HomeMy WebLinkAboutAgreement A-21-082 with State DOR.pdf 5CU IU: 51 bu-3 I b(ol Agreement No. 21-082
STATE OF CAUFDRNIA-DEPARTMENT OF GENERAL SERVICES
STANDARD AGREEMENT AGREEMENT NUMBER PURCHASfNGAIlIHORITYNUMBERpfAppGcable)
STD 213(Rev.04/2020) 31662
1,This Agreement is entered into between the Contracting Agency anc the Contractor named below:
CONTRACTING AGENCY NAME
Department of Rehabilitation
CONTRACTOR NAME
County of Fresno-Department of Behavioral Health
2.The term of this Agreement is:
START DATE
January 1.2020
THROUGH END DATE
June 30,2020
3.The maximum amount of this Agreement is.
31,515.00
4.The parties agree to comply with the terms and conditions of the following exhibits,which are by this reference made a part of the Agreement.
Exhibits Title Pages
Exhibit A Scope of Work 1
Exhibit A.1 Contractor's Program Scope of Work 5
Exhibit B Budget Detail and Payment Provisions 4
t
Exhibit B.1 Contractor's Program Budget(s)and Narrative(s) S
Exhibit C* General Terms and Conditions GTC 04/2017 (Dated 04/2017)
+ Exhibit D Special Terms and Conditions(Attached hereto as part of this agreement) 8
Exhibit E Additional Provisions Federally Funded Agreements 3
Exhibit F Additional Provisions-Cooperative/Case Services 3
Items shown with an asterisk ,arehereby incorporated yreference andiriadepartof this agreementas ilottachedhetelo.
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IN WITNESS WHEREOF;7W AGREEMEWHASBE6M EXTCUMDSYMEPA1RTJES HERETO.
CONTRACTOR
CONTRACTOR NAME(d other than an individual.state whether a corporation,partnership,etc.)
County of Fresno Depatment of Behavioral Health
CONTRACTOR BUSINESS ADDRESS CITY STATE 21P
P 0 Box45003 Fresno CA 93718
PRINTfo NAME OF PERS N SIGNING TITLE
Steve Etrandau Chairman of the Board of Supervisors
CONTRACTOR [14 EO SIGNATI.IRE ATTEST: DATE SIGNED
BERNICE E.SEIDEL
Clerk of the Board of Supervisors d 1
County of Fresno,State of Ca!'omia
By_ Deputy
Pacie 1 of 2
SCO ID: 5160-31662
STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES
STANDARD AGREEMENT AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER(If Applicable)
STD 213(Rev.04/2020) 31662
STATE OF CALIFORNIA
CONTRACTING AGENCY NAME
Department of Rehabilitation
CONTRACTING AGENCY ADDRESS CITY STATE JZIP
721 Capitol Mall,6th Floor Sacramento CA 95814
PRINTED NAME OF PERSON SIGNING TITLE
CONTRACTING AGENCY AUTHORIZED SIGNATURE DATE SIGNED
CALIFORNIA DEPARTMENT OF GENERAL SERVICES APPROVAL EXEMPTION(If Applicable)
Paqe 2 of 2
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FOR ACCOUNTING USE ONLY:
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Fund: 0001
3 Subclass: 10000
Org: 56304533
4 Account: 7295
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EXHIBIT A
(Standard Agreement - Subvention)
1. PURPOSE
Subvention: VR Third Party Cooperative/Case Service Agreements: Mental Health
2. AUTHORITY
Legislation: Rehabilitation Act of 1973, as amended, Title I, Parts A and B, Sec. 100-111; 29
U.S.C. 720-731.
Regulations: 34 CFR 361.3
Assistance Listing Number: 84.126A
3. CONTRACT REPRESENTATIVES
Direct all inquiries during the term of this Agreement to the Contract Administrators listed
herein:
Department of Rehabilitation County of Fresno Department of
Levi Van Fossen Behavioral Health
DOR Contract Administrator Dawan Utecht
2550 Mariposa Mall, Room 2000 Director of the Department of Behavioral
Fresno, California 93721 Health
(559)444-2410 office 1925 E. Dakota Avenue
(559)444-2595 fax Fresno, CA 93728
Levi.Van Fosse n(a)-dor.ca.gov (559) 600-6899 Office
(559) 600-7711 fax
dutecWD-fresnocountyca.gov
4. DESCRIPTION OF SERVICES/DELIVERABLES
See attached program description - EXHIBIT A.1
1
Exhibit A
EXHIBIT A.1
Cooperative Contract
County of Fresno
Department of Behavioral Health
Mental Health Program
SCOPE OF WORK
I. Introduction
The San Joaquin Valley District Office of the Department of Rehabilitation (DOR) and the County of
Fresno, Department of Behavioral Health (DBH) shall combine staff and resources to provide
vocational rehabilitation services to persons with severe and persistent mental disabilities.
DOR will determine eligibility and functional limitations, assist the DOR/DBH clients to develop and
Individualized Plan for Employment (IPE), provide vocational counseling, and service coordination
that will lead to a successful employment outcome.
The DOR/DBH cooperative agreement shall include Transitional Aged Youth (TAY) defined as ages
16-24 who have current open cases within DBH or contract provider.
All of the following conditions must be met for DOR/DBH clients referred to the Cooperative
Program:
• Individuals must have medical documentation of psychiatric diagnosis signed by a
licensed physician
• Individuals must be a legal resident of Fresno County
• Individuals must be at least 16 years of age
• Individuals must meet criteria under DOR's Order of Selection
• Individuals must be receiving services from DBH or mental heal contract provider such
as Turning Point of Crestwood.
For fiscal year 2019-2020, a total of 110 unduplicated DOR student/consumers will receive services
through this cooperative contract.
As a result of services provided through this contract, it is expected that DOR will:
• Open 50 new cases
• Develop 35 new Individual Plans for Employment (IPE)
• Close 24 cases successfully
RESPONSIBILITIES OF DBH COUNTY
DBH will provide administrative support staff and contract administration for this contract. The
services will be implemented by planning, organizing, coordinating and evaluating the work of
multidisciplinary professional staff and support personnel engaged in providing services to
DOR/DBH clients.
Client referrals will be made from DBH's case management service teams and other DBH
contracted vendors. S.E.E.S. will provide weekly program orientations to DOR services.
1
Exhibit A.1
OUTCOME MONITORING
Review teams are instrumental for ensuring that the goal in the IPE materializes. Agency
Coordination Meetings on a routine basis would include the Cooperative Program Manager, DBH
case manager, job developer/coach, adult education teacher, DOR counselor, consumer, and
anyone else the consumer requests to be present. The routine meetings would address coordinated
service deliver, the joint planning process, and IPE.
II. Services to be Provided
The following vocational rehabilitation services are designed to be provided under the auspices of a
DOR third-party cooperative agreement, and individualized to each student/DOR consumer needs,
taking into account the student's preferences and interests as well as DOR IPE goals and
objectives.
A. Vocational Assessment (VA)
1. Description of Service
This service as authorized by a DOR Counselor and provided to DOR/DBH clients by the
Employment/Vocational Specialist, are limited in scope and short in duration. Services assess basic
information about a DOR/DBH client's current education and vocational levels, abilities, and
interests. Assessment materials or questionnaires are not reflective of standardized test and are
developed by DBH. DBH staff will see information through a questionnaire, an interview, and review
of collateral information. Extensive occupation option or labor market analyses are not included in
this service.
Vocational Assessment Services provides information to a DOR/DBH client and referring DOR
counselor, to assist in eligibility determination, ability to participate in rehabilitation planning, and/or
to determine the nature and scope of DOR services to be provided.
2. Service Goals/Number to be served
During fiscal year 2019-2020, it is expected that:
• There shall be 40student/DOR consumers who receive Assessment services
B. Employment Services
1. Description of Services
Employment Services (ES) assist a student/DOR consumer prepare for, obtain, and retain
employment. A continuum of services provides guidance and direction to a student/DOR consumer
in the development of job search techniques and appropriate work-related behaviors that will
enhance the consumer's employability. ES components provide assistance in the development of
job search skills, coordination of job search activities, and identification of appropriate job openings.
Employment Retention services are designed to support DOR consumers and employers in
achieving a successful employment outcome and in meeting DOB's criteria for successful case
closure.
2
Exhibit A.1
Employment Services (ES) as referred by a DOR counselor and provided to a DOR/DBH client by
the Employment/Vocational Specialist, assists DOR/DBH clients prepare, obtain, and retain
employment. A continuum of services provides guidance and direction to a DOR/DBH client in the
development of job search techniques and appropriate work-related behaviors that will enhance the
DOR/DBH client's employability. Employment Services components provide assistance in the
development of job search skills, coordination of job search activities, and identification of appropriate
job openings. Employment Retention services are designed to support DOR/DBH clients and
employers in achieving a successful employment outcome and in meeting DOR's criteria for case
closure.
a. Employment Preparation:
Upon determination of a DOR/DBH client's readiness to engage in Employment Preparation services
DBH staff and DOR/DBH client will participate in the following activities as guided by the ISP;
■ Interviewing techniques
■ Resume development
■ Application preparation
■ Appropriate work behaviors and work ethics
■ Relevant work practices
■ Appropriate grooming and hygiene
■ Assistance in becoming knowledgeable regarding the impact of employment on the
consumer and their disability
■ Assistance with benefits planning related to employment
■ Identification of additional support services such as meeting transportation, child care, or
other needs.
2. Service Goals/Number to be served
During fiscal year 2019-2020, it is expected that:
• There shall be 35 student/DOR consumers who receive Employment Preparation services.
b. Job Development, Placement and Retention:
Upon determination of a DOR/DBH client's preparedness to engage in job search activities, DBH staff
and the DOR/DBH client will collaborate in the following activities as guided by the IPE;
■ Identification of specific job openings appropriate for the DOR/DBH client as indicated in
their IPE and ISP.
■ Contact of employers to identify job openings
■ Obtaining information detailing qualifications and work site requirements for specific job
opportunities to ensure applicant readiness and success on the job.
■ Job site consultation to identify or modify barriers
■ Negotiating job carving, work site analysis or other job accommodations
■ Assisting job applicant in the interviewing process
■ Assisting the job applicant in coordinating transportation needs
■ Provision of job club or tools to assist in job search
Upon job placement:
■ Job destination training
■ Job orientation assistance
■ Information on conditions of employment, such as:
1. job duties' and job descriptions
2. performance expectations
3
Exhibit A.1
3. name of immediate supervisor
4. responsibilities of the employer
5. wage payment practices
6. benefits
7. company policies and procedures including conflict resolution procedures and health
and safety practices
8. probation and performance evaluation procedures
9. union status, as appropriate
c. Employment Retention:
Upon DOR/DBH client's acceptance of employment of a job that is consistent with the IPE goal and
meets the needs for hours, wages, and benefits the DBH staff will provide at least 90 days of the
following Employment Retention activities;
■ phone or personal contact, on or off the job, with the DOR/DBH client to determine ongoing
satisfaction with the terms of employment
■ phone or personal contact with the employer to determine ongoing satisfaction with the terms
of employment
■ no less than two contacts a month are required for a minimum of 90 days.
■ Communication with DOR SVRC at least monthly to discuss progress and coordination for
any additional services that may be required
■ assistance with necessary minimal supports to sustain employment. Intensive
support services, as determined by the DBH staff and DOR SVRC, may require additional
hours to be authorized for job coaching services.
3. Service Goals/Number to be served
During fiscal year 2019-2020, it is expected that:
• There shall be 35 student/DOR consumers who receive Job Development services.
• There shall be 24 student/DOR consumers placed in employment consistent with the IPE
goal.
• The placements shall result in 24 successful DOR closures
d. Short-Term Supports:
The Short-Term Supports (STS) service is provided to the DOR consumer upon placement into a
Competitive Integrated Employment (CIE) setting. Employment settings include but are not limited
to placement into a permanent job.
This service is time-limited, proactive, and individualized to match the consumer's employment-
related needs. The STS service focuses on assisting the DOR consumer to learn job duties, adjust
to the work environment, and maintain CIE by developing natural supports within the employment
setting. STS is completed within 90 days, unless additional support is needed to ensure stabilization
in the employment setting. Short-Term Support services will be provided by the
Employment/Vocational Specialist.
4. Service Goals/Number to be served
During fiscal year 2019-2020, it is expected that:
• There shall be 35 student/DOR consumers who receive Short-Term Supports services.
4
Exhibit A.1
III. Contract Administrator/Program Coordinator
Department of Rehabilitation Fresno County
Levi Van Fossen Dawan Utecht
DOR Contract Administrator Director of the Department of Behavioral Health
2550 Mariposa Mall, Room 2000 1925 E. Dakota Avenue
Fresno, California 93721 Fresno, CA 93728
(559)444-2410 office (559)600-6899 office
(559)444-2595 fax (559)600-7711 fax
Levi.VanFossen(a)dor.ca.gov dutecht(a)fresnocountyca.gov
IV. Linkages to Other Community Agencies
The Fresno DBH has regular contact and ongoing working relationships with the following agencies
to increase opportunities for DOR student/consumers and avoid duplication of services:
• California State University, Fresno
• Reedley College
• Fresno City College
• Employment Development Department
• Independent Living Center
• Central Valley Regional Center
• California Community Colleges
• Social Security Administration
• Department of Motor Vehicles
• CalWORKs
• Fresno County Career Services "One Stops"
• Any adult supportive services agencies
• Local business/employer community
V. In Service Training
Twice a year or more frequently as needed, in-service trainings will be conducted to cross-train in
each agency's mission, services, procedures, and professional approaches. The cooperative
program partners may also jointly request specific trainings from the DOR/DHCS statewide
cooperative unit.
5
Exhibit A.1
EXHIBIT B
(Standard Agreement - Subvention)
BUDGET DETAIL AND PAYMENT PROVISIONS
1. INVOICING AND PAYMENT
A. Service Budget Payment of Expenditure
1. This is a cost reimbursement Agreement for subvention services. For services
satisfactorily completed, and upon receipt and approval of the invoices, the Department
of Rehabilitation (DOR) agrees to reimburse the Contractor for actual expenditures
incurred subject to the approved Scope of Work, Service Budget, Budget Narrative, and
applicable regulations as attached or referenced hereto and made a part of this
Agreement.
2. All expenses shall be reviewed and approved by the DOR Contract Administrator before
payment can be made to the Contractor.
3. The Service Budget must set forth in detail the reimbursable items, unit rates and
extended total amounts for each line item. The Contractor's Service Budget shall include
items directly related to this Agreement to include a Budget Narrative that fully explains
why and how the costs are necessary to the Agreement.
B. Submission of Invoice(s)
1. Monthly invoices must be completed using the DR 801 B Service Invoice form (DR801 B)
and shall provide an actual line-item detail of expenditure(s) that supports the approved
Service Budget and Budget Narrative. The DR801 B shall include the Agreement Number
and be submitted in duplicate not more frequently than monthly in arrears to the DOR
Contract Administrator or designee (listed in Exhibit A).
2. An original DR801 B must be submitted and signed by authorized personnel as listed on
the Signature Authorization (DR 325) form.
3. Supporting documentation must be available upon request at any time by DOR staff, or
other State and Federal representatives.
4. Federal and State funds are time limited, therefore, invoices (service and certified match)
must be submitted as soon as possible, but no later than 60 days after the service
month. Final submission of all fiscal year-end invoices is due no later than November
1 st, to allow for payment and draw down prior to the close out of Federal/State funds.
5. If budgetary funds revert due to failure to submit timely invoices or failure to submit a
properly prepared invoice, related Federal and State funds will no longer be available for
use which will require the contractor to submit a claim through the Victims Compensation
and Government Claims Board, where approval to pay is not guaranteed.
6. The DOR is committed to issue payments as quickly as possible following the receipt of
an accurate and complete invoice of allowable costs as approved by the DOR Contract
Administrator.
1
Exhibit B
C. Appropriate Expenditures
Budgets must not contain line items that are or will be reimbursed/paid by another source of
funding during the period covered by this Agreement. Unexpended funds for a fiscal year
shall not be carried over to another fiscal year. Agreement expenditures reimbursed by DOR
must be reported as federal funds in the contractor's accounting records and on the
Schedule of Federal Awards under the CFDA # listed for this Agreement and prepared for
the Title 2 Code of Federal Regulations, Part 200 (2 CFR 200) Single Audit.
D. Invoice Claim Adjustments
1. Surplus funds from a given line item, within a fiscal year budget may be used to defray
allowable costs under the approved budget line items contained within the same fiscal
year. A claim adjustment is required on the Service Invoice (DOR 801 B) with an
attached brief narrative explaining each line item impacted and may not exceed up to a
cumulative amount of ten percent (10%) of the total annual contract Service Budget for
all budget years as long, as there is neither an increase nor decrease of the total annual
contract Service Budget. A formal amendment is required if it does not meet the above
criteria.
2. Staff line item salary ranges and percentage of time are projected estimates and are
subject to change based on actual salary and chargeable time costs. Claim adjustments
are allowable as long as the annualized total line item costs do not exceed what is
allowed in Item 1 above.
E. Budget Contract Amendments
A contract amendment between both parties is required for any budget changes not covered
in Section D above. This includes any major category or detailed line item description
changes to the approved Service Budget and Budget Narrative as outlined below:
• Adding and deleting a major category budget or detailed line item.
• Line item adjustments that exceed a cumulative amount of 10%.
• Decrease/increase to the total annual budget award or the total Agreement award for
all budget years.
• Any word for word changes to the written budget narrative or budget cost detail.
(Note. ALL changes must be made in bold.)
F. Travel Reimbursements
If travel is reimbursable, the Contractor agrees that all travel expenses and per diem rates
paid to its employees under this Agreement shall be reimbursed at actual costs not to
exceed the California Department of Human Resources (CaIHR) designated rates for
excluded employees. Go to CaIHR website at
http://www.calhr.ca.gov/employees/pages/travel-reimbursements.aspx. No travel outside
the State of California except for bordering California states shall be reimbursed without
prior documented written authorization from DOR.
2
Exhibit B
Upon request from the DOR, Contractor will provide sufficient documentation to support
travel expenditures such as travel claims, mileage logs, and receipts for lodging,
transportation, and meal costs.
2. BUDGET CONTINGENCY CLAUSE
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years
covered under this Agreement does not appropriate sufficient funds for the program, this
Agreement shall be of no further force and effect. In this event, the State shall have no
liability to pay any funds whatsoever to Contractor or to furnish any other considerations
under this Agreement and Contractor shall not be obligated to perform any provisions of this
Agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this
program, the State shall have the option to either cancel this Agreement with no liability
occurring to the State, or offer an Agreement amendment to Contractor to reflect the
reduced amount.
3. BUDGET CONTINGENCY CLAUSE FOR FEDERALLY FUNDED AGREEMENTS
A. It is mutually understood between the parties that this Agreement may have been written for
the mutual benefit of both parties before ascertaining the availability of congressional
appropriation of funds to avoid program and fiscal delays that would occur if the Agreement
were executed after that determination was made.
B. This Agreement is valid and enforceable only if sufficient funds are made available to the
State by the United States Government for the current year and/or any subsequent year for
the purpose of this program. In addition, this Agreement is subject to any additional
restrictions, limitations, or conditions enacted by Congress or to any statute enacted by
Congress that may affect the provisions, terms, or funding of this Agreement in any manner.
C. The parties mutually agree that if Congress does not appropriate sufficient funds for the
program, this Agreement shall be amended to reflect any reduction in funds.
4. PROMPT PAYMENT CLAUSE
Payment will be made in accordance with, and within the time specified in, Government Code
Chapter 4.5, commencing with section 927.
5. PRINCIPLES AND STANDARDS FOR DETERMINING ALLOWABLE COSTS, INCLUDING
REQUIREMENTS FOR DOCUMENTING PERSONNEL ACTIVITY CHARGEABLE TO THE
AGREEMENT
Agreements awarded by the Department shall be subject to actual costs for services rendered
under this Agreement. Allowable costs under this Agreement must meet the following general
criteria:
• Be generally recognized and necessary for the operation of the Contractor's organization.
• Be reasonable for the performance of the Agreement, including acceptable sound business
practices.
3
Exhibit B
• Be subject to the terms and conditions of the Agreement and approved DOR budgeted line
items.
• Not be used for general expenses required to carry out other responsibilities of the
Contractor.
• Be properly documented and supported.
Documenting and supporting the distribution of all costs, including the allocation of time
chargeable to the Agreement, is required. The Contractor agrees to comply with the 2 CFR 200
cost principles regarding documentation for the support of personnel activity chargeable to the
Agreement.
6. ACCOUNTING SYSTEM REQUIREMENTS
A. Contractor must maintain an appropriate fund accounting system that accurately
accumulates and segregates reasonable, allocable, and allowable costs in compliance with
state and federal regulations, and generally accepted accounting principles. The
Contractor's financial management system shall provide:
• Accurate, current, and complete disclosure of the financial results of each federally
sponsored project.
• Records that identify adequately the source and application of funds for federally
sponsored activities.
• Written procedures for determining the reasonableness, allocable, and allowable
costs in accordance with the provisions of the applicable federal cost principles and
the terms and conditions of the Agreement.
• Accurate fund accounting records that track the revenues received from
funders/sources and the expenditures paid to vendors for goods and services, and
that are supported by adequate source documentation.
B. Contractor shall submit to State such reports, accounts, and records as deemed necessary
by the State to discharge its obligation under State and Federal laws and regulations
4
Exhibit B
Exhibit B.1
STATE OF CALIFORNIA DEPARTMENT OF REHABILITATION
SERVICE BUDGET
❑Original ❑Amendment
Contractor Name and Address Contract Number Federal ID Number Page 1 of 1
County Of Fresno, Deparment of Behavioral Health 94-60000512
P.O. Box 712 Budget Period Budget Period Budget Period
Fresno, CA 93712 January 1, 2020-June 30, 2020
Effective Date (Amendments Only) Effective Date (Amendments Only) Effective Date (Amendments Only)
Line Annual Amount Annual Amount Annual Amount
No. PERSONNEL-Position Title &Time Base Annual Salar FTE Budgeted Annual Salary FTE Budgeted Annual Salary FTE Budgeted
Cooperative Program Manager
1 1 FTE=40 hrs/wk, 12 months $635.00 0.80 $508.00
Employment/Vocational Specialist
2 1 FTE=40 hrs/wk, 12 months $16,335.29 0.95 $15,518.53
Vocational Support Staff
3 11 FTE=40 hrs/wk, 12 months 1 $75.40 0.90 $67.86
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16 S u btota 1 $16,094.39
17 OPERATING EXPENSES
20 Communications $6,363.99
21 Office Supplies $59.59
22 Facility Service Charges $4,886.48
24
25 Operating Subtotal $11,310.06
26 Personnel and Operating Subtotal $27,404.45
27 Indirect Rate Percentage 15.00%
28 Indirect Cost $4,110.67
29 TOTAL(rounded to nearest dollar) $31,515
1
Exhibit BA
Insert Service Budget Narrative
County of Fresno- Department of Behavioral Health
Service Budget Narrative
Personnel
This Cooperative Agreement between DOR and Fresno County Department of Behavioral Health (DBH)
will provide the positions identified below for the Cooperative Program and be paid the actual costs as
identified in the Service Budget. Selection and hiring decisions will be made with the joint participation of
the appropriate DOR staff.
Personnel Benefits:
Full-time permanent employees (Cooperative Program Manager, Employment/Vocational Specialists,
Vocational Support Staff)will receive: unemployment, retirement, OASDI, health insurance, life insurance,
benefits administration, and workers compensation insurance. Benefits are calculated at 42% of salary.
Cooperative Program Job Duties
Cooperative Program Manager
• DOR related activities include: supervise Employment/Vocational Specialist, Vocational Support Staff
and part-time Vocational Assistants.
• Provides backup support to the Employment/Vocational Specialist to provide Employment Services
and Vocational assessment the Contract.
• Coordinates with Employment/Vocational Specialists providing services with mutual DOR/DBH
clients.
• Coordinates benefit services and counseling to DOR/DBH clients countywide.
• Acts as a liaison between DOR and other Fresno County MH staff to the Contract.
• Provides assistance with accessing DOR/DBH clients MH records and diagnostic information for
DOR and DBH staff to the contract.
• Ensure maintenance of referral information and documentation on DOR/DBH clients.
• Ensures proper maintenance of referral information, documentation, and DOR/DBH clients tracking
documents.
• Ensures DBH staff is correctly documenting DOR/DBH client progress and correctly coding to the
contract.
• Assist in preparing and maintaining DOR/DBH client tracking documents.
• Attends Quarterly meetings and monthly meetings relating to the Contract between DOR and DBH.
Traditional Mental Health Duties
Clinical Supervisor
• Supervises staff in DBH's Supported Education and Employment Services (S.E.E.S.) providing
traditional MH services.
• Communicates and interprets Mental Health program goals, policies, and procedures to staff,
community agencies, clients, and the public.
• Develops and implements work schedules to assure proper Mental Health program coverage.
2
Exhibit BA
• Assures proper maintenance of the physical facility and availability of supplies for the provision of
Mental Health services.
• In accordance with state licensing requirements, may provide direct client services including
evaluating and developing treatment plans, conducting therapy session, and consulting with other
agencies regarding client treatment.
Employment/Vocational Specialist
• Provides Employment Services and Vocational Assessment under the contract to DOR/DBH clients.
• Develops employment opportunities in the community for DOR/DBH clients.
• Maintains strong relationships with employers within Fresno County for the purposes of placement of
DOR/DBH clients in employment.
• Regularly meets with employers to address concerns, and/or problems regarding DOR/DBH clients on
the job.
• Maintains ongoing contact with the DOR counselor, DOR/DBH clients, and/or employer.
• Provides assistance in direct job placement activities for DOR/DBH clients.
• Maintains referral information for DOR/DBH clients.
• Provides employment preparation services to DOR/DBH clients.
• Provides reporting documentation to DOR regarding job placement and retention services for
DOR/DBH clients.
• May provide assistance for Vocational Assessment and/or Job Coaching as needed for DOR/DBH
clients.
• Provide monthly reports on DOR/DBH activities/needs to DOR Counselor related to DOR/DBH
clients.
• Help DOR/DBH clients prepare resumes or complete employment applications.
• Will meet with DOR/DBH clients on a 1:1 basis to complete vocational assessments.
• Conduct assessments/evaluations of functional/occupational performance in simulated environments
for DOR/DBH clients.
• Explore vocational preferences; identify accommodations needed for DOR/DBH clients.
• Assess labor markets related to for DOR/DBH client's vocational goal preferences.
• Perform preference and interest inventories and psychometric testing as needed for DOR/DBH clients.
• Analyze prior work experience and transferable skills for DOR/DBH clients.
• Provide on or off-the-job support services to assist DOR/DBH clients in adjustment to a new
job.
• Promote job retention of DOR/DBH clients.
• Assist DOR/DBH clients with changes in the work environment.
• Teach job tasks to DOR/DBH clients.
• Provide assistance with social interaction and relationships within the work setting to DOR/DBH
clients.
• Completes comprehensive reports and other necessary documents to be submitted to DOR Counselor
upon DOR/DBH client's completion of each component of the employment services and /or vocational
assessment.
• Attend and participate in monthly meetings with DOR Counselor(s) and Quarterly meetings with the
DOR/DBH staff related to the Contract.
• Supports and participates in program events, celebrations and other activities.
3
Exhibit BA
• May act as a liaison between SEES, DBH teams and other FSP providers.
Traditional Mental Health Department Duties
Community Mental Health Specialist
• Develops and implements treatment plans to resolve client's problems and needs concerning the
necessities of day to day living; assesses and evaluates progress made.
• Confers with clinical staff regarding client's progress.
• Under the direction of a clinician, may assist in carrying out activities described in treatment plan,
including recreation, daily living skills, and use of community resources.
• May meet regularly with participants at various mental health program sites to inform clients of issues
and policies, which impact their mental health services. Gathers client opinions and represents those
opinions in the appropriate forums.
• Under general supervision, provide supportive services to mentally ill adults and perform related work
as required.
• Assist clients with employment interviews and counsel clients regarding employment responsibilities.
• Prepares and writes case records and maintains appropriate controls and records.
Vocational Support Staff (1 position)
• Assist in maintaining vocational case files for DOR/DBH clients.
• Keep statistics as required by DOR for the Cooperative Contract.
• Mail reporting information to DOR relating to the Contract.
• Prepare invoices related to the Contract with proper documentation on a monthly basis and forward
to DOR Contract Administrator.
Traditional Mental Health Duties
Office Assistant III
• Establish and maintain a MH filing system.
• Maintain MH records that involve reconciling computer reports to source documents.
• Process MH records, which include entering data on forms.
Operating Expenses
Communications:
Monthly service charges pertaining to all telecommunication services such as telephone, cell phone,
FAX, and internet utilized for the DOR Contract staff in the delivery of contract services.
Office Supplies:
General office supplies necessary for staff to perform duties as required under the Contract. These
include pens, paper, toner cartridges for printers, and other miscellaneous office supplies necessary for
the provision of employment/vocational and job development services.
4
Exhibit BA
Facility Service Charges:
Expense is for the DOR Contract staff and associated building. Expense is incurred based on utilities,
janitorial services and actual cost of items purchased. Utilities are calculated by multiplying the
percentage of space occupied by the Fresno Co. MH cooperative program staff by the monthly bill. The
total amount of space occupied by DBH is 50% of the total building.
Calculation of space occupied by DBH:
• Square footage occupied by the Fresno Co. MH cooperative program staff = 3,550 sq. ft.
• Total footage of the building = 7,100 sq. ft.
• 3,550 / 7,100 = 50% which is equal to $30,024
Indirect Cost/Administrative Overhead:
Indirect-cost of the DBH cooperative program are those costs which have been calculated and approved
by Fresno County Human Service Finance. This includes computer technical support, personnel,
insurance, accounting/audit costs and administrative support.
5
Exhibit BA
EXHIBIT C
GENERAL TERMS AND CONDITIONS (GTC 4/2017)
PLEASE NOTE: The General Terms and Conditions will be included in the Agreement by
reference, you can view them at the Department of General Services, Office of Legal Services
website at_: https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-
Resources-List-Folder/Standard-Contract-Lanquage. Go to Resources, click on the Standard
Contract Language section to expand, then click on GTC 4/2017.
1
Exhibit C
EXHIBIT D
(Standard Agreement - Subvention)
SPECIAL TERMS AND CONDITIONS
1. NOTIFICATION & COMPLIANCE
All notices required by either party shall be in writing and sent by email, mail, or personally
delivered to the appropriate address. Mailing addresses may be changed by written notice.
Contractor agrees to comply with all laws, regulations, ordinances, and policies of any
governmental unit having jurisdiction over the rehabilitation program with regards to
construction, medicine, health, safety, wages, hours, working conditions, workers'
compensation, licensing and all other activities requiring compliance. Contractor shall accept
financial responsibilities in the event of non-compliance.
2. DISPUTES
If Contractor believes that there is a dispute or grievance between Contractor and the State
arising out of or relating to this Agreement, Contractor shall first discuss and attempt to resolve
the issue informally with the DOR Contract Administrator. If the issue cannot be resolved at this
level, Contractor shall follow the following procedures:
A. If the issue cannot be resolved informally with the DOR Contract Administrator, Contractor
shall submit, in writing, a grievance report together with any evidence to the DOR Contract
Administrator's Supervisor. The grievance report must state the issues in the dispute, the
legal authority, or other basis for the Contractor's position and the remedy sought. Within
ten (10) working days of receipt of the written grievance report from the Contractor the DOR
Supervisor shall make a determination on the problem and shall respond in writing to the
Contractor indicating the decision and reasons, therefore. Should the Contractor disagree
with the Supervisor's decision, Contractor may appeal to the next level following the
procedure in "Disputes", paragraph B listed below.
B. Contractor's letter of appeal must be submitted within ten (10) working days of the receipt of
the Contract Administrator's Supervisor's written decision. Contractor must submit a letter
of appeal to the Department's Contract Officer explaining the disagreement with the
Contract Administrator's supervisor's decision. The letter must include, as an attachment,
copies of the Contractor's original grievance report, evidence originally submitted, and
response from Supervisor. The Contracting Officer shall, within twenty (20) working days of
receipt of Contractor's letter of appeal, review the issues raised and shall render a written
decision to the Contractor. The decision of the Director or designee shall be final.
3. RIGHT TO TERMINATE
A. Either party reserves the right to terminate this Agreement subject to 30 days written notice.
B. However, the Agreement can be immediately terminated for cause. The term "for cause"
shall mean that the Contractor fails to meet the terms, conditions, and/or responsibilities of
the Agreement. In this instance, the Agreement termination shall be effective as of the date
indicated on the State's notification to the Contractor.
1
Exhibit D
4. TRAINING SEMINARS, WORKSHOPS OR CONFERENCES
If said Contractor provides training seminars, workshops, or conferences, Contractor must
obtain prior DOR approval for the location, costs, dates, agenda, instructors, instructional
materials, and attendees at any reimbursable training seminar, workshop, or conference
pursuant to this Agreement and of any reimbursable publicity or educational materials to be
made available for distribution. The Contractor shall acknowledge the support of the State
whenever publicizing the work under this Agreement in any media. The provision does not
apply to necessary staff meetings or training sessions held for the staff of the Contractor to
conduct routine business matters.
5. INSURANCE REQUIREMENTS
General Provisions Applying to All Policies
A. Coverage Term — Coverage needs to be in force for the complete term of the contract. If
insurance expires during the term of the contract, a new certificate must be received by the
State at least ten (10) days prior to the expiration of this insurance. Any new insurance must
still comply with the original terms of the contract.
B. Policy Cancellation or Termination & Notice of Non-Renewal — Contractor is responsible
to notify the State within five business days before the effective date of any cancellation,
non-renewal, or material change that affects required insurance coverage. In the event
Contractor fails to keep in effect the specified insurance coverage, the State may, in addition
to any other remedies it may have, terminate this Contract upon the occurrence of such
event, subject to the provisions of this Contract.
C. Deductible — Contractor is responsible for any deductible or self-insured retention contained
within their insurance program.
D. Insurance Carrier Required Rating — All insurance companies must carry a rating
acceptable to the Office of Risk and Insurance Management. If the Contractor is self-insured
for a portion or all of its insurance, review of financial information including a letter of credit
may be required.
E. Endorsements — Any required endorsements requested by the State must be physically
attached to all requested certificates of insurance and not substituted by referring to such
coverage on the certificate of insurance.
F. Inadequate Insurance — Inadequate or lack of insurance does not negate the contractor
obligations under the contract.
G. Satisfying an SIR - All insurance required by this contract must allow the State to pay
and/or act as the contractor's agent in satisfying any self-insured retention (SIR). The choice
to pay and/or act as the contractor's agent in satisfying any SIR is at the State's discretion.
H. Available Coverages/Limits - All coverage and limits available to the contractor shall also
be available and applicable to the State.
I. Subcontractors - In the case of Contractor utilization of subcontractors to complete the
contracted scope of work, contractor shall include all subcontractors as insured under
Contractor and insurance or supply evidence of insurance to The State equal to policies,
coverages and limits required of Contractor.
2
Exhibit D
i. Commercial General Liability — Contractor shall maintain general liability on an
occurrence form with limits not less than $1,000,000 per occurrence for bodily injury and
property damage liability combined with a $2,000,000 annual policy aggregate. The
policy shall include coverage for liabilities arising out of premises, operations,
independent contractors, products, completed operations, personal & advertising injury,
and liability assumed under an insured Agreement. This insurance shall apply separately
to each insured against whom claim is made or suit is brought subject to the Contractor's
limit of liability. The policy must include:
The State of California, its officers, agents, and employees as additional insured, but
only with respect to work performed under the Agreement.
Endorsements must be physically attached to all requested certificates of
insurance and not substituted by referring to such coverage on the certificate of
insurance. The endorsement must be acceptable to the DGS Office of Risk and
Insurance Management.
ii. Automobile Liability (If Applicable) — For DOR consumers being provided transportation
under said Agreement, the Contractor shall maintain motor vehicle liability with limits not
less than $1,000,000 combined single limit per accident. Such insurance shall cover
liability arising out of a motor vehicle including owned, hired and non-owned motor
vehicles to include the following additional insurance coverage below:
• For public schools and for-profit organizations: Automobile Liability insurance must
include Any-Auto, Hired-Autos, Non-Owned Autos, and any other auto used in
performing services under the Agreement. For seating capacity up to 7 people
(includes driver), the Contractor's certificate of insurance shall state a limit of liability of
not less than $1,000,000 per occurrence for bodily injury and property damage liability
combined. For seating capacity for 8 —15 people (includes driver) the certificate of
insurance shall state a limit of liability of not less than $1,500,000 per occurrence for
bodily injury and property damage liability combined. For seating capacity for 16
passengers or more the certificate of insurance shall state a limit of liability of not less
than $5,000,000 per occurrence for bodily injury and property damage liability combined.
• For non-profit organizations: Automobile Liability insurance must include Any-Auto,
Hired-Autos, Non-Owned Autos, and any other auto used in performing services under
the Agreement. For seating capacity of up to 15 people (includes driver) the certificate
of insurance shall state a limit of liability of not less than $1,000,000 per occurrence for
bodily injury and property damage liability combined. For seating capacity for 16
passengers or more the certificate of insurance shall state a limit of liability of not less
than $5,000,000 per occurrence for bodily injury and property damage liability combined.
The same additional insured designation and endorsement required for general
liability is to be provided for this coverage.
iii. Workers Compensation and Employers Liability — Contractor shall maintain statutory
worker's compensation and employer's liability coverage for all its employees who will be
engaged in the performance of the Agreement. Employer's liability limits of $1,000,000
are required.
3
Exhibit D
The workers' compensation policy shall contain a waiver of subrogation in favor of
the State. The waiver of subrogation endorsement shall be provided.
iv. Self-insurance - Contractor shall supply the consent letter of self-insurance or the
Certificate of Consent to Self-Insure. The Waiver of Subrogation is not required.
6. CONFLICT OF INTEREST
A. Contractor certifies that it's employees and the officers of its governing body shall avoid any
actual or potential conflicts of interest and that no officer or employee who exercises any
functions or responsibilities in connection with this Agreement shall have any personal
financial interest or benefit which either directly or indirectly arises from this Agreement.
B. Contractor shall establish safeguards to prohibit its employees or its officers from using their
positions for a purpose which could result in private gain or which gives the appearance of
being motivated for private gain for themselves or others, particularly those with whom they
have family, business, or other ties.
7. CONFIDENTIALITY
A. Contractor agrees to comply with the provisions applicable to consumer information as set
forth in 34 Code of Federal Regulations, Section 361.38 and Title 9, California Code of
Regulations, Section 7140 et seq., and personal information as set forth in the Information
Practices Act of 1977 (California Civil Code Section 1798 et seq.).
B. Contractor agrees that any personal information, as defined by the Information Practices Act
of 1977 (California Civil Code Section 1798 et seq.) and this Agreement, obtained in the
performance of this Agreement is classified as confidential and shall not be subject to
disclosure to any source except as required by this contract or otherwise authorized by
DOR.
C. Contractor agrees to remove all confidential, sensitive, or personal information from any
reports, publications, or other materials created during the performance of this contract prior
to being released to the scientific and academic community, or other individuals or entities.
The removal method(s) must be reasonable and appropriate to ensure that any confidential,
sensitive, or personal information cannot be recovered, accessed, used or disclosed, which
would result in a security breach or an information security incident.
D. Subject to the applicable requirements of the regulations cited above, Contractor agrees to
report any security breach or information security incident involving confidential, sensitive, or
personal information (e.g., consumer information) obtained in the performance of this
contract to the DOR's Contract Administrator and the DOR's Information Security Officer.
The DOR's Information Security Officer can be contacted via e-mail at iso ,dor.ca.gov.
E. Security breaches or information security incidents that shall be reported include, but are not
limited to:
1. Inappropriate use or unauthorized disclosure of confidential, sensitive, or personal
information (e.g., consumer information) obtained in the performance of this contract by
4
Exhibit D
the Contractor or the Contractor's assignees. Disclosure methods include, but are not
limited to, electronic, paper, and verbal.
2. Unauthorized access to confidential, sensitive, or personal information (e.g., consumer
information) obtained in the performance of this contract. Information can be held in
medium that includes, but is not limited to, electronic and paper.
3. Loss or theft of information technology (IT) equipment, electronic devices/media, paper
media, or data containing confidential, sensitive, or personal information (e.g., consumer
information) obtained in the performance of this contract. IT equipment and electronic
devices/media include, but are not limited to, computers (e.g., laptops, desktops,
tablets), smartphones, cell phones, CDs, DVDs, USB flash drives, servers, printers,
peripherals, assistive technology devices (e.g., notetakers, videophones), and copiers.
Data can be held in medium that includes, but is not limited to, electronic and paper.
F. Contractor agrees to provide annual security and privacy training for all individuals who have
access to confidential, sensitive, or personal information (e.g., consumer information)
obtained in the performance of this contract.
G. Contractor agrees to obtain and maintain acknowledgements from all individuals to evidence
their understanding of the consequences of violating California privacy laws and the
contractor's information privacy and security policies.
H. For contractors that do not have a security program that includes annual security and
privacy training, a self-training manual is available on the DOR website in the "Requirements
for Becoming a Service Provider" section under "Annual Security and Privacy Training for
VR Service Providers." The self-training manual is named "Protecting Privacy in State
Government" and can be downloaded at the following link:
https://www.dor.ca.gov/Home/SecuritVandPrivacV.
I. Additional training and awareness tools are available at the California Information Security
Office (CISO) website and the California Department of Justice — Privacy Enforcement and
Protection website. These state entities created the self-training manual, "Protecting
Privacy in State Government" that DOR revised to meet its business needs.
8. AUDIT AND REVIEW REQUIREMENTS
A. General Audit and Review Requirements
1. The State shall have the right to conduct inspections, reviews, and/or audits of the
Contractor to determine whether the services provided, and the expenditures invoiced by
the Contractor were in compliance with this Agreement and other applicable federal or
state statutes and regulations.
2. Contractor agrees that Department of Rehabilitation, State Controller's Office,
Department of General Services, Bureau of State Audits, Federal Department of
Education Auditors, or their designated representatives shall have the right to review and
to copy any records and supporting documentation pertaining to the performance of the
Agreement, including but not limited to, accounting records, consumer service records,
records and evaluations of individuals referred to the program, and other supporting
documentation that may be relevant to the audit or investigation.
5
Exhibit D
3. The Contractor shall submit to the State such reports, accounts, and records deemed
necessary by the State to discharge its obligation under State and Federal laws and
regulations, including the applicable OMB cost principles and administrative
requirements.
4. Contractor agrees to allow the auditors access to such records during normal business
hours and to allow interviews of any employees who might reasonably have information
related to such records.
5. Contractor agrees to maintain such records for possible audit for a minimum of five (5)
years after final payment or until resolution of all issues which may arise as a result of
any litigation, claim, negotiation, audit, or any other action involving the records prior to
expiration of the five (5) year period, whichever is later.
B. Annual Federal Audit (For Agreements that received Federal Funds $750,000 and above):
1. In addition to the General Audit and Review Requirements above, the Contractor agrees
to provide an annual audit as required by the federal "Single Audit Act" of 1994, as
amended. These annual audit documents shall be maintained by the Contractor and
provided to the auditing agency when requested. This audit shall be made in
accordance with 2 CFR 200.
9. COMPETITIVE BIDDING AND PROCUREMENTS
A. Contractor shall comply with applicable laws and regulations regarding securing competitive
bids and undertaking negotiations in Contractor's Agreements with other entities for
acquisition of goods and services with funds provided by the State or Federal under this
Agreement. A minimum of two competitive quotations is required for any purchase order or
subcontract for services over $2,500, and should be submitted to the DOR contract
administrator or adequate justification provided for the absence of bidding.
B. Contractors must maintain a copy of the narrative description of the procurement systems
guidelines, rules or regulations that will be used to make purchases under this Agreement.
The State reserves the right to request a copy of these documents and to inspect the
purchasing practices of the Contractor at any time.
C. The Contractor should seek prior approval for any purchase or subcontract exceeding
$2,500 per unit or more for commodities, supplies, and services related to this Agreement.
The Contractor must provide in its request for approval all particulars necessary, as
specified by DOR, for evaluating the necessity or desirability of incurring such costs.
D. For all purchases made, subject to this Agreement, the Contractor must maintain copies of
all paid vendor invoices, documents, bids and other information used in vendor selection, for
inspection or audit.
10. USE OF SUBCONTRACTOR(S)
If the Contractor desires to accomplish part of the services through the use of one (1) or more
subcontractors, the following conditions must be met:
A. The Contractor shall submit any subcontracts to the State for approval prior to starting any
of the work;
B. The Agreement between the primary Contractor and the subcontractor must be in writing;
6
Exhibit D
C. The subcontract must include specific language which establishes the rights of the auditors
of the State to examine the records of the subcontractor relative to the services and
materials provided under the Agreement; and
D. Upon termination of any subcontract, the State shall be notified immediately, in writing.
E. Contractor shall assure that all subcontractor administrative fees are reasonable considering
the services being provided, and they may only pay overhead charges on the first $25,000
for each subcontract.
Further, any subcontract in excess of $100,000 entered into as a result of this Agreement shall
contain all applicable provisions stipulated in this Agreement.
11. POTENTIAL SUBCONTRACTORS
Nothing contained in this Agreement or otherwise, shall create any contractual relation between
the State and any subcontractors, and no subcontract shall relieve the Contractor of his
responsibilities and obligations hereunder. The Contractor agrees to be as fully responsible to
the State for the acts and omissions of its subcontractors and of persons either directly or
indirectly employed by any of them as it is for the acts and omissions of persons directly
employed by the contractor. The Contractor's obligation to pay its subcontractors is an
independent obligation from the State's obligation to make payments to the Contractor. As a
result, the State shall have no obligation to pay or to enforce the payment of any moneys to any
subcontractor. Contractor shall not subcontract any services under this Agreement without
prior approval of the State.
12. CONTRACT AMENDMENTS
In the event that additional program services must be performed which was wholly
unanticipated and is not specified in the written Scope of Work, but is, in the opinion of both
parties necessary to the successful accomplishment of the general scope of work outlined, an
amendment to the Agreement is required.
13. SOFTWARE
Contractor certifies that it has appropriate systems and controls in place to ensure that state
funds will not be used in the performance of this contract for the acquisition, operation or
maintenance of computer software in violation of copyright laws.
14. THEFT SENSITIVE ITEMS
DOR is requiring nonexpendable electronic items purchased to be listed under a separate line
item titled "Theft Sensitive Items". Contractor shall maintain an inventory record for each
nonexpendable item purchased or built with funds provided under the terms of the contract.
The inventory record of each item shall include the date acquired, total cost, serial number,
model identification and any other information or description necessary to identify said item. A
copy of the inventory record must be submitted annually to the State Contract Administrator.
The following items, regardless of cost must be inventoried:
1. Computers/printers
2. Laptops/tablets
Exhibit D
3. Copiers/fax
4. Smart phones/cell phones
5. Other electronic items required to provide contract services
Upon termination of the agreement, DOR may request equipment be returned to DOR or
authorize the continued use of equipment for work to be performed under a different
agreement.
DOR reserves title to equipment purchased under this agreement that are not fully consumed
during the life of the agreement.
15. ATTRIBUTION
The Contractor agrees to acknowledge the sponsorship of DOR with respect to any public
statement, press release, news item, or publication related to a program funded all or in part
with funds from DOR. Contractor further agrees to identify the role of DOR with respect to any
individual highlighted or publicized by or through Contractor, when such individual is a DOR
consumer.
16. UNRUH CIVIL RIGHTS ACT AND THE FAIR EMPLOYMENT & HOUSING ACT
Pursuant to Public Contract Code section 2010, if a bidder or proposer executes or renews a
contract over $100,000 on or after January 1, 2017, the bidder or proposer hereby certifies
compliance with the following:
The contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil
Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code);
and
If the contractor has an internal policy against a sovereign nation or peoples recognized by the
United States government, the Contractor certifies that such policies are not used in violation of
the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing
Act (Section 12960 of the Government Code).
s
Exhibit D
EXHIBIT E
(Standard Agreement - Subvention)
ADDITIONAL PROVISIONS — Federally Funded Agreements
1. FEDERAL REQUIREMENTS
The Federal Office of Management and Budget (OMB) has established uniform administrative
requirements and cost principles for determining allowable costs chargeable to Federal awards.
The Contractor agrees to abide by the Title 2 Code of Federal Regulations, Part 200 (2 CFR
200), except where the Agreement is more restrictive. The federal regulations are available for
review on the Internet at www.ecfr.gov under Title 2-Grants and Agreements.
2. FEDERAL FUNDING INTELLECTUAL PROPERTY
A. In any Agreement funded in whole or in part by the federal government, DOR may acquire
and maintain the Intellectual Property rights, title and ownership, which results directly and
indirectly from the Agreement. However, the federal government shall have non-exclusive,
non-transferable, irrevocable, paid-up license throughout the world to use, duplicate, or
dispose of such Intellectual Property throughout the world in any manner for governmental
purposes and to have and permit others to do so.
B. Evaluation of Discovery or Invention: If any discovery or invention arises as a result of
funded work, the Contractor must refer the discovery or invention to the DOR. The
Rehabilitation Services Administration (RSA) and its representatives have the sole and
exclusive power to determine whether or not and where a patent should be filed and the
disposition of all rights, including title and license rights, which may result. RSA's
determination of these issues shall be considered final. In addition, the DOR and RSA
shall acquire at least an irrevocable, non-exclusive, and royalty-free license to utilize for
government purposes of any of these inventions. By signing this Agreement, the Contractor
agrees that determinations of rights to inventions made in the course of or under the
Agreement shall be made by RSA or its authorized representative.
C. Copyrights and Patents: The Federal awarding agency and/or the DOR reserves a royalty-
free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to
authorize others to use, for Federal Government purposes:
1. The copyright in any work developed under a grant, subgrant, or Agreement under a
grant or subgrant; and
2. Any rights of copyright to which a grantee, subgrantee or a contractor purchases
ownership with grant support.
3. DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
Federal and State agencies shall not award assistance to applicants that are debarred or
suspended, or otherwise excluded from or ineligible for participation in Federal assistance
programs under Executive Order 12549. By signing this Agreement, Contractor certifies that
neither it nor its principals or subcontractors are presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from participation in this transaction by
any Federal department of agency.
1
Exhibit E
4. PROHIBITION ON TAX DELINQUENCY
Any Agreement that a state agency enters into after July 1 , 2012, is void if the contract is
between a state agency and a contractor, or subcontractor, whose name appears on either list
of the 500 largest tax delinquencies pursuant to Section 7063 or 19195 of the Revenue and
Taxation Code. In accordance with Public Contract Code Section 10295.4, agencies are
required to cancel Agreements with entities that appear on either list.
(Franchise Tax Board) https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-
balances/index.html
(Department of Tax and Fee Administration) https://www.cdtfa.ca.gov/taxes-and-
fees/top5OO.htm
5. THE FOLLOWING PROVISIONS ARE SUBJECT TO THIS AGREEMENT
A. Equal Employment Opportunity--All Agreements require compliance with E.O. 11246--Equal
Employment Opportunity, as amended by E.O. 1137--Amending Executive Order 11246
Relating to Equal Employment Opportunity, and as supplemented by regulations at 41 CFR
Chapter 60 Office of Federal Contract Compliance Programs, Equal Employment
Opportunity, Department of Labor, Part 60-1 Obligations of Contractors and Subcontractors,
Subpart A. Preliminary Matters; Equal Opportunity Clause; Compliance Reports.
B. Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act (33
U.S.C. 1251 et seq.), as amended--Agreements of amounts in excess of $100,000 shall
require the Contractor to agree to comply with all applicable standards, orders, or
regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal
Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be
reported to ED and the Regional Office of the Environmental Protection Agency (EPA).
C. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)--By signing this Agreement, the
Contractor who is awarded an Agreement of $100,000 or more 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 covered by 31 U.S.C. 1352.
Contractor shall also disclose any lobbying with non-Federal funds that takes place in
connection with obtaining any Federal award.
D. All contractors shall comply with the following statutes and regulations:
1. Subject: Discrimination on the basis of race, color, or national origin.
Statute: Title VI of the Civil Rights Act of 1964 (45 U.S.C. 2000 through 2000d-4).
Regulation: 34 CFR part 100.
2. Subject: Discrimination on the basis of sex
Statute: Title IX of the Education Amendments of 1972 (20 U.S.C. 1681-1683).
Regulations: 34 CFR part 106.
3. Subject: Discrimination on the basis of handicap.
Statute: Section 504 of the Rehabilitation Act of 1973 (29U.S.C. 794).
Regulation: 34 CFR part 104handicap.
4. Subject: Discrimination on the basis of age.
Statute: The Age Discrimination Act (42 U.S.C. 6101 et seq.).
2
Exhibit E
Regulation: 34 CFR part 110
6. RETURN OF INAPPROPRIATE USE OF FUNDS
By signing this Agreement, Contractor shall certify that in the event of funds used
inappropriately, funds must be returned to DOR.
7. AMERICANS WITH DISABILITIES ACT (ADA)
By signing this Agreement, Contractor/Grantee agrees to comply with the Americans with
Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well
as, all applicable regulations and guidelines issued pursuant to the ADA (42 U.S.C. 12101 et
seq.). In compliance with the Rehabilitation Act of 1973, 29 U.S.C. §794 et seq. and
Government Code, Section 11135 et seq.; Section 504 imposes affirmative disability-related
responsibilities on recipients of federal financial assistance as well as federal programs and
activities and prohibits disability-based discrimination; and Section 508, requires electronic and
information technology be accessible to people with disabilities.
3
Exhibit E
EXHIBIT F
(COOP/Case Services Agreements-Subvention)
ADDITIONAL PROVISIONS - COOPERATIVE/CASE SERVICES
1. MATCH REQUIREMENTS
Contractor shall submit the certified expenditure invoice on a timely basis (i.e. same time as
submission of service budget invoice) for proper DOR processing. To ensure sufficient match is
available to leverage federal funding, the contractor is required to submit 100% of their
obligated certified/cash match to meet their full budgeted amount by the end of each fiscal year.
Refer to the Contract Handbook for Case Services and Cooperative Program Agreements for
more information regarding certified/cash match requirements.
For Agreements that include CERTIFIED EXPENDITURE MATCH:
A. Contractor shall certify to the State, on a monthly basis as specified in Exhibit B & G, the
Contractor's allowable costs to provide the cooperative program services identified in the
Scope of Work, in accordance with the Cooperative Agency Certified Expenditure Budget
Summary and Narrative, and applicable Federal regulations. All such expenditures shall be
under the administrative supervision of the State and no portion of the certified expenditures
shall come from Federal funds. The State shall not be obligated to pay the Contractor for
any contributions made by the Contractor in accordance with the Cooperative Agency
Certified Expenditure Budget Summary.
B. The total Cooperative Agency certified expenditure share will be matched to Federal funds
at no less than 25%, as indicated on the DOR Program Budget Summary. If the value of the
certified expenditures by the Contractor is below 25% of the actual total program cost, the
Service Budget may be reduced after review by the DOR Contract Administrator. The State
will not pay the Contractor for actual costs claimed on the Service Invoice (DOR 801 B) until
the certified expenditure summary for the same period has been submitted.
C. Contractor contributions, including any excess of the amount specified in the "Cooperative
Agency Certified Expenditure Budget Summary", will be used by the State to obtain Federal
funds under Section 110 of the Rehabilitation Act of 1973, as amended. Federal funds
obtained in excess of the "Total Program Cost" as identified on the "DOR Program Budget
Summary" shall accrue to the State.
For Agreements that include CASH MATCH:
A. Each fiscal year Contractor will pay to State, no less than quarterly and in advance, upon
receipt of an invoice from the State, all those cash matching funds which are identified within
the Program Budget Summary for that fiscal year. The State shall not be obligated to pay
the Contractor for any contributions made by the Contractor in accordance with the
approved budget, it being understood that all matching funds obtained by the State from the
Contractor shall be exclusive funds of the State and no portion of the cash match shall come
from Federal funds.
1
Exhibit F
B. The total Cooperative Agency cash share will be matched to Federal funds at no less than
21.3% as indicated on the "DOR Program Budget Summary."
2. INDIRECT COSTS
Indirect costs are allowable expenses incurred by an organization which support the activities of
a program or contract, but are not directly assigned to the specific program or contract and are
allocated to the program or contract using a method in compliance with 2 CFR 200. The
allocation method must be fully explained in the contract budget narrative and must be
supported by actual costs incurred and paid by the organization. The allocation of indirect costs
cannot be based on an arbitrary fixed rate and there is a 15% cap on the service budget. There
is no cap on the certified match, however, indirect costs over 40% require a copy of the rate
approval document from the cognizant federal agency or state department designee (e.g.
California Department of Education {CDE} or established through an independent audit).
3. CONTRACT HANDBOOK
Contractor acknowledges and agrees with the policies requirements and conditions of the
Department of Rehabilitation's Contract Handbook and its additional policy requirements and
conditions for Case Services/Cooperative Program Agreements as applicable for the Fiscal
Year(s) covered under this Agreement. Match requirements are applicable to Cooperative
Programs Agreements only.
4. DOR'S CONTRACT MONITORING
The DOR Contract Administrator will monitor and document the contractor's performance to
ensure compliance with all Agreement provisions. The DOR Contractor Administrator will:
A. Maintain documentation on all Agreement activities, including the performance of the
Agreement services, invoice reviews and approvals, monitoring activities, and other
Agreement administration activities.
B. Monitor the Agreement to ensure services were performed according to the quality, quantity,
objectives, timeframes and manner specified in the Agreement, and that the Contractor
prepares and maintains adequate documentation to support the services provided,
expenditures reimbursements, and/or any applicable match requirements.
C. Review and approve invoices for payment to substantiate expenditures for the work
performed, including verification that costs invoiced for the provision of services to DOR
applicants/consumers during the Agreement period are based on reasonable costs, and that
the invoices are current, correct, and timely.
D. Ensure that all Service Invoices (DR801 B) and Certified Expenditure Summaries, if
applicable, are received no later than November 1 s', to allow for payment and draw down
prior to the close out of Federal/State funds.
E. Verify that the contractor has fulfilled all requirements of the Agreement before approving
the final invoice.
2
Exhibit F
F. Ensure there are sufficient funds to pay for all services rendered as required by the
Agreement.
G. Ensure, by the end of the second quarter, that the projected certified expenditure match will
be sufficient to support the budgets as outlined in this Agreement. If not, contact the
appropriate Collaborative Services Program Specialist. (Cooperative Program Agreements
only)
H. Identify low usage levels and consider partial disencumbrance of Agreement funds.
I. Periodically review personnel activity reports for staff funded by the Agreement to ensure
that the Contractor is preparing and maintaining personnel activity reports in compliance
with the applicable OMB cost principle.
J. Verify that all Agreement staff are providing services in accordance to their duties specified
in the Agreement, including ensuring that:
• Personnel duty statements or a copy of the Agreement Budget Narrative/Agreement
Duty Statement has been provided to each staff person to communicate the specific
duties to be performed under the Agreement.
• Verify that job duties, as provided by the Agreement staff, match Agreement duty
statements and service descriptions.
• Ensure that the contractor has submitted to DOR appropriate documentation that
supports the services provided to DOR applicants/consumers, including monthly (or
otherwise specified) progress reports, consumer listings, utilization/service reports,
and/or other agreed-upon documentation.
• Verify that Contract staff provide services only to authorized DOR consumers.
3
Exhibit F