HomeMy WebLinkAboutAgreement A-15-315 with Licensed Residential Svcs Prog..pdfAgreement No. 15-315
AGREEMENT 1
2 THIS AGREEMENT is made and entered into this i L.f -f'l-. day of----=:r=· =u =--;~ Y~---
3 2015, by and between the COUNTY OF FRESNO, a Political Subdivision ofthe State of California,
4 hereinafter referred to as "COUNTY", and each provider listed in Exhibit A, attached to this
5 Agreement and by this reference incorporated herein, collectively hereinafter referred to as
6 "CONTRACTOR(S)" and such additional Contractors as may, from time to time during the term of this
7 Agreement, be added by COUNTY's Director, Department of Behavioral Health or designee in
8 accordance with this Agreement.
9 W I T N E S S E T H:
10 WHEREAS, certain licensed residential care facilities are able to provide supplemental care and
11 supervision for COUNTY placed clients with a mental health condition; and
12 WHEREAS, supplemental care includes, in such combination as may be applicable to the type
13 of facility operated, personal care, protection, supervision, assistance, guidance or training, planned
14 activities, food service, and incidental medical and dental care; and
15 WHEREAS, COUNTY, through its Department of Behavioral Health (DBH), Transitional
16 Rehabilitation Services Program (TRSP), has established a supplemental rate system for residential
17 care facilities in Fresno County in order to address the special needs above and beyond the basic needs
18 of the COUNTY placed clients with a mental health condition; and
19 WHEREAS, COUNTY's DBH, desires to contract with licensed residential care facilities
20 willing and able to provide supplemental residential care services.
21 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
22 hereto agree as follows:
1. SERVICES 23
24 A. CONTRACTOR(S) shall provide supplemental residential care services to
25 COUNTY placed clients with a mental health condition in accordance with the certification
26 requirements identified in Exhibit B, attached hereto and by this reference incorporated herein and in
27 accordance with the quality assurance standards identified in Exhibit C, attached hereto and by this
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COUNTY OF FRESNO
Fresno, CA
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reference incorporated herein. Eligibility for TRSP services is at the sole discretion of COUNTY's
Department of Behavioral Health designated staff.
B. For COUNTY clients that are determined not eligible for the TRSP services
described herein, as determined by designated COUNTY's Department of Behavioral Health staff,
CONTRACTOR(S) shall still accept referred non-eligible COUNTY clients to live at the board and
care residences, although they will not receive TRSP services as described herein.
2. TERM
This Agreement shall become effective on the 1st day of July, 2015 and shall
terminate on the 30th day of June, 2017.
3. TERMINATION
A. Non-Allocation of Funds -The terms of this Agreement, and the services to be
provided thereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated at any time by giving the CONTRACTOR(S) thirty (30) days advance written notice.
B. Breach of Contract -The COUNTY may immediately suspend or terminate this
Agreement in whole or in part, where in the determination of the COUNTY there is:
1) An illegal or improper use of funds;
2) A failure to comply with any term of this Agreement;
3) A substantially incorrect or incomplete report submitted to COUNTY;
4) Improperly performed service.
5) Suspension or revocation of the license by any regulatory agency of the
State of California to operate the facility.
In no event shall any payment by the COUNTY constitute a waiver by the
COUNTY of any breach of this Agreement or any default which may then exist on the part of the
CONTRACTOR(S). Neither shall such payment impair or prejudice any remedy available to the
COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of the
CONTRACTOR(S) the repayment to the COUNTY of any funds disbursed to the CONTRACTOR(S)
under this Agreement, which in the judgment of the COUNTY were not expended in accordance with
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1 the terms of this Agreement. The CONTRACTOR(S) shall promptly refund any such funds upon
2 demand or, at the COUNTY's option, such repayment shall be deducted from future payments owing to
3 CONTRACTOR under this Agreement.
4 C. Without Cause -Under circumstances other than those set forth above, this
5 Agreement may be terminated by CONTRACTOR(S) or COUNTY upon the giving of thirty (30) days
6 advance written notice of an intention to terminate.
7 4. COMPENSATION
8 For each COUNTY client who is not a recipient of Social Security Insurance (SSI)/Social
9 Security Administration (SSA) benefits who is eligible for TRSP services, COUNTY agrees to pay and
10 CONTRACTOR(S) agrees to receive compensation for basic board and care at the monthly rate set forth
11 by the Social Security Administration. All parties agree that for each COUNTY client, regardless of
12 whether or not client receives SSI/SSA benefits, who is eligible for TRSP services, the daily flat rate
13 during Fiscal Year (Fiscal Year or FY is defined herein as July 1 through June 30) 2015-16 for TRSP
14 services per eligible resident shall be Fourteen and 65/100 Dollars ($14.65) per day or Four Hundred
15 Forty-Five and 74/100 Dollars ($445.74) per month (a fourteen (14) percent increase from the FY
16 2014-15 monthly rate of$391or $12.85 per day).The daily flat rate during FY 2016-17 shall be the FY
17 2015-16 rate increased at the positive Consumer Price Index (CPI) rate, not to exceed four (4) percent,
18 released by the U.S. Department of Labor-Bureau of Labor Statistics in June ofFY 2015-16 and shall
19 be the 12-month CPI for the expenditure sub-category of"Nursing Homes/Adult Day Care Services"
20 for supplemental services provided to the client. If the CPI is negative, the rate will remain the same
21 from the previous FY. In no event shall actual services performed under this Agreement for all COUNTY
22 clients by all CONTRACTORS collectively exceed the maximum compensation amount of Two Million
23 Four Hundred Fifteen Thousand, Five Hundred and No/100 Dollars ($2,415,500) for the two-year period.
24 It is understood that all expenses incidental to CONTRACTOR(S) performance of services under this
25 Agreement shall be borne by CONTRACTOR(S).
26 COUNTY shall pay and CONTRACTOR agrees to receive Fourteen and 651100 Dollars
27 ($14.65) per day or Four Hundred Forty-Five and 741100 Dollars ($445.74) per month for each client
28 placed by COUNTY at CONTRACTORS' facility(ies) during FY 2015-16. The total maximum
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1 compensation for all clients under this Agreement shall not be in excess of One Million Two Hundred
2 Seven Thousand, Seven Hundred Fifty and No/100 Dollars ($1,207,750) for Fiscal Year 2015-16.
3 COUNTY shall pay and CONTRACTOR agrees to receive up to Fifteen and 24/100
4 Dollars ($15.24) per day or Four Hundred Sixty-Three and 57/100 Dollars ($463.57) per month for
5 each client placed by COUNTY at CONTRACTORS' facility(ies) during FY 2016-17. The total
6 maximum compensation for all clients under this Agreement shall not be in excess of One Million Two
7 Hundred Seven Thousand, Seven Hundred Fifty and No/100 Dollars ($1,207,750) for Fiscal Year
8 2016-17.
9 COUNTY and CONTRACTOR(S) acknowledge that the rates recited in the preceding
10 paragraphs may be subject to adjustment pursuant to rates set by the State of California Department of
11 Health Care Services or the Social Security Administration for supplemental residential care services,
12 as appropriate, during each term ofthis Agreement. Rate adjustment(s) shall be approved by
13 COUNTY's DBH Director, or designee and CONTRACTOR(S), and shall become part of this
14 Agreement. COUNTY agrees to pay CONTRACTOR(S) the adjusted rate after the effective date of the
15 adjustment is authorized by the State of California Department of Health Care Services or Social
16 Security Administration, as appropriate, and CONTRACTOR(S) agree to accept such supplemental
17 residential care rates as of the effective date of such adjustment, whether or not the cost of providing
18 such services shall have exceeded the amount ofthe payments hereunder. Any rate adjustment shall not
19 result in an increase to the maximum amount of the Agreement as stated herein. COUNTY shall notify
20 CONTRACTOR(S) in writing of any supplemental residential care rate change within thirty (30) days
21 of COUNTY receiving notice of any rate change from the State of California Department of Health
22 Care Services or Social Security Administration.
23 Payment by COUNTY shall be in arrears, based on CONTRACTOR's monthly invoice
24 submitted for services provided during the preceding month, within forty-five ( 45) days after receipt,
25 verification and approval of CONTRACTOR's monthly invoices by COUNTY's DBH. In addition, it
26 is understood by CONTRACTOR that at the discretion of COUNTY's DBH Director or designee,
27 COUNTY reserves the right to deny payment of any additional invoices received ninety (90) days after
28 the expiration of each term of this Agreement or termination of this Agreement. If CONTRACTOR
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1 should fail to comply with any provision of this Agreement, COUNTY shall be relieved of its
2 obligation for further compensation
3 5. INVOICING
4 CONTRACTOR shall invoice COUNTY in arrears by the 1Oth of each month for actual
5 expenses incurred and services rendered in the previous month, to: DBH-Invoices@co.fresno.ca.us or
6 addressed to Fresno County Department of Behavioral Health, Accounts Payable, P.O. Box 45003,
7 Fresno, CA 93702.
8 Invoices shall be submitted using the TRSP Monthly Billing Invoice, as shown in
9 Exhibit D attached hereto and by this reference incorporated herein. No reimbursement for services
10 shall be made until invoices are received and reviewed by COUNTY's DBH. In addition, for invoices
11 received ninety (90) days after the expiration of each term of this Agreement or termination of this
12 Agreement, at the discretion of COUNTY's DBH Director or designee, COUNTY reserves the right to
13 deny payment of any additional invoices received.
14 At the discretion of COUNTY's DBH Director or designee, if an invoice is incorrect or is
15 otherwise not in proper form or substance, COUNTY shall have the right to withhold payment as to
16 only that portion of the invoice that is incorrect or improper and CONTRACTOR agrees to continue to
17 provide services for a period of ninety (90) days and, if after the ninety (90) day period, the invoice(s)
18 is still not corrected to COUNTY's DBH satisfaction, COUNTY may elect to terminate this Agreement
19 with individual CONTRACTOR(S), pursuant to the termination provisions stated in Section Three (3)
20 of this Agreement.
21 6. INDEPENDENT CONTRACTOR
22 In performance of the work, duties, and obligations assumed by CONTRACTOR(S)
23 under this Agreement, it is mutually understood and agreed that CONTRACTOR(S), including any and
24 all ofCONTRACTOR(S') officers, agents, and employees will at all times be acting and performing as
25 independent CONTRACTOR(S), and shall act in an independent capacity and not as an officer, agent,
26 servant, employee, joint venturer, partner, or associate ofthe COUNTY. Furthermore, COUNTY shall
27 have no right to control or supervise or direct the manner or method by which CONTRACTOR(S) shall
28 perform their work and function. However, COUNTY shall retain the right to administer this
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1 Agreement so as to verify that CONTRACTOR(S) is/are performing their obligations in accordance
2 with the terms and conditions thereof. CONTRACTOR(S) and COUNTY shall comply with all
3 applicable provisions of law and the rules and regulations, if any, of governmental authorities having
4 jurisdiction over matters which are directly or indirectly the subject of this Agreement.
5 Because of their status as independent contractors, CONTRACTOR(S) shall have
6 absolutely no right to employment rights and benefits available to COUNTY employees.
7 CONTRACTOR(S) shall be solely liable and responsible for providing to, or on behalf of, their
8 employees all legally-required employee benefits. In addition, CONTRACTOR(S) shall be solely
9 responsible and save COUNTY harmless from all matters relating to payment ofCONTRACTOR(S')
10 employees, including compliance with Social Security, withholding, and all other regulations governing
11 such matters. It is acknowledged that during the term of this Agreement, CONTRACTOR(S) may be
12 providing services to others unrelated to the COUNTY or to this Agreement.
7. MODIFICATION 13
14 A. Any matters of this Agreement may be modified from time to time by the written
15 consent of COUNTY and CONTRACTOR(S) without, in any way, affecting the remainder.
16 B. Notwithstanding the above, changes to the providers listed in Exhibit A may be
17 made in accordance with Section Sixteen (16) ofthis Agreement.
18 C. Additionally, changes to the licensed residential supplemental rate, as dictated by
19 the State of California, may be made in accordance with Section Four (4) ofthis Agreement. Such
20 licensed residential supplemental rate changes shall not result in any changes to the maximum
21 compensation amount payable to CONTRACTOR(S).
22 8. NON-ASSIGNMENT
23 No party shall assign, transfer or subcontract this Agreement nor their rights or duties
24 under this Agreement without the prior written consent of the other party.
25 9. HOLD-HARMLESS
26 CONTRACTOR(S) agree to indemnify, save, hold harmless, and at COUNTY's request,
27 defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including
28 attorney's fees and court costs, damages, liabilities, claims and losses occurring or resulting to
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1 COUNTY in connection with the performance, or failure to perform, by CONTRACTOR(S), their
2 officers, agents or employees under this Agreement, and from any and all costs and expenses, including
3 attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any
4 person, firm or corporation who may be injured or damaged by the performance, or failure to perform,
5 of CONTRACTOR(S), their officers, agents or employees under this Agreement. In addition,
6 CONTRACTOR(S) agree(s) to indemnify COUNTY for Federal, State of California and/or local audit
7 exceptions resulting from noncompliance herein on the part of the CONTRACTOR(S).
8 10. INSURANCE
9 Without limiting the COUNTY's right to obtain indemnification from
10 CONTRACTOR(S) or any third parties, CONTRACTOR(S), at its sole expense, shall maintain in full
11 force and effect the following insurance policies throughout the term of this Agreement:
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B.
Commercial General Liability
Commercial General Liability Insurance with limits of not less than One Million
Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million
Dollars ($2,000,000). This policy shall be issued on a per occurrence basis.
COUNTY may require specific coverage including completed operations,
product liability, contractual liability, Explosion, Collapse, and Underground
(XCU), fire legal liability or any other liability insurance deemed necessary
because of the nature of the Agreement.
Automobile Liability
Comprehensive Automobile Liability Insurance with limits for bodily injury of
not less than Two Hundred Fifty Thousand Dollars ($250,000) per person, Five
Hundred Thousand Dollars ($500,000) per accident and for property damages of
not less than Fifty Thousand Dollars ($50,000), or such coverage with a
combined single limit of Five Hundred Thousand Dollars ($500,000). Coverage
should include owned and non-owned vehicles used in connection with this
Agreement.
C. Professional Liability
If CONTRACTOR(S) employs licensed professional staff (e.g. Ph.D., R.N.,
L.C.S.W., M.F.T.) in providing services, Professional Liability Insurance with
limits of not less than One Million Dollars ($1 ,000,000) per occurrence, Three
Million Dollars ($3,000,000) annual aggregate. CONTRACTOR agrees that it
shall maintain, at its sole expense, in full force and effect for a period of three (3)
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years following the termination of this Agreement, one or more policies of
professional liability insurance with limits of coverage as specified herein.
Worker's Compensation
A policy of Worker's Compensation Insurance as may be required by the
California Labor Code.
6 CONTRACTOR(S) shall obtain endorsements to the Commercial General Liability
7 insurance naming the County of Fresno, its officers, agents, and employees, individually and
8 collectively, as additional insured, but only insofar as the operations under this Agreement are
9 concerned. Such coverage for additional insured shall apply as primary insurance and any other
10 insurance, or self-insurance, maintained by the COUNTY, its officers, agents and employees shall be
11 excess only and not contributing with insurance provided under the CONTRACTOR(S) policies herein.
12 This insurance shall not be cancelled or changed without a minimum ofthirty (30) days advance
13 written notice given to COUNTY.
14 Within thirty (30) days from the date CONTRACTOR(S) signs this Agreement,
15 CONTRACTOR(S) shall provide certificates of insurance and endorsements as stated above for all of
16 the foregoing policies, as required herein, to the County of Fresno, 4441 E. Kings Canyon, Fresno,
17 California, 93 702, Attention: Contracts Section, stating that such insurance coverage's have been
18 obtained and are in full force; that the County of Fresno, its officers, agents and employees will not be
19 responsible for any premiums on the policies; that such Commercial General Liability insurance names
20 the County of Fresno, its officers, agents and employees, individually and collectively, as additional
21 insured, but only insofar as the operations under this Agreement are concerned; that such coverage for
22 additional insured shall apply as primary insurance and any other insurance, or self-insurance,
23 maintained by the COUNTY, its officers, agents and employees, shall be excess only and not
24 contributing with insurance provided under the CONTRACTOR(S') policies herein; and that this
25 insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written
26 notice given to COUNTY.
27 In the event CONTRACTOR(S) fails to keep in effect at all times insurance coverage as
28 herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
this Agreement upon the occurrence of such event.
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1 All policies shall be with admitted insurers licensed to do business in the State of
2 California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of
3 A FSC VIII or better.
4 11. CONFIDENTIALITY
5 All services performed by CONTRACTOR under this Agreement shall be in strict
6 conformance with all applicable Federal, State of California and/or local laws and regulations relating
7 to confidentiality.
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12. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
A. The parties to this Agreement shall be in strict conformance with all applicable
10 Federal and State of California laws and regulations, including but not limited to Sections 5328, 10850,
11 and 14100.2 et seq. ofthe Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. ofTitle 42,
12 Code ofFederal Regulations (CFR), Section 56 et seq. ofthe California Civil Code, Sections 11977
13 and 11812 ofTitle 22 ofthe California Code ofRegulations, and the Health Insurance Portability and
14 Accountability Act (HIPAA), including but not limited to Section 1320 D et seq. of Title 42, United
15 States Code (USC) and its implementing regulations, including, but not limited to Title 45, CFR,
16 Sections 142, 160, 162, and 164, and The Health Information Technology for Economic and Clinical
17 Health Act (HITECH) regarding the confidentiality and security of patient information.
18 Except as otherwise provided in this Agreement, CONTRACTOR, as a Business
19 Associate of COUNTY, may use or disclose Protected Health Information (PHI) to perform functions,
20 activities or services for or on behalf of COUNTY, as specified in this Agreement, provided that such
21 use or disclosure shall not violate the Health Insurance Portability and Accountability Act (HIPAA),
22 USC 1320d et seq. The uses and disclosures of PHI may not be more expansive than those applicable
23 to COUNTY, as the "Covered Entity" under the HIPAA Privacy Rule (45 CFR 164.500 et seq), except
24 as authorized for management, administrative or legal responsibilities of the Business Associate.
25 B. CONTRACTOR shall protect, from unauthorized access, use, or disclosure of
26 names and other identifying information concerning persons receiving services pursuant to this
27 Agreement, except where permitted in order to carry out data aggregation purposes for health care
28 operations [45 CFR Sections 164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)]-This
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1 pertains to any and all persons receiving services pursuant to a COUNTY funded program.
2 CONTRACTOR shall not use such identifying information for any purpose other than carrying out
3 CONTRACTOR's obligations under this Agreement.
4 C. CONTRACTOR shall not disclose any such identifying information to any
5 person or entity, except as otherwise specifically permitted by this Agreement, authorized by law, or
6 authorized by the client/patient.
7 D. For purposes of the above sections, identifying information shall include, but not
8 be limited to name, identifying number, symbol, or other identifying particular assigned to the
9 individual, such as finger or voice print, or a photograph.
10 E. CONTRACTOR shall provide access, at the request of COUNTY, and in the
11 time and manner designated by COUNTY, to PHI in a designated record set (as defined in 45 CFR
12 Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45 CFR
13 Section164.524 regarding access by individuals to their PHI.
14 CONTRACTOR shall make any amendment(s) to PHI in a designated record set
15 at the request of COUNTY, and in the time and manner designated by COUNTY in accordance with 45
16 CFR Section 164.526.
17 CONTRACTOR shall provide to COUNTY or to an individual, in a time and
18 manner designated by COUNTY, information collected in accordance with 45 CFR Section 164.528, to
19 permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI in
20 accordance with 45 CFR Section 164.528.
21 F. CONTRACTOR shall report to COUNTY, in writing, any knowledge or
22 reasonable belief that there has been unauthorized access, viewing, use, disclosure, or breach of
23 Protected Information not permitted by this Agreement, and any breach of unsecured PHI of which it
24 becomes aware, immediately and without reasonable delay and in no case later than two (2) business
25 days of discovery. Immediate notification shall be made to COUNTY's Information Security Officer
26 and Privacy Officer and COUNTY's Department of Behavioral Health HIPAA Representative, within
27 two (2) business days of discovery. The notification shall include, to the extent possible, the
28 identification of each individual whose unsecured PHI has been, or is reasonably believed to have been,
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1 accessed, acquired, used, disclosed, or breached. CONTRACTOR shall take prompt corrective action
2 to cure any deficiencies and any action pertaining to such unauthorized disclosure required by
3 applicable Federal and State Laws and regulations. CONTRACTOR shall investigate such breach and
4 is responsible for all notifications required by law and regulation or deemed necessary by COUNTY
5 and shall provide a written report of the investigation and reporting required to COUNTY's
6 Information Security Officer and Privacy Officer and COUNTY's Department of Behavioral Health
7 HIP AA Representative. This written investigation and description of any reporting necessary shall be
8 postmarked within the thirty (30) working days of the discovery of the breach to the addresses below:
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County of Fresno
Dept. of Behavioral Heatlh
HIP AA Representative
(559) 600-9180
4441 E. Kings Canyon
Fresno, CA 93702
County of Fresno
Dept. of Public Health
Privacy Officer
(559) 445-3249
1221 Fulton Mall
Fresno, CA 93 728
County of Fresno
Information Technology Services
Information Security Officer
(559) 494-3255
2048 N. Fine Street
Fresno, CA 93727
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G. CONTRACTOR shall make its internal practices, books, and records relating to
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the use and disclosure of PHI received from COUNTY, or created or received by the CONTRACTOR
on behalf of COUNTY, available to the United States Department of Health and Human Services upon
demand.
H. Safeguards
CONTRACTOR shall implement administrative, physical, and technical
safeguards as required by 45 CFR 164.308, 164.310, and 164.312 that reasonably and appropriately
protect the confidentiality, integrity, and availability of PHI, including electronic PHI, that it creates,
receives, maintains or transmits on behalf of COUNTY; and to prevent access, use or disclosure of PHI
other than as provided for by this Agreement. CONTRACTOR shall develop and maintain a written
information privacy and security program that includes administrative, technical and physical
safeguards appropriate to the size and complexity of CONTRACTOR's operations and the nature and
scope of its activities. Upon COUNTY's request, CONTRACTOR shall provide COUNTY with
information concerning such safeguards.
CONTRACTOR shall implement strong access controls and other security
safeguards and precautions in order to restrict logical and physical access to confidential, personal (e.g.,
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PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include the
following administrative and technical password controls for all systems used to process or store
confidential, personal, or sensitive data:
1. Passwords must not be:
a. Shared or written down where they are accessible or recognizable
by anyone else; such as taped to computer screens, stored under keyboards, or visible in a work area;
b. A dictionary word; or
c. Stored in clear text
2. Passwords must be:
a. Eight (8) characters or more in length;
b. Changed every ninety (90) days;
c. Changed immediately if revealed or compromised; and
d. Composed of characters from at least three of the following four
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15 1) Upper case letters (A-Z);
16 2) Lowercase letters (a-z);
17 3) Arabic numerals (0 through 9); and
18 4) Non-alphanumeric characters (punctuation symbols).
19 CONTRACTOR shall implement the following security controls on each
20 workstation or portable computing device (e.g., laptop computer) containing confidential,
21 personal, or sensitive data:
22 1. Network-based firewall and/or personal firewall;
23 2. Continuously updated anti-virus software; and
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3. Patch management process including installation of all operating
system/software vendor security patches.
CONTRACTOR shall utilize a commercial encryption solution that has received
FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable
electronic media (including, but not limited to, compact disks and thumb drives) and on portable
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1 computing devices (including, but not limited to, laptop and notebook computers).
2 CONTRACTOR shall not transmit confidential, personal, or sensitive data via e-
3 mail or other internet transport protocol unless the data is encrypted by a solution that has been
4 validated by the National Institute of Standards and Technology (NIST) as conforming to the Advanced
5 Encryption Standard (AES) Algorithm.
6 I. Mitigation of Harmful Effects
7 CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that
8 is known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or breach of PHI by
9 CONTRACTOR or its subcontractors in violation of the requirements ofthese provisions.
10 J. Contractor's S ubontractors
11 CONTRACTOR shall ensure that any of its contractors, including
12 subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created or
13 received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions and conditions that
14 apply to CONTRACTOR with respect to such PHI; and to incorporate, when applicable, the relevant
15 provisions of these provisions into each subcontract or sub-award to such agents or subcontractors ..
16 K. Employee Training and Discipline
17 CONTRACTOR shall train and use reasonable measures to ensure compliance
18 with the requirements of these provisions by employees who assist in the performance of functions or
19 activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such
20 employees who intentionally violate any provisions of these provisions, including termination of
21 employment.
22 L. Termination for Cause
23 Upon COUNTY's knowledge of a material breach of these provisions by
24 CONTRACTOR, COUNTY shall either:
25 1. Provide an opportunity for CONTRACTOR to cure the breach or end the
26 violation and terminate this Agreement if CONTRACTOR does not cure the breach or end the violation
27 within the time specified by COUNTY; or
28 2. Immediately terminate this Agreement if CONTRACTOR has breached a
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1 material term of these provisions and cure is not possible.
2 3. If neither cure nor termination is feasible, the COUNTY Privacy Officer
3 shall report the violation to the Secretary of the U.S. Department of Health and Human Services.
4 M. Judicial or Administrative Proceedings
5 COUNTY may terminate this Agreement in accordance with the terms and
6 conditions ofthis Agreement as written hereinabove, if: (I) CONTRACTOR is found guilty in a
7 criminal proceeding for a violation of the HIP AA Privacy or Security Laws or the HITECH Act; or (2)
8 a finding or stipulation that the CONTRACTOR has violated a privacy or security standard or
9 requirement of the HITECH Act, HIP AA; or other security or privacy laws in an administrative or civil
10 proceeding in which the CONTRACTOR is a party.
11 N. Effect of Termination
12 Upon termination or expiration of this Agreement for any reason,
13 CONTRACTOR shall return or destroy all PHI received from COUNTY (or created or received by
14 CONTRACTOR on behalf of COUNTY) that CONTRACTOR still maintains in any form, and shall
15 retain no copies of such PHI. If return or destruction of PHI is not feasible, it shall continue to extend
16 the protections of these provisions to such information, and limit further use of such PHI to those
17 purposes that make the return or destruction of such PHI infeasible. This provision shall apply to PHI
18 that is in the possession of subcontractors or agents, if applicable, of CONTRACTOR. If Contractor
19 destroys the PHI data, a certification of date and time of destruction shall be provided to the COUNTY
20 by CONTRACTOR.
21 0. Disclaimer
22 COUNTY makes no warranty or representation that compliance by
23 CONTRACTOR with these provisions, the HITECH Act, HIP AA or the HIP AA regulations will be
24 adequate or satisfactory for CONTRACTOR's own purposes or that any information in
25 CONTRACTOR's possession or control, or transmitted or received by CONTRACTOR, is or will be
26 secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely
27 responsible for all decisions made by CONTRACTOR regarding the safeguarding of PHI.
28 P. Amendment
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1 The parties acknowledge that Federal and State laws relating to electronic data
2 security and privacy are rapidly evolving and that amendment of these provisions may be required to
3 provide for procedures to ensure compliance with such developments. The parties specifically agree to
4 take such action as is necessary to amend this agreement in order to implement the standards and
5 requirements of HIP AA, the HIP AA regulations, the HITECH Act and other applicable laws relating to
6 the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days written
7 notice in the event that CONTRACTOR does not enter into an amendment providing assurances
8 regarding the safeguarding of PHI that COUNTY in its sole discretion, deems sufficient to satisfy the
9 standards and requirements of HIP AA, the HIP AA regulations and the HITECH Act.
10 Q. No Third-Party Beneficiaries
11 Nothing express or implied in the terms and conditions of these provisions is
12 intended to confer, nor shall anything herein confer, upon any person other than COUNTY or
13 CONTRACTOR and their respective successors or assignees, any rights, remedies, obligations or
14 liabilities whatsoever.
15 R. Interpretation
16 The terms and conditions in these provisions shall be interpreted as broadly as
17 necessary to implement and comply with HIP AA, the HIP AA regulations and applicable State laws.
18 The parties agree that any ambiguity in the terms and conditions of these provisions shall be resolved in
19 favor of a meaning that complies and is consistent with HIP AA and the HIP AA regulations.
20 s. Regulatory References
21 A reference in the terms and conditions ofthese provisions to a section in the
22 HIP AA regulations means the section as in effect or as amended.
23 T. Survival
24 The respective rights and obligations of CONTRACTOR as stated in this Section
25 shall survive the termination or expiration of this Agreement.
26 u. No Waiver of Obligations
27 No change, waiver or discharge of any liability or obligation hereunder on any
28 one or more occasions shall be deemed a waiver of performance of any continuing or other obligation,
-15 COUN'lY CW FRESNO
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1 or shall prohibit enforcement of any obligation on any other occasion.
2 13. DATA SECURITY
3 For the purpose of preventing the potential loss, misappropriation or inadvertent access,
4 viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse
5 of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that
6 enter into a contractual relationship with the COUNTY for the purpose of providing services under this
7 Agreement must employ adequate data security measures to protect the confidential information
8 provided to CONTRACTOR by the COUNTY, including but not limited to the following:
9 A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices
10 CONTRACTOR may not connect to COUNTY networks via personally-owned
11 mobile, wireless or handheld devices, unless the following conditions are met:
12 1) CONTRACTOR has received authorization by COUNTY for
13 telecommuting purposes;
Current virus protection software is in place; 14
15
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17
2)
3)
4)
Mobile device has the remote wipe feature enabled; and
A secure connection is used.
B. CONTRACTOR-Owned Computers or Computer Peripherals
18 CONTRACTOR may not bring CONTRACTOR-owned computers or computer
19 peripherals into the COUNTY for use without prior authorization from the COUNTY's Chief
20 Information Officer, and/or designee(s), including but not limited to mobile storage devices. If data is
21 approved to be transferred, data must be stored on a secure server approved by the COUNTY and
22 transferred by means of a Virtual Private Network (VPN) connection, or another type of secure
23 connection. Said data must be encrypted.
24 C. COUNTY-Owned Computer Equipment
25 CONTRACTOR or anyone having an employment relationship with the
26 COUNTY may not use COUNTY computers or computer peripherals on non-COUNTY premises
27 without prior authorization from the COUNTY's Chieflnformation Officer, and/or designee(s).
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1 D. CONTRACTOR may not store COUNTY's private, confidential or sensitive
2 data on any hard-disk drive, portable storage device, or remote storage installation unless encrypted.
3 E. CONTRACTOR shall be responsible to employ strict controls to ensure the
4 integrity and security of COUNTY's confidential information and to prevent unauthorized access,
5 viewing, use or disclosure of data maintained in computer files, program documentation, data
6 processing systems, data files and data processing equipment which stores or processes COUNTY data
7 internally and externally.
8 F. Confidential client information transmitted to one party by the other by means of
9 electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128
10 BIT or higher. Additionally, a password or pass phrase must be utilized.
11 G. CONTRACTOR is responsible to immediately notify COUNTY of any
12 violations, breaches or potential breaches of security related to COUNTY's confidential information,
13 data maintained in computer files, program documentation, data processing systems, data files and data
14 processing equipment which stores or processes COUNTY data internally or externally.
15 H. COUNTY shall provide oversight to CONTRACTOR's response to all incidents
16 arising from a possible breach of security related to COUNTY's confidential client information
17 provided to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected
18 individuals as required by law or as deemed necessary by COUNTY in its sole discretion.
19 CONTRACTOR will be responsible for all costs incurred as a result of providing the required
20 notification.
21 14. NON-DISCRIMINATION
22 During the performance of this Agreement CONTRACTOR(S) shall not unlawfully
23 discriminate against any employee or applicant for employment, or recipient of services, because of
24 race, religion, color, national origin, ancestry, physical disability, medical condition, marital status, age
25 or gender, pursuant to all applicable State of California and Federal statutes and regulations.
26 15. SEPARATE AGREEMENT
27 It is mutually understood by the parties that this Agreement does not, in any way, create
28 a joint venture among the individual CONTRACTOR(S). By execution of the Agreement, the
-17 -COLJN'IY OF FRESNO
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1 CONTRACTOR(S) understand(s) that a separate Agreement is formed between each individual
2 CONTRACTOR and COUNTY.
3 16. ADDITIONS/DELETIONS OF CONTRACTORS
4 COUNTY's DBH Director, or designee, reserves the right at any time during the term of
5 this Agreement to add new CONTRACTOR(S) to those contained in Exhibit A. It is understood any
6 such additions will not affect compensation paid to the other CONTRACTOR(S), and therefore such
7 additions may be made by COUNTY without notice to or approval of other CONTRACTOR(S) under
8 this Agreement. These same provisions shall apply to the deletion of any CONTRACTOR(S)
9 contained in Exhibit A, except that deletions shall be by written mutual agreement between the
10 COUNTY and the particular CONTRACTOR(S) to be deleted, or shall be in accordance with the
11 provisions of Section Three (3) of this Agreement.
12 17. COMPLAINTS
13 CONTRACTOR(S) shall log all complaints and the disposition of all complaints from a
14 client or a client's family. CONTRACTOR(S) shall provide a summary ofthe complaint log entries
15 concerning COUNTY sponsored clients to COUNTY at monthly intervals, by the tenth (1Oth) day of
16 the following month, in a format that is mutually agreed upon. Said monthly summary must
17 accompany the monthly invoicing referenced in Section Five (5). CONTRACTOR(S) shall post signs
18 informing clients of their right to file a complaint or grievance. CONTRACTOR(S) shall notify
19 COUNTY of all incidents reportable to state licensing bodies that affect COUNTY clients within
20 twenty-four (24) hours of receipt of a complaint. Consistent with client privacy rights;
21 CONTRACTOR(S) shall allow Patient Rights Advocates access to the acute psychiatric inpatient units
22 to investigate all complaints concerning conditions in the unit.
23 18. CONFLICT OF INTEREST
24 No officer, agent, or employee of the COUNTY who exercises any function or
25 responsibility for planning and carrying out the services provided under this Agreement shall have any
26 direct or indirect personal financial interest in this Agreement. The CONTRACTOR(S) shall comply
27 with all Federal, State of California, and local conflict of interest laws, statutes, and regulations, which
28
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1 shall be applicable to all parties and beneficiaries under this Agreement and any officer, agent, or
2 employee ofthe COUNTY.
3 19. LICENSES
4 CONTRACTOR(S) shall throughout the term of this Agreement, maintain all necessary
5 licenses, permits approvals, certificates, waivers and exceptions necessary for the provision of the
6 services hereunder and required by the laws and regulations of the United States, State of California,
7 County of Fresno, and any other applicable governmental agencies. In addition, CONTRACTOR(S)
8 shall throughout each term ofthis Agreement ensure that all of its personnel performing services under
9 this Agreement are licensed and/or certified and shall maintain such licensure and/or certification
10 throughout each term of this Agreement where required, to lawfully perform their duties.
11 CONTRACTOR(S) shall notify COUNTY immediately in writing of its inability to
12 obtain or maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions
13 irrespective of the pendency of any appeal related thereto. Additionally, CONTRACTOR(S) shall
14 comply with all other applicable laws, rules or regulations, as any may now exist or be hereafter
15 changed. CONTRACTOR(S) shall maintain copies of all licenses, certifications, etc., noted above and
16 shall allow COUNTY's DBH to review these documents upon request.
17 20. REFERENCE TO LAWS AND RULES
18 CONTRACTOR(S) shall maintain in full force and effect and comply with any and all
19 licensing, local zoning, and State of California fire and safety ordinances and regulations.
20
21
21. APPLICABLE RECORDS
A. Case Records: CONTRACTOR(S) shall maintain adequate case records on each
22 individual patient which shall include client assessment, individual program plan, and records of
23 services provided by the various professional and para-professional personnel in sufficient detail to
24 make possible an evaluation of services, and contain all the data necessary in reporting to the State,
25 including records of patient interviews and progress notes. All such records shall be maintained
26 pursuant to applicable laws concerning confidentiality and, in the case of Mental Health records,
27 California Welfare and Institutions Code, section 5328, et al, and Title 45, Code of Federal
28 Regulations, section 205.50. All case management records shall be considered the property of
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1 COUNTY and shall be retained by the COUNTY at the termination of this Agreement. The
2 CONTRACTOR(S) may retain copies of these records at the time of termination if they so choose. All
3 the terms and conditions of this Agreement concerning the confidentiality of such records shall survive
4 such termination of this Agreement and shall continue to apply to such copies ofthose records retained
5 by CONTRACTOR(S).
6 B. Financial Records: Statistical data shall be kept and reports made as required by
7 COUNTY'S DBH Director and the State of California.
8 c. COUNTY and State of California reserve the right to use and reproduce all
9 reports and data produced and delivered pursuant to this Agreement, and reserve the right to authorize
10 others to use or reproduce such materials, unless of a confidential nature.
11 22. COMPLIANCE WITH STATE MEDI-CAL REQUIREMENTS
12 CONTRACTOR(S) shall be required to maintain organizational provider certification
13 by host-county. A copy of this bi-annual renewal certificate must be furnished to COUNTY within
14 thirty (30) days of receipt of certificate from host-county. CONTRACTOR(S) must meet Medi-Cal
15 organization provider standards as listed on Exhibit C, Medi-Cal Organizational Provider Standards,
16 attached hereto and incorporated herein.
17 23. COMPLIANCE WITH STATE REQUIREMENTS
18 CONTRACTOR(S) recognize that COUNTY operates its Department of Behavioral
19 Health under an agreement with the State of California Department of Health Care Services, and that
20 under said agreement the State imposes certain requirements on the COUNTY and its subcontractors.
21 CONTRACTOR(S) shall adhere to all State of California requirements, including those identified in
22 Exhibit E, attached hereto and by this reference incorporated herein.
23 24. AUDITS AND INSPECTIONS
24 The CONTRACTOR(S) shall at any time during business hours, and as often as the
25 COUNTY may deem necessary, make available to the COUNTY for examination all of their records
26 and data with respect to the matters covered by this Agreement. The CONTRACTOR(S) shall, upon
27 request by the COUNTY, permit the COUNTY to audit and inspect all such records and data necessary
28 to ensure CONTRACTOR(S') compliance with the terms ofthis Agreement.
-20 -COUNTY OF JiRESNO
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1 Ifthis Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00),
2 CONTRACTOR(S) shall be subject to the examination and audit of the State Auditor General for a
3 period of three (3) years after final payment under contract (California Government Code section
4 8546.7).
5 25. REPORTING
6 CONTRACTOR shall provide at COUNTY's request, any required reports to COUNTY
7 which may include performance outcome measurement reports as communicated by the County to
8 CONTRACTOR.
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26. MONITORING
CONTRACTOR(S) agree to extend to COUNTY's DBH and the State Department of
Mental Health, or their designees, the right to review and monitor records, programs or procedures, at
any time, in regard to clients, as well as the overall operation ofCONTRACTOR(S)' programs in order
to ensure compliance with the terms and conditions ofthis Agreement.
27. PROHIBITION ON PUBLICITY
None ofthe funds, materials, property or services provided directly or indirectly under
this Agreement shall be used for CONTRACTOR(S)'advertising, fundraising, or publicity (i.e.,
purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion.
Notwithstanding the above, publicity ofthe services described in Section One (1) of this Agreement
shall be allowed as necessary to raise public awareness about the availability of such specific services
when approved in advance by COUNTY's DBH Director, or designee and at a cost to be provided in
writing for such items as written/printed materials, the use of media (i.e., radio, television, newspapers)
and any other related expense(s).
28. NOTICES
The persons and their addresses having authority to give and receive notices under this
Agreement include the following:
COUNTY
Director, Fresno County
Department of Behavioral Health
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CONTRACTOR(S)
SEE EXHIBIT A
COUN'lY CW FRESNO
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7
4441 E. Kings Canyon Road
Fresno, CA 93 702
Any and all notices between the COUNTY and the CONTRACTOR(S) provided for or
permitted under this Agreement or by law shall be in writing and shall be deemed duly served when
personally delivered to one of the parties, or in lieu of such personal service, when deposited in the
United States Mail, postage prepaid, addressed to such party.
29. GOVERNING LAW
8 The parties agree that for the purposes of venue, performance under this Agreement is to
9 be in Fresno County, California.
10 The rights and obligations of the parties and all interpretation and performance of this
11 Agreement shall be governed in all respects by the laws of the State of California.
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30. ENTIRE AGREEMENT
This Agreement, including all Exhibits, constitutes the entire agreement between the
CONTRACTOR(S) and COUNTY with respect to the subject matter hereof and supersedes all
previous agreement negotiations, proposals, commitments, writings, advertisements, publications, and
understandings of any nature whatsoever unless expressly included in this Agreement.
Ill
Ill
Ill
Ill
Ill
Ill
Ill
Ill
Ill
Ill
Ill
Ill
-22 -COUNTY CW FRESNO
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1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
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ATTEST:
CONTRACTORS:
SIGNATURE PAGES ATTACHED
COUNTY OF FRESNO
By:
BERNICE E. SEIDEL, Clerk
Board of Supervisors
By:
PLEASE SEE ADDITIONAL
SIGNATURE PAGE ATTACHED
-23 -COUNTY OF FRESNO
Fresno, CA
1 APPROVED AS TO LEGAL FORM:
DANIEL C. CEDERBORG, COUNTY COUNSEL 2
:By et¥
5 APPROVED AS TO ACCOUNTING FORM:
6 VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
7
8
9 By a?t ~:?J~tk
()
10 REVIEWED AND RECOMMENDED FOR
11 APPROVAL:
12 ~~ 'i
13 Rt_ ~P..lt&dl DAAN~R 14 DEPARTMENT OF BEHAVIORAL HEALTH
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Fund/Subclass:
Organization:
Account/Program:
0001/10000
56302175
7294/0
FY 2015-16: $1,207,750
FY 2016-17: $1,207,750
-24 -COUNTY CW I<'RESNO
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CONTRACTOR:
THE CHIMES HOME
By ~cr I
Print Name A fYlo 12-. A · A LEG ~
Title: A J IYI; /1\; sfn..--foV' / h.ee0. 5e-e-
Mailing Address:
3041 E. Clinton A venue
Fresno, CA 93 703
(559) 244-0479 I 369-9949
Contact: Amor Alegre
-25 -COUN1Y OF FRESNO
Fresno,CA
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CONTRACTOR:
DAILEY'S HAVEN
PrintName f'Sfel/<:. j)a,' /-e.J
Title: l?z:t;:n;;1, · s_ .J ~ct -f-t,d4cu n ~.
Mailing Address:
5261 E. McKenzie
Fresno, CA 93727
(559) 456-9440/255-2253
Contact: Estelle Dailey
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CONTRACTOR:
FILLMORE CHRISTIAN GARDEN
By --------l---!--1 ~~· M::::___j_._ll!j11~-¥----
Print Name l ntbone M ·, ll ¥
Title: Ctcen~ ;·~~-,~
6/ot/t~
Mailing Address:
4826 East Fillmore
Fresno, CA 93727
(559) 307-4170
Contact: Inthone Milly
-27 -COUNTY OF FRESNO
Fresno, CA
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CONTRACTOR:
GARDEN MANOR
Print Name --::Jofl/1) {3LJrc._. \~
Mailing Address:
4983 East Olive
Fresno, CA 93727
(559) 255-8650 ext 201
Contact: Joan Black
-28 -COUN1Y OF FRESNO
Fresno, CA
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CONTRACTOR:
HASKINS RESIDENTIAL CARE
By~~
Print Name~..} c/ ~ j/,;. f
Title:___.~~~~~·~-~--
Mailing Address:
1 037 South Chestnut
Fresno, CA 93702
(559) 453-6832
Contact: Donald Haskins
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Fresno, CA
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CONTRACTOR:
MODESTO RESIDENTIAL LIVING CENTER
By~~~
I
PrintName LENA !bALDWIN
Title: FAC!.itrTy MANAG£te-
Mailing Address:
1932 Evergreen Ave.
Modesto, CA 95350
Phone: (209) 530-9300
Contact: Lena Baldwin
-32 -COUNTY OF FRESNO
Ft·esno, CA
Exhibit A
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
TRANSITIONAL RESIDENTIAL SERVICES PROGRAM (TRSP)
1 Chimes Home
10 beds/female
Contact: Debra De Lash
2640 Stuart Avenue
Modesto, CA 95350
(559) 244-0479/322-1557
2 Dailey's Haven
6 beds/male
Contact: Estelle Dailey
5261 E. McKenzie
Fresno, CA 93727
(559) 456-9440/255-2253
3 Fillmore Christian Garden
26 beds/co-ed
Contact: lnthone Milly
4826 E. Fillmore
Fresno, CA 93727
(559) 307-4170
Master TRSP Agt. -Revised 5/2/2015
VENDOR LIST
4 Garden Manor
49 beds/co-ed
Contact: Joan Black
4983 E. Olive
Fresno, CA 93727
(559) 255-8650 ext. 201
5 Haskins Residential Care
18 beds/males
Contact: Donald Haskins
1037 S. Chestnut
Fresno, CA 93702
(559) 453-6832
6 Modesto Residential Living Center
96 beds
Contact: Lena Baldwin
1932 Evergreen Avenue
Clovis, CA 93611
(209) 530-9300
FRESNO COUNTY-DEPARTMENT OF BEHAVIORAL HEALTH
TRANSITIONAL RESIDENTIAL SERVICES PROGRAM (TRSP)
CERTIFICATION REQUIREMENTS
Exhibit 8
Page 1 of 4
I. Facilities eligible to be certified for payment for Transitional Residential Services Program
from Fresno County Department of Behavioral Health SHALL:
A. Be a licensed Adult Residential Care Facility or licensed Residential Care Facility for
the Elderly, authorized by the California State Department of Social Services,
Community Care Licensing Division, to provide care and supervision to mentally
disabled adults.
B. Ensure the facility administrator has completed 20 hours per year of the continuing
education or in-service training in mental health issues or related topics, in
accordance with the education or training specifications of the California State
Department of Social Services, Community Care Licensing Division.
C. Ensure direct care staff, employed by the facility, participates in the training activities
specified in the "Fresno County Department of Behavioral Health, Quality Assurance
Standards for Licensed Adult Residential Care Facilities, and Residential Care
Facilities, Section 9."
D. Provide information for monthly billing and other data, as required by the County's
management information system.
E. Provide a monthly statement of all clients living in the facility.
II. Facilities SHALL be certified for participation by the COUNTY and services SHALL be
provided through written agreement. THESE FACILITIES SHALL:
A. Cooperate with County staff, subsequent to referral and with authorization by the
County, in completing the "Appraisal/Needs and Services Plan," as indicated by the
California Department of Social Services, Adult Residential Facilities, Division 6,
Chapter 1, Section 80068.2, to meet the goals, objectives, and activities appropriate
to the resident. This plan shall be completed and placed in the resident's record on
or before the first day of placement and kept current.
B. Complete a "Facility Service Plan" indicating the specific services to be provided to
address the needs identified in the "Appraisal/Needs and Services Plan." This plan
shall be completed and placed in the resident's record on or before the first day of
placement.
C. Maintain individual resident records, on the premises, in accordance with "Fresno
County Department of Behavioral Health, Quality Assurance Standards for Licensed
Adult Residential Care Facilities and Residential Care Facilities, Section 8-Resident
Records" to promote the services to each individual. These records SHALL include:
1. The "Appraisal/Needs and Services Plan" specifying the needs to be
addressed.
2. Weekly progress notes and monthly summary notes, and maintain in
resident's record.
a. Weekly notes SHALL:
Master TRSP Agt. -Revised 5/2/2015
Exhibit 8
Page 2 of 4
i. Addres~ all needs, objectives, and services provided by facility
staff to Implement the "Facility Service Plan" for each resident.
ii. Address significant occurrences affecting the resident
(incidents, illness. exacerbation of symptoms, signs of
improved functioning, etc.), as appropriate.
iii. Describe behavioral observations and symptoms.
iv. Be written by staff having direct supervision/observation of the
resident.
b. Monthly summary notes SHALL reflect all needs and services
addressed in the "Needs/Appraisal Plan." (Refer to "Fresno County
Department of Behavioral Health, Quality Assurance Standards for
Licensed Adult Residential Care Facilities and Residential Care
Facilities, Section 8-Resident Records.")
3. All other documents/information as required by State Community Care
Licensing Division.
D. Allow access to the facility, to the extent authorized by law, by County and State staff
for assessment of client(s), monitoring of the contract, record review, consultation
with staff, and evaluation of the facility and services.
E. Maintain the capability to provide the services required to meet the specialized needs
of residents, as identified in residents' "Appraisal/Needs and Services Plans."
F. Cooperate and consult with County staff to improve/enhance/modify program
services to meet the need of residents as indicated in their "Appraisal/Needs and
Services Plans."
G. Inform COUNTY's Case Manager and Transitional Residential Services Program
Coordinator immediately and provide a written report within 24 hours of all incidents
necessitating an incident report to State Licensing Division. Incidents to be reported
include, but are not limited to, death, accident/injury, abuse, and absence without
leave (AWOL).
H. Inform the TRSP Coordinator within 24 hours of all client movements (i.e. admissions
to a general hospital, acute psychiatric facility, and/or AWOL).
I. As residents increase ability to function in particular areas, increase residents'
responsibilities for own care/activities in those areas, as specified in their
"Appraisal/Needs and Services Plan."
J. Offer residents opportunities to function/perform in those areas where residents are
competent or are learning new life skills.
K. Encourage clients to take increased responsibility for own treatment by setting self-
established goals.
L. Provide scheduled and posted activities to encourage the development of activities
satisfying to residents, as specified in their "Appraisal/Needs and Services Plans."
The posted monthly schedules SHALL reflect the interests of residents, expose
residents to and develop a variety of leisure interests, and develop interpersonal
skills and relationships.
Master TRSP Agt. -Revised 5/2/2015
Exhibit B
Page 3 of 4
Ill. Transitional Residential Program Services may consist of, but not limited to, all of the
components listed below. They are to be provided to each resident as specified in the
resident's "Appraisal/Needs and Services Plan," or as the need arises.
A. Training in grooming and hygiene and supervision to ensure grooming/hygiene is
maintained at an adequate level.
B. Training in activities of daily living: These may include, but are not limited to:
1. Budgeting--developing a spending plan for necessities/personal shopping,
how to plan for larger purchases, how to make economical purchases,
where to shop, credit buying, opening a savings account, etc.
2. Use of money--paying bills, making change, getting receipts, keeping
money safe, opening an account, etc.
3. Menu planning, shopping for and preparing individual/family sized/balanced
meals, reading instructions/recipes, kitchen hygiene/cleanliness, use of
kitchen utensils and appliances.
4. Housekeeping/cleaning/making own bed.
5. Laundry and maintenance of clothing.
6. Education on the following topics.
a. Maintaining good health and eating wholesome and nutritious diet
b. Basic disease prevention concepts
c. Importance of regular exercise and adequate sleep
d. Proper use of over the counter medication
e. Dangers of excessive use of alcohol, tobacco and street drugs
f. Proper use of the transportation system
C. Assistance with personal shopping, as appropriate. Assistance with coordinating
clothing and making purchases to complete/supplement wardrobe.
D. Training to develop adequate medication management skills including, but not limited
to:
1. When and how much of each medication to take.
2. How to read instructions on medication containers.
3. How to relate and talk with the doctor about symptoms, complaints and side
effects of medications.
E. Working with residents to express feelings appropriately including, but not limited to:
1. Dealing with conflict.
2. Dealing with anger.
3. Dealing with loss or grief.
4. Expressing a variety of feelings, including positive feelings.
F. Working with residents to develop skills including, but not limited to:
1. Starting and maintaining conversations,
2. Dealing with family, and significant others,
Master TRSP Agt. -Revised 5/2/2015
3. Talking with persons of either gender,
4. Asserting own needs/desires/choices.
Exhibit 8
Page 4 of 4
G. Encouraging observations of culturally appropriate holidays, events, and traditions, in
accordance with the ethnic background of residents and residents' wishes. This may
include, but not be limited to, offering activities, foods, and decorations appropriate to
the resident.
H. Providing close supervision of and interactions with residents who require
management of difficult behavioral problems consistent with the "Appraisal/Needs
and Services Plan." This may include, but not be limited to:
1. Providing support and encouragement;
2. Providing specific individualized directions;
3. Providing alternative activities;
4. Setting specific behavioral limitations;
5. Allowing for the appropriate expression of feelings;
6. Separating the resident from others, when interactions tend to exacerbate
behaviors; and,
7. Establishing a behavioral contract with the resident.
If it is determined a CONTRACTOR is not providing services as agreed, the
COUNTY may withhold or deny payment.
IV. All required insurance coverage shall be with a company or companies authorized by law to
transact insurance business in the State of California.
V. CONTRACTOR shall provide at COUNTY's request, any required reports to COUNTY which
may include performance outcome measurement reports as communicated by the County to
CONTRACTOR.
Master TRSP Agt. -Revised 5/2/2015
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
TRANSITIONAL RESIDENTIAL SERVICES PROGRAM (TRSP)
Exhibit C
Page 1 of 7
QUALITY ASSURANCE STANDARDS FOR LICENSED ADULT RESIDENTIAL CARE
FACILITIES AND RESIDENTIAL CARE FACILITIES
BASIC CARE AND SUPERVISION
SECTION I -PROGRAM
1.1 Each facility has a written Program Design (Title 22, Plan of Operation) approved by the
Department of Behavioral Health (DBH) which contains a statement of purpose, a
statement of goals, a description of program methods and a staff training plan.
1.2 The activities and opportunities provided to each resident are consistent with the written
Program Design.
1.3 The facility administrator, resident and agency referral person/authorized representatives
are involved in the development of the resident's "Appraisal/ Needs and Services Plan."
1.4 The facility ensures continuity in each resident's planned activities by having staff
communicate and participate with other agencies in case conferences and in the
development of a plan of care or educational plan.
1.5 The supervision and training provided to each resident follows the objectives and plans
written in the "Needs and Appraisal Plan."
1.6 The facility provides supervision and training seven days per week with a staff ratio
adequate to implement the "Appraisal/Needs and Services Plan."
1.7 The facility has a written monthly Activity Schedule posted for all hours that residents are
awake and under the supervision of the facility, seven days per week. The Activity
Schedule reflects the time and place of usual resident activities. The Activity Schedule
reflects at least one recreational activity each day and at least one activity in the
community each week.
1.8 The facility teaches and enables residents to practice skills and behaviors that are
necessary for attaining greater independence in the home and in the community in
accordance with the "Appraisal/Needs and Services Plan." The facility encourages use
of leisure time in a constructive manner.
1.9 Daily activities are age appropriate.
1.10 Natural environments and materials are used in teaching skills to residents.
1.11 Training techniques are individualized .in accordance with the "Appraisal/Needs and
Services Plan."
1.12 Training techniques are consistent with the principles of least restrictive method.
Master TRSP Agt.-Revised 5/2/2015
Exhibit C
Page 2 of7
1.13 All staff persons responsible for carrying out a resident's "Training/Treatment" are
familiar with its objectives and methods of implementation.
1.14 There is a continuity, through staff changes, in training provided to residents, as
evidenced by either oral or written communications between staff on different shifts.
1.15 Every twelve (12) months the "Appraisal/Needs and Services Plan" is reviewed by the
case manager/authorized representative, resident and facility staff to measure and
document progress of set objectives and/or the need to modify.
Every six months the client is assessed by case manager with input from the
CONTRACTOR.
1.16 When the "Needs Service Plan" needs to be updated, facility staff bring this to the
attention of the case manager. The facility staff, case manager and resident
participate in the revision, as appropriate.
SECTION 2 -RIGHTS
2.1 A statement of resident rights is posted where it is easily accessible to residents and
visitors. The statement includes a description of procedures to be followed and whom to
contact if the person has questions or complaints regarding rights.
2.2 Upon admission, each resident is given instruction on his or her rights via
communication methods which are appropriate for that resident.
2.3 There is no denial of resident's rights unless the facility follows the procedures specified
bylaw.
2.4 House rules are in writing and posted and are appropriate for the residents.
2.5 The facility's house rules are explained to each resident via communication methods
which are appropriate for that resident.
2.6 There is a complaint procedure which residents may use to appeal a decision made by a
staff member.
2. 7 The complaint procedure is written and posted and, upon admission, explained to each
resident via communication methods which are appropriate for that resident.
2.8 All residents have access to the facility 24 hours a day.
SECTION 3-COMMUNITY INTEGRATION
3.1 If the facility is located in a residential neighborhood, it must be physically compatible
with residences in that neighborhood.
Master TRSP Agt. -Revised 5/2/2015
Exhibit C
Page 3 of7
3.2 Residents have access to resources available to other members of the local community
and are given regular opportunities to use those resources.
3.3 Residents are given opportunities to practice community and independent living skills in
their local community.
3.4 The facility provides group activities which include activities involving six or fewer
residents.
3.5 The facility offers at least one recreational activity a week in the community appropriate
to the interests or development of interests of the residents. (Refer to Section 1 -1.7)
SECTION 4 -SOCIAL -PSYCHOLOGICAL ENVIRONMENT
4.1 The physical aspects of the facility must be appropriate to the age and physical abilities
of the residents.
4.2 Residents eat in the dining room or eating areas typically used by family and/or staff
members.
4.3 Each resident wear/have properly fitting clothing.
4.4 Each resident shall receive training, or be assisted, in selecting clothing which is
appropriate to his or her age, sex and the season.
4.5 Each resident wears his or her own clothing.
4.6 There is recognition and acceptance by staff of residents' cultural and ethnic differences.
4.7 Communication and interaction between staff and residents reflect respect and caring.
4.8 Staff makes an effort to establish positive relationships with residents via communication
methods which are appropriate for those residents.
4.9 Staff makes an effort to establish positive relationships with residents' family members.
4.10 Residents share in facility decision-making through weekly house meetings designed to
encourage participation.
4.11 Residents are encouraged to pursue individual interests and schedules.
4.12 The facility is furnished, decorated, and arranged to provide a home-like, non-
institutional atmosphere.
4.13 Bathroom facilities are designed and equipped to afford privacy.
4.14 No more than two residents shall share a bedroom.
Master TRSP Agt.-Revised 5/2/2015
4.15 Bedrooms are not used as passageways to other rooms.
4.16 Residents are allowed to use bedrooms as places to be alone.
Exhibit C
Page 4 of7
4.17 Residents have access to all common areas of the residence, except controlled storage
areas and staff designated areas.
SECTION 5 -HEALTH
5.1 Medical and dental evaluations and care are obtained at regular intervals, depending
upon each resident's age and condition, or as specified in the "Facility Service Plan."
5.2 Residents who require adaptive devices (eyeglasses, hearing aids, dentures, wheel
chairs, etc.) are given assistance in securing and maintaining these devices.
5.3 Staff present a copy of the medication log to health professionals prior to treatment.
5.4 Staff ensure each resident displays good personal hygiene with regard to skin, nails,
teeth, hair and clothing and the facility shall provide personal grooming supplies. Staff
encourage each resident to maintain adequate grooming.
5.5 The facility has a method for ensuring that the nutritional needs of all residents are
satisfied. Monthly menus are posted and corrected as served.
5.6 The food served in the facility provides variety and is presented in an appetizing manner
and reflects the ethnicity of the residents.
5.7 Notice of any unusual incident (AWOL, hospital admission, abuse), accident or death is
immediately reported to the Case Manager, TRSP Coordinator, Conservator/Guardian
(as appropriate), and State Community Care Licensing. A copy of the incident report is
provided to the Department of Behavioral Health Case Manager by the end of the next
business day.
SECTION 6 -PHYSICAL ENVIRONMENT AND SAFETY
6.1 The facility is safe, clean and well maintained, both inside and out.
6.2 Each resident is provided with a comfortable bed with clean linens, warm blankets and a
pillow.
6.3 Each resident is provided closet space and a dresser or drawer space for the exclusive
use of the resident.
6.4 All residents' medications are stored in a centrally located, locked storage area. All
medications received and dispensed are entered in the medication log.
Master TRSP Agt. -Revised 5/2/2015
Exhibit C
Page 5 of7
6.5 All potentially dangerous non-edible or toxic items are clearly labeled, and stored away
from food supplies.
6.6 The facility is equipped with first aid supplies and a first aid manual.
6. 7 The facility provides fire/disaster plan training for staff and residents and conducts and
documents at least one drill each quarter.
6.8 Vehicles used for transporting residents are properly maintained and equipped with seat
belts. Residents use seat belts when vehicle is in motion.
SECTION 7 -ADMINISTRATION
7.1 Relevant chapters of Title 22 are maintained in the administrative offices of the facility
and available to all staff and residents upon request.
7.2 A notice is posted stating that the results of State Licensing evaluations are available
upon request to residents or other persons with a legitimate need to know.
7.3 The facility operates within the limitations of its license.
7.4 Maintain a record of any resident's money handled by the facility, documenting each
resident's income, disbursements made to the resident and expenditures made on
behalf of the resident by facility staff.
7.5 When cash is given to a resident, he/she signs or places his/her mark on a receipt or log
specifying the cash amount.
7.6 Receipts are retained for expenditures made on behalf of the resident by facility staff.
7.7 A resident's funds are used only by that resident or for that resident's expenditures.
7.8 Residents' funds are kept separate from facility funds,
7.9 The facility has procedures for protecting residents' personal property from loss or abuse
and which also allows each resident easy access to his/her own property.
7.10 The facility has established screening procedures to evaluate a potential employee's
character and his/her employment history. The facility has complied with any and all
State Department of Social Services, Community Care Licensing Division's requirements
for screening and fingerprinting.
7.11 The facility administrator or designee is available at all hours to respond to any needs
from staff or residents. There shall be a notice posted with their 24 hour contact
number.
7.12 The facility provides or arranges for local transportation and/or training in use of public
transportation in order for residents to:
Master TRSP Agt.-Revised 5/2/2015
Exhibit C
Page 6 of7
•:• participate in programs and services outside the facility.
•:• engage in activities of daily living and leisure activities/events as cited in each
resident's "Appraisal/Needs and Services Plan."
7.13 The facility will encourage residents' use of public transportation. The facility will be
responsible to ensure the resident's safety regardless of the mode of transportation
chosen.
7.14 The facility provides transportation and supervision to get residents safely to and from
medical/dental appointments and communicates adequately with the medical/dental
provider.
7.15 All staff have knowledge about legal requirements for reporting resident abuse.
SECTION 8 -RESIDENT RECORDS
8. 1 A document file of resident's records is maintained at the facility for each resident. Each
resident's file includes, but is not limited to, the following information:
a. Resident rights
b. Resident's social security number
c. Name, address and phone numbers of conservator or family member
d. Dates of major illnesses
e. Record of psychiatric/medical/dental treatments
f. Admission physical and diagnosis
g. Record of allergies
h. TB clearance
i. Funeral arrangements
j. Weight record
k. Resident's personal property list
I. Current admission agreement
m. Current "Facility Service Plan"
n. Weekly progress notes and monthly summary
8.2 All treatment services to be provided to the resident, except emergency services, are
noted in "Facility Service Plan."
8.3 The facility maintains a medical log for each resident: type of medication, dosage,
frequency of administration, time of each administration, and initials of staff person
supervising administration of medication. The facility makes clear on the medication log
which medications are psychotropic medications. Psychotropic medications need to
indicate: name of medication, reason for its use and possible side effects.
8.4 Resident records are confidential in accordance with California Welfare and Institutions
Code provisions.
Master TRSP Agt. -Revised 5/2/2015
Exhibit C
Page 7 of7
8.5 Any consent for release of information provided by the resident, or the resident's
conservator specify: the information to be released; the purpose of the release; the
agency or person to whom release is to be made; and, the time period for which the
release is valid. Consents for Release of Information are maintained permanently in the
resident's record.
8.6 Resident records contain monthly summary notes addressing all needs/services in the
"Facility Service Plan" and other significant events/observations affecting the resident.
SECTION 9 -TRAINING
9.1 Direct-care staffs complete on-the-job training by the facility within one month following
employment. At a minimum, the subjects covered in the training include: Special
Incident Reports, health and emergency procedures, medications, client rights and
abuse reporting.
9.2 Direct-care staffs complete orientation within one month from start date of employment.
The orientation includes at least the following topics: awareness of mental health
programs, review of quality assurance standards, and the placement packet.
9.3 All direct-care staffs have a current first aid training and CPR certification from an
appropriate agency, such as the Red Cross.
9.4 The facility administrator completes at least 20 hours per year of continuing education or
in service training. Topics of education or training are chosen from those approved by
the State Community Care Licensing Division.
9.5 Direct-care staff complete at least 9 hours of continuing education or in service training
in mental health issues or related topics. Topics of education or training are chosen from
those approved by the State Community Care Licensing Division.
Master TRSP Agt.-Revised 5/2/2015
TRSP Monthly Billing Invoice Admissions/Discharges Billing Month:------------------Name of Facility:-------------------Administrator Signature:-------------------Resident Name Case Manager Name Admit Date Discharge Date Comments Exhibit D Invoice Date: --------------Capacity:-----------Vacancy(ies): -----------Basic Rent Supplemental Total Rate $ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -TOTAL: $ -$ -$ -Master TRSP -Revised 5/2/2015
FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
TRANSITIONAL RESIDENTIAL SERVICES PROGRAM (TRSP)
MENTAL HEALTH STATE REQUIREMENTS
1. CONTROL REQUIREMENTS
Exhibit E
Page 1 of 2
The COUNTY and its subcontractors shall provide services in accordance with all
applicable Federal and State statutes and regulations.
2. PROFESSIONAL LICENSURE
All (professional level) persons employed by the COUNTY Mental Health Program
(directly or through contract) providing Short-Doyle/Medi-Cal services have met
applicable professional licensure requirements pursuant to Business and Professions
and Welfare and Institutions Codes.
3. \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 42, Code of Federal
Regulations sections 2.1 et seq; California Welfare and Institutions Code, sections
14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 ofthe California Health and Safety
Code; Title 22, California Code of Regulations, section 51 009; and Division 1, Part 2.6,
Chapters 1-7 of the California Civil Code.
4. NON-DISCRIMINATION
A. Eligibility for Services
CONTRACTOR shall prepare and make available to COUNTY and to the public
all eligibility requirements to participate in the program plan set forth Paragraph
One (1) of the Agreement No person shall, because of ethnic group
identification, age, gender, color, disability, medical condition, national origin,
race, ancestry, marital status, religion, religious creed, political belief or sexual
preference be excluded from participation, be denied benefits of, or be subject to
discrimination under any program or activity receiving Federal or State of
California assistance.
B. Employment Opportunity
CONTRACTOR shall comply with COUNTY policy, and the Equal Employment
Opportunity Commission guidelines, which forbids discrimination against any
person on the grounds of race, color, national origin, sex, religion, age, disability
status, or sexual preference in employment practices. Such practices include
Master TRSP Agt.-Revised 5/2/2015
Exhibit E
Page 2 of 2
retirement, recruitment advertising, hiring, layoff, termination, upgrading,
demotion, transfer, rates of pay or other forms of compensation, use of facilities,
and other terms and conditions of employment.
C. Suspension of Compensation
If an allegation of discrimination occurs, COUNTY may withhold all further funds,
until CONTRACTOR can show clear and convincing evidence to the satisfaction
of COUNTY that funds provided under this Agreement were not used in
connection with the alleged discrimination.
D. Nepotism
Except by consent of COUNTY's Department of Behavioral Health Director, or
designee, no person shall be employed by CONTRACTOR who is related by
blood or marriage to, or who is a member of the Board of Directors or an officer
of CONTRACTOR.
5. PATIENTS' RIGHTS
CONTRACTOR shall comply with applicable laws and regulations, including but not
limited to, laws, regulations, and State policies relating to patients' rights
Master TRSP Agt-Revised 5/2/2015