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HomeMy WebLinkAboutAgreement A-23-240 Amendment III to Agreement with YLI.pdf Agreement No. 23-240 1 AMENDMENT III TO AGREEMENT 2 THIS AMENDMENT, hereinafter referred to as "Amendment III", is made and entered into this 3 6th day of June 2023, by and between the COUNTY OF FRESNO, a Political 4 Subdivision of the State of California, hereinafter referred to as "COUNTY", and YOUTH 5 LEADERSHIP INSTITUTE, a California non-profit corporation, whose address is 209 91" Street, Suite 6 200, San Francisco, CA 94103-6800, hereinafter referred to as "CONTRACTOR" (collectively the 7 "parties"). 8 WHEREAS, COUNTY and CONTRACTOR entered into that certain Agreement, identified as 9 COUNTY Agreement No. 21-270, effective July 13, 2021, COUNTY Amendment No. 22-165, 10 effective April 19, 2022, and COUNTY Amendment No. 22-268, effective June 21, 2022, herein 11 collectively referred to as the Agreement, whereby, CONTRACTOR agreed to provide substance use 12 disorder primary prevention services for Fresno County youth and young adults ages 10-20; and 13 WHEREAS, the California Department of Health Care Services (DHCS) has issued new 14 requirements; and 15 WHEREAS, the parties desire to amend the Agreement regarding changes as stated below 16 and restate the Agreement in its entirety. 17 NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which 18 is hereby acknowledged, COUNTY and CONTRACTOR agree as follows: 19 1. That in the existing COUNTY Agreement, beginning on Page One (1), Line Twenty-Five 20 (25) beginning with "B." and ending on Page One (1) Line Twenty-Eight (28) with "Agreement" be 21 deleted in its entirety and replaced with the following: 22 "B. CONTRACTOR shall align program, services, and practices with the vision and 23 mission within Exhibit B, DBH Guiding Principles of Care Delivery, attached hereto and by this 24 reference incorporated herein. Contractor may be required to utilize and integrate clinical tools such 25 as Reaching Recovery at DBH's discretion. Employees involved in a crisis incident should be offered 26 appropriate Employee Assistance Program (EAP) or similar related wellness and recovery 27 assistance. In conjunction with the County DBH's Guiding Principles of Care Delivery and wellness of 28 the workforce, Contractors shall align their practices around this vision and ensure needed debriefing - 1 - 1 services are offered to all employees involved in a crisis incident. Employees shall be afforded all 2 services to strengthen their recovery and wellness related to the crisis incident. Appropriate follow-up 3 with the employee shall be carried out and a plan for workforce wellness shall be submitted to the 4 County's DBH." 5 2. That Section Ten (10), of the Agreement beginning on Page Eight (8), Line Twenty-One 6 (21) through Page Nine (9) Line Three (3), is deleted in its entirety and replaced with the following: 7 "10. HOLD HARMLESS 8 The Contractor shall indemnify and hold harmless and defend the County (including its 9 officers, agents, employees, and volunteers) against all claims, demands, injuries, damages, costs, 10 expenses (including attorney fees and costs), fines, penalties, and liabilities of any kind to the County, 11 the Contractor, or any third party that arise from or relate to the performance or failure to perform by 12 the Contractor (or any of its officers, agents, subcontractors, or employees) under this Agreement. 13 The County may conduct or participate in its own defense without affecting the Contractor's obligation 14 to indemnify and hold harmless or defend the County. This clause survives the termination of this 15 Agreement." 16 3. That Section Thirteen (13) of the Agreement, beginning on Page Twelve (12), Line Four 17 (4) and ending on Page Thirteen (13), Line Nineteen (19) be deleted in its entirety and replaced with 18 the following: 19 "13. DATA SECURITY 20 CONTRACTOR shall comply with all the data security requirements in Exhibit L to this 21 Agreement. Exhibit L is attached and incorporated by this reference." 22 4. That in the existing COUNTY Agreement, beginning on Page Fifteen (15), Line Thirteen 23 (13) beginning with "C." and ending on Page Fifteen (15) Line Fifteen (15) with "reference" be deleted 24 in its entirety and replaced with the following: 25 "C. CONTRACTOR shall comply with requirements stated within the SABG 26 Application as listed in Revised Exhibit D, SABG Specific Requirements, attached hereto and by this 27 reference incorporated herein; and with all other provisions set forth in the SABG Application, made 28 available by the Department of Behavioral Health (DBH) at the following web address and by this - 2 - 1 reference incorporated herein: https://www.co.fresno.ca.us/departments/behavioral-health/home/for- 2 providers/contractproviders/substance-use-disorder-providers. CONTRACTOR is referred to therein 3 as "Subcontractor" and COUNTY is referred to therein as "Contractor. 4 CONTRACTOR shall comply with requirements contained in the SABG 5 Application with DHCS, until such time that a new SABG Application is approved. Upon amendment 6 of the SABG Application, the terms of such amendment shall automatically be incorporated into this 7 Agreement." 8 5. That all text in reference to "Exhibit D" shall be changed to read "Revised Exhibit D", 9 which is attached hereto and incorporated herein by this reference. 10 6. That in the existing COUNTY Agreement, beginning on Page Nineteen (19), Line 11 Twenty-Two (22) beginning with the word "COUNTY" and ending on Page Nineteen (19) Line 12 Twenty-Five (25) with "CONTRACTOR" be deleted in its entirety and replaced with the following: 13 "COUNTY shall recapture from CONTRACTOR the value of any services or other 14 expenditures determined to be ineligible based on the COUNTY or State monitoring results. The 15 COUNTY reserves the right to enter into a repayment agreement with CONTRACTOR, with total 16 monthly payments not to exceed twelve (12) months from the date of the repayment agreement, to 17 recover the amount of funds to be recouped. The COUNTY has the discretion to extend the 18 repayment plan up to a total of twenty-four (24) months from the date of the repayment agreement. 19 The repayment agreement may be made with the signed written approval of COUNTY's DBH 20 Director, or his or her designee, and respective CONTRACTOR through a repayment agreement. The 21 monthly repayment amounts may be netted against the CONTRACTOR's monthly billing for services 22 rendered during the month, or the COUNTY may, in its sole discretion, forego a repayment 23 agreement and recoup all funds immediately. This remedy is not exclusive, and COUNTY may seek 24 requital from any other means, including, but not limited to, a separate contract or agreement with 25 CONTRACTOR." 26 7. That Section Thirty-One (31) of the Agreement, beginning on Page Twenty-Five (25), 27 Line Twenty-Five (25) through Page Twenty-Six (26) Line Five (5), is deleted in its entirety and 28 replaced with the following: - 3 - 1 "31. PROHIBITION ON PUBLICITY 2 None of the funds, materials, property or services provided directly or indirectly under 3 this Agreement shall be used for CONTRACTOR's advertising, fundraising, or publicity (i.e., 4 purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. 5 Notwithstanding the above, publicity of the services described in Section One (1), SERVICES, of this 6 Agreement shall be allowed as necessary to raise public awareness about the availability of such 7 specific services when approved in advance by the DBH Director, or his or her designee, and at a 8 cost to be provided for such items as written/printed materials, the use of media (i.e., radio, television, 9 newspapers) and any other related expense(s). Communication products must follow DBH graphic 10 standards, including typefaces and colors, to communicate our authority and project a unified brand. 11 This includes all media types and channels and all materials on and offline that are created as part of 12 DBH's efforts to provide information to the public. 13 CONTRACTOR shall notify COUNTY of any community event of which CONTRACTOR 14 is the primary organizer at least thirty (30) days in advance of said event. CONTRACTOR shall 15 disclose and supply COUNTY with all written/printed/digital materials and media used in the 16 marketing and operation of this event. CONTRACTOR shall provide all materials to COUNTY at least 17 two weeks prior to the date of the event. COUNTY reserved the right to review and approve all 18 CONTRACTOR submitted materials." 19 8. COUNTY and CONTRACTOR agree that this Amendment III is sufficient to amend the 20 Agreement, and that upon execution of this Amendment III, the Agreement, Amendment I, 21 Amendment II, and this Amendment III together shall be considered the Agreement. 22 The Agreement, as hereby amended, is ratified and continued. All provisions, terms, 23 covenants, conditions and promises contained in the Agreement and not amended herein shall 24 remain in full force and effect. 25 26 27 28 - 4 - 1 IN WITNESS WHEREOF, the parties hereto have executed this Amendment III to 2 COUNTY Agreement as of the day and year first hereinabove written. 3 4 YOU LEADERSHIP INSTITUTE COUNTY OF FRESNO 5 (Authorized Signature) S Quit ro, hairman of the Board of 6 S or the County of Fresno 7 Patricia Barahona, CEO Print Name &Title 8 9 209 9th Street, Suite 200 10 San Francisco, CA 94103 11 Mailing Address ATTEST: 12 Bernice E. Seidel Clerk of the Board of Supervisors 13 County of Fresno, State of California 14 By: A9�ujy"C' 4'..' 15 ( thorized Signature) Deputy 16 Joninna S. Simpson Print Name 17 Chief Financial Officer 18 Title: Secretar y (of Corporation), or 19 any Assistant Secretary, or Chief Financial Officer, or 20 any Assistant Treasurer 21 FOR ACCOUNTING USE ONLY: 22 Fund: 0001 23 Subclass: 10000 ORG: 56302081 24 Account: 7295 25 Funding Source FY21/22 FY22/23 FY 23/24 FY 24/25 FY 25/26 26 SABG $1,219,352 $1,234,352 $1,234,352 $1,219,352 $1,219,352 CRRSAA $50,000 27 ARPA $300,288 $300,288 $300,289 Total $1,269,352 $1,534,640 $1,534,640 $1,519,641 $1,219,352 28 - 5 - Exhibit B - Page 1 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery DBH VISION: Health and well-being for our community. DBH MISSION: The Department of Behavioral Health is dedicated to supporting the wellness of individuals, families and communities in Fresno County who are affected by, or are at risk of, mental illness and/or substance use disorders through cultivation of strengths toward promoting recovery in the least restrictive environment. DBH GOALS: Quadruple Aim • Deliver quality care • Maximize resources while focusing on efficiency • Provide an excellent care experience • Promote workforce well-being GUIDING PRINCIPLES OF CARE DELIVERY: The DBH 11 principles of care delivery define and guide a system that strives for excellence in the provision of behavioral health services where the values of wellness, resiliency, and recovery are central to the development of programs, services, and workforce. The principles provide the clinical framework that influences decision-making on all aspects of care delivery including program design and implementation, service delivery, training of the workforce, allocation of resources, and measurement of outcomes. 1. Principle One -Timely Access & Integrated Services o Individuals and families are connected with services in a manner that is streamlined, effective, and seamless o Collaborative care coordination occurs across agencies, plans for care are integrated, and whole person care considers all life domains such as health, education, employment, housing, and spirituality o Barriers to access and treatment are identified and addressed o Excellent customer service ensures individuals and families are transitioned from one point of care to another without disruption of care 1 rev 2017 Dec Exhibit B - Page 2 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 2. Principle Two - Strengths-based o Positive change occurs within the context of genuine trusting relationships o Individuals, families, and communities are resourceful and resilient in the way they solve problems o Hope and optimism is created through identification of, and focus on, the unique abilities of individuals and families 3. Principle Three - Person-driven and Family-driven o Self-determination and self-direction are the foundations for recovery o Individuals and families optimize their autonomy and independence by leading the process, including the identification of strengths, needs, and preferences o Providers contribute clinical expertise, provide options, and support individuals and families in informed decision making, developing goals and objectives, and identifying pathways to recovery o Individuals and families partner with their provider in determining the services and supports that would be most effective and helpful and they exercise choice in the services and supports they receive 4. Principle Four- Inclusive of Natural Supports o The person served identifies and defines family and other natural supports to be included in care o Individuals and families speak for themselves o Natural support systems are vital to successful recovery and the maintaining of ongoing wellness; these supports include personal associations and relationships typically developed in the community that enhance a person's quality of life o Providers assist individuals and families in developing and utilizing natural supports. 5. Principle Five - Clinical Significance and Evidence Based Practices (EBP) o Services are effective, resulting in a noticeable change in daily life that is measurable. o Clinical practice is informed by best available research evidence, best clinical expertise, and client values and preferences o Other clinically significant interventions such as innovative, promising, and emerging practices are embraced 2 rev 2017 Dec Exhibit B - Page 3 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 6. Principle Six- Culturally Responsive o Values, traditions, and beliefs specific to an individual's or family's culture(s) are valued and referenced in the path of wellness, resilience, and recovery o Services are culturally grounded, congruent, and personalized to reflect the unique cultural experience of each individual and family o Providers exhibit the highest level of cultural humility and sensitivity to the self- identified culture(s) of the person or family served in striving to achieve the greatest competency in care delivery 7. Principle Seven -Trauma-informed and Trauma-responsive o The widespread impacts of all types of trauma are recognized and the various potential paths for recovery from trauma are understood o Signs and symptoms of trauma in individuals, families, staff, and others are recognized and persons receive trauma-informed responses o Physical, psychological and emotional safety for individuals, families, and providers is emphasized 8. Principle Eight - Co-occurring Capable o Services are reflective of whole-person care; providers understand the influence of bio-psycho-social factors and the interactions between physical health, mental health, and substance use disorders o Treatment of substance use disorders and mental health disorders are integrated; a provider or team may deliver treatment for mental health and substance use disorders at the same time 9. Principle Nine - Stages of Change, Motivation, and Harm Reduction o Interventions are motivation-based and adapted to the client's stage of change o Progression though stages of change are supported through positive working relationships and alliances that are motivating o Providers support individuals and families to develop strategies aimed at reducing negative outcomes of substance misuse though a harm reduction approach o Each individual defines their own recovery and recovers at their own pace when provided with sufficient time and support 3 rev 2017 Dec Exhibit B - Page 4 of 4 Fresno County Department of Behavioral Health Guiding Principles of Care Delivery 10. Principle Ten - Continuous Quality Improvement and Outcomes-Driven o Individual and program outcomes are collected and evaluated for quality and efficacy o Strategies are implemented to achieve a system of continuous quality improvement and improved performance outcomes o Providers participate in ongoing professional development activities needed for proficiency in practice and implementation of treatment models 11. Principle Eleven - Health and Wellness Promotion, Illness and Harm Prevention, and Stigma Reduction o The rights of all people are respected o Behavioral health is recognized as integral to individual and community well-being o Promotion of health and wellness is interwoven throughout all aspects of DBH services o Specific strategies to prevent illness and harm are implemented at the individual, family, program, and community levels o Stigma is actively reduced by promoting awareness, accountability, and positive change in attitudes, beliefs, practices, and policies within all systems o The vision of health and well-being for our community is continually addressed through collaborations between providers, individuals, families, and community members 4 rev 2017 Dec Revised Exhibit D Page 1 of 15 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SABG) SPECIFIC REQUIREMENTS Fresno County, through the Department of Behavioral Health, makes Substance Use Disorder (SUD)treatment services available throughout the county to eligible persons served through funds provided under a Substance Abuse Block Grant(SABG)with the California Department of Health Care Services. The County, and all contracted providers, must comply with the terms of the SABG application, and any amendments thereto, including but not limited to the following: 1. STATE ALCOHOL AND DRUG REQUIREMENTS A. INDEMNIFICATION The CONTRACTOR agrees to indemnify, defend and save harmless the State, its officers, agents and employees from any and all claims and losses accruing or resulting to any and all contractors, subcontractors, materialmen, laborers and any other person, firm or corporation furnishing or supplying work, services, materials or supplies in connection with the performance of this Agreement and from any and all claims and losses accruing or resulting to any person, firm or corporation who may be injured or damaged by the CONTRACTOR in the performance of this Agreement. B. INDEPENDENT CONTRACTOR The CONTRACTOR and the agents and employees of CONTRACTOR, in the performance of this Agreement, shall act in an independent capacity and not as officers or employees or agents of State of California. C. CONFIDENTIALITY CONTRACTOR shall conform to and COUNTY shall monitor compliance with all State of California and Federal statutes and regulations regarding confidentiality, including but not limited to confidentiality of information requirements at Part 2, Title 42, Code of Federal Regulations; California Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the California Health and Safety Code; Title 22, California Code of Regulations, section 51009; and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code. CONTRACTOR shall ensure that all of its employees sign a written Confidentiality Oath, attached hereto as Exhibit K, before they begin employment with CONTRACTOR and shall renew said document annually thereafter. CONTRACTOR shall retain each employee's written confidentiality oath for COUNTY and DHCS inspection for a period of six (6) years following the termination of this agreement. D. REVENUE COLLECTION POLICY CONTRACTOR shall conform to all policies and procedures regarding revenue collection issued by the State under the provisions of the Health and Safety Code, Division 10.5. E. EXPENDITURE OF STATE GENERAL AND FEDERAL FUNDS CONTRACTOR agrees that all funds paid out by the State shall be used exclusively for providing alcohol and/or drug program services, administrative costs, and allowable Revised 02/03/22 Revised Exhibit D Page 2 of 15 overhead. F. ACCESS TO SERVICES CONTRACTOR shall provide accessible and appropriate services in accordance with Federal and State statutes and regulations to all eligible persons. G. REPORTS CONTRACTOR agrees to participate in surveys related to the performance of this Agreement and expenditure of funds and agrees to provide any such information in a mutually agreed upon format. H. AUDITS All State and Federal funds furnished to the CONTRACTOR(S) pursuant to this Agreement along with related patient fees, third party payments, or other related revenues and funds commingled with the foregoing funds are subject to audit by the State. The State may audit all alcohol and drug program revenue and expenditures contained in this Agreement for the purpose of establishing the basis for the subsequent year's negotiation. I. RECORDS MAINTENANCE 1) CONTRACTOR shall maintain books, records, documents, and other evidence necessary to monitor and audit this Agreement. 2) CONTRACTOR shall maintain adequate program and fiscal records relating to individuals served under the terms of this Agreement, as required, to meet the needs of the State in monitoring quality, quantity, fiscal accountability, and accessibility of services. Information on each individual shall include, but not be limited to, admission records, patient and participant interviews and progress notes, and records of service provided by various service locations, in sufficient detail to make possible an evaluation of services provided and compliance with this Agreement. 3) CONTRACTOR shall include in any contract with an audit firm a clause to permit access by DHCS to the working papers of the external independent auditor and require that copies of the working papers shall be made for DHCS at its request. 2. CONTROL REQUIREMENTS Performance under this Agreement is subject to all applicable Federal and State laws, regulations and standards. CONTRACTOR(S) shall establish written procedures consistent with the Control requirements. The provisions of this Agreement are not intended to abrogate any provisions of law or regulation existing or enacted during the term of this Agreement. These requirements include, but may not be limited to, those set forth in this Agreement, and: A. HSC, Division 10.5, Part 2 commencing with Section 11760, State Government's Role to Alleviate Problems Related to the Inappropriate Use of Alcoholic Beverages and Other Drug Use. B. California Code of Regulations (CCR), Title 9, Division 4, commencing with Chapter 1(herein referred to as Title 9). Revised 02/03/22 Revised Exhibit D Page 3 of 15 C. Government Code (GC), Title 2, Division 4, Part 2, Chapter 2, Article 1.7, Federal Block Grant Funds. D. GC, Title 5, Division 2, Part 1, Chapter 1, Article 7, Federally Mandated Audits of Block Grant Funds Allocated to Local Agencies, commencing with Section 53130. E. United State Code (USC), Title 42, Chapter 6A, Subchapter XVII, Part B, Subpart ii, commencing with Section 300x-21, Block Grants for Prevention and Treatment of Substance Abuse. F. Code of Federal Regulations (CFR), Title 45, Part 75, Uniform Administration Requirements, Cost Principles, and Audit Requirements for Federal Awards. G. CFR, Title 45, Part 96, Block Grants. H. CFR, Title 42, Part 2, Confidentiality of Substance Use Disorder Patient Records. I. Title 42, CFR, Part 8, Medication Assisted Treatment for Opioid Use Disorders. J. CFR, Title 21, Chapter 11, Drug Enforcement Administration, Department of Justice. K. State Administrative Manual (SAM), Chapter 7200, General Outline of Procedures. 3. MINIMUM QUALITY DRUG TREATMENT STANDARDS CONTRACTOR shall comply with the Minimum Quality Drug Treatment Standards for SABG for all SUD treatment programs. The Minimum Quality Drug Treatment Standards are attached hereto and by this reference incorporated herein as Attachment A. 4. SALARY RESTRICTION CONTRACTOR agrees that no part of any federal funds provided under this Contract shall be used by CONTRACTOR to pay the salary and wages of an individual at a rate in excess of Level II of the Executive Schedule as found online at: https://grants.nih.gov/qrants/policy/salcap summary.htm. Executive salaries shall be provided to COUNTY in the annual Provider Risk Assessment and/or upon request. SABG funds used to pay a salary in excess of the rate of basic pay for Level I of the Executive Schedule shall be subject to disallowance. The amount disallowed shall be determined by subtracting the individual's actual salary from the Level I rate of basic pay and multiplying the result by the percentage of the individual's salary that was paid with SABG funds (Reference: Terms and Conditions of the SABG award). Note that indirect costs can only be allocated to SABG contracted services using any of the following cost allocation methodologies; percentage of direct cost, percentage of direct salary cost, or federally-approved indirect cost rate. Revised 02/03/22 Revised Exhibit D Page 4 of 15 5. PERINATAL PRACTICE GUIDELINES CONTRACTOR shall comply with the perinatal program requirements as outlined in the current version of the Perinatal Practice Guidelines available online at: https://www.dhcs.ca.gov/individuals/Pages/Perinatal-Services.aspx 6. RESTRICTIONS ON USE OF SUBSTANCE ABUSE BLOCK GRANT (SABG) FUNDS TO PAY FOR SERVICES REIMBURSABLE BY MEDI-CAL CONTRACTOR shall ensure that billing SABG funds only occurs for services that are not reimbursable by Medi-Cal. If CONTRACTOR utilizes SABG funds to pay for a service included in the DMC-ODS, CONTRACTOR shall maintain documentation sufficient to demonstrate that Medi- Cal reimbursement was not available. This documentation shall be provided to COUNTY at the time of billing and retained in the person served's file for review. 7. BARRIERS TO SERVICES CONTRACTOR shall provide services to all eligible persons in accordance with state and federal statutes and regulations. CONTRACTOR shall assure that in planning for the provision of services, the following barriers to services are considered and addressed: A. Lack of educational materials or other resources for the provision of services. B. Geographic isolation and transportation needs of persons seeking services or remoteness of services. C. Institutional, cultural, and ethnicity barriers. D. Language differences. E. Lack of service advocates. F. Failure to survey or otherwise identify the barriers to service accessibility. G. Needs of persons with a disability. 8. RISK ASSESSMENT CONTRACTOR shall comply with the sub-recipient pre-award risk assessment requirements contained in 45 CFR 72.205. COUNTY shall review the merit and risk associated with each potential CONTRACTOR annually prior to making an award. COUNTY shall perform and document annual sub-recipient pre-award risk assessments for each CONTRACTOR and retain documentation for audit purposes. 9. CALIFORNIA OUTCOMES MEASUREMENT SYSTEM FOR TREATMENT (CALOMS-TX) — PAGE 19 CONTRACTOR shall comply with the CalOMS-Tx data collection requirements for submission of data to COUNTY. CONTRACTOR shall submit admission, discharge, annual update, resubmission of records containing errors or in need of correction, and "provider no activity" report records in a format approved by COUNTY. Revised 02/03/22 Revised Exhibit D Page 5 of 15 10. CAPACITY REPORTING — page 21 CONTRACTOR shall ensure that if their program reaches or exceeds 90 percent of dedicated capacity CONTRACTOR shall report this information to COUNTY and DHCSOWPS@dhcs.ca.gov within four days of reaching capacity. 11. DRUG AND ALCOHOL TREATMENT ACCESS REPORT (DATAR) — page 21 CONTRACTOR shall submit monthly DATAR reports by the 51" of the month following the report activity month. CONTRACTOR shall be considered compliant if a minimum of 95 percent of required DATAR reports are received by the due date. 12. CHARITABLE CHOICE— page 22 CONTRACTOR shall document the total number of referrals necessitated by religious objection to other alternative SUD providers. CONTRACTOR may not discriminate in its program delivery against a client or potential client on the basis of religion or religious belief, a refusal to hold a religious belief, or a refusal to actively participate in a religious practice. Any specifically religious activity or service made available to individuals by the CONTRACTOR must be voluntary as well as separate in time and location from County funded activities and services. CONTRACTOR shall inform County as to whether it is faith-based. If CONTRACTOR identifies as faith-based it must submit to DBH Contracts Division —Substance Use Disorder(SUD) Services a copy of its policy on referring individuals to alternate treatment CONTRACTOR and include a copy of this policy in its client admission forms. The policy must inform individuals that they may be referred to an alternative provider if they object to the religious nature of the program and include a notice to SUD Services. Adherence to this policy will be monitored during annual site reviews, and a review of client files. If CONTRACTOR identifies as faith-based, by July 1 of each year CONTRACTOR will be required to report to SUD Services the number of individuals who requested referrals to alternate providers based on religious objection. 13. DRUG FREE WORKPLACE—need to review more closely CONTRACTOR shall comply with the requirements of the Drug-Free Work Place Act of 1990 (California Government Code section 8350). 14. SUBCONTRACT PROVISIONS The following contract provisions are required to be included in all agreements verbatim by the Department of Health Care Services. Any references to "County" in the foregoing clauses shall apply to the CONTRACTORS noted in Exhibit A of this agreement. A. ADDITIONAL CONTRACT RESTRICTIONS This Contract is subject to any additional restrictions, limitations, or conditions enacted by the Congress, or any statute enacted by the Congress, which may affect the provisions, terms, or funding of this Contract in any manner. B. HATCH ACT County agrees to comply with the provisions of the Hatch Act (USC, Title 5, Part III, Subpart F., Chapter 73, Subchapter 111), which limit the political activities of employees whose principal employment activities are funded in whole or in part with federal funds. Revised 02/03/22 Revised Exhibit D Page 6 of 15 C. NO UNLAWFUL USE OR UNLAWFUL MESSAGE REGARDING DRUGS County agrees that information produced through these funds, and which pertains to drugs and alcohol-related programs, shall contain a clearly written statement that there shall be no unlawful use of drugs or alcohol associated with the program. Additionally, no aspect of a drug or alcohol-related program shall include any message on the responsible use, if the use is unlawful, of drugs or alcohol (HSC, Division 10.7, Chapter 1429, Sections 11999-11999.3). By signing this Enclosure, County agrees that it will enforce, and will require its subcontractors to enforce, these requirements. CONTRACTOR must sign the Unlawful Use of Drugs and Alcohol Certification, attached hereto as Attachment B, incorporated herein by reference and made part of this Agreement, agreeing to uphold the obligations of HSC 11999 — 11999.3. This agreement may be unilaterally terminated, without penalty, if CONTRACTOR or a subcontractor that is a private entity is determined to have violated a prohibition of the Unlawful Use of Drugs and Alcohol message or has an employee who is determined by the DBH Director or her designee to have violated a prohibition of the Unlawful Use of Drugs and Alcohol message. D. LIMITATION ON USE OF FUNDS FOR PROMOTION OF LEGALIZATION OF CONTROLLED SUBSTANCES None of the funds made available through this Contract may be used for any activity that promotes the legalization of any drug or other substance included in Schedule I of Section 202 of the Controlled Substances Act (21 USC 812). E. DEBARMENT AND SUSPENSION COUNTY shall not subcontract with or employ any party listed on the government wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp. p. 189) and 12689 (3 CFR part 1989., p. 235), "Debarment and Suspension." SAM exclusions contain the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The County shall advise all subcontractors of their obligation to comply with applicable federal debarment and suspension regulations, in addition to the requirements set forth in 42 CFR Part 1001. If a County subcontracts or employs an excluded party, DHCS has the right to withhold payments, disallow costs, or issue a CAP, as appropriate, pursuant to HSC Code 11817.8(h). F. RESTRICTION ON DISTRUBUTION OF STERILE NEEDLES No SABG funds made available through this Contract shall be used to carry out any program that includes the distribution of sterile needles or syringes for the hypodermic injection of any illegal drug unless DHCS chooses to implement a demonstration syringe services program for injecting drug users. Revised 02/03/22 Revised Exhibit D Page 7 of 15 G. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996 All work performed under this Contract is subject to HIPAA, County shall perform the work in compliance with all applicable provisions of HIPAA. As identified in Exhibit E, DHCS and County shall cooperate to assure mutual agreement as to those transactions between them, to which this provision applies. Refer to Exhibit E for additional information. 1. Trading Partner Requirements a) No Changes. County hereby agrees that for the personal health information (Information), it will not change any definition, data condition or use of a data element or segment as proscribed in the Federal Health and Human Services (HHS) Transaction Standard Regulation (45 CFR 162.915 (a)). b) No Additions. County hereby agrees that for the Information, it will not add any data elements or segments to the maximum data set as proscribed in the HHS Transaction Standard Regulation (45 CFR 162.915 (b)). c) No Unauthorized Uses. County hereby agrees that for the Information, it will not use any code or data elements that either are marked "not used" in the HHS Transaction's Implementation specification or are not in the HHS Transaction Standard's implementation specifications (45 CFR 162.915 (c)). d) No Changes to Meaning or Intent. County hereby agrees that for the Information, it will not change the meaning or intent of any of the HHS Transaction Standard's implementation specification (45 CFR 162.915 (d)). 2. Concurrence for Test Modifications to HHS Transaction Standards County agrees and understands that there exists the possibility that DHCS or others may request an extension from the uses of a standard in the HHS Transaction Standards. If this occurs, County agrees that it will participate in such test modifications. 3. Adequate Testing County is responsible to adequately test all business rules appropriate to their types and specialties. If the County is acting as a clearinghouse for enrolled providers, County has obligations to adequately test all business rules appropriate to each and every provider type and specialty for which they provide clearinghouse services. 4. Deficiencies County agrees to correct transactions, errors, or deficiencies identified by DHCS, and transactions errors or deficiencies identified by an enrolled provider if the County is acting as a clearinghouse for that provider. When County is a clearinghouse, County agrees to properly communicate deficiencies and other pertinent information regarding electronic transactions to enrolled providers for which they provide clearinghouse services. 5. Code Set Retention Revised 02/03/22 Revised Exhibit D Page 8 of 15 Both parties understand and agree to keep open code sets being processed or used in this Contract for at least the current billing period or any appeal period, whichever is longer. 6. Data Transmission Log Both parties shall establish and maintain a Data Transmission Log which shall record any and all Data Transmissions taking place between the Parties during the term of this Contract. Each party will take necessary and reasonable steps to ensure that such Data Transmission Logs constitute a current, accurate, complete, and unaltered record of any and all Data Transmissions between the parties, and shall be retained by each Party for no less than twenty-four (24) months following the date of the Data Transmission. The Data Transmission Log may be maintained on computer media or other suitable means provided that, if it is necessary to do so, the information contained in the Data Transmission Log may be retrieved in a timely manner and presented in readable form. H. NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS FOR RELIGIOUS PROVIDERS County shall establish such processes and procedures as necessary to comply with the provisions of USC, Title 42, Section 300x-65 and CFR, Title 42, Part 54. These regulations prohibit discrimination against nongovernmental organizations and certain individuals on the basis of religion in the distribution of government funds to provide substance abuse services and to allow the organizations to accept the funds to provide the services to the individuals without impairing the religious character of the organizations or the religious freedom of the individuals. I. COUNSELOR CERTIFICATION Any counselor or registrant providing intake, assessment of need for services, treatment or recovery planning, individual or group counseling to participants, patients, or residents in a DHCS licensed or certified program is required to be registered or certified as defined in CCR, Title 9, Division 4, Chapter 8. J. CULTURAL AND LINGUISTIC PROFICIENCY To ensure equal access to quality care by diverse populations, each service provider receiving funds from this Contract shall adopt the Federal Office of Minority Health Culturally and Linguistically Appropriate Service (CLAS) national standards as outlined online at: https://minoritVhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53https://thinkcuIturalhealth.hhs.gov/c las/standards CONTRACTOR must comply with 42 CFR 438.206(c)(2). CONTRACTOR shall promote the delivery of services in a culturally competent manner to all persons served, including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual orientation or gender identity. CONTRACTOR shall provide effective, equitable, understandable and respectful quality of care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs. K. INTRAVENOUS DRUG USE (IVDU) TREATMENT Revised 02/03/22 Revised Exhibit D Page 9 of 15 County shall ensure that individuals in need of IVDU treatment shall be encouraged to undergo AOD treatment (42 USC 300x-23 (45 CFR 96.126(e)). L. TUBERCULOSIS TREATMENT County shall ensure the following related to Tuberculosis (TB): 1. Routinely make available TB services to individuals receiving treatment. 2. Reduce barriers to patients' accepting TB treatment. 3. Develop strategies to improve follow-up monitoring, particularly after patients leave treatment, by disseminating information through educational bulletins and technical assistance. M. TRAFFICKING VICTIMS PROTECTION ACT OF 2000 County and its subcontractors that provide services covered by this Contract shall comply with the Trafficking Victims Protection Act of 2000 (USC, Title 22, Chapter 78, Section 7104) as amended by section 1702 of Pub. L. 112-239. CONTRACTOR, CONTRACTOR's employees, subrecipients, and subrecipients' employees may not: 1. Engage in severe forms of trafficking in persons during the period of time that the award is in effect; 2. Procure a commercial sex act during the period of time that the award is in effect; or 3. Use forced labor in the performance of the award or subawards under the award. This agreement may be unilaterally terminated, without penalty, if CONTRACTOR or a subrecipient that is a private entity is determined to have violated a prohibition of the TVPA or has an employee who is determined by the DBH Director or her designee to have violated a prohibition of the TVPA through conduct that is either associated with performance under the award or imputed to the CONTRACTOR or their subrecipient using the standards and due process for imputing the conduct of an individual to an organization that are provided in 2 C.F.R. Part 180, OMB Guidelines to Agencies on Government-wide Debarment and Suspension (Nonprocurement). CONTRACTOR must inform the DBH Director or her designee immediately of any information received from any source alleging a violation of a prohibition of the TVPA. CONTRACTOR must sign a certification annually acknowledging the Trafficking Victims Protection Act of 2000 requirements (TVPA Certification), attached hereto as Attachment C, incorporated herein by reference and made part of this Agreement and must require all employees to complete annual TVPA training. N. TRIBAL COMMUNITIES AND ORGANIZATIONS Revised 02/03/22 Revised Exhibit D Page 10 of 15 County shall regularly review population information available through Census, compare to information obtained in the California Outcome Measurement System for Treatment (CalOMS-Tx) to determine whether the population is being reached, and survey Tribal representatives for insight in potential barriers to the substance use service needs of the American Indian/Alaskan Native (AI/AN) population within the County geographic area. Contractor shall also engage in regular and meaningful consultation and collaboration with elected officials of the tribe, Rancheria, or their designee for the purpose of identifying issues/barriers to service delivery and improvement of the quality, effectiveness, and accessibility of services available to MAN communities within the County. O. MARIJUANA RESTRICTION Grant funds may not be used, directly or indirectly, to purchase, prescribe, or provide marijuana or treatment using marijuana. Treatment in this context includes the treatment of opioid use disorder. Grant funds also cannot be provided to any individual who or organization that provides or permits marijuana use for the purposes of treating substance use or mental disorders. See, e.g., 45 CFR. § 75.300(a) (requiring HHS to "ensure that Federal funding is expended . . . in full accordance with U.S. statutory . . . requirements."); 21 USC § 812(c) (10) and 841 (prohibiting the possession, manufacture, sale, purchase or distribution of marijuana). This prohibition does not apply to those providing such treatment in the context of clinical research permitted by the DEA and under an FDA-approved investigational new drug application where the article being evaluated is marijuana or a constituent thereof that is otherwise a banned controlled substance under Federal law. P. PARTICIPATION OF COUNTY BEHAVIORAL HEALTH DIRECTOR'S ASSOCIATION OF CALIFORNIA The County AOD Program Administrator shall participate and represent the County in meetings of the County Behavioral Health Director's Association of California for the purposes of representing the counties in their relationship with DHCS with respect to policies, standards, and administration for AOD abuse services. The County AOD Program Administrator shall attend any special meetings called by the Director of DHCS. Participation and representation shall also be provided by the County Behavioral Health Director's Association of California. Q. ADOLESCENT BEST PRACTICES GUIDELINES County must utilize DHCS guidelines in developing and implementing youth treatment programs funded under this Enclosure The Adolescent Best Practices Guidelines can be found at: https://www.dhcs.ca.gov/Documents/CSD CMHCS/Adol%20Best%2OPractices%2OGuide/AdolBe stPracGu ideOCTOBER2020.pdf R. BYRD ANTI-LOBBYING AMENDMENT (31 USC 1352) County certifies that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award Revised 02/03/22 Revised Exhibit D Page 11 of 15 covered by 31 USC 1352. County shall also disclose to DHCS any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. S. NONDISCRIMINATION IN EMPLOYMENT AND SERVICES County certifies that under the laws of the United States and the State of California, County will not unlawfully discriminate against any person. T. FEDERAL LAW REQUIREMENTS 1. Title VI of the Civil Rights Act of 1964, Section 2000d, as amended, prohibiting discrimination based on race, color, or national origin in federally-funded programs. 2. Title VIII of the Civil Rights Act of 1968 (42 USC 3601 et seq.) prohibiting discrimination on the basis of race, color, religion, sex, handicap, familial status or national origin in the sale or rental of housing. 3. Age Discrimination Act of 1975 (45 CFR Part 90), as amended 42 USC Sections 6101 6107), which prohibits discrimination on the basis of age. 4. Age Discrimination in Employment Act (29 CFR Part 1625). 5. Title I of the Americans with Disabilities Act (29 CFR Part 1630) prohibiting discrimination against the disabled in employment. 6. Title II of the Americans with Disabilities Act (28 CFR Part 35) prohibiting discrimination against the disabled by public entities. 7. Title III of the Americans with Disabilities Act (28 CFR Part 36) regarding access. 8. Section 504 of the Rehabilitation Act of 1973, as amended (29 USC Section 794), prohibiting discrimination on the basis of individuals with disabilities. 9. Executive Order 11246 (42 USC 2000(e) et seq. and 41 CFR Part 60 regarding nondiscrimination in employment under federal contracts and construction contracts greater than $10,000 funded by federal financial assistance. 10. Executive Order 13166 (67 FR 41455) to improve access to federal services for those with limited English proficiency. 11. The Drug Abuse Office and Treatment Act of 1972, as amended, relating to nondiscrimination on the basis of drug abuse. 12. Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2, Subparts A— E) U. STATE LAW REQUIREMENTS 1. Fair Employment and Housing Act (Government Code Section 12900 et seq.) and the applicable regulations promulgated thereunder (2 CCR 7285.0 et seq.). 2. Title 2, Division 3, Article 9.5 of the Government Code, commencing with Section 11135. Revised 02/03/22 Revised Exhibit D Page 12 of 15 3. Title 9, Division 4, Chapter 8 of the CCR, commencing with Section 13000. 4. No federal funds shall be used by the County or its subcontractors for sectarian worship, instruction, or proselytization. No federal funds shall be used by the County or its subcontractors to provide direct, immediate, or substantial support to any religious activity. V. ADDITIONAL CONTRACT RESTRICTIONS 1. Noncompliance with the requirements of nondiscrimination in services shall constitute grounds for DHCS to withhold payments under this Contract or terminate all, or any type, of funding provided hereunder. 2. This Contract is subject to any additional restrictions, limitations, or conditions enacted by the federal or state governments that affect the provisions, terms, or funding of this Contract in any manner. W. INFORMATION ACCESS FOR INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY 1. County shall comply with all applicable provisions of the Dymally- Alatorre Bilingual Services Act (Government Code sections 7290-7299.8) regarding access to materials that explain services available to the public as well as providing language interpretation services. 2. County shall comply with the applicable provisions of Section 1557 of the Affordable Care Act (45 CFR Part 92), including, but not limited to, 45 CFR 92.201, when providing access to: (a) materials explaining services available to the public, (b) language assistance, (c) language interpreter and translation services, or (d) video remote language interpreting services. 15. FEDERAL DEBARMENT AND SUSUPENSTION CERTIFICATION —Enclosure 5 page 26 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS A. DBH and CONTRACTOR recognize that Federal assistance funds will be used under the terms of this Agreement. For purposes of this section, DBH will be referred to as the "prospective recipient". B. This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). 1) The prospective recipient of Federal assistance funds certifies by entering this Agreement, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2) The prospective recipient of funds agrees by entering into this Agreement, that it shall not knowingly enter into any lower tier covered transaction with a person Revised 02/03/22 Revised Exhibit D Page 13 of 15 who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Federal department or agency with which this transaction originated. 3) Where the prospective recipient of Federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 4) The CONTRACTOR shall provide immediate written notice to DBH if at any time CONTRACTOR learns that its certification in this clause of this Agreement was erroneous when submitted or has become erroneous by reason of changed circumstances. 5) The prospective recipient further agrees that by entering into this Agreement, it will include a clause identical to this clause of this Agreement, and titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions", in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 6) The certification in this clause of this Agreement is a material representation of fact upon which reliance was placed by COUNTY when this transaction was entered into. C. CONTRACTOR shall not employ or subcontract with any party listed in the government wide exclusions in the System for Award Management (SAM) in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp. p. 189) and 12689 (3 CFR part 1989., p. 235), "Debarment and Suspension." SAM exclusions contain the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. If CONTRACTOR employs or subcontracts an excluded party, DHCS has the right to withhold payments, disallow costs, or issue a CAP, as appropriate, pursuant to HSC Code 11817.8(h). D. If CONTRACTOR subcontracts or employs an excluded party, COUNTY and DHCS have the right to withhold payments, disallow costs, or issue a CAP, as appropriate, pursuant to HSC Code 11817.8(h). 1) By signing this Agreement, the Contractor/Grantee agrees to comply with applicable federal suspension and debarment regulations including, but not limited to 2 CFR 180, 2 CFR 376 2) By signing this Agreement, the Contractor certifies to the best of its knowledge and belief, that it and its principals: (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 application/proposal/agreement 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) violation of Federal or State antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making Revised 02/03/22 Revised Exhibit D Page 14 of 15 false statements, tax evasion, receiving stolen property, making false claims, obstruction of justice, or the commission of any other offense indicating a lack of business integrity or business honesty that seriously affects its business honesty; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in Paragraph b(2) herein; and (d) Have not within a three-year period preceding this application/proposal/agreement had one or more public transactions (Federal, State or local) terminated for cause or default. (e) Have not, within a three-year period preceding this application/proposal/agreement, engaged in any of the violations listed under 2 CFR Part 180, Subpart C as supplemented by 2 CFR Part 376. (f) Shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under federal regulations (i.e., 48 CFR part 9, subpart 9.4), debarred, suspended, declared ineligible, or voluntarily excluded from participation in such transaction, unless authorized by the State. (g) Will include a clause entitled, "Debarment and Suspension Certification" that essentially sets forth the provisions herein, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. E. If the Contractor is unable to certify to any of the statements in this certification, the Contractor shall submit an explanation to the DBH Program Contract Manager. F. The terms and definitions herein have the meanings set out in 2 CFR Part 180 as supplemented by 2 CFR Part 376. G. If the Contractor knowingly violates this certification, in addition to other remedies available to the Federal Government, the DBH may terminate this Agreement for cause or default. 16. SMOKING-FREE WORKPLACE CERTIFICATION —enclosure 5 page 27 (Applicable to federally funded agreements and subcontracts, that provide health, day care, early childhood development services, education or library services to children under 18 directly or through local governments.) A. Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by federal programs either directly or through state or local governments, by federal grant, contract, loan, or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed. Revised 02/03/22 Revised Exhibit D Page 15 of 15 B. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible party. C. By signing this Agreement, Contractor certifies that it will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act. The prohibitions herein are effective December 26, 1994. D. Contractor further agrees that it will insert this certification into any subawards entered into that provide for children's services as described in the Act. 17. ADA CONSIDERATIONS CONTRACTOR shall ensure that physical access, reasonable accommodations, and accessible equipment for persons served with physical or mental disabilities are provided to all persons served in accordance with CFR Title 45, Part 84 and the American with Disabilities Act. 18. INTERIM SERVICES CONTRACTOR must adhere to the State-County Contract requirement to provide Interim Services in the event that an individual must wait to be placed in treatment. Interim Substance Abuse Services means services that are provided until an individual is admitted to a substance abuse treatment program. The purposes of the services are to reduce the adverse health effects of such abuse, promote the health of the individual, and reduce the risk of transmission of disease. At a minimum, interim services include counseling and education about HIV and tuberculosis (TB), about the risks of needle-sharing, the risks of transmission to sexual partners and infants, and about steps that can be taken to ensure the HIV and TB transmission does not occur, as well as referral for HIV or TB treatment services if necessary. For pregnant women, interim services also include counseling on the effects of alcohol and drug use on the fetus, as well as referral for prenatal care. Records must indicate evidence that Interim Services have been provided and documentation will be reviewed for compliance. Revised 02/03/22 Attachment A Minimum Quality Drug Treatment Standards Compliance with the following Minimum Quality Treatment Standards is required for all SLID treatment programs (contractors and sub-contractors). A. Personnel Policies 1. Personnel files shall be maintained on all employees and volunteers/interns and shall contain the following: a) Application for employment and/or resume; b) Signed employment confirmation statement/duty statement; c) Job description; d) Performance evaluations; e) Health records/status as required by program or Title 9; f) Other personnel actions (e.g., commendations, discipline, status change, employment incidents and/or injuries); g) Training documentation relative to substance use disorders and treatment; h) Current registration, certification, intern status, or licensure; i) Proof of continuing education required by licensing or certifying agency and program; j) Program Code of Conduct and for registered, certified, and licensed staff, a copy of the certifying/licensing body's code of conduct as well; and k) Salary schedule and salary adjustment information. 2. Job descriptions shall be developed, revised as needed, and approved by the Program's governing body. The job descriptions shall include: a) Position title and classification; b) Duties and responsibilities; c) Lines of supervision; and d) Education, training, work experience, and other qualifications for the position. Revised 9/20/18 Page 1 of 5 Attachment A 3. Written code of conduct for employees and volunteers/interns shall be established which address at least the following: a) Use of drugs and/or alcohol; b) Prohibition of social/business relationship with clients or their family members for personal gain; c) Prohibition of sexual contact with clients; d) Conflict of interest; e) Providing services beyond scope; f) Discrimination against clients or staff; g) Verbally, physically, or sexually harassing, threatening, or abusing clients, family members or other staff; h) Protection of client confidentiality; i) The elements found in the code of conduct(s) for the certifying organization(s) the program's counselors are certified under; and j) Cooperation with complaint investigations. 4. If a program utilizes the services of volunteers and or interns, procedures shall be implemented which address: a) Recruitment; b) Screening; c) Selection; d) Training and orientation; e) Duties and assignments; f) Scope of practice; g) Supervision; h) Evaluation; i) Protection of client confidentiality;and j) Code of Conduct Revised 9/20/18 Page 2 of 5 Attachment A 5. Written roles and responsibilities and a code of conduct for the medical director (if applicable) shall be clearly documented, signed and dated by an authorized program representative and the medical director. B. Program Management 1. Admission or Readmission a) Each program shall include in its policies and procedures written admission and readmission criteria for determining client's eligibility and suitability for treatment. These criteria shall include, at minimum: i. Use of alcohol/drugs of abuse; ii. Physical health status; iii. Documentation of social and psychological problems; and iv. A statement of nondiscrimination requiring that admission shall not be denied on the basis of ethnic group identification, religion, age, gender, race, disability, or sexual orientation. The above shall not preclude programs from emphasizing services for specific populations. b) If a potential client does not meet the admission criteria, the client shall be referred to an appropriate service provider. c) If a client is admitted to treatment, a consent to treatment form shall be signed by the client. d) All referrals made by the program shall be documented in the client record. e) Copies of the following documents shall be provided to the client upon admission: i. Client rights, client fee policies, and consent to treatment. f) Copies of the following shall be provided to the client or posted in a prominent place accessible to all clients: i. A statement of nondiscrimination by race, religion, sex, gender identity, ethnicity, age, disability, sexual preference, and ability to pay; ii. Grievance procedures; iii. Appeal process for involuntary discharge; and iv. Program rules,expectations and regulations. Revised 9/20/18 Page 3 of 5 Attachment A g) Where drug screening by urinalysis is deemed appropriate the program shall: i. Establish procedures which protect against the falsification and/or contamination of any urine sample;and ii. Document urinalysis results in the client's file. 2. Treatment a) Assessment for all clients shall include: i. Drug/Alcohol use history; ii. Medical history; iii. Family history; iv. Psychiatric history; V. Social/recreational history; vi. Financial status/history; vii. Educational history; viii. Employment history; ix. Criminal history, legal status; and X. Previous SUD treatment history. b) Treatment plans shall be developed with the client within 30 days of admission and include: i. A problem statement for all problems identified through the assessment whether addressed or deferred; ii. Goals to address each problem statement (except when deferred); iii. Action steps to meet the goals that include who is responsible for the action and the target date for completion; and iv. Signature of primary counselor and client. All treatment plans shall be reviewed periodically and updated to accurately reflect the client's progress or lack of progress in treatment. Revised 9/20/18 Page 4 of 5 Attachment A c) Progress notes shall document the client's progress toward completion of activities and achievement of goals on the treatment plan. d) Discharge documentation shall be developed with the client, if possible and include: i. Description of the treatment episode; ii. Prognosis; iii. Client's plan for continued recovery including support systems and plans for relapse prevention; iv. Reason and type of discharge; V. Signature of primary counselor and client; vi. A copy of the discharge documentation shall be given to the client; vii. Current alcohol and/or other drug usage; viii. Vocational and educational achievements; ix. Transfers and referrals; and X. Client comments. Revised 9/20/18 Page 5 of 5 Attachment B Page 1 of 1 UNLAWFUL USE OF DRUGS AND ALCOHOL CERTIFICATION I, as an authorized agent of (Print Name) acknowledge the requirement to (Organization Name) comply with California HSC 11999-11999.3, which authorizes the County of Fresno to terminate a contract, without penalty, if this organization or its employees, or a subcontractor or its employees fail to ensure that: • The program contains a component that clearly explains in written materials that there shall be no unlawful use of drugs or alcohol. No aspect of a drug- or alcohol-related program shall include any message on the responsible use, if the use is unlawful, of drugs or alcohol; • All aspects of a drug- or alcohol-related program are consistent with the "no unlawful use" message, including, but not limited to, program standards, curricula, materials, and teachings; and • The "no unlawful use" of drugs and alcohol message contained in drug- or alcohol-related programs applies to the use of drugs and alcohol prohibited by law. I understand that the State of California enforces an Unlawful Use policy in which there is zero tolerance for promoting the unlawful use of and drugs or alcohol in an AOD treatment facility. If this organization fails to satisfy the guidelines adopted by the State of California, the drug or alcohol program shall not receive state funds and their contract with Fresno County will be terminated. I understand that this organization is obligated to ensure any subcontractors are informed of the requirements of HSC 11999-11999.3 and, if found in violation, will be immediately terminated. Signature: Date: Title: Attachment C Page 1 of 1 TRAFFICKING VICTIMS PROTECTION ACT OF 2000 CERTIFICATION I, as an authorized agent of (Print Name) acknowledge the requirement to (Organization Name) comply with the Trafficking Victims Protection Act of 2000 (TVPA), specifically Section 106(g), which authorizes the County of Fresno to terminate a contract, without penalty, if this organization or its employees, or a subcontractor or its employees: • Engages in severe forms of trafficking in persons during the period of time that the award is in effect; • Procures a commercial sex act during the period of time that the award in in effect; or • Uses forced labor in the performance of the award or subawards under the award. I understand that the TVPA establishes human trafficking and related offenses as federal crimes and attaches severe penalties to them. I will immediately inform the County of Fresno, Department of Behavioral Health, Contracts Division — Substance Use Disorder (SUD) Services immediately of any information received from any source alleging a violation of the TVPA by either this organization or its employees, or a subcontractor or its employees during the term of this contract. I understand that this organization is obligated to ensure any subcontractors are informed of the requirements of the TVPA and, if found in violation, will be immediately terminated. I agree to submit this signed certification annually on behalf of the organization acknowledging requirements under the TVPA and attesting that all employees will receive annual TVPA training, and that documentation of training will be placed in personnel files. Signature: Date: Title: Exhibit K- Page 1 of 1 PRIVACY AND SECURITY AGREEMENT REGARDING AUTHORIZED ACCESS TO CONFIDENTIAL PROTECTED HEALTH INFORMATION FOR FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH(DBH) EMPLOYEES AND/OR NON-DBH SUD SERVICES WORKFORCE MEMBERS OATH OF CONFIDENTIALITY As a condition of obtaining access to any Protected Health Information(PHI)that is necessary to carry out my function with DBH, I , agree to not divulge any PHI to unauthorized persons. Furthermore, I maintain that I will not publish or otherwise make public any information regarding persons who receive Substance Use Disorder Services such that the persons who receive or have received such services are identifiable. Access to such data shall be limited to Fresno County DBH personnel, subcontractors, and subcontractors' personnel who require this information in the performance of their duties and have signed an Oath of Confidentiality with DBH. By signing this oath, I agree to uphold the security and confidentiality requirements outlined by the Medi- Cal Privacy and Security Agreement signed by DBH, surveillance and safeguarding announcements issued by DHCS, and other applicable terms and stipulations provided by the HIPAA doctrine as well as other relevant state and federal regulations. I hereby certify my understanding of the need to: 1. Exercise due care to preserve data integrity and confidentiality. 2. Treat passwords and user accounts as confidential information. 3. Take reasonable precautions to ensure the protection of PHI from unauthorized access. 4. Notify DHCS when there is a possible security violation including unauthorized access to PHI by completing a"Privacy Incident Report"at: http://www.dhcs.ca.gov/fonnsandpubs/laws/priv/Pages/DHCSBusinessAssociatesOnly.aspx and return the completed form to: privacyofficer(kdhcs.ca.gov. I recognize that unauthorized release of confidential information may make me subject to civil and criminal sanctions pursuant to the provisions of the Welfare and Institutions Code Section 14100.2, Welfare and Institutions Code Section 5328 et seq. and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). I further acknowledge that the unauthorized release of confidential information as described in this document may result in disciplinary action up to and including termination of any office of employment or contract. Agency Name: Signature: Date: Exhibit L Page 1 of 8 Data Security 1. Definitions Capitalized terms used in this Exhibit L have the meanings set forth in this section 1. (A) "Authorized Employees" means the Contractor's employees who have access to Personal Information. (B) "Authorized Persons" means: (i) any and all Authorized Employees; and (ii) any and all of the Contractor's subcontractors, representatives, agents, outsourcers, and consultants, and providers of professional services to the Contractor, who have access to Personal Information and are bound by law or in writing by confidentiality obligations sufficient to protect Personal Information in accordance with the terms of this Exhibit L. (C) "Director" means the County's Director of the Department of Behavioral Health or his or her designee. (D) "Disclose" or any derivative of that word means to disclose, release, transfer, disseminate, or otherwise provide access to or communicate all or any part of any Personal Information orally, in writing, or by electronic or any other means to any person. (E) "Person" means any natural person, corporation, partnership, limited liability company, firm, or association. (F) "Personal Information" means any and all information, including any data, provided, or to which access is provided, to the Contractor by or upon the authorization of the County, under this Agreement, including but not limited to vital records, that: (i) identifies, describes, or relates to, or is associated with, or is capable of being used to identify, describe, or relate to, or associate with, a person (including, without limitation, names, physical descriptions, signatures, addresses, telephone numbers, e-mail addresses, education, financial matters, employment history, and other unique identifiers, as well as statements made by or attributable to the person); (ii) is used or is capable of being used to authenticate a person (including, without limitation, employee identification numbers, government-issued identification numbers, passwords or personal identification numbers (PINs), financial account numbers, credit report information, answers to security questions, and other personal identifiers); or (iii) is personal information within the meaning of California Civil Code section 1798.3, subdivision (a), or 1798.80, subdivision (e). Personal Information does not include publicly available information that is lawfully made available to the general public from federal, state, or local government records. (G) "Privacy Practices Complaint" means a complaint received by the County relating to the Contractor's (or any Authorized Person's) privacy practices, or alleging a Security Breach. Such complaint shall have sufficient detail to enable the Contractor to promptly investigate and take remedial action under this Exhibit L. (H) "Security Safeguards" means physical, technical, administrative or organizational security procedures and practices put in place by the Contractor (or any Authorized Persons) that relate to the protection of the security, confidentiality, value, or integrity of Personal Information. Security Safeguards shall satisfy the minimal requirements set forth in section 3(C) of this Exhibit L. Exhibit L Page 2 of 8 (1) "Security Breach" means (i) any act or omission that compromises either the security, confidentiality, value, or integrity of any Personal Information or the Security Safeguards, or (ii) any unauthorized Use, Disclosure, or modification of, or any loss or destruction of, or any corruption of or damage to, any Personal Information. (J) "Use" or any derivative of that word means to receive, acquire, collect, apply, manipulate, employ, process, transmit, disseminate, access, store, disclose, or dispose of Personal Information. 2. Standard of Care (A) The Contractor acknowledges that, in the course of its engagement by the County under this Agreement, the Contractor, or any Authorized Persons, may Use Personal Information only as permitted in this Agreement. (B) The Contractor acknowledges that Personal Information is deemed to be confidential information of, or owned by, the County (or persons from whom the County receives or has received Personal Information) and is not confidential information of, or owned or by, the Contractor, or any Authorized Persons. The Contractor further acknowledges that all right, title, and interest in or to the Personal Information remains in the County (or persons from whom the County receives or has received Personal Information) regardless of the Contractor's, or any Authorized Person's, Use of that Personal Information. (C) The Contractor agrees and covenants in favor of the Country that the Contractor shall: (i) keep and maintain all Personal Information in strict confidence, using such degree of care under this section 2 as is reasonable and appropriate to avoid a Security Breach; (ii) Use Personal Information exclusively for the purposes for which the Personal Information is made accessible to the Contractor pursuant to the terms of this Exhibit L; (iii) not Use, Disclose, sell, rent, license, or otherwise make available Personal Information for the Contractor's own purposes or for the benefit of anyone other than the County, without the County's express prior written consent, which the County may give or withhold in its sole and absolute discretion; and (iv) not, directly or indirectly, Disclose Personal Information to any person (an "Unauthorized Third Party") other than Authorized Persons pursuant to this Agreement, without the Director's express prior written consent. (D) Notwithstanding the foregoing paragraph, in any case in which the Contractor believes it, or any Authorized Person, is required to disclose Personal Information to government regulatory authorities, or pursuant to a legal proceeding, or otherwise as may be required by applicable law, Contractor shall (i) immediately notify the County of the specific demand for, and legal authority for the disclosure, including providing County with a copy of any notice, discovery demand, subpoena, or order, as applicable, received by the Contractor, or any Authorized Person, from any government regulatory authorities, or in relation to any legal proceeding, and (ii) promptly notify the County Exhibit L Page 3 of 8 before such Personal Information is offered by the Contractor for such disclosure so that the County may have sufficient time to obtain a court order or take any other action the County may deem necessary to protect the Personal Information from such disclosure, and the Contractor shall cooperate with the County to minimize the scope of such disclosure of such Personal Information. (E) The Contractor shall remain liable to the County for the actions and omissions of any Unauthorized Third Party concerning its Use of such Personal Information as if they were the Contractor's own actions and omissions. 3. Information Security (A) The Contractor covenants, represents and warrants to the County that the Contractor's Use of Personal Information under this Agreement does and will at all times comply with all applicable federal, state, and local, privacy and data protection laws, as well as all other applicable regulations and directives, including but not limited to California Civil Code, Division 3, Part 4, Title 1.81 (beginning with section 1798.80), and the Song- Beverly Credit Card Act of 1971 (California Civil Code, Division 3, Part 4, Title 1.3, beginning with section 1747). If the Contractor Uses credit, debit or other payment cardholder information, the Contractor shall at all times remain in compliance with the Payment Card Industry Data Security Standard ("PCI DSS") requirements, including remaining aware at all times of changes to the PCI DSS and promptly implementing and maintaining all procedures and practices as may be necessary to remain in compliance with the PCI DSS, in each case, at the Contractor's sole cost and expense. (B) The Contractor covenants, represents and warrants to the County that, as of the effective date of this Agreement, the Contractor has not received notice of any violation of any privacy or data protection laws, as well as any other applicable regulations or directives, and is not the subject of any pending legal action or investigation by, any government regulatory authority regarding same. (C) Without limiting the Contractor's obligations under section 3(A) of this Exhibit L, the Contractor's (or Authorized Person's) Security Safeguards shall be no less rigorous than accepted industry practices and, at a minimum, include the following: (i) limiting Use of Personal Information strictly to the Contractor's and Authorized Persons' technical and administrative personnel who are necessary for the Contractor's, or Authorized Persons', Use of the Personal Information pursuant to this Agreement; (ii) ensuring that all of the Contractor's connectivity to County computing systems will only be through the County's security gateways and firewalls, and only through security procedures approved upon the express prior written consent of the Director; (iii) to the extent that they contain or provide access to Personal Information, (a) securing business facilities, data centers, paper files, servers, back-up systems and computing equipment, operating systems, and software applications, including, but not limited to, all mobile devices and other equipment, operating systems, and software applications with information storage capability; (b) Exhibit L Page 4 of 8 employing adequate controls and data security measures, both internally and externally, to protect (1) the Personal Information from potential loss or misappropriation, or unauthorized Use, and (2) the County's operations from disruption and abuse; (c) having and maintaining network, device application, database and platform security; (d) maintaining authentication and access controls within media, computing equipment, operating systems, and software applications; and (e) installing and maintaining in all mobile, wireless, or handheld devices a secure internet connection, having continuously updated anti-virus software protection and a remote wipe feature always enabled, all of which is subject to express prior written consent of the Director; (iv) encrypting all Personal Information at advance encryption standards of Advanced Encryption Standards (AES) of 128 bit or higher (a) stored on any mobile devices, including but not limited to hard disks, portable storage devices, or remote installation, or (b) transmitted over public or wireless networks (the encrypted Personal Information must be subject to password or pass phrase, and be stored on a secure server and transferred by means of a Virtual Private Network (VPN) connection, or another type of secure connection, all of which is subject to express prior written consent of the Director); (v) strictly segregating Personal Information from all other information of the Contractor, including any Authorized Person, or anyone with whom the Contractor or any Authorized Person deals so that Personal Information is not commingled with any other types of information; (vi) having a patch management process including installation of all operating system and software vendor security patches; (vii) maintaining appropriate personnel security and integrity procedures and practices, including, but not limited to, conducting background checks of Authorized Employees consistent with applicable law; and (viii) providing appropriate privacy and information security training to Authorized Employees. (D) During the term of each Authorized Employee's employment by the Contractor, the Contractor shall cause such Authorized Employees to abide strictly by the Contractor's obligations under this Exhibit L. The Contractor shall maintain a disciplinary process to address any unauthorized Use of Personal Information by any Authorized Employees. (E) The Contractor shall, in a secure manner, backup daily, or more frequently if it is the Contractor's practice to do so more frequently, Personal Information received from the County, and the County shall have immediate, real time access, at all times, to such backups via a secure, remote access connection provided by the Contractor, through the Internet. (F)The Contractor shall provide the County with the name and contact information for each Authorized Employee (including such Authorized Employee's work shift, and at least one alternate Authorized Employee for each Authorized Employee during such work shift) who shall serve as the County's primary security contact with the Contractor and shall be Exhibit L Page 5 of 8 available to assist the County twenty-four (24) hours per day, seven (7) days per week as a contact in resolving the Contractor's and any Authorized Persons' obligations associated with a Security Breach or a Privacy Practices Complaint. (G)The Contractor shall not knowingly include or authorize any Trojan Horse, back door, time bomb, drop dead device, worm, virus, or other code of any kind that may disable, erase, display any unauthorized message within, or otherwise impair any County computing system, with or without the intent to cause harm. 4. Security Breach Procedures (A) Immediately upon the Contractor's awareness or reasonable belief of a Security Breach, the Contractor shall (i) notify the Director of the Security Breach, such notice to be given first by telephone at the following telephone number: (559)600-9058, followed promptly by email at the following email address: sholt@fresnocountyca.gov (which telephone number and email address the County may update by providing notice to the Contractor), and (ii) preserve all relevant evidence (and cause any affected Authorized Person to preserve all relevant evidence) relating to the Security Breach. The notification shall include, to the extent reasonably possible, the identification of each type and the extent of Personal Information that has been, or is reasonably believed to have been, breached, including but not limited to, compromised, or subjected to unauthorized Use, Disclosure, or modification, or any loss or destruction, corruption, or damage. (B) Immediately following the Contractor's notification to the County of a Security Breach, as provided pursuant to section 4(A) of this Exhibit L, the Parties shall coordinate with each other to investigate the Security Breach. The Contractor agrees to fully cooperate with the County, including, without limitation: (i) assisting the County in conducting any investigation; (ii) providing the County with physical access to the facilities and operations affected; (iii) facilitating interviews with Authorized Persons and any of the Contractor's other employees knowledgeable of the matter; and (iv) making available all relevant records, logs, files, data reporting and other materials required to comply with applicable law, regulation, industry standards, or as otherwise reasonably required by the County. To that end, the Contractor shall, with respect to a Security Breach, be solely responsible, at its cost, for all notifications required by law and regulation, or deemed reasonably necessary by the County, and the Contractor shall provide a written report of the investigation and reporting required to the Director within 30 days after the Contractor's discovery of the Security Breach. (C) County shall promptly notify the Contractor of the Director's knowledge, or reasonable belief, of any Privacy Practices Complaint, and upon the Contractor's receipt of that notification, the Contractor shall promptly address such Privacy Practices Complaint, including taking any corrective action under this Exhibit L, all at the Contractor's sole expense, in accordance with applicable privacy rights, laws, regulations and standards. Exhibit L Page 6 of 8 In the event the Contractor discovers a Security Breach, the Contractor shall treat the Privacy Practices Complaint as a Security Breach. Within 24 hours of the Contractor's receipt of notification of such Privacy Practices Complaint, the Contractor shall notify the County whether the matter is a Security Breach, or otherwise has been corrected and the manner of correction, or determined not to require corrective action and the reason for that determination. (D) The Contractor shall take prompt corrective action to respond to and remedy any Security Breach and take mitigating actions, including but not limiting to, preventing any reoccurrence of the Security Breach and correcting any deficiency in Security Safeguards as a result of such incident, all at the Contractor's sole expense, in accordance with applicable privacy rights, laws, regulations and standards. The Contractor shall reimburse the County for all reasonable costs incurred by the County in responding to, and mitigating damages caused by, any Security Breach, including all costs of the County incurred relation to any litigation or other action described section 4(E) of this Exhibit L. (E) The Contractor agrees to cooperate, at its sole expense, with the County in any litigation or other action to protect the County's rights relating to Personal Information, including the rights of persons from whom the County receives Personal Information. 5. Oversight of Security Compliance (A) The Contractor shall have and maintain a written information security policy that specifies Security Safeguards appropriate to the size and complexity of the Contractor's operations and the nature and scope of its activities. (B) Upon the County's written request, to confirm the Contractor's compliance with this Exhibit L, as well as any applicable laws, regulations and industry standards, the Contractor grants the County or, upon the County's election, a third party on the County's behalf, permission to perform an assessment, audit, examination or review of all controls in the Contractor's physical and technical environment in relation to all Personal Information that is Used by the Contractor pursuant to this Agreement. The Contractor shall fully cooperate with such assessment, audit or examination, as applicable, by providing the County or the third party on the County's behalf, access to all Authorized Employees and other knowledgeable personnel, physical premises, documentation, infrastructure and application software that is Used by the Contractor for Personal Information pursuant to this Agreement. In addition, the Contractor shall provide the County with the results of any audit by or on behalf of the Contractor that assesses the effectiveness of the Contractor's information security program as relevant to the security and confidentiality of Personal Information Used by the Contractor or Authorized Persons during the course of this Agreement under this Exhibit L. (C) The Contractor shall ensure that all Authorized Persons who Use Personal Information agree to the same restrictions and conditions in this Exhibit L. that apply to the Contractor with respect to such Personal Information by incorporating the relevant provisions of these provisions into a valid and binding written agreement between the Contractor and such Authorized Persons, or amending any written agreements to provide same. Exhibit L Page 7 of 8 6. Return or Destruction of Personal Information. Upon the termination of this Agreement, the Contractor shall, and shall instruct all Authorized Persons to, promptly return to the County all Personal Information, whether in written, electronic or other form or media, in its possession or the possession of such Authorized Persons, in a machine readable form used by the County at the time of such return, or upon the express prior written consent of the Director, securely destroy all such Personal Information, and certify in writing to the County that such Personal Information have been returned to the County or disposed of securely, as applicable. If the Contractor is authorized to dispose of any such Personal Information, as provided in this Exhibit L, such certification shall state the date, time, and manner (including standard) of disposal and by whom, specifying the title of the individual. The Contractor shall comply with all reasonable directions provided by the Director with respect to the return or disposal of Personal Information and copies of Personal Information. If return or disposal of such Personal Information or copies of Personal Information is not feasible, the Contractor shall notify the County according, specifying the reason, and continue to extend the protections of this Exhibit L to all such Personal Information and copies of Personal Information. The Contractor shall not retain any copy of any Personal Information after returning or disposing of Personal Information as required by this section 6. The Contractor's obligations under this section 6 survive the termination of this Agreement and apply to all Personal Information that the Contractor retains if return or disposal is not feasible and to all Personal Information that the Contractor may later discover. 7. Equitable Relief. The Contractor acknowledges that any breach of its covenants or obligations set forth in this Exhibit L may cause the County irreparable harm for which monetary damages would not be adequate compensation and agrees that, in the event of such breach or threatened breach, the County is entitled to seek equitable relief, including a restraining order, injunctive relief, specific performance and any other relief that may be available from any court, in addition to any other remedy to which the County may be entitled at law or in equity. Such remedies shall not be deemed to be exclusive but shall be in addition to all other remedies available to the County at law or in equity or under this Agreement. 8. Indemnity. The Contractor shall defend, indemnify and hold harmless the County, its officers, employees, and agents, (each, a "County Indemnitee") from and against any and all infringement of intellectual property including, but not limited to infringement of copyright, trademark, and trade dress, invasion of privacy, information theft, and extortion, unauthorized Use, Disclosure, or modification of, or any loss or destruction of, or any corruption of or damage to, Personal Information, Security Breach response and remedy costs, credit monitoring expenses, forfeitures, losses, damages, liabilities, deficiencies, actions, judgments, interest, awards, fines and penalties (including regulatory fines and penalties), costs or expenses of whatever kind, including attorneys' fees and costs, the cost of enforcing any right to indemnification or defense under this Exhibit L and the cost of pursuing any insurance providers, arising out of or resulting from any third party claim or action against any County Indemnitee in relation to the Contractor's, its officers, employees, or agents, or any Authorized Employee's or Authorized Person's, performance or failure to perform under this Exhibit L or arising out of or resulting from the Contractor's failure to comply with any of its obligations under this section 8. The provisions of this section 8 do not apply to the acts or omissions of the County. The provisions of this section 8 are cumulative to any other obligation of the Contractor to, defend, indemnify, or hold harmless any County Indemnitee under this Agreement. The provisions of this section 8 shall survive the termination of this Agreement. Exhibit L Page 8 of 8 9. Survival. The respective rights and obligations of the Contractor and the County as stated in this Exhibit L shall survive the termination of this Agreement. 10. No Third Party Beneficiary. Nothing express or implied in the provisions of in this Exhibit L is intended to confer, nor shall anything in this Exhibit L confer, upon any person other than the County or the Contractor and their respective successors or assignees, any rights, remedies, obligations or liabilities whatsoever. 11. No County Warranty. The County does not make any warranty or representation whether any Personal Information in the Contractor's (or any Authorized Person's) possession or control, or Use by the Contractor (or any Authorized Person), pursuant to the terms of this Agreement is or will be secure from unauthorized Use, or a Security Breach or Privacy Practices Complaint.