HomeMy WebLinkAboutAgreement A-16-570 with CDVA.pdfAgreement No. 16-570
CALIFORNIA DEPARTMENT OF VETERANS AFFAIRS
Annual Subvention Program Certificate of Compliance
Fiscal Year 2016/2017
Charge:
Funds are distributed under this program to counties as partial reimbursement for expenses
incurred in the operation of the County Veterans Service Office. Funds are distributed
according to Military and Veterans Code Sections 972, and 972.1, a State General Fund
Expenditure, and 972.2 a Special Fund Expenditure.
County Certification:
I certify that Fresno County has appointed a veteran to serve as the
County Veterans Service Officer according to California Code of Regulations Title 12,
Subchapter 4. This County Veterans Service Officer will administer the aid provided for in
Military and Veterans Code Division 4, Chapter 5. This County Veterans Service Officer and
Veterans Service Representative staff must achieve and maintain accreditation from the
California Department ofVeterans Affairs (CalVet) within 18 months of employment.
I further certify that the County Veteran Service Officer will assist every veteran of the United
States, as well as their dependents and survivors, in presenting and pursuing such claim as they
may have against the United States. The County Veterans Service Officer and all accredited
staff will also assist in establishing veterans, dependents and survivors' rights to any privilege,
preference, care or compensation provided for by the laws and regulations of the United States,
the State of California, or any local jurisdiction.
I certify that the current fiscal year proposed expenditures exceeds the actual fiscal year 1988-
89 expenditures by at least, the full amount of the current annual allocation.
I also agree that this county, through the County Veterans Service Office, will maintain records
for audit. These records will be maintained for a minimum of two years. The county agrees to
submit reports in accordance with the procedures and timelines established by CalVet and in
accordance with the CalVe! Procedure Manual for Subvention and Medi-Cal Cost Avoidance
for the current state fiscal year. The County Veterans Service Officer will permit CalVet
representatives to inspect all records.
I further authorize the County Veterans Service Officer to actively participate in the promotion
of the California Veterans License Plate program.
£:_ :7-~
Ernest Buddy Mende , Chairman
County Board of Supervisors
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Date ·
SCAN AND UPLOAD THIS COMPLETED FORM VIA THE AGENCY
ATTACHMENTS IN VETPRO
(Rev3/16)
ATTEST:
BERNICE E. SEIDEL, Clerk
~rvisors ~ty
CALIFORNIA DEPARTMENT OF VETERANS AFFAIRS
Annual Medi-Cal Cost Avoidance Program Certificate of Compliance
Fiscal Year 2016/2017
I certify that Fresno County has appointed a County Veterans Service
Officer (CVSO) in compliance with California Code of Regulations, Title 12, Subchapter 4.
Please consider this as our application to participate in the Medi-Cal Cost Avoidance Program
authorized by Military and Veterans Code Section 972.5.
I understand and will comply with the following:
1. All activities of the CVSO for which payment is made by the Cal Vet under this
agreement will reasonably benefit the Department of Health Care Services
(DHCS) or realize cost avoidance to the Medi-Cal program. All State and
County Medi-Cal Eligibility Workers who generate a Form CW-5 (Veterans
Benefits Referral) and/or MC 05 (Military Verification and Referral form) will be
instructed to indicate the applicant's Aid Code on the face of the form.
2. All monies received under this agreement shall be allocated to and spent on
the salaries and expenses of the CVSO.
3. This agreement is binding only if federal funds are available to CalVet from the
DHCS.
4. The CVSO is responsible for administering this program in accordance with
California Code of Regulations, Title 12, Subchapter 4 and the CalVet Procedure
Manual for Subvention and Medi-Cal Cost Avoidance for the current state fiscal
year.
£*~~ Ernest Buddy Mendes, hatrman
County Board of Supervisors
SCAN AND UPLOAD THIS COMPLETED FORM VIA THE AGENCY
ATTACHMENTS IN VETPRO
ATIEST:
(Rev 3/16)