Loading...
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. Then doctimenu can be vtewed at (11vEvw dgf Ctf gavlOLStResosrr4°s 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 1 FOR ACCOUNTING USE ONLY: 2 Fund: 0001 3 Subclass: 10000 Org: 56304533 4 Account: 7295 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 4 5 6 7 8 9 10 11 12 13 14 15 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