0 0.00 21.00 21.00 53.00 53.00 SPECIAL CRESTWOOD MANOR-FREMONT 0.00 0.00 21.00 21.00 29.00 29.00 53.00 53.00 EXHIBIT C-3 Page9of9 CRESTWQ BEHAVIORAL HEALTH INC, 07/01/2016 The following rates include room and board, nursing care,special treatment program services, activity program, OTC medications, dietary, etc. Physician services, pharmacy and other ancillary medical services are not included in the per diem rate and are separately billable in accordance with Title 22,CCR,section 51611 C. MEN TA ,.HEALTH REHAB'CENTERS SACRAMENTO MHRC 212.00 SUB ACUTE 256.00 SAN JOSE 253.00 PREGNANT 264.00 VALLEJO LEVEL 1 313.00 LEVEL 2 266.00 LEVEL 3 236.00 LEVEL 4 221.00 ANGWIN LEVEL 1 303.00 LEVEL 2 242.00 LEVEL 3 197.00 BAKERSFIELD LEVEL 1 256.00 LEVEL 2 568.00 EUREKA 267.00 SAN DIEGO LEVEL 1 362.00 LEVEL 2 310.00 LEVEL 3 259.00 BED HOLD 254.00 CHULA VISTA LEVEL 1 362.00 LEVEL 2 310.00 LEVEL 3 259.00 BED HOLD 254.00 7/1/2016 1/1/2017 KINGSBURG LEVEL 1 400.00 362.00 .LEVEL 2 350.00 310.00 LEVEL 3 300.00 259.00 BED HOLD 250.00 254.00 EXHIBIT C-4 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) GOLDEN STATE HEALTH CENTERS, INC., d.b.a. SYLMAR HEALTH AND REHABILITATION CENTER Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary SNF/IMD services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. Other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). III. SUB-ACUTE TREATMENT SERVICES Sub-acute SNF includes services that are non-acute 24-hour voluntary or involuntary care that is required for the provision of mental health services to adults with a mental health condition who are not in need of acute mental health care, but who require general mental health evaluation, diagnostic assessment, treatment, nursing and/or related services, on a 24-hour per day basis in order to achieve stabilization and/or an optimal level of functioning. Such clients are those who, if in the community, would require the services of a licensed health facility providing 24-hour sub-acute mental health care. Such facilities include, but are not limited to, Skilled Nursing Facilities with special treatment programs. Sub-acute has the same meaning as non-acute as defined in this section. EXHIBIT C-4 Page 2 of 3 IV. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. V. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal)** $178.24 per client per day Bed Hold Rate $171.16 per client per day Enhanced Services Rate (with Medi-Cal)** $204.09 per client per day Subacute $253.79 per client per day Other Services Rate Range Physician/Psychiatric Services ^ $75.00 - $190.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). The Basic Daily Rate will either be inclusive of all physician/psychiatric services provided to clients such as weekly visits, which may consist of an initial, brief or routine psychiatric assessments/visits, and annual evaluation and declarations for LPS conservatorship renewal, or a separate rate (or rate range) shall be established for psychiatric services as stated below. ** Rate is set at State Medi-Cal rate and will be adjusted if the Medi-Cal rate changes. In the event a client is placed who does not have Medi-Cal and is under age 65, County will pay both the "with Medi-Cal" rate and the "without Medi-Cal" rate above to cover room and board charges. ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-4 Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: GOLDEN STATE HEALTH CENTERS, INC., d.b.a. SYLMAR HEALTH AND REHABILITATION CENTER By PrintName: Title: re.'l Chairman of the Board, or President, or any Vice President or Director of Operations By Print Name: Title: 5;eepekew Secretary(of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Maillina Address: 12220 Foothill Blvd. Sylmar, CA 91342 Phone: (818)834-5082 Fax: (818) 896-8097 Email: mrmweiss@gmail.com Contact: Martin Weiss, President Fund: 0001/10000 Organization: 56302175 Account/Program: 729610 EXHIBIT C-5 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) HELIOS HEALTHCARE, LLC, d.b.a IDYLWOOD CARE CENTER Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. ENHANCED SERVICES: Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services by using the Special Services Authorization Form (Exhibit G). II. REQUIREMENTS: Contractor shall provide available beds needed for authorized County clients during each term of the Agreement. The County does not guarantee any minimum number of beds for all services provided by the Contractor and payment will be based on usage. III. RATES: The following are the rates per client per day: Program Services Rate Enhanced Services Rate-Tier 1* $ 105.00 per day Enhanced Services Rate-Tier 2* $ 124.00 per day Enhanced Services Rate-Tier 3* $ 150.00 per day Conversion (requires private room)* $ 270.20 per day *All rates other than Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than Basic Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). EXHIBIT C-5 Page 2 of 3 The identified rates include room and board, nursing care, special treatment program services, activity program, over-the-counter medications, diet, etc. Physician services, pharmacy and other ancillary medical services are not included in the per diem rate and are separately billable in accordance with Title 22, CCR, section 51511 C. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-5 Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: HELIOS HEALTHCARE, LLC, d.b.a IDYLWOOD CARE CENTER By Name: Title: Chairman of the Board, or President, or any Vice President or Director of Operations By Print Name: Yl�r Title: �:' /— Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 520 Capitol Mall, Suite 800 Sacramento, CA 95814 Phone: (916) 471-2240 Email: gzeyen@cbhi.net Contact: Gary Zeyen Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-6 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) KF COMMUNITY CARE, LLC., d.b.a. COMMUNITY CARE CENTER Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary SNF/IMD services to adults with mental health conditions, plus those services that are included in Special Treatment Programs (STP) as contained in Title 22 of the California Code of Regulations, sections 72443-72475. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit H). III. SUB-ACUTE TREATMENT SERVICES Sub-acute SNF includes services that are non-acute 24-hour voluntary or involuntary care that is required for the provision of mental health services to adults with mental health conditions who are not in need of acute mental health care, but who require general mental health evaluation, diagnostic assessment, treatment, nursing and/or related services, on a 24-hour per day basis in order to achieve stabilization and/or an optimal level of functioning. Such clients are those who, if in the community, would require the services of a licensed health facility providing 24-hour sub-acute mental health care. Such facilities include, but are not limited to, Skilled Nursing Facilities with special treatment programs. Sub-acute has the same meaning as non-acute as defined in this section. EXHIBIT C-6 Page 2 of 3 IV. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. V. RATES* Program Services Rate Basic Daily Rate (Bungalow) $317.32 per client per day 1:1 Supervision (Bungalow) $12.50 per hour per client Basic Daily Rate (IMD) $216.30 per client per day Enhanced Services (IMD) $325.00 per client per day Other Services Rate (Range) / Unit Physician/Psychiatric Services ** $60.00-$155.00 per visit *All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time- limited and approval must be sought using the Special Services Authorization Form (Exhibit G). **Physician/Psychiatric services (provided to clients placed by County at Contractor's facilities who are not covered by Medi-Cal, private insurance or personal/other funds) shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-6 Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By OavvonUteoht. C)inector Department of Behavioral Health CONTRACTOR KF COMMUNITY CARE, LLC', d.b.a. COMMUNITY CARE CENTER By Print Name: Title: [ Chairman of the Board, or President, or any Vice President nr Director ofOperations By - cr�etary (of Corporation), or any Assistant Secretary, or Chief Financial Offioer, or any Assistant Treasurer/Facility ' Administrator Address:Mailing 2335 S. Mountain Avenue Duarte, CA81O1O Phone: /020\ 357'3207. Ext. 225 Fax: (028) 303-1118 Email: bouonnor@ohnna.uo Contact: Barbara {}'Connor. Administrator Fund: 0001/10000 Organization: 56302175 Account/Program: 7295./0 EXHIBIT C-7a Page 1 of 4 DESCRIPTION OF SERVICES & RATES (FY 2016-17) MORTON BAKAR CENTER, A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES: Basic Daily Rate services consist of usual and customary SNF/IMD services to adults with mental health conditions, plus those services that are included in Special Treatment Programs as contained in Title 22 of the California Code of Regulations, sections 72443-72475. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services. II. ENHANCED SERVICES Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. A charge in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor for Enhanced and STP services by using the Special Services Authorization Form (Exhibit G). The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. III. REQUIREMENTS Contractor shall provide available beds for authorized County clients during each term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7a Page 2 of 4 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) ** $222.39 per client Basic Daily Rate (IMD/STP without Medi-Cal) $222.39 per client Enhanced Services (with Medi-Cal) ** $127.18 per client Enhanced Services (without Medi-Cal) $127.18 per client Bed Hold Rate $349.57 per client 1:1 Supervision $26.72 per hour Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ** Rate is set at State Medi-Cal rate and will be adjusted if the Medi-Cal rate changes. In the event a client is placed that does not have Medi-Cal and is under age 65, County will pay both the "with Medi-Cal" rate and the "without Medi-Cal" rate above to cover room and board charges. ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or EXHIBIT C-7a Page 3 of 4 resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7a Page 4 of 4 REVIEWED AND RECOMMENDED FOR APPROVAL: By Akw� -2&� Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: MORTON BAKAR CENTER, A DIVISION OF TELECARE CORPORATION By Print Name: J--N IT 0 kZ I-- C,14 r: G' Title: ^r 01�' C Chairman of the Board, or President, or any Vice President or Director of Operations By Z C Print Name: L Title: VP c4- cx-tA Cl--& Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: deonnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-7b Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) CORDILLERAS MENTAL HEALTH CENTER (MHRC), A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7b Page 2 of 3 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) $263.10 per client Bed Hold Rate $263.10 per client 1:1 Supervision $27.34 per hour Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7b Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By 7tA--� Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: CORDILLERAS MENTAL HEALTH CENTER (MHRC), A DIVISION OF TELECARE CORPORATION By -2, 0 L Print Name: 1-4 0,T-C. j4t &, Title: �^. VP 0� e-';e (ot?V,c-, Chairman of the Board, or President, or any Vice President or Director of Operations By IV k, VL Print Name: A \Q,- L L N 0 C4--7 e L V-") Title: 'kip ",A. C-1- Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: dconnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-7c Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) GLADMAN MENTAL HEALTH REHABILITATION CENTER, A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7c Page 2 of 3 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) $419.82 per client Bed Hold Rate $419.82 per client 1:1 Supervision $23.50 per hour Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7c Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Adll� -2t � Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: GLADMAN MENTAL HEALTH REHABILITATION CENTER, A DIVISION OF TELECARE CORPORATION By / 0 / , S/. 2'ot Print Name: Lz Title: o-( C) ev e to Chairman of the Board, or President, or any Vice President or Director of Operations By A&MV (-4/ '3 C*/ C'i L, Print Name: 1-tNP-Sk4AL4 L-NQG�--GLIQ) Title: C-V— V P c)(- Pinctv-%ce of,A Ci--O Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: dconnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-7d Page 1 of 4 DESCRIPTION OF SERVICES & RATES (FY 2016-17) LA PAZ GEROPSYCHIATRIC CENTER, A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Geropsychiatric Nursing Care Facility (GNCF) services for adults age 65 years and older with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 of seq., Title 22 of the California Code of Regulations, sections 51335, 71443-72475, and the California Department of Health Care Services' Policies and Directives, and other applicable statutes and regulations. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary SNF/IMD services to adults, ages 65 and older, with mental health conditions, plus those services that are included in Special Treatment Programs as contained in Title 22 of the California Code of Regulations, sections 72443-72475. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. A charge in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor for Enhanced and STP services by using the Special Services Authorization Form (Exhibit G). The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7d Page 2 of 4 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) ** $172.41 per client Basic Daily Rate (IMD/STP without Medi-Cal) $172.41 per client Enhanced Services (with Medi-Cal) ** $135.20 per client Enhanced Services (without Medi-Cal) $135.20 per client 1:1 Supervision $20.51 per hour Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ** Rate is set at State Medi-Cal rate and will be adjusted if the Medi-Cal rate changes. In the event a client is placed that does not have Medi-Cal and is under age 65, County will pay both the "with Medi-Cal" rate and the "without Medi-Cal" rate above to cover room and board charges. ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all EXHIBIT C-7d Page 3 of 4 costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7d Page 4 of 4 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: LA PAZ GEROPSYCHIATRIC CENTER, A DIVISION OF TELECARE CORPORATION By 1, i" �/10 / z Print Name: Title: VP Chairman of the Board, or President, or any Vice President or Director of Operations By IzV11111 ( > // V 'V , VVVL Print Name: MMl , 'Sl4 N L Title: S r, 'UP 0(- C. PC) Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: dconnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-7e Page 1 of 4 DESCRIPTION OF SERVICES & RATES (FY 2016-17) GARFIELD NEUROBEHAVIORAL CENTER, A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults between the ages of 18 to 64 years with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives; and other applicable statutes and regulations that apply to the SNF/IMD facilities and programs. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES: Basic Daily Rate services consist of usual and customary SNF/IMD services to adults with mental health conditions, plus those services that are included in Special Treatment Programs as contained in Title 22 of the California Code of Regulations, sections 72443-72475. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. A charge in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor for Enhanced and STP services by using the Special Services Authorization Form (Exhibit G). The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. III. REQUIREMENTS Contractor shall provide available beds for authorized County clients during each term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7e Page 2 of 4 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) ** $283.52 per client Basic Daily Rate (IMD/STP without Medi-Cal) $283.52 per client Enhanced Services (with Medi-Cal) ** $241.11 per client Enhanced Services (without Medi-Cal) $241.11 per client Bed Hold Rate $524.63 per client 1:1 Supervision $26.32 per hour Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ** Rate is set at State Medi-Cal rate and will be adjusted if the Medi-Cal rate changes. In the event a client is placed that does not have Medi-Cal and is under age 65, County will pay both the "with Medi-Cal" rate and the "without Medi-Cal" rate above to cover room and board charges. ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by EXHIBIT C-7e Page 3 of 4 CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7e Page 4 of 4 REVIEWED AND RECOMMENDED FOR APPROVAL: By Al"4vLt� -764��� Dawan Utecht, Director Department of Behavioral Health CONTRACTOR GARFIELD NEUROBEHAVIORAL CENTER, A DIVISION OF TELECARE CORPORATION By Print Name: Title: VP e Chairman of the Board, or President, or any Vice President or Director of Operations By d 1/11 V Print Name: L'�Qo--C- L'o t Title: ! r. VP 04-, Piv-%Ck�ce aVIA C P 0 Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: dconnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-7f Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) VILLA FAIRMONT MENTAL HEALTH REHABILITATION CENTER, A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Care Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, bilingual/bicultural programming, and will assist in arranging transportation to needed off-site services. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7f Page 2 of 3 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) $375.00 per client Enhanced Services (with Medi-Cal) $375.00 per client Bed Hold Rate $375.00 per client Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7f Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Acw� Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: VILLA FAIRMONT MENTAL HEALTH REHABILITATION CENTER, A DIVISION OF TELECARE CORPORATION By Print Name: I-G Title: S%�I '�P of- Chairman of the Board, or President, or any Vice President or Director of Operations By 111111&111r7� 2,01 Print Name: IANR��h6L i 7-A Q 6, i-- I Title: VP 4, r- 1 qA ce C'P 0 Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: dconnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-7g Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) VILLA FAIRMONT MHRC — FLEX UNIT, A DIVISION OF TELECARE CORPORATION Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the State Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Care Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, bilingual/bicultural programming, and will assist in arranging transportation to needed off-site services. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-7g Page 2 of 3 IV. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) $440.00 per client Enhanced Services (with Medi-Cal) $440.00 per client Bed Hold Rate $440.00 per client Other Services Rate / Rate Range Physician/Psychiatric Services ^ $175.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^ Physician/psychiatric services (provided to clients placed by County at Contractor's facilities) not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. V. HOLD HARMLESS Contractor will adhere to the following Hold Harmless clause, in place of the contract language stated on Page 11, Paragraph 10, Lines 20 through 27 of this Agreement: CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in connection with the performance, or failure to perform, by CONTRACTOR, its officers, agents or employees under this Agreement, and from any and all costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses occurring to or resulting from any person, firm or corporation who may be injured or damaged by the performance, or failure to perform, of CONTRACTOR, its officers, agents or employees under this Agreement, excluding, however, such liability, claims, losses, damages, or expenses arising from COUNTY's sole negligence or willful acts. EXHIBIT C-7g Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By A-cul-Zt4,1--�� Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: VILLA FAIRMONT (MHRC) - FLEX UNIT, A DIVISION OF TELECARE CORPORATION By Print Name: fi (-t P---t:C'14 T— Title: Si-, V P 0-F �C.0 C + Chairman of the Board, or President, or any Vice President or Director of Operations By Print Name: Title: Sc-, VP C4-' t=M ��ce a L Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 1080 Marina Village Parkway, Suite 100 Alameda, CA 94501-1043 Phone: (510) 337-7950 Ext. 1183 Fax: (510) 337-7969 Email: deonnolly@telecarecorp.com Contact: Dwain Connolly, Contracts Analyst Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-8a Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) VISTA PACIFICA ENTERPRISES, INC., d.b.a. VISTA PACIFICA CENTER Contractor agrees to provide County with Skilled Nursing Facility (SNF)/Institutions for Mental Disease (IMD) services for mentally disabled adult persons ages 18 or older, pursuant to California's Welfare and Institutions Code, Division 5, commencing with section 5000, Title 22 of the California Code of Regulations, sections 72001, et seq.; the California Department of Health Care Services' Policies and Directives, and other applicable statutes and regulations. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily [not more than seven (7) days] absent from a facility. An emergency IMD bed-hold for psychiatric reasons beyond one (1) day must be approved by the County's Department of Behavioral Health (DBH) Director, or designee. The County will pay for the first bed-hold day and approval may be provided by the County for an additional two (2) bed-hold days after consulting with the Contractor. The County will have the final say on a case—by-case basis if an extended bed-hold of beyond three (3) days is necessary. The Contractor will notify the County immediately if client has a relapse and Contractor has knowledge that the client will require long-term treatment at an acute facility lasting seven (7) days or more. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non- psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary SNF/IMD services to adults with mental health conditions, plus those services that are included in Special Treatment Programs as contained in Title 22 of the California Code of Regulations, sections 72443-72475. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. SPECIAL TREATMENT PROGRAMS Special Treatment Programs (STP) serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. These clients require continuous supervision and may be expected to benefit from an active rehabilitation program designed to improve their adaptive functioning or prevent any further deterioration of their adaptive functioning. Services are provided to individuals having special needs or deficits in one (1) or more of the following areas: self-help skills; behavioral adjustment; interpersonal relationships; pre-vocation preparation, alternative placement planning, and/or pre-release planning. II. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. EXHIBIT C-8a Page 2 of 3 A charge in addition to the Enhanced Services bed rate may be negotiated on an individual client need basis between County's DBH Director, or designee, and Contractor for Enhanced and STP services by using the Special Services Authorization Form (Exhibit G). The County's DBH Director, or designee, must approve these rates before the client is placed or initiation of any enhanced services takes place. III. REQUIREMENTS Contractor shall provide up to thirty-five (35) beds per day for authorized County clients during each term of the Agreement. In addition, Contractor shall provide additional beds as needed by the County, subject to availability of said beds by the Contractor. The County does not guarantee any minimum number of beds for all services provided by the Contractor and payment will be based on usage. IV. RATES* Program Services Rate Basic Daily Bed + STP $198.20 per client per day Bed Hold Rate $191.07 per client per day Enhanced Services (Negotiable & with Pre-Authorization) Rate Patch Level A (augmented behavioral problems)+ daily rate $60.00 per client per day Patch Level B (augmented behavioral problems)+ daily rate $130.00 per client per day Patch Level C (augmented behavioral problems)+ daily rate $170.00 per client per day Patch Level D (Competency to Stand Trial)+ daily rate $250.00 per client per day Other Services Rate Range Physician Services^ $60.00-$100.00 per visit *All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time- limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^Psychiatric services (provided to clients placed by County at Contractor's facilities who are not covered by Medi-Cal, private insurance or personal/other funds) shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but are not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-8a Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: VISTA PACIFICA ENTERPRISES, INC., d.b.a. VISTA PACT CENTER By Z4 ee' -- A Print Name. ,,/, T" ' Title: Chairman of the Board, or President, or any Vice President or Director of Operations By Print Name: 1Jf---kv272:7Z7V'J Title: 6:ew'.." Secretary(of Corporati&), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 3674 Pacifica Avenue Jurupa Valley, CA 92509 Phone: (951)682-4833, Ext. 106 Fax: (951)682-1503 Email: cjumonville@vistapacificaent.com Contact: Cheryl Jumonville, President Fund: 0001/10000 Organization: 56302175 Account/Program: 7296JO EXHIBIT C-8b Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) VISTA PACIFICA ENTERPRISES, INC., d.b.a. VISTA PACIFICA CONVALESCENT Contractor agrees to provide County with Skilled Nursing Facility (SNF) pursuant to California's Welfare and Institutions Code, Division 5, commencing with section 5000, Title 22 of the California Code of Regulations, sections 72001, et seq.; the California Department of Health Care Services' Policies and Directives, and other applicable statutes and regulations. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily [not more than seven (7) days] absent from a facility. An emergency bed-hold for psychiatric reasons beyond one (1) day must be approved by the County's Department of Behavioral Health (DBH) Director, or designee. The County will pay for the first bed-hold day and approval may be provided by the County for an additional two (2) bed-hold days after consulting with the Contractor. The County will have the final say on a case—by-case basis if an extended bed-hold of beyond three (3) days is necessary. The Contractor will notify the County immediately if client has a relapse and Contractor has knowledge that the client will require long-term treatment at an acute facility lasting seven (7) days or more. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non- psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES: Basic Daily Rate services consist of usual and customary SNF services to adults with medical and mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. II. ENHANCED SERVICES: Enhanced Services consist of specialized program services, which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. A charge in addition to the Enhanced Services bed rate may be negotiated on an individual client need basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor for Enhanced and Behavioral Services by using the Special Services Authorization Form (Exhibit G). III. REQUIREMENTS: Contractor may provide up to forty-nine (49) beds per day for authorized County clients during each term of the Agreement, as needed by the County, subject to availability of said beds by the Contractor. The County does not guarantee any minimum number of beds for all services provided by the Contractor and payment will be based on usage. EXHIBIT C-8b Page 2 of 3 IV. RATES* Program Services Rate Basic Daily Bed $182.14 per client per day Enhanced Services (Negotiable & with Pre-Authorization) Rate Patch Level A (augmented behavioral problems) + daily rate $60.00 per client per day Patch Level B (augmented behavioral problems) + daily rate $130.00 per client per day Patch Level C (augmented behavioral problems) + daily rate $170.00 per client per day Bed Hold Rate $175.06 per client per day Other Services Rate Range Physician/Psychiatric Services^ $60.00 - $100.00 per visit *All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time- limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^Psychiatric services (provided to clients placed by County at Contractor's facilities who are not covered by Medi-Cal, private insurance or personal/other funds) shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but are not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-8b Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: VISTA PACIFICA ENT., INC., d.b.a. VISTA PACIFICAeONVALESCENT -00 By Print Name: Title: Chairman of the Board, or President, or any Vice President or Director Operatio By Print Na mg Title: Secretary(of Corporation any Assistant Secretary, r Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 3662 Pacifica Avenue Jurupa Valley, CA 92509 Phone: (951)682-4833, Ext. 106 Fax: (951)682-1503 Email: cjumonviile@vistapacificaent.com Contact: Cheryl Jumonville, President Fund: 0001/10000 Organization: 56302175 Account/Program: 7296/0 EXHIBIT C-9 Page 1 of 4 DESCRIPTION OF SERVICES & RATES (FY 2016-17) MEDICAL HILL REHAB CENTER, LLC., d.b.a. KINDRED NURSING AND REHABILITATION - MEDICAL HILL Contractor agrees to provide County with Skilled Nursing Facility/Institutions for Mental Disease (SNF/IMD) services to adults ages 18 to 64 years with mental health conditions, pursuant to Welfare and Institutions Code, section 5900, et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives, and other applicable statutes and regulations. In addition, Contractor agrees to provide County with Geropsychiatric Nursing Care Facility (GNCF) services for adults age 65 years and older with mental health conditions, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, sections 51335, 71443-72475, and the California Department of Health Care Services' Policies and Directives, and other applicable statutes and regulations. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily [not more than seven (7) days] absent from a facility. An emergency IMD bed-hold for psychiatric reasons beyond one (1) day must be approved by the County's Department of Behavioral Health (DBH) Director, or designee. The County will pay for the first bed-hold day and approval may be provided by the County for an additional two (2) bed-hold days after consulting with the Contractor. The County will have the final say on a case—by-case basis if an extended bed-hold of beyond three (3) days is necessary. The Contractor will notify the County immediately if client has a relapse and Contractor has knowledge that the client will require long-term treatment at an acute facility lasting seven (7) days or more. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non- psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary GNCF services to adults ages 65 and older with mental health conditions as an alternative to State hospitalization or other higher levels of care. In addition, contractor will provide SNF/IMD services to adults ages 18 to 64 years of age with mental health conditions. Services shall be provided in a secure, skilled nursing facility located at 475 Twenty-Ninth Street, Oakland, CA 94609, which offers twenty-four (24) hour care and staffing. Contractor shall, in conjunction with County, develop and implement a treatment plan, using resources available to both Contractor and County. Contractor shall provide appropriate activities for County clients and ongoing consultation with the County DBH's Older Adult Team. Contractor shall use its best efforts to facilitate each patient's transfer to a lower level of care, through collaboration with County. Contractor shall ensure that the County Public Guardian receives two (2) physician's declarations required to renew LPS Conservatorships at least forty-five (45) days prior to the expiration of the conservatorship term. EXHIBIT C-9 Page 2 of 4 Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services, and bilingual/bicultural programming as appropriate. II. SPECIAL TREATMENT PROGRAMS Special Treatment Programs (STP) serve clients who have a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. These clients require continuous supervision and may be expected to benefit from an active rehabilitation program designed to improve their adaptive functioning or prevent any further deterioration of their adaptive functioning. Services are provided to individuals having special needs or deficits in one (1) or more of the following areas: self-help skills; behavioral adjustment; interpersonal relationships; pre-vocation preparation, alternative placement planning, and pre-release planning. III. ENHANCED SERVICES Enhanced Services augment the services of Basic and Special Treatment Programs. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The target population includes adults with serious and persistent mental health conditions whose behavior requires more intensive programming than is available from Basic Services. It is anticipated that the intensive treatment and staffing provided by enhanced services will prevent State Hospital admissions. The target population may include persons who are often at risk of elopement and occasionally assaultive or self-destructive. They may have complicating medical problems. Additionally, they may require specialized services to insure successful transition to community living. The major objectives for these services are: to control and modify the client's destructive behavior; and, to prevent or reduce acute psychiatric hospitalization or long-term State hospitalization. IV. REQUIREMENTS All patients designated to receive enhanced services shall be approved in writing by the County's Department of Behavioral Health (DBH) Director, or designee, prior to the implementation of said enhanced services at the time of placement. If the services of a client housed in the facility has a need to increase the level of care from Basic to Enhanced services then a prior approval must be obtained from the County's DBH Director, or designee, utilizing the Special Services Authorization Form (Exhibit G). Any emergency provision of enhanced services will need a written authorization within five (5) working days of any oral authorization. The above bed requirements are based on average use and County does not guarantee any minimum bed days. Payment will only be made for beds utilized. Upon mutual oral consent of the Contractor and County's DBH Director, or designee, Contractor shall accept and place into Contractor's facility all clients referred by County. County shall coordinate the placement of consumers with Contractor's admission staff. EXHIBIT C-9 Page 3 of 4 V. RATES* Program Services Rate Basic Daily Rate (IMD/STP with Medi-Cal) $400.55 per client per day SNF Geropsychiatric Bed Basic Daily Rate (IMD/STP without Medi-Cal) $160.00 per client per day SNF Geropsychiatric Bed Enhanced Services (with Medi-Cal) Negotiated by DBH Director on a case-by-case basis SNF Geropsychiatric Bed (STP) Enhanced Services (without Medi-Cal) Negotiated by DBH Director on a case-by-case basis SNF Geropsychiatric Bed (Enhanced) Bed Hold Rate Negotiated by DBH Director on a case-by-case basis Other Services Rate (Range) Physician Services** $165.00 per visit *All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time- limited and approval must be sought using the Special Services Authorization Form (Exhibit G). **Physician/Psychiatric services (provided to clients placed by County at Contractor's facilities who are not covered by Medi-Cal, private insurance or personal/other funds) shall be billed through the Contractor via the monthly service invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but is not limited to, date and location of service, service provided, service duration, name of provider. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi- Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-9 Page 4 of 4 REVIEWED AND RECOMMENDED FOR APPROVAL: By Dawan Utecht, Director Department of Behavioral Heafth CONTRACTOR: MEDICAL HILL REHAB CENTER, LLC. d.b.a. KINDRED NURSING AND REHABILITATION—MEDICAL HILL Print Name: Title: Chairman of the Board, or President, or any Vice President or Director of Operations By X Print Name: A k" 4' Title: ::4- Secretary (of Corp4ration), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 475 29u' Street Oakland, CA 94609 Phone: (510) 832-3222 Fax: (510)832-5617 Email: anna.cervantes@kindred,com Contact: Anna Cervantes, Business Office Manager Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 EXHIBIT C-10 Page 1 of 3 DESCRIPTION OF SERVICES & RATES (FY 2016-17) 71" AVENUE CENTER, LLC Contractor agrees to provide County with Mental Health Rehabilitation Center (MHRC) services for adults with mental health conditions 18 to 64, pursuant to California's Welfare and Institutions Code, section 5900 et seq., Title 22 of the California Code of Regulations, the California Department of Health Care Services' Policies and Directives, Title 9, California Code of Regulations, Division 1, Sub-Chapter 3.5, and other applicable statutes and regulations. Participation in MHRCs is limited to facilities that meet the licensing and certification requirements of the California Department of Health Services Licensing and Certification Division. For the purposes of this Agreement, the term "bed day" includes beds held vacant for clients who are temporarily (not more than seven (7) days) absent from a facility. A bed-hold day cannot be in place when the client is in a psychiatric health facility (PHF) or any acute hospital for psychiatric reasons. A bed hold can only be placed for non-psychiatric reasons, e.g., medical hospitalization. In addition to the services listed in "Scope of Work" (Exhibit B), Contractor shall provide the following: I. BASIC DAILY RATE SERVICES Basic Daily Rate services consist of usual and customary MHRC services to adults with mental health conditions. Basic Daily Rate services include reasonable access to required medical treatment, up-to-date psychopharmacology, transportation to needed off-site services and bilingual/bicultural programming. ll. ENHANCED SERVICES Enhanced Services consist of specialized program services which augment basic services. Enhanced Services are designed to serve clients who have sub-acute psychiatric impairment and/or whose adaptive functioning is severely impaired. The Enhanced Services bed rate or any other charges in addition to the Enhanced Services bed rate may be negotiated for an individual client on an as-needed basis between the County's Department of Behavioral Health (DBH) Director, or designee, and Contractor. The County's DBH Director, or designee, must approve these rates before the client is provided any services more intensive than the Basic Services. Approval for such services may be sought using the Special Services Authorization Form (Exhibit G). The need for continuing Enhanced Services will be re-assessed on a weekly to monthly basis throughout the individual's stay. III. REQUIREMENTS Contractor shall provide available beds needed for authorized County clients during the term of the Agreement. The County does not guarantee any minimum number of beds. EXHIBIT C-10 Page 2 of 3 IV. RATES* Program Services Rate Basic Daily Rate $220.58 per client per day Bed Hold Rate $213.73 per bed per day Enhanced Services Rate $35.00 to $250.00 per bed per day 1:1 Supervision $200.00 per day Other Services Rate Physician/Psychiatric Services^ $100.00 per visit * All rates other than the Basic Daily Rate services must be pre-approved by the County's DBH Director, or designee, prior to placement or initiation of such services. For any rate higher than the Basic Rate Services, both the rationale and the extra services must be specified and time-limited and approval must be sought using the Special Services Authorization Form (Exhibit G). ^ Psychiatric services (provided to clients placed by County at Contractor's facilities who are not covered by Medi-Cal, private insurance or personal/other funds shall be billed through the Contractor via the monthly services invoice. Psychiatric services billed by the service provider on Health Insurance Claim Forms (HICF 1500) or other forms directly to County will be rerouted to Contractor for inclusion in the monthly invoice. Contractor shall attach supporting documentation verifying services provided on all psychiatric invoices submitted. Supporting documentation should include, but are not limited to, date and location of service, service provided, service duration, name of provider. Should a client require 1:1 Supervision longer than 24 hours while awaiting return to his/her home county, there will be an additional charge of $200.00 per day for a period not to exceed five (5) days. Ancillary outpatient services (laboratory, x-rays, or other medical services performed offsite to a client residing in an IMD/SNF/MHRC) must be billed directly to Medi-Cal, pursuant to Title 22 of the CCR. County shall be informed and/or approve of any such service(s) to Medi-Cal ineligible clients in advance of services being provided, where possible. Ancillary charges for non-Medi-Cal clients or non-Medi-Cal billable services may be billed separately from the monthly service invoice and submitted with supporting documentation to County. EXHIBIT C-10 Page 3 of 3 REVIEWED AND RECOMMENDED FOR APPROVAL: By Aujjyl-�- Dawan Utecht, Director Department of Behavioral Health CONTRACTOR: 7 th AVENUE CENTER, LLC By Print Name: AV\\/\. IA. FD Title: P ft5-Nae L&� Chairman of the Board, or President, or any Vice President or Director of Operations By Print Name: 5x kcl- Title: Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: 2115 7 th Avenue Santa Cruz, CA 95062 Phone: (831) 420-0120, Ext. 109 Email: NDattile@frontst.com Contact: Natalie D'Attile, Accounting Manager Fund: 0001/10000 Organization: 56302175 Account/Program: 7295/0 Exhibit D Page 1 of 2 DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT I. Identifying Information Name of entity D/B/A Address(number,street) City State ZIP code CLIA number Taxpayer ID number(EIN) /Telephone number l ) II. Answer the following questions by checking "Yes" or "No." If any of the questions are answered "Yes," list names and addresses of individuals or corporations under"Remarks"on page 2. Identify each item number to be continued. YES NO A. Are there any individuals or organizations having a direct or indirect ownership or control interest of five percent or more in the institution, organizations, or agency that have been convicted of a criminal offense related to the involvement of such persons or organizations in any of the programs established by Titles XVIII, XIX, or XX?......................................................................................................................... o 0 B. Are there any directors, officers, agents, or managing employees of the institution, agency, or organization who have ever been convicted of a criminal offense related to their involvement in such programs established by Titles XVIII, XIX, or XX?...................................................................................... o 0 C. Are there any individuals currently employed by the institution, agency, or organization in a managerial, accounting, auditing, or similar capacity who were employed by the institution's, organization's, or agency's fiscal intermediary or carrier within the previous 12 months? (Title XVII I providers only)........... o 0 III. A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names and addresses under "Remarks" on page 2. If more than one individual is reported and any of these persons are related to each other, this must be reported under"Remarks." NAME ADDRESS EIN B. Type of entity: o Sole proprietorship o Partnership o Corporation o Unincorporated Associations o Other(specify) C. If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations under"Remarks." D. Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities? (Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses of individuals, and provider numbers........................................................................................................... o 0 NAME ADDRESS PROVIDER NUMBER Exhibit D Page 2 of 2 YES NO IV. A. Has there been a change in ownership or control within the last year? ....................................................... o 0 If yes, give date. B. Do you anticipate any change of ownership or control within the year?....................................................... o 0 If yes, when? C. Do you anticipate filing for bankruptcy within the year?................................................................................ o 0 If yes, when? V. Is the facility operated by a management company or leased in whole or part by another organization?.......... o 0 If yes, give date of change in operations. VI. Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... o 0 VII. A. Is this facility chain affiliated? ...................................................................................................................... o 0 (If yes, list name, address of corporation, and EIN.) Name EIN Address(number,name) City State ZIP code B. If the answer to question VII.A. is NO, was the facility ever affiliated with a chain? (If yes, list name, address of corporation, and EIN.) Name EIN Address(number,name) City State ZIP code Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the information requested may result in denial of a request to participate or where the entity already participates, a termination of its agreement or contract with the agency, as appropriate. Name of authorized representative(typed) Title Signature Date Remarks Exhibit E 1 of 2 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS--PRIMARY COVERED TRANSACTIONS INSTRUCTIONS FOR CERTIFICATION 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Exhibit E 2 of 2 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) (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Signature: Date: (Printed Name & Title) (Name of Agency or Company) Exhibit F 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 F Page 2 of 2 (1)Company Board Member Information: Name: Date: Job Title: (2)Company/Agency Name and Address: (3) Disclosure(Please describe the nature of the self-dealing transaction you are a party to) (4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a) (5)Authorized Signature Signature: Date: CO U� F► Department of Behavioral Health Dawan Utecht, Mental Health Director/Public Guardian Providing Quality Mental Health and Substance Abuse Services for the People of Fresno County SPECIAL SERVICES AUTHORIZATION FORM (Exhibit G) Date: Whereas the Fresno County Client: Name: Has exhibited the following behaviors: Fresno County hereby authorizes: Facility: Address: City: Zip Code: Phone: Fax: To provide the following special services on behalf of this client: Service: Daily Duration: For the period of time (please fill by month): Beginning Date: Ending Date: The treatment strategy upon completion of these services will be: In consideration of these services, Fresno County agrees to pay this Facility the additional amount of: $ Per: This agreement is authorized by: Division Manager(Print Name): Signature Date Supervisor(Print Name): Signature Date This Facility agrees to provide these special services and to abide by the terms of this agreement. Authorized Person (Print Name): Signature Date 4441 E. Kings Canyon Road/Fresno, California 93702-3604 (559)600-9180 ♦FAX(559)600-7674 Equal Employment Opportunity ♦ Affirmative Action♦ Disabled Employer www.co.fresno.ca.us www.fresno.networkofcare.or�4