HomeMy WebLinkAboutAgreement A-17-530 with Alliant University.pdf Agreement No. 17-530
1 AGREEMENT
2 THIS AGREEMENT is made and entered into this 17th day of October , 2017, by
3 and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, hereinafter
4 referred to as "COUNTY"; and ALLIANT INTERNATIONAL UNIVERSITY,INC., a California
5 corporation,whose address is 5130 E. Clinton Way, Fresno, California, 93727-2014, hereinafter referred
6 to as"UNIVERSITY".
7 WITNESSETH:
8 WHEREAS,UNIVERSITY has an approved graduate program in clinical counseling that require
9 facilities to provide clinical and field experience for required learning experiences for its students; and
10 WHEREAS, UNIVERSITY has approved doctorate programs in clinical psychology that require
11 facilities to provide clinical and field experience for required learning experiences for its students; and
12 WHEREAS, COUNTY,through its Department of Behavioral Health (DBH), maintains and
13 operates facilities for furnishing such clinical and field experience; and
14 WHEREAS, it is to the mutual benefit of the parties hereto that personnel and students of
15 UNIVERSITY's graduate program in clinical counseling and doctoral programs in clinical psychology
16 use COUNTY's facilities for their clinical and field experience.
17 NOW, THEREFORE, in consideration of their mutual covenants and conditions,the parties
18 hereto agree as follows:
19 1. RIGHTS AND RESPONSIBILITIES OF THE UNIVERSITY
20 A. UNIVERSITY will designate students enrolled in the clinical counseling and
21 clinical psychology programs of the UNIVERSITY to be assigned for clinical and field experience at
22 the COUNTY, and schedule the clinical and field experience of the students in conformity with the
23 calendar of the UNIVERSITY's academic year and with the curriculum of the educational programs of
24 the UNIVERSITY. The students selected shall have at the minimum, the following qualifications:
25 1) Graduate Students—Each graduate level student will be currently enrolled
26 in academic coursework at UNIVERSITY in clinical counseling and have spent at least one (1) year of
27 supervised professional experience (fifteen (15)to twenty (20)hours per week). Students will have
28 completed pre-practicum coursework in assessment and clinical interviewing, intervention, ethical and
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1 legal knowledge, and individual and cultural differences. Practicum readiness shall be determined via
2 the Practicum Readiness Evaluations, identified in Exhibit A, attached hereto and by this reference
3 incorporated herein.
4 2) Doctoral Students—Each doctoral level student will have earned a
5 Master's Degree (or equivalent), have spent at least one (1) year of supervised professional experience
6 (fifteen (15)to twenty(20) hours per week). Students will have completed pre-practicum coursework
7 in assessment and clinical interviewing, intervention, ethical and legal knowledge, and individual and
8 cultural differences. Practicum readiness shall be determined via the Evaluation of Core Competencies
9 and Clinical Competency Exam as identified in Exhibit A.
10 B. UNIVERSITY recognizes that the clinical and field education programs
11 conducted pursuant to the terms and conditions of this Agreement are education programs of
12 UNIVERSITY and not of COUNTY, and that students participating in UNIVERSITY's program shall
13 at all times be under the exclusive jurisdiction of UNIVERSITY.
14 C. UNIVERSITY shall designate students enrolled in the counseling and psychology
15 programs of UNIVERSITY to be assigned for clinical and field experience at COUNTY facilities, in
16 such numbers as can be supported and to be mutually agreed upon by both COUNTY's DBH Director,
17 or designee, and UNIVERSITY.
18 D. UNIVERSITY shall establish a rotational plan for the clinical and field
19 experience available at COUNTY facilities and shall schedule the students in conformity with the
20 calendar of UNIVERSITY's academic year and with the curriculum of the counseling and psychology
21 programs of UNIVERSITY; provided, however, that the specific COUNTY client care areas to be
22 utilized by UNIVERSITY are identified and available, as subsequently agreed upon by mutual
23 agreement between COUNTY's DBH Director, or designee and UNIVERSITY's chairpersons, or duly
24 authorized representatives, of the psychology program.
25 E. UNIVERSITY shall supervise all instruction of the clinical and field experience
26 provided at COUNTY facilities to assigned students and shall provide the necessary instructors for the
27 educational training program provided for under this Agreement.
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1 F. UNIVERSITY shall keep all attendance and academic records of students
2 participating in the clinical and field experience program provided for under this Agreement.
3 G. UNIVERSITY shall certify to COUNTY at the time each student first reports to
4 COUNTY's facilities to participate in the clinical and field education program, that the student shall be
5 enrolled with UNIVERSITY's available health plan for students.
6 H. UNIVERSITY shall ensure students act professionally and appropriately while at
7 COUNTY facilities and/or participating in projects with/for the COUNTY.
8 I. UNIVERSITY shall require every student to conform to all applicable COUNTY
9 policies, procedures, regulations, and all requirements and restrictions specified jointly by
10 representatives of UNIVERSITY and COUNTY.
11 J. UNIVERSITY shall require its instructors to notify COUNTY's DBH Director, or
12 designee, as appropriate in advance of student placement regarding:
13 1) Locations, dates, times and the number of hours or changes thereof,
14 regarding student availability for clinical and field assignment(s); and
15 2) Any change in the placement of students in clinical and field assignments.
16 K. UNIVERSITY shall, in consultation and coordination with COUNTY'S DBH
17 Director, or designee, arrange for periodic conferences between appropriate representatives of
18 UNIVERSITY and COUNTY to evaluate the clinical and field experience programs provided under
19 this Agreement.
20 L. UNIVERSITY shall provide and be responsible for the use and control of its
21 educational supplies, materials and equipment used for instruction during the clinical and field
22 experience program.
23 M. UNIVERSITY shall distribute to each student a statement which explains the
24 hazards of drug abuse in their profession.
25 N. UNIVERSITY shall provide for an introductory orientation to students assigned
26 to COUNTY facilities, which shall provide an overview of the clinical and field assignment(s) and the
27 terms and conditions of student placement at COUNTY facilities.
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1 O. UNIVERSITY shall agree that initiating work, reviews, or studies related to the
2 production of special reports, projects, theses, and/or publications based on studies and research arising
3 out of the cooperative education experience permitted by this Agreement may require advance approval
4 from COUNTY's DBH. In some cases, approval may include the Institutional Review Board process,
5 as determined to be appropriate by COUNTY staff.
6 P. UNIVERSITY shall agree that special reports, projects, thesis, and/or publications
7 based upon studies and research arising out of the cooperative education experience permitted by this
8 Agreement, shall be reviewed and approved prior to release through the committee responsible for
9 planning the course and then with the COUNTY's DBH Director or designee, as appropriate, for
10 approval by means of such procedures as COUNTY's DBH shall designate. Approval of reports by
11 UNIVERSITY's planning committee and COUNTY's DBH shall not be unreasonably withheld.
12 Q. UNIVERSITY shall agree to complete an evaluation of each student at least once
13 during a specific program period.
14 R. UNIVERSITY shall allow COUNTY program managers and other designated
15 personnel to attend meetings of UNIVERSITY's faculty, or any committee thereof, to coordinate the
16 clinical and field experience programs provided under this Agreement and to designate lines of
17 authority and communication for coordination of relations between COUNTY personnel and
18 UNIVERSITY instructors.
19 S. UNIVERSITY's employees, agents, and students shall abide by the provisions of
20 State of California law relating to confidentiality of medical records, further described in Paragraph
21 Fifteen(15) of this Agreement, and any person knowingly and intentionally violating provisions of
22 State of California law may be guilty of a misdemeanor.
23 T. UNIVERSITY's employees, agents, and students shall be issued COUNTY
24 identification badges which must be worn only at COUNTY facilities while participating in the clinical
25 and field experience program,pursuant to the terms and conditions of this Agreement.
26 U. UNIVERSITY will ensure that each participating student understands that
27 students are not employees of COUNTY, and students shall have absolutely no right to employment
28 right and benefits available to COUNTY employees.
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1 2. RIGHTS AND RESPONSIBILITIES OF THE COUNTY
2 A. COUNTY's DBH Director, or designee, at their sole discretion, shall have the
3 right to approve and accept, or reject, each student selected by UNIVERSITY for clinical and field
4 experience placement at COUNTY's facilities. For each student selected and designated by
5 UNIVERSITY, COUNTY shall permit each student to receive clinical and field experience pursuant to
6 Paragraph One (1) of this Agreement, at an agreed(between COUNTY and UNIVERSITY) location
7 and number of hours, and shall furnish and permit students and/or instructors access to appropriate
8 COUNTY facilities for such clinical and field experience, subject to the terms and conditions of this
9 Agreement.
10 B. COUNTY shall furnish the appropriate facilities, as applicable, in such a manner
11 that there will be no conflict in the use thereof between UNIVERSITY's students and those from other
12 educational institutions, if any.
13 C. COUNTY shall, subject to budgetary and operational concerns, maintain clinical
14 and field facilities used for the learning experience in a manner that shall at all times conform to the
15 requirements of UNIVERSITY's clinical programs listed in the "Witnesseth" section of this
16 Agreement.
17 D. COUNTY shall provide staff adequate in number and quality to provide safe and
18 continuous health care to clients involved in clinical and field experience programs.
19 E. COUNTY shall provide to students and instructors appropriate space to conduct
20 clinical and field experience work, as applicable.
21 F. COUNTY shall provide emergency health care (on a fee for service basis) for any
22 student and/or instructor who become sick or injured by conditions arising out of or in the course of
23 any student's and/or instructor's participation in the clinical and field experience within COUNTY
24 facilities. The recipient of emergency health care shall be responsible for the payment of all emergency
25 health care services provided.
26 G. COUNTY shall permit its clinical staff to participate in the instructional phase of
27 UNIVERSITY's clinical and field experience programs.
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1 H. COUNTY shall permit its various program directors and other designated
2 personnel to attend meetings of the UNIVERSITY's faculty, or any committee thereof, to coordinate
3 the clinical and field experience programs provided for under this Agreement, and to designate lines of
4 authority and communication for coordination of relations between UNIVERSITY instructors and
5 COUNTY personnel.
6 I. COUNTY shall provide an introductory orientation for UNIVERSITY instructors
7 and faculty staff which shall provide an overview of COUNTY facilities, clinical and field experience
8 opportunities, and the terms and conditions of student placement within a clinical and field experience,
9 as applicable.
10 J. COUNTY shall notify UNIVERSITY's instructors, in advance, of any change in
11 its Director(s) or designee(s) appointments.
12 K. COUNTY shall, within the limits of its resources,provide whatever equipment,
13 supplies, and assistance necessary for the care of COUNTY clients in the course of UNIVERSITY's
14 students clinical and field experience and consistent with COUNTY's plan of care.
15 L. COUNTY shall reserve the absolute right to review, authorize, and at its sole
16 discretion, deny access or admission by any student, instructor and/or UNIVERSITY representative
17 into COUNTY facilities.
18 M. COUNTY shall provide input into the evaluation conducted by UNIVERSITY, of
19 students' skills and progress.
20 N. COUNTY shall agree to allow access to existing break room space for students'
21 break and meal periods. UNIVERSITY's students shall purchase food in the regular system or bring
22 food with them; no special arrangements for food will be made.
23 3. JOINT RESPONSIBILITIES OF THE COUNTY AND THE UNIVERSITY
24 Each student nominated by the UNIVERSITY and accepted by the COUNTY for
25 placement in this program shall enter into a signed agreement. UNIVERSITY shall forward to
26 COUNTY a copy of the signed student agreements and COUNTY will append each one to this
27 Agreement and they shall become addendums to this Agreement. Addendums shall include at least the
28 following:
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1 A) Certification of the student's prior educational experience.
2 B) Objectives required to be accomplished by the student,by the UNIVERSITY and
3 the individual's designed curriculum.
4 C) Administrative responsibilities of the student while engaged in the clinical and
5 field experience at COUNTY.
6 D) A schedule of hours that include consultation as well as training.
7 E) Each addendum shall be signed by at least the following individuals:
8 1) UNIVERSITY's Placement Coordinator, or designee
9 2) COUNTY's Placement Coordinator, or equivalent
10 3) Student
11 4. TERM
12 The term of this Agreement shall be for a period of three (3)years, effective upon
13 execution through June 30, 2020. This Agreement may be extended for two (2) additional twelve (12)
14 month periods subject to satisfactory performance and upon the same terms and conditions herein set
15 forth,unless written notice of non-renewal is given by COUNTY, CONTRACTOR, or COUNTY's
16 DBH Director, or designee, no later than thirty(30) days prior to the close of the then current
17 Agreement term.
18 5. TERMINATION
19 A. Non-Allocation of Funds - The terms of this Agreement, and the services to be
20 provided thereunder, are contingent on the approval of funds by the appropriating government agency.
21 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
22 terminated at any time by giving the UNIVERSITY thirty(30) days advance written notice.
23 B. Breach of Contract- COUNTY may immediately suspend or terminate this
24 Agreement in whole or in part, where in the determination of COUNTY there is:
25 1) A failure to comply with any term of this Agreement;
26 2) A substantially incorrect or incomplete report submitted to COUNTY; or
27 3) Improperly performed service.
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1 C. Without Cause -Under circumstances other than those set forth above, this
2 Agreement may be terminated by UNIVERSITY or COUNTY upon the giving of thirty(30) days
3 advance written notice of an intention to terminate.
4 6. COMPENSATION
5 The clinical and field learning experience program conducted pursuant to the terms and
6 conditions of this Agreement shall be performed without the payment of any monetary consideration by
7 UNIVERSITY or COUNTY, one to the other, or by or to any student participating in the program.
8 7. INDEPENDENT CONTRACTOR
9 In performance of the work, duties, and obligations assumed by UNIVERSITY under this
10 Agreement, it is mutually understood and agreed that UNIVERSITY, including any and all of
11 UNIVERSITY's students, instructors, faculty, officers, agents, and employees will at all times be
12 acting and performing as independent contractors, and shall act in an independent capacity and not as
13 an officer, agent, servant, employee,joint venture,partner, or associate of COUNTY. Furthermore,
14 COUNTY shall have no right to control or supervise or direct the manner or method by which
15 UNIVERSITY shall perform its work and function. However, COUNTY shall retain the right to
16 administer this Agreement so as to verify that UNIVERSITY is performing its obligations in
17 accordance with the terms and conditions thereof. UNIVERSITY and COUNTY shall comply with all
18 applicable provisions of law and the rules and regulations, if any, of governmental authorities having
19 jurisdiction over matters which are directly or indirectly the subject of this Agreement.
20 Because of its status as an independent contractor, UNIVERSITY shall have absolutely
21 no right to employment rights and benefits available to COUNTY employees. UNIVERSITY shall be
22 solely liable and responsible for providing to, or on behalf of, its employees all legally-required
23 employee benefits. In addition, UNIVERSITY shall be solely responsible and save COUNTY
24 harmless from all matters relating to payment of UNIVERSITY's employees, including compliance
25 with Social Security, withholding, and all other regulations governing such matters. As between the
26 COUNTY and UNIVERSITY, should the students be deemed employees by any governmental or
27 regulatory body, the students shall be the employees of the UNIVERSITY. It is acknowledged that
28 during the term of this Agreement, UNIVERSITY may be providing services to others unrelated to
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1 COUNTY or to this Agreement.
2 8. MODIFICATION
3 Any matters of this Agreement may be modified from time to time by the written consent
4 of all the parties without, in any way, affecting the remainder.
5 Notwithstanding the above, changes in addresses to which notices are to be sent may be
6 made by written approval of COUNTY's DBH Director, or designee, and UNIVERSITY.
7 9. NON-ASSIGNMENT
8 No party shall assign, transfer or subcontract this Agreement nor their rights or duties
9 under this Agreement without the prior written consent of COUNTY and UNIVERSITY.
10 10. HOLD-HARMLESS
11 UNIVERSITY agrees to indemnify, save, hold harmless, and at COUNTY's request,
12 defend COUNTY, its officers, agents and employees from any and all costs and expenses, including
13 attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY
14 in connection with the performance, or failure to perform,by UNIVERSITY, its officers, agents,
15 instructors, faculty, employees, students, or volunteers under this Agreement, and from any and all
16 costs and expenses, including attorney fees and court costs, damages, liabilities, claims and losses
17 occurring or resulting to any person, firm or corporation who may be injured or damaged by the
18 performance, or failure to perform, of UNIVERSITY, its officers, agents, instructors, faculty,
19 employees, students, or volunteers under this Agreement.
20 UNIVERSITY agrees to indemnify COUNTY for Federal and/or State of California audit
21 exceptions resulting from noncompliance herein on the part of UNIVERSITY.
22 COUNTY and UNIVERSITY shall give timely notice to the other of any claim, demand, lien, or
23 suit coming to its knowledge which in any way might affect the other party and each party shall have
24 the right to participate in the defense of the same to the extent of its interest. COUNTY and
25 UNIVERSITY recognize that the significant mutual benefits of this Agreement depend upon close
26 cooperation and good faith handling of matters subject to such indemnification provisions.
27 11. INSURANCE
28 For the purposes of this Agreement, students/interns will be explicitly considered
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1 employees of the UNIVERSITY. Without limiting COUNTY's right to obtain indemnification from
2 UNIVERSITY or any third parties, UNIVERSITY, at its sole expense, shall maintain in full force and
3 effect the following insurance policies or a program of self-insurance, including but not limited to, an
4 insurance pooling or Joint Powers Agreement (JPA) throughout the term of this Agreement:
5 A. Commercial General Liability
6 Commercial General Liability Insurance with limits of not less than One Million
7 Dollars ($1,000,000)per occurrence and an annual aggregate of Two Million
Dollars ($2,000,000). This policy shall be issued on a per occurrence basis.
8 COUNTY may require specific coverage including completed operations,product
9 liability, contractual liability, Explosion, Collapse, and Underground(XCU), fire
legal liability or any other liability insurance deemed necessary because of the
10 nature of the Agreement.
11 B. Automobile Liabilitv
12
Comprehensive Automobile Liability Insurance with limits for bodily injury of
13 not less than Two Hundred Fifty Thousand Dollars ($250,000)per person, Five
Hundred Thousand Dollars ($500,000)per accident and for property damages of
14 not less than Fifty Thousand Dollars ($50,000), or such coverage with a combined
15 single limit of Five Hundred Thousand Dollars ($500,000). Coverage should
include owned and non-owned vehicles used in connection with this Agreement.
16 UNIVERSITY shall ensure that each student as part of this Agreement procures
and maintains their own private vehicle coverage in force during the term of this
17 Agreement, at the student's sole cost and expense.
18
C. Professional Liability
19
If UNIVERSITY employs licensed professional staff(e.g. Ph.D., R.N., L.C.S.W.,
20 L.M.F.T.) in providing services, Professional Liability Insurance with limits of
21 not less than One Million Dollars ($1,000,000)per occurrence, Three Million
Dollars ($3,000,000) annual aggregate. UNIVERSITY shall ensure that each
22 student who participates in COUNTY's "covered functions" (as defined by the
23 HIPAA regulations at 45 C.F.R. §164.501)procures and maintains in force during
the term of this Agreement, at the student's sole cost and expense, Professional
24 Liability Insurance in amounts reasonably necessary to protect the student against
liability arising from any and all negligent acts or incidents caused by the student.
2 5 Coverage under such professional liability insurance shall not be less than One
26 Million Dollars ($1,000,000)per occurrence, Three Million Dollars ($3,000,000)
annual aggregate. This policy shall include Limited General Liability coverage
27 for sexual harassment and abuse, standards of care,property damage,bodily
28 injury, and personal injury within the stated limits.
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1 F. Worker's Compensation
2 A policy of Worker's Compensation Insurance as may be required by the
California Labor Code. UNIVERSITY shall be responsible for Worker's
3 Compensation coverage for students who participate in the program.
4 G. Child Abuse/Molestation and Social Services Coverage
5
UNIVERSITY shall have either separate policies or umbrella policy with
6 endorsements covering Child Abuse/Molestation and Social Services Liability
7 coverage or have a specific endorsement on their General Commercial liability
policy covering Child Abuse/Molestation and Social Services Liability. The
8 policy limits for these policies shall be $1,000,000 per occurrence with
9 $2,000,000 annual aggregate. The policies are to be on a per occurrence basis.
10 The County of Fresno, its officers, agents, and employees, individually and collectively,
11 are included as additional insureds on the required Commercial General Liability insurance, but only to
12 the extent of liabilities falling within UNIVERSITY's indemnity obligations pursuant to the terms of
13 this Agreement. Such additional insured status may be conveyed via a blanket endorsement.
14 UNIVERSITY's insurance shall apply as primary insurance, without a right of contribution from any
15 and all insurance maintained by or otherwise afforded to COUNTY but only to the exten of liabilities
16 falling within UNIVERSITY's indemnity obligations pursuant to the terms of this Agremeent. This
17 insurance shall not be cancelled or changed without UNIVERSITY providing a minimum of thirty(30)
18 days advance written notice to COUNTY.
19 Within thirty (30) days from the date UNIVERSITY signs this Agreement, UNIVERSITY
20 shall provide certificates of insurance and endorsements as stated above for all of the foregoing
21 policies, as required herein, to the County of Fresno, Department of Behavioral Health, 3133 N.
22 Millbrook Avenue, Fresno, California, 93703, Attention: Mental Health Contracts Section, stating that
23 such insurance coverages have been obtained and are in full force; that the County of Fresno, its
24 officers, agents and employees will not be responsible for any premiums on the policies; that such
25 Commercial General Liability insurance names the County of Fresno, its officers, agents and
26 employees, individually and collectively, as additional insured, but only insofar as the operations under
27 this Agreement are concerned; that such coverage for additional insured shall apply as primary
28 insurance and any other insurance, or self-insurance, maintained by COUNTY, its officers, agents and
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1 employees, shall be excess only and not contributing with insurance provided under UNIVERSITY's
2 policies herein; and that this insurance shall not be cancelled or changed without a minimum of thirty
3 (30) days advance written notice given to COUNTY.
4 In the event UNIVERSITY fails to keep in effect at all times insurance coverage as herein
5 provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this
6 Agreement upon the occurrence of such event.
7 All policies shall be with admitted insurers licensed to do business in the State of
8 California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of
9 A FSC VII or better.
10 12. LICENSES/CERTIFICATES
11 Throughout each term of this Agreement, UNIVERSITY and UNIVERSITY's staff shall
12 maintain all necessary licenses,permits, approvals, certificates, waivers and exemptions necessary for
13 the provision of the services hereunder and required by the laws and regulations of the United States of
14 America, State of California, the County of Fresno, and any other applicable governmental agencies.
15 UNIVERSITY shall notify COUNTY immediately in writing of its inability to obtain or maintain such
16 licenses,permits, approvals, certificates, waivers and exemptions irrespective of the pendency of any
17 appeal related thereto. Additionally, UNIVERSITY and UNIVERSITY's staff shall comply with all
18 applicable laws, rules or regulations, as may now exist or be hereafter changed.
19 13. MONITORING
20 UNIVERSITY agrees to extend to COUNTY's staff, COUNTY's DBH Director and
21 DHCS, or their designees, the right to review and monitor records, programs or procedures, at any time,
22 in regard to clients, as well as the overall operation of UNIVERSITY's programs, in order to ensure
23 compliance with the terms and conditions of this Agreement.
24 14. REFERENCES TO LAWS AND RULES
25 In the event any law, regulation, or policy referred to in this Agreement is amended
26 during the term thereof, the parties hereto agree to comply with the amended provision as of the
27 effective date of such amendment.
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1 15. CONFIDENTIALITY
2 A. The parties to this Agreement shall be in strict conformance with all applicable
3 Federal and State of California laws and regulations, including but not limited to Sections 5328, 10850,
4 and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. of Title 42,
5 Code of Federal Regulations (CFR), Sections 56 et seq. of the California Civil Code, Sections 11977
6 and 11812 of Title 22 of the California Code of Regulations, and the Health Insurance Portability and
7 Accountability Act(HIPAA), including but not limited to Section 1320 D et seq. of Title 42, United
8 States Code (USC) and its implementing regulations, including,but not limited to Title 45, CFR,
9 Sections 142, 160, 162, and 164, The Health Information Technology for Economic and Clinical
10 Health Act(HITECH) regarding the confidentiality and security of patient information, and the Genetic
11 Information Nondiscrimination Act(GINA) of 2008 regarding the confidentiality of genetic
12 information.
13 Except as otherwise provided in this Agreement, UNIVERSITY, as a Business Associate
14 of the COUNTY, may use or disclose Protected Health Information (PHI) to perform functions,
15 activities, or services for or on behalf of COUNTY, as specified in this Agreement, provided that such
16 use or disclosure shall not violate the Health Insurance Portability and Accountability Act (HIPAA),
17 USC 1320d et seq. The uses and disclosures of PHI may not be more expansive than those applicable
18 to COUNTY, as the "Covered Entity"under the HIPAA Privacy Rule (45 CFR 164.500 et seq.), except
19 as authorized for management, administrative or legal responsibilities of the Business Associate.
20 B. UNIVERSITY, including its students, subcontractors, and employees, shall
21 protect from unauthorized access,use, or disclosure of names and other identifying information,
22 including genetic information, concerning persons receiving services pursuant to this Agreement,
23 except where permitted in order to carry out data aggregation purposes for health care operations [45
24 CFR Sections 164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)] This pertains to any and
25 all persons receiving services pursuant to a COUNTY funded program. This requirement applies to
26 electronic PHI. UNIVERSITY shall not use such identifying information or genetic information for
27 any purpose other than carrying out UNIVERSITY's obligations under this Agreement.
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1 C. UNIVERSITY, including its students, subcontractors and employees, shall not
2 disclose any such identifying information or genetic information to any person or entity, except as
3 otherwise specifically permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 or
4 other law, required by the Secretary, or authorized by the client/patient in writing. In using or
5 disclosing PHI that is permitted by this Agreement or authorized by law, UNIVERSITY shall make
6 reasonable efforts to limit PHI to the minimum necessary to accomplish intended purpose of use,
7 disclosure, or request.
8 D. For purposes of the above sections, identifying information shall include,but not
9 be limited to name, identifying number, symbol, or other identifying particular assigned to the
10 individual, such as finger or voice print, or photograph.
11 E. For the purposes of the above sections, genetic information shall include genetic
12 tests of family members of an individual or individual, manifestation of disease or disorder of family
13 members of an individual, or any request for or receipt of, genetic services by individual or family
14 members. Family member means a dependent or any person who is first, second, third, or fourth
15 degree relative.
16 F. UNIVERSITY shall provide access, at the request of COUNTY, and in the time
17 and manner designated by COUNTY, to PHI in a designated record set(as defined in 45 CFR Section
18 164.501), to an individual or to County in order to meet the requirements of 45 CFR Section 164.524
19 regarding access by individuals to their PHI. With respect to individual requests, access shall be
20 provided within thirty(30) days from request. Access may be extended if UNIVERSITY cannot
21 provide access and provides individual with the reasons for the delay and the date when access may be
22 granted. PHI shall be provided in the form and format requested by the individual or COUNTY.
23 UNIVERSITY shall make any amendment(s) to PHI in a designated record set at
24 the request of COUNTY or individual, and in the time and manner designated by COUNTY in
25 accordance with 45 CFR Section 164.526.
26 UNIVERSITY shall provide to COUNTY or to an individual, in a time and
27 manner designated by COUNTY, information collected in accordance with 45 CFR Section 164.528, to
28 permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI in
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1 accordance with 45 CFR Section 164.528.
2 UNIVERSITY shall cooperate with the compliance and investigation reviews
3 conducted by the Secretary. PHI access to the Secretary must be provided during the UNIVERSITY's
4 normal business hours, however, upon exigent circumstances access at any time must be granted.
5 Upon the Secretary's compliance or investigation review, if PHI is unavailable to UNIVERSITY and in
6 possession of a Subcontractor, it must certify efforts to obtain the information to the Secretary.
7 G. UNIVERSITY shall report to COUNTY, in writing, any knowledge or reasonable
8 belief that there has been unauthorized access, viewing, use, disclosure, security incident, or breach of
9 unsecured PHI not permited by this Agreement of which it becomes aware, immediately and without
10 reasonable delay and in no case later than two (2) business days of discovery. Immediate notification
11 shall be made to COUNTY's Information Security Officer and Privacy Officer and COUNTY's DPH
12 HIPAA Representative, within two (2)business days of discovery. The notification shall include, to th
13 extent possible, the identification of each individual whose unsecured PHI has been, or is reasonably
14 believed to have been, accessed, acquired, used, disclosed, or breached. UNIVERSITY shall take
15 prompt corrective action to cure any deficiencies and any action pertaining to such unauthorized
16 disclosure required by applicable Federal and State Laws and regulations. UNIVERSITY shall
17 investigate such breach and is responsible for all notifications required by law and regulation or
18 deemed necessary by COUNTY and shall provide a written report of the investigation and reporting
19 required to COUNTY's Information Security Officer and Privacy Officer and COUNTY's DPH
20 HIPAA Representative. This written investigation and description of any reporting necessary shall be
21 postmarked within the thirty(30)working days of the discovery of the breach to the addresses below:
22
23 COUNTY of Fresno County of Fresno County of Fresno
Dept. of Behavioral Health Dept. of Public Health Information Technology Services
24 HIPAA Representative Privacy Officer Information Security Officer
25 (559) 600-6798 (559) 600-6439 (559) 600-5800
26 3147 N. Millbrook Ave. P.O. Box 11867 2048 N. Fine Street
27 Fresno, CA 93703 Fresno, CA 93755 Fresno, CA 93727
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1 H. UNIVERSITY shall makes its internal practices, books, and records relating to
2 the use and disclosure of PHI received from COUNTY, or created or received by the UNIVERSITY on
3 behalf of COUNTY, in compliance with HIPAA's Privacy Rule, including, but not limited to the
4 requirements set forth in Title 45, CFR, Sections 160 and 164. CONTRACTOR shall make its internal
5 practices,books, and records relating to the use and disclosure of PHI received from COUNTY, or
6 created or received by the CONTRACTOR on behalf of COUNTY, available to the United States
7 Department of Health and Human Services (Secretary)upon demand.
8 UNIVERSITY shall cooperate with the compliance and investigation reviews
9 conducted by the Secretary. PHI access to the Secretary must be provided during the UNIVERSITY's
10 normal business hours, however, upon exigent circumstances access at any time must be granted. Upon
11 the Secretary's compliance or investigation review, if PHI is unavailable to UNIVERSITY and in
12 possession of a Subcontractor, it must certify to obtain the information to the Secretary.
13 I. Safeguards
14 UNIVERSTIY shall implement administrative,physical, and technical safeguards
15 as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that reasonably and appropriately
16 protect the confidentiality, integrity, and availability of PHI, including electronic PHI, that it creates,
17 receives, maintains or transmits on behalf of COUNTY and to prevent unauthorized access, viewing,
18 use, disclosure, or breach of PHI other than as provided for by this Agreement. UNIVERSITY shall
19 conduct an accurate and thorough assessment of the potential risks and vulnerabilities to the
20 confidential, integrity and availability of electronic PHI. UNIVERSITY shall develop and maintain a
21 written information privacy and security program that includes administrative, technical, and physical
22 safeguards appropriate to the size and complexity of UNIVERSITY's operations and the nature and
23 scope of its activities. Upon COUNTY's request, UNIVERSITY shall provide COUNTY with
24 information concerning such safeguards.
25 UNIVERSITY shall implement strong access controls and other security
26 safeguards and precautions in order to restrict logical and physical access to confidential, personal (e.g.,
27 PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include the
28 following administrative and technical password controls for all systems used to process or store
- 16 - COUNTY OF FRESNO
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1 confidential, personal, or sensitive data:
2 1. Passwords must not be:
3 a. Shared or written down where they are accessible or recognizable
4 by anyone else; such as taped to computer screens, stored under keyboards, or visible in a work area;
5 b. A dictionary word; or
6 C. Stored in clear text
7 2. Passwords must be:
8 a. Eight(8) characters or more in length;
9 b. Changed every ninety(90) days;
10 C. Changed immediately if revealed or compromised; and
11 d. Composed of characters from at least three (3) of the following
12 four(4) groups from the standard keyboard:
13 1) Uppercase letters (A-Z);
14 2) Lowercase letters (a-z);
15 3) Arabic numerals (0 through 9); and
16 4) Non-alphanumeric characters (punctuation symbols).
17 UNIVERSITY shall implement the following security controls on each
18 workstation or portable computing device (e.g. laptop computer) containing confidential,personal, or
19 sensitive data:
20 1. Network-based firewall and/or personal firewall;
21 2. Continuously updated anti-virus software; and
22 3. Patch management process including installation of all operating
23 system/software vendor security patches.
24 UNIVERSITY shall utilize a commercial encryption solution that has received
25 FIPS 140-2 validation to encrypt all confidential,personal, or sensitive data stored on portable
26 electronic media(including, but not limited to, compact disks and thumb drives) and on portable
27 computing devices (including,but not limited to, laptop and notebook computers).
28
- 17 - COUNTY OF FRESNO
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1 UNIVERSITY shall not transmit confidential, personal, or sensitive data via e-
2 mail or other internet transport protocol unless the data is encrypted by a solution that has been
3 validated by the National Institute of Standards and Technology(MIST) as conforming to the Advanced
4 Encryption Standard(AES) Algorithm. UNIVERSITY must apply appropriate sanctions against its
5 employees who fail to comply with these safeguards. UNIVERSITY must adopt procedures for
6 terminating access to PHI when employment of employee ends.
7 J. Mitigation of Harmful Effects
8 UNIVERSITY shall mitigate, to the extent practicable, any harmful effect that is
9 suspected or known to UNIVERSITY of an unauthorized access, viewing, use, disclosure, or breach of
10 PHI by UNIVERSITY or its subcontractors in violation of the requirements of these provisions.
11 UNIVERSITY must document suspected or known harmful effects and the outcome.
12 K. UNIVERSITY's Subcontractors
13 UNIVERSITY shall ensure that any of its contractors, including subcontractors, if
14 applicable, to whom UNIVERSITY provides PHI received from or created or received by
15 UNIVERSITY on behalf of COUNTY, agree to the same restrictions, safeguards, and conditions that
16 apply to UNIVERSITY with respect to such PHI and to incorporate, when applicable, the relevant
17 provisions of these provisions into each subcontract or sub-award to such agents or subcontractors.
18 L. Employee Training and Discipline
19 UNIVERSITY shall train and use reasonable measures to ensure compliance with
20 the requirements of these provisions by employees who assist in the performance of functions or
21 activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such
22 employees who intentionally violate any provisions of these provisions, including termination of
23 employment.
24 M. Termination for Cause
25 Upon COUNTY's knowledge of a material breach of these provisions by
26 UNIVERSITY, COUNTY shall either:
27 1. Provide an opportunity for UNIVERSITY to cure the breach or end the
28 violation and terminate this Agreement if UNIVERSITY does not cure the breach or end the violation
- 18 - COUNTY OF FRESNO
Fresno, CA
1 within the time specified by COUNTY; or
2 2. Immediately terminate this Agreement if UNIVERSITY has breached a
3 material term of these provisions and cure is not possible.
4 3. If neither cure nor termination is feasible, the COUNTY's Privacy Officer
5 shall report the violation to the Secretary of the U.S. Department of Health and Human Services.
6 N. Judicial or Administrative Proceedings
7 COUNTY may terminate this Agreement in accordance with the terms and
8 conditions of this Agreement as written hereinabove, if(1)UNIVERSITY is found guilty in a criminal
9 proceeding for a violation of the HIPAA Privacy or Security laws or the HITECH Act; or(2) a finding
10 or stipulation that the UNIVERSITY has violated a privacy security standard or requirement of the
11 HITECH Act, HIPAA, or other security or privacy laws in an administrative or civil proceeding in
12 which the UNIVERSITY is a party.
13 O. Effect of Termination
14 Upon termination or expiration of this Agreement for any reason, UNIVERSITY
15 shall return or destroy all PHI received from COUNTY, or created or received by UNIVERSITY on
16 behalf of the COUNTY, that UNIVERSITY still maintains in any form, and shall retain no copies of
17 such PHI. If return or destruction of PHI is not feasible, it shall continue to extend the protections of
18 these provisions to such information, and limit further use of such PHI to those purposes that make the
19 return or destruction of such PHI infeasible. This provision shall apply to PHI that is in the possession
20 of subcontractors or agents, if applicable, of UNIVERSITY. If UNIVESRITY destroys the PHI data, a
21 certification of date and time of destruction shall be provided to the COUNTY by UNIVERSITY.
22 P. Disclaimer
23 COUNTY makes no warranty or representation that compliance by
24 UNIVERSITY with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will be
25 adequate or satisfactory for UNIVERSITY's own purposes or that any information in UNIVERSITY's
26 possession or control, or transmitted or received by UNIVERSITY, is or will be secure from
27 unauthorized access, viewing,use, disclosure, or breach. UNIVERSITY is solely responsible for all
28 decisions made by UNIVERSITY regarding the safeguarding of PHI.
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1 Q. Amendment
2 The parties acknowledge that Federal and State laws relating to electronic data
3 security and privacy are rapidly evolving and that amendment of these provisions may be required to
4 provide for procedures to ensure compliance with such developments. The parties specifically agree to
5 take such action as is necessary to amend this agreement in order to implement the standards and
6 requirements of HIPAA, the HIPAA regulations, the HITECH Act and other applicable laws relating to
7 the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty(30) days written
8 notice in the event that UNIVERSITY does not enter into an amendment providing assurances
9 regarding the safeguarding of PHI that COUNTY in its sole discretion deems sufficient to satisfy the
10 standards and requirements of HIPAA, the HIPAA regulations and the HITECH Act.
11 R. No Third-Party Beneficiaries
12 Nothing express or implied in the terms and conditions of these provisions is
13 intended to confer, nor shall anything herein confer, upon any person other than COUNTY or
14 UNIVERSITY and their respective successors or assignees, any rights, remedies, obligations or
15 liabilities whatsoever.
16 S. Interpretation
17 The terms and conditions in these provisions shall be interpreted as broadly as
18 necessary to implement and comply with HIPAA, the HIPAA regulations and applicable State laws.
19 The parties agree that any ambiguity in the terms and conditions of these provisions shall be resolved in
20 favor of a meaning that complies and is consistent with HIPAA and the HIPAA regulations.
21 T. Regulatory References
22 A reference in the terms and conditions of these provisions to a section in the
23 HIPAA regulations means the section as in effect or as amended.
24 U. Survival
25 The respective rights and obligations of UNIVERSITY as stated in this Section
26 shall survive the termination or expiration of this Agreement.
27 V. No Waiver of Obligations
28 No change, waiver, or discharge of any liability or obligation hereunder on any
- 20 - COUNTY OF FRESNO
Fresno, CA
1 one or more occasions shall be deemed a waiver of performance of any continuing or other obligation,
2 or shall prohibit enforcement of any obligation on any other occasion.
3 16. DATA SECURITY
4 For the purpose of preventing the potential loss, misappropriation or inadvertent access,
5 viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse
6 of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that
7 enter into a contractual relationship with the COUNTY for the purpose of providing services under this
8 Agreement must employ adequate data security measures to protect the confidential information
9 provided to UNIVERSITY by the COUNTY, including but not limited to the following:
10 A. UNIVERSITY-Owned Mobile, Wireless, or Handheld Devices
11 UNIVERSITY may not connect to COUNTY networks via personally-owned
12 mobile, wireless or handheld devices, unless the following conditions are met:
13 1) UNIVERSITY has received authorization by COUNTY for
14 telecommuting purposes;
15 2) Current virus protection software is in place;
16 3) Mobile device has the remote wipe feature enabled; and
17 4) A secure connection is used.
18 B. UNIVERSITY-Owned Computers or Computer Peripherals
19 UNIVERSITY may not bring UNIVERSITY-owned computers or computer
20 peripherals into the COUNTY for use without prior authorization from the COUNTY's Chief
21 Information Officer, and/or designee(s), including but not limited to mobile storage devices. If data is
22 approved to be transferred, data must be stored on a secure server approved by the COUNTY and
23 transferred by means of a Virtual Private Network(VPN) connection, or another type of secure
24 connection. Said data must be encrypted.
25 C. COUNTY-Owned Computer Equipment
26 UNIVERSITY, including its subcontractors and employees, may not use
27 COUNTY computers or computer peripherals on non-COUNTY premises without prior authorization
28 from the COUNTY's Chief Information Officer, and/or designee(s).
- 21 - COUNTY OF FRESNO
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1 D. UNIVERSITY may not store COUNTY's private, confidential or sensitive data
2 on any hard-disk drive,portable storage device, or remote storage installation unless encrypted.
3 E. UNIVERSITY shall be responsible to employ strict controls to ensure the
4 integrity and security of COUNTY's confidential information and to prevent unauthorized access,
5 viewing, use or disclosure of data maintained in computer files,program documentation, data
6 processing systems, data files and data processing equipment which stores or processes COUNTY data
7 internally and externally.
8 F. Confidential client information transmitted to one party by the other by means of
9 electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128
10 BIT or higher. Additionally, a password or pass phrase must be utilized.
11 G. UNIVERSITY is responsible to immediately notify COUNTY of any violations,
12 breaches or potential breaches of security related to COUNTY's confidential information, data
13 maintained in computer files, program documentation, data processing systems, data files and data
14 processing equipment which stores or processes COUNTY data internally or externally.
15 H. COUNTY shall provide oversight to UNIVERSITY's response to all incidents
16 arising from a possible breach of security related to COUNTY's confidential client information
17 provided to UNIVERSITY. UNIVERSITY will be responsible to issue any notification to affected
18 individuals as required by law or as deemed necessary by COUNTY in its sole discretion.
19 UNIVERSITY will be responsible for all costs incurred as a result of providing the required
20 notification.
21 17. NON-DISCRIMINATION
22 During the performance of this Agreement, UNIVERSITY shall not unlawfully
23 discriminate against any employee or applicant for employment, or recipient of services, because of
24 race, religion, color, national origin, ancestry, physical handicap, mental disability, medical condition,
25 genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual
26 orientation, or military and veteran status, pursuant to all applicable State and Federal statutes and
27 regulations. This non-discrimination policy covers admission and access to and treatment and
28 employment in the UNIVERSITY's programs and activities, including occupational education.
- 22 - COUNTY OF FRESNO
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1 18. CONFLICT OF INTEREST
2 No officer, agent, or employee of the COUNTY who exercises any function or
3 responsibility for planning and carrying out the services provided under this Agreement shall have any
4 direct or indirect personal financial interest in this Agreement. UNIVERSITY shall comply with all
5 Federal, State of California, and local conflict of interest laws, statutes, and regulations, which shall be
6 applicable to all parties and beneficiaries under this Agreement and any officer, agent, or employee of
7 the COUNTY.
8 19. COMPLIANCE
9 UNIVERSITY agrees to comply with the COUNTY's Contractor Code of Conduct and
10 Ethics and the COUNTY's Compliance Program in accordance with Exhibit B, attached hereto and this
11 reference incorporated herein. Within thirty(30) days of entering into this Agreement with the
12 COUNTY, UNIVERSITY shall have all of UNIVERSITY's employees, agents and subcontractors
13 providing services under this Agreement certify in writing, that he or she has received, read,
14 understood, and shall abide by the Contractor Code of Conduct and Ethics. UNIVERSITY shall ensure
15 that within thirty(30) days of hire, all new employees, agents and subcontractors providing services
16 under this Agreement shall certify in writing that he or she has received, read, understood, and shall
17 abide by the Contractor Code of Conduct and Ethics. UNIVERSITY understands that the promotion of
18 and adherence to the Code of Conduct is an element in evaluating the performance of UNIVERSITY
19 and its employees, agents and subcontractors
20 Within thirty(30) days of entering into this Agreement, and annually thereafter, all
21 clinical and field experience students receiving services under this Agreement shall complete general
22 compliance training. All clinical and field experience students shall attend the appropriate training
23 within thirty(30) days of hire. Each individual who is required to attend training shall certify in
24 writing that he or she has received the required training. The certification shall specify the type of
25 training received and the date received. The certification shall be provided to the COUNTY's
26 Compliance Officer at 3133 N. Millbrook Avenue, Fresno, CA 93703. UNIVERSITY agrees to
27 reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal
28 Government as a result of UNIVERSITY's violation of the terms of this Agreement.
- 23 - COUNTY OF FRESNO
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1 20. COMPLIANCE WITH STATE REQUIREMENTS
2 UNIVERSITY recognizes that COUNTY operates its mental health system under an
3 agreement with the California Department of Health Care Services, and that under said agreement the
4 State of California imposes certain requirements on the COUNTY and its subcontractors.
5 UNIVERSITY shall adhere to all State of California requirements, including those
6 identified in Exhibit B.
7 21. DISCLOSURE OF SELF-DEALING TRANSACTIONS
8 This provision is only applicable if the UNIVERSITY is operating as a corporation (a
9 for-profit or non-profit corporation) or if during the term of this Agreement, the UNIVERSITY changes
10 its status to operate as a corporation.
11 Members of the UNIVERSITY's Board of Directors shall disclose any self-dealing
12 transactions that they are a party to while UNIVERSITY is providing goods or performing services
13 under this agreement. A self-dealing transaction shall mean a transaction to which the UNIVERSITY
14 is a party and in which one or more of its directors has a material financial interest. Members of the
15 Board of Directors shall disclose any self-dealing transactions that they are a party to by completing
16 and signing a Self-Dealing Transaction Disclosure Form (Exhibit C) attached hereto and by this
17 reference incorporated herein and made part of this Agreement and submitting it to the COUNTY prior
18 to commencing with the self-dealing transaction or immediately thereafter.
19 22. AUDITS AND INSPECTIONS
20 UNIVERSITY shall at any time during business hours, and as often as the COUNTY
21 may deem necessary, make available to the COUNTY for examination all of its records and data with
22 respect to the matters covered by this Agreement. UNIVERSITY shall, upon request by COUNTY,
23 permit COUNTY to audit and inspect all such records and data necessary to ensure UNIVERSITY's
24 compliance with the terms of this Agreement.
25 23. NOTICES
26 The persons having authority to give and receive notices under this Agreement and their
27 addresses include the following:
28
- 24 - COUNTY OF FRESNO
Fresno, CA
1 COUNTY UNIVERSITY
Director, Fresno County Provost
2 Department of Behavioral Health Alliant International University
3 4441 E. Kings Canyon Rd 5130 E. Clinton Way
Fresno, CA 93702 Fresno, CA 93727-2014
4
5 Any and all notices between COUNTY and UNIVERSITY provided for or permitted
6 under this Agreement or by law shall be in writing and shall be deemed duly served when personally
7 delivered to one of the parties, or in lieu of such personal service,when deposited in the United States
8 Mail, postage prepaid, addressed to such party.
9 24. SEVERABILITY
10 The provisions of this Agreement are severable. The invalidity or unenforceability of any
11 one provision in the Agreement shall not effect the other provisions.
12 25. GOVERNING LAW
13 Venue for any action arising out of or related to this Agreement shall only be in Fresno
14 County, California.
15 The rights and obligations of the parties and all interpretation and performance of this
16 Agreement shall be governed in all respects by the laws of the State of California.
17 26. ENTIRE AGREEMENT
18 This Agreement, including all Exhibits, constitutes the entire agreement between
19 UNIVERSITY and COUNTY with respect to the subject matter hereof and supersedes all previous
20 agreement negotiations,proposals, commitments,writings, advertisements, publications, and
21 understandings of any nature whatsoever unless expressly included in this Agreement.
22 ///
23
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- 25 - COUNTY OF FRESNO
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1 LN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
3 UNIVERSITY; COUNTY OF FRESNO
4 ALLIANT INTERNATIONAL
UNIVERSITY
5 i
6 i
7
i
By: By� L OL
8 �
i
9 Chairman, Board of Supervisors
10 nt Name: �►
11 n
12 Title:
Chairman of Board, or President
13 Or any Vice President,Or CEO
BERNICE E. SEIDEL,Clerk
14 Board of Supervisors
15 By
16
17 Print Name: By_ �� Awn l�j 1
19 Title:
cam,
20 Secretary of Corporation,or
Any Assistant Secretary,or
21 Chief Financial Officer, or
Any Assistant Treasurer
22
23 i
24 Mailing Address:
25 5130 E. Clinton Way PLEASE SEE ADDITIONAL j
Fresno,CA 93727-2014 SIGNATURE PAGE ATTACHED
26 Phone: (559)456-2777
27
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26 - COUNTY OF FRESNO
Fresno, CA
1 APPROVED AS TO LEGAL FORM:
2 DANIEL C. CEDERBORG, COUNTY COUNSEL
3
4
By j6
5
6
7 REVIEWED AND RECOMMENDED FOR APPROVAL:
8
9 All~
By
10 Dawan Utecht, Director
11 Department of Behavioral Health
12
13
14 Fund/Subclass: 0001/10000
Account/Program: 7295/0
15 Organization: 5630
16
17
18
19
20
EM
21
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- 27 - COUNTY OF FRESNO
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Exhibit A
Page 1 of 8
Practicum Readiness Evaluation
PSY 6728 Mid-Term/Final Assessment Form
Student Name:
Evaluation Date:
Purposes:
1. To provide trainee with an opportunity to review levels of competency in the
performance skill areas of basic helping skills and procedural skills.
2. To provide the trainee with a basis for identifying areas of emphasis within
supervision.
Basic Helping Skills Not evident Learning Recognize Basic Mastery
1. Ability to demonstrate active attending behavior. 1 2 3 4 5 N/0*
2. Ability to listen to and understand nonverbal behavior. 1 2 3 4 5 N/O
3. Ability to listen to what client says verbally, noticing 1 2 3 4 5 N/O
mix of experiences, behaviors and feelings.
4. Ability to understand the client's point of view. 1 2 3 4 5 N/O
5. Ability to identify themes in client's story. 1 2 3 4 5 N/O
6. Ability to respond with accurate empathy. 1 2 3 4 5 N/O
7. Ability to ask open-ended questions. 1 2 3 4 5 N/O
8. Ability to help clients clarify and focus. 1 2 3 4 5 N/O
9. Ability to balance empathic response,clarification, and 1 2 3 4 5 N/O
probing.
10. Ability to assess accurately severity of client's problems. 1 2 3 4 5 N/O
11. Ability to establish a collaborative working relationship 1 2 3 4 5 N/O
with client.
12. Ability to paraphrase client's statements. 1 2 3 4 5 N/O
13. Ability to summarize client's statements. 1 2 3 4 5 N/O
14. Ability to reflect on client's feelings. 1 2 3 4 5 N/O
15. Ability to explore the counselor-client relationship. 1 2 3 4 5 N/O
Exhibit A
Page 2 of 8
16. Ability to identify inconsistencies between client's story 1 2 3 4 5 N/O
and reality and then use confrontation effectively.
Basic Helping Skills Not evident Learning Recognize Basic Mastery
17. Ability to identify and challenge unhealthy or distorted 1 2 3 4 5 N/O
thinking or behavior.
18. Ability to provide nonjudgmental feedback to peers. 1 2 3 4 5 N/O
19. Ability to share information appropriately 1 2 3 4 5 N/O
(psych oeducation).
20. Ability to share constructively some of own experiences, 1 2 3 4 5 N/O
behaviors,and feelings through self-disclosure with clients.
21. Ability to assess client's strengths and 1 2 3 4 5 N/O
resources,and encourage client's to use these assets in problem solving.
22. Ability to help clients set goals and move toward action in 1 2 3 4 5 N/O
problem solving.
23. Ability to understand and facilitate decision making. 1 2 3 4 5 N/O
24. Ability to recognize and manage client reluctance and 1 2 3 4 5 N/O
resistance.
25. Ability to help clients explore consequences of the goals 1 2 3 4 5 N/O
they set.
26. Ability to help clients sustain action in direction of goals. 1 2 3 4 5 N/O
27. Ability to help clients review and revise,or recommit to, 1 2 3 4 5 N/O
goals based on new experiences.
Diversity and Social Justice Advocacy integration
28.Ability to broach issues of race, ethnicity,gender, 1 2 3 4 5 N/O
social class,ability, sexual orientation, religion, national origin.
29.Ability to identify and articulate social justice advocacy 1 2 3 4 5 N/O
issues in client's situation.
Procedural Skills
30. Ability to open session smoothly, 1 2 3 4 5 N/O
including providing informed consent.
31. Ability to work with client to identify important 1 2 3 4 5 N/O
concerns for the session.
Exhibit A
Page 3 of 8
32. Ability to work with a client who is in crisis or a situation 1 2 3 4 5 N/0
in which confidentiality needs to be broken.
33. Ability to close session smoothly, 1 2 3 4 5 N/O
including providing summary statement of the session.
Metacognitive Competencies (Ridley et al.,2011)
Not evident Learning Recognize Basic Mastery
34.Ability to demonstrate purposefulness in guiding sessions
and intentionality in selection of interventions. 1 2 3 4 5 N/0
35.Ability to demonstrate energy and motivation towards
attaining appropriate therapeutic outcomes. 1 2 3 4 5 N/0
36.Ability to use discernment in the selection of
appropriate techniques and strategies. 1 2 3 4 5 N/0
37.Ability to appropriately sequence the microskills
to attain desired therapeutic outcomes. 1 2 3 4 5 N/0
38.Ability to use appropriate timing in the
therapeutic encounter. 1 2 3 4 5 N/0
Overall Counseling Skills 1 2 3 4 5
Comments:
Students must score at least a "2" on all of the items and average at or above a "3" overall.
Students who do not meet these expectations will develop, in conjunction with the SERC, a
remediation plan that includes a timeline and specific goals relevant to areas of deficit,
including repeating the O & I course as needed. Permission to enroll in Practicum will not be
granted until that plan is completed to the satisfaction of the involved faculty, SERC and
Program Director.
Exhibit A
Page 4 of 8
Alliant International University—CSPP-Fresno Doctor of Psychology Program in Clinical Psychology
Novice Practicum Competencies Form
Evaluation of core competencies prior to students beginning Gl/first supervised practicum
Note: This document is adapted from the 2004 Report on Practicum Competencies developed by The Association of Directors of Psychology
Training Clinics (ADPTC)Practicum Competencies Workgroup (Hatcher&Lassiter).
Student's Name: Date:
Process:During student evaluation meetings("Globals")held each January,the clinical program faculty discuss the interpersonal,academic and professional competencies
demonstrated across students' first semester in the program. This checklist is used to both inform faculty judgment as to whether the student is ready to begin functioning as a
clinician under supervision and to also identify areas that students must work on during the initial practicum placement. If concerns are raised in this meeting,the student is not
allowed to begin the PSY6570 First Year Practicum and readiness must be re-assessed in the May Globals meeting on the basis of student performance in spring G-1 classes.
The required level of competency will be referred to as novice(N),and is defined as follows:Novices have limited knowledge and understanding of(a)how to analyze
problems and of(b)intervention skills and the processes and techniques of implementing them.They learn general principles or specific techniques to use,but the student's
beginning level of experience limits the flexible use of these skills.Novices do not yet recognize patterns,and do not differentiate well between important and unimportant details;
they do not have filled-in cognitive maps of how,for example,a given patient may move from where he/she is to a place of better functioning. (Benner,1984). Students must score
at least a"2"on all of the items and average at or above a"Y'overall. Students who do not meet these expectations will be referred to SERC to develop a remediation plan.
Permission to enroll in the G-1 Practicum will be granted when that plan is completed to the satisfaction of the involved faculty, SERC and Program Director.
A. Baseline Competencies: Skills.Attitudes and Knowledge that students should possess at the Novice level prior to their practicum training: Scale: 1 =Not evident
Before beginning practicum,the Novice student should possess and demonstrate a set of basic personal and intellectual skills,attitudes and values,and a 2=Aware 3 =Emerging
core of professional knowledge.This core knowledge and these skills,attitudes and values are baseline competencies of the professional psychologist.
The work of subsequent clinical training is to shape and refine these baseline skills into professional skills. 4=Basic 5 =Mastery
1.Personal Characteristics and Skills
a) Interpersonal skills:ability to listen and be empathic with others;respect for/interest in others'cultures,experiences,values,points of view,goals
and desires, fears, strengths and limitations, etc. Trainee is able to establish and maintain appropriate boundaries with others. Skills in this domain
include verbal as well as non-verbal domains.
b) Cognitive skills:problem-solving ability,critical thinking,organized reasoning,intellectual curiosity and flexibility.
c) Affective skills: affect tolerance;tolerance/understanding of interpersonal conflict;tolerance of ambiguity,uncertainty,and ambivalence.
d) Attitudes:Demonstrates a desire to help others;openness to new ideas;honesty/integrity/valuing of ethical behavior;personal courage.
e) Expressive skills: ability to communicate one's ideas,feelings and information in verbal,non-verbal and written forms.
f) Reflective skills: ability to examine and consider one's own motives,attitudes,behaviors,one's effect onothers and especially the ability to be
open to feedback.
g) Personal skills:personal organization,personal hygiene,and appropriate dress. /Average=
1
Exhibit A
Page 5 of 8
2.Knowledge from Classroom Experience:
The practicum experience will engage and develop skills and knowledge that have been the focus of pre-practicumcoursework. Grades of B-or better(CR for PSY6123)must
be achieved in the following courses:Intellectual Assessment,PSY6501,Basic Foundations of Clinical Practice,PSY6507,Introduction to Ethical Practice and Law,
PSY6530A,and Cultural Diversity Training I,PSY6123.
PSY6123 Grade= PSY6501 Grade= PSY6507 Grade= PSY6530A Grade=
a) Assessment&Clinical Interviewing competencies from Intellectual Assessment PSY6501 and Basic Foundations of Clinical Practice I
i) Knowledge of scientific,theoretical,empirical and contextual bases of psychological assessment.
ii) Knowledge of test construction,validity, score reliability and related assessment psychometrics.
iii) Training in principles and practice of systematic administration,data-gathering and interpretation forassessment,including identifying problems,
formulating diagnoses,goals and case conceptualizations;understanding the relationship between assessment and intervention,assessment of treatment
progress and outcome.
iv) Training in the models and techniques of clinical interviewing.
b) Intervention competencies from Basic Foundations of Clinical Practice I PSY650
i) Basic knowledge of scientific,theoretical,empirical and contextual bases ofintervention.
ii) Training in basic clinical skills, such as empathic listening, framing problems,etc.
iii) Training in assessment of treatment progress and outcome.
iv) Training in emergency assessment and management of risk for harm to self or others
c) Ethical&Legal knowledge from Introduction to Ethical Practice and Law PSY6530A and other first semester coursework
i) Principles of ethical practice and decision making(APA,2010)
ii) Legal knowledge related to the practice of psychology[Federal(e.g.,HIPAA),State law]
iii) Specific knowledge and understanding of CA statutes on mandated child and elder abusereporting
d) Individual and Cultural Differences(ICD)from Cultural Diversity Training I,PSY6123 and other first semester coursework
i) Knowledge and understanding of the principles and findings related to ICD as they apply to professionalpsychology.
ii) Understanding of one's own situation(e.g.,one's ethnic/racial,socioeconomic,gender,sexual orientation;one'sattitudes towards diverse others)relative to the
dimensions of ICD(e.g.,class,race,physical disability etc.).
iii) Understanding of the need to consider ICD issues in all aspects of professional psychology work(e.g.,assessment,treatment,research,relationships with
colleagues,etc.).
Concerns identified by faculty and recommendations:
2
Exhibit A
Page 6 of 8
Clinical Competency Exam - EVALUATION FORM
Fresno Clinical PhD Program
Student: Interviewer 1::
Date: Interviewer 2:
RATING KEY
Please rate using a six point scale—2 points within each category.
• Outstanding Progress"Excel in performance beyond normal expectations
• "Competent Progress"Performance demonstrates high standard of clinical competence expected of students at the ` eady
for internship"level,in accordance with developmental criteria(see CSPP,APAandNCSPP).
• 'Insufficient Progress,Remediation Indicated"
1 2 3 4 5 6
SIGNIFICANTLY BELOW GENERALLY CLEARLY EXCEEDS GREATLY
BELOW EXPECTATIONS MEETS MEETS EXPECTATIONS EXCEEDS
EXPECTATIONS EXPECTATIONS EXPECTATIONS EXPECTATION
INSUFFICIENT PROGRESS COMPETENT PROGRESS OUTSTANDING PROGRESS
1. ASSESSMENT CIRCLE ONE
Appropriate assessment methods and/or tools are selected taking into account client's 1 2 3 4 5 6
presentation or presenting problem.
Student appropriately uses, interprets, and integrates assessment data skillfully 1 2 3 4 5 6
(includinq Mental Status
Assessment findings are used appropriately in the generation of a treatment plan for 1 2 3 4 5 6
the client.
Appropriate DSM diagnostic impressions, including justification and differential 1 2 3 4 5 6
diagnoses
Use of ongoing assessment data to monitor treatment 1 2 3 4 5 6
Selection of assessment methods and/or tools takes into account ethnic, cultural and 1 2 3 4 5 6
class variables.
CATEGORY SCORE 1 2 3 4 5 6
Strengths:
Areas for Improvement:
2. FORMULATION CIRCLE ONE
Formulation is appropriately grounded in clinical data. 1 2 3 4 5 6
Student is aware of alternative formulations and limits of own formulations. 1 2 3 4 5 6
Formulation of the problem takes into account the influences of ethnic, cultural, and 1 2 3 4 5 6
class variables.
Formulation of the problem demonstrates an understanding of the client's level of 1 2 3 4 5 6
acculturation or stage of adaptation to the dominant culture.
CATEGORY SCORE 1 2 3 4 5 6
Strengths:
Exhibit A
Page 7 of 8
Areas for Improvement:
3. Intervention Strategy: CIRCLE ONE
Clarity and thoroughness of treatment program. 1 2 3 4 5 6
Ability to integrate patient expectations into interventions when appropriates. 1 2 3 4 5 6
Appropriate consideration of time limitations, resource constraints, and community 1 2 3 4 5 6
resources in the choice of interventions.
Shows evidence of ability to modify therapeutic approach when necessary 1 2 3 4 5 6
Intervention strategies are consistent with the client's level of acculturation, language, 1 2 3 4 5 6
cultural values, and interpersonal styles.
CATEGORY SCORE 1 2 3 4 5 6
Strengths:
Areas for Improvement:
4. Relationship: CIRCLE ONE
Ability to establish atmosphere that facilitates effective communication. 1 2 3 4 5 6
Demonstrates concern and respect in an empathic manner. 1 2 3 4 5 6
Able to establish and maintain professional objectivity. 1 2 3 4 5 6
Assesses and when appropriate discusses the influence of the client's ethnicity, 1 2 3 4 5 6
culture, and class on the development of the therapeutic relationship.
CATEGORY SCORE 1 2 3 4 5 6
Strengths:
Areas for Improvement:
5. Self Examination: CIRCLE ONE
Understands own personality and biases. 1 2 3 4 5 6
Able to question and reflect on own feelings, attitudes, and behavior during treatment 1 2 3 4 5 6
process.
Able to recognize limits of competence. 1 2 3 4 5 6
Examines the impact on treatment of own attitudes about ethnicity, culture, and class. 1 2 3 4 5 6
CATEGORY SCORE 1 2 3 4 5 6
Strengths:
11 Areas for Improvement:
Exhibit A
Page 8 of 8
6. Professional Communication Skills: CIRCLE ONE
Able to communicate orally. 1 2 3 4 5 6
Responsive to questions and feedback. 1 2 3 4 5 6
Manages stress appropriately. 1 2 3 4 5 6
Quality of written work. (weighted equally with above three oral categories) 1 2 3 4 1 5 1 6
CATEGORY SCORE 1 2 3 4 5 6
Strengths:
Areas for Improvement:
OVERALL RATING:
Notes and Comments:
"Competent Progress, Clearly Meets Expectations." [or whatever outcome is]
Exhibit B
Page 1 of 3
FRESNO COUNTY MENTAL HEALTH COMPLIANCE PROGRAM
CONTRACTOR CODE OF CONDUCT AND ETHICS
Fresno County is firmly committed to full compliance with all applicable laws,
regulations, rules and guidelines that apply to the provision and payment of mental health services.
Mental health contractors and the manner in which they conduct themselves are a vital part of this
commitment.
Fresno County has established this Contractor Code of Conduct and Ethics with which
contractor and its employees and subcontractors shall comply. Contractor shall require its employees
and subcontractors to attend a compliance training that will be provided by Fresno County. After
completion of this training, each contractor, contractor's employee and subcontractor must sign the
Contractor Acknowledgment and Agreement form and return this form to the Compliance officer or
designee.
Contractor and its employees and subcontractor shall:
1. Comply with all applicable laws, regulations, rules or guidelines when providing and billing
for mental health services.
2. Conduct themselves honestly, fairly, courteously and with a high degree of integrity in their
professional dealing related to their contract with the County and avoid any conduct that could
reasonably be expected to reflect adversely upon the integrity of the County.
3. Treat County employees, consumers, and other mental health contractors fairly and with
respect.
4. NOT engage in any activity in violation of the County's Compliance Program, nor engage in
any other conduct which violates any applicable law, regulation, rule or guideline
5. Take precautions to ensure that claims are prepared and submitted accurately, timely and are
consistent with all applicable laws, regulations, rules or guidelines.
6. Ensure that no false, fraudulent, inaccurate or fictitious claims for payment or reimbursement
of any kind are submitted.
7. Bill only for eligible services actually rendered and fully documented. Use billing codes that
accurately describe the services provided.
Exhibit B
Page 2 of 3
8. Act promptly to investigate and correct problems if errors in claims or billing are discovered.
9. Promptly report to the Compliance Officer any suspected violation(s) of this Code of Conduct
and Ethics by County employees or other mental health contractors, or report any activity that
they believe may violate the standards of the Compliance Program, or any other applicable
law, regulation, rule or guideline. Fresno County prohibits retaliation against any person
making a report. Any person engaging in any form of retaliation will be subject to disciplinary
or other appropriate action by the County. Contractor may report anonymously.
10. Consult with the Compliance Officer if you have any questions or are uncertain of any
Compliance Program standard or any other applicable law, regulation, rule or guideline.
11. Immediately notify the Compliance Officer if they become or may become an Ineligible person
and therefore excluded from participation in the Federal Health Care Programs.
Exhibit B
Page 3 of 3
Fresno County Mental Health Compliance Program
Contractor Acknowledgment and Agreement
I hereby acknowledge that I have received, read and understand the Contractor Code of Conduct and
Ethics. I herby acknowledge that I have received training and information on the Fresno County Mental
Health Compliance Program and understand the contents thereof. I further agree to abide by the
Contractor Code of Conduct and Ethics, and all Compliance Program requirements as they apply to my
responsibilities as a mental health contractor for Fresno County.
I understand and accept my responsibilities under this Agreement. I further understand that any
violation of the Contractor Code of Conduct and Ethics or the Compliance Program is a violation of
County policy and may also be a violation of applicable laws, regulations, rules or guidelines. I further
understand that violation of the Contractor Code of Conduct and Ethics or the Compliance Program
may result in termination of my agreement with Fresno County. I further understand that Fresno
County will report me to the appropriate Federal or State agency.
For Individual Providers
Name (print):
Discipline: ❑ Psychiatrist ❑ Psychologist ❑ LCSW ❑ LMFT
Signature : Date
For Group or Organizational Providers
Group/Org. Name (print):
Employee Name (print):
Discipline: ❑ Psychiatrist ❑ Psychologist ❑ LCSW ❑ LMFT
❑ Other:
Job Title (if different from Discipline):
Signature: Date: / /
Exhibit C
Page 1 of 2
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as "County"), members
of a contractor's board of directors (hereinafter referred to as "County Contractor"), must disclose any
self-dealing transactions that they are a party to while providing goods, performing services, or both
for the County. A self-dealing transaction is defined below:
"A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest"
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member's name,job title (if applicable), and date this disclosure is being made.
(2) Enter the board member's company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a. The name of the agency/company with which the corporation has the transaction; and
b. The nature of the material financial interest in the Corporation's transaction that the
board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self-dealing transaction
described in Sections (3) and (4).
Exhibit C
Page 2 of 2
(1)Company Board Member Information:
Name: Date:
Job Title:
(2)Company/Agency Name and Address:
(3)Disclosure(Please describe the nature of the self-dealing transaction you are a party to)
(4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a)
(5)Authorized Signature
Signature: Date: