HomeMy WebLinkAboutAgreement A-18-367 with J. Melton & Associates.pdf1
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Agreement No. 18-367
AGREEMENT
THIS AGREEMENT is made and entered into this __ 1-'-'0=th_,__ __ day of __ J_u ..... ly ___ _
3 2018, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California,
4 hereinafter referred to as "COUNTY," and J. Melton & Associates, a Sole Proprietor, whose address
5 is 5562 W. River Bottom Ave, Fresno, CA 93722, hereinafter referred to as "CONTRACTOR".
6 WI T N E S S E T H:
7 WHEREAS, COUNTY, through its Department of Behavioral Health (DBH) has a need for a
8 Certification Review Hearing Officer to perform certification hearings at various psychiatric
9 hospitals/acute psychiatric programs in the County of Fresno for adults, adolescents and children in
10 order to comply with the Lanterman-Petris-Short Act as set forth in the State of California Welfare and
11 Institutions Code (W&I Code); and
12 WHEREAS, W&I Code section 5256.1 precludes any employee of a COUNTY mental health
13 program from serving in the capacity of a Certification Review Hearing Officer; and
14 WHEREAS, CONTRACTOR has the professional expertise necessary to perform as a
15 Certification Review Hearing Officer for adults, adolescents and children, and is willing to perform in
16 such capacity subject to the terms and conditions of this Agreement.
17 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
18 hereto agree as follows:
19 1. SERVICES
20 CONTRACTOR shall perform all services and fulfill all responsibilities set forth in the
21 "Scope of Work" identified in Exhibit A, attached hereto and by this reference incorporated herein.
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23 CONTRACTOR shall possess and maintain the qualifications for Certification Review
24 Hearing Officer for adults, adolescents and children, as required by W&I Code § 5256.1 and Section
25 Fifteen (15) of this Agreement during the entire term of this Agreement. In addition, CONTRACTOR
26 shall ensure that any and all of CONTRACTOR's employees, agents and sub-contractors performing
27 services under this Agreement shall likewise maintain the required qualifications for Certification
28 Hearing Review Officers as set forth in W&I Code section § 5256.1 and Section Fifteen (15) of this
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Agreement.
2. TERM
The term of this Agreement shall be for a period of three (3) years, commencing on the
1st day of July, 2018 through and including the 30th day of June, 2021.
This Agreement may be extended for two (2) additional consecutive twelve (12) month
periods upon written approval of both parties no later than thirty (30) days prior to the first day of the
next twelve (12) month extension period. The County’s DBH Director or his or her designee is
authorized to execute such written approval on behalf of COUNTY based on CONTRACTOR’S
satisfactory performance.
3. TERMINATION
A. Non-Allocation of Funds - The terms of this Agreement, and the services to be
provided hereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated at any time by giving the CONTRACTOR thirty (30) days advance written notice.
B. Breach of Contract - The COUNTY may immediately suspend or terminate this
Agreement in whole or in part, where in the determination of the COUNTY there is:
1) An illegal or improper use of funds;
2) A failure to comply with any term of this Agreement;
3) A substantially incorrect or incomplete report submitted to the COUNTY;
4) Improperly performed service;
5) A failure to meet the statutory requirements of W&I Code section 5256.1.
In no event shall any payment by the COUNTY constitute a waiver by the
COUNTY of any breach of this Agreement or any default which may then exist on the part of the
CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the COUNTY
with respect to the breach or default. The COUNTY shall have the right to demand of the
CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR under this
Agreement, which in the judgment of the COUNTY were not expended in accordance with the terms of
this Agreement. The CONTRACTOR shall promptly refund any such funds upon demand or, at the
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COUNTY’s option, such repayment shall be deducted from future payments owing to CONTRACTOR
under this Agreement.
C. Without Cause - Under circumstances other than those set forth above, this
Agreement may be terminated by either CONTRACTOR or COUNTY or COUNTY’s Director,
Department of Behavioral Health or designee, upon the giving of thirty (30) days advance written
notice of an intention to terminate.
4. COMPENSATION
COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive
compensation at the rate of Eighty-Five and No/100 Dollars ($85.00) per Certification Review Hearing.
Services are to be delivered to mental health clients (clients) who have been determined by
COUNTY’s DBH to be the responsibility of COUNTY, and for Community Behavioral Health Center
(CBHC) mental health clients, that are conducted at each psychiatric unit at various psychiatric
hospitals/acute psychiatric facilities in the County of Fresno which are designated as seventy-two (72)
hour treatment and evaluation facilities. It is acknowledged and agreed between the parties that non-
COUNTY inpatient facilities, other than CBHC, shall make separate arrangements with
CONTRACTOR for compensation for services provided by CONTRACTOR within their inpatient
facilities to mental health clients who are determined by COUNTY’s Managed Care Division to not be
the responsibility of COUNTY.
In no event shall all actual services performed under this Agreement be in excess of
One Hundred Forty Thousand and No/100 Dollars ($140,000.00) for each twelve (12) month period of
this Agreement starting with July 1, 2018 through June 30, 2019. It is understood that all expenses
incidental to CONTRACTOR’s performance of services under this Agreement shall be borne by
CONTRACTOR.
Payments by COUNTY shall be in arrears, for actual services provided during the
preceding month, within forty-five (45) days of receipt, verification and approval of CONTRACTOR’s
invoices, accompanied by CONTRACTOR’s monthly report as further described in Section Thirteen
(13) of this Agreement. If CONTRACTOR should fail to comply with any provision of this Agreement,
COUNTY shall be relieved of its obligation for further compensation.
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5. INVOICING
CONTRACTOR shall invoice COUNTY monthly by the 20th of each month for the prior
month’s actual services rendered to DBH-Invoices@co.fresno.ca.us. Each invoice submitted by
CONTRACTOR shall include the facility at which the services were provided.
Hearing services under this Agreement will be provided for mental health clients
determined by DBH to be the responsibility of the COUNTY and for clients at CBHC. CONTRACTOR
understands that hearing services conducted at non-Fresno County facilities, except for CBHC, will not
be paid for by COUNTY. Separate arrangements for compensation must be made between the
CONTRACTOR and the non-Fresno County inpatient facilities, other than CBHC, for services provided to
individuals who are not the responsibility of the COUNTY.
If an invoice is incorrect or is otherwise not in proper form or substance or if
CONTRACTOR fails to provide data and/or reports, further described in Section fourteen (14) of this
Agreement, as provided herein to the COUNTY to meet State requirements, COUNTY’s DBH Director or
designee shall have the right to withhold payment after five (5) days prior written notice to
CONTRACTOR. CONTRACTOR agrees to continue to provide services for a period of ninety (90) days
after notification of an incorrect or improper invoice(s), data and/or reports. If after said ninety (90) day
period the invoice(s), data and/or reports are still not corrected to COUNTY’s DBH satisfaction, it shall be
deemed sufficient cause for the COUNTY to withhold monthly payments until compliance is established.
If after said ninety (90) day period invoice(s), data and/or reports are still not received or corrected to
COUNTY’s DBH satisfaction, COUNTY’s DBH Director or designee may elect to terminate this
Agreement, pursuant to Section Three (3) of this Agreement.
In addition, CONTRACTOR shall submit all invoices, data and/or reports to COUNTY’s
DBH for services provided within ninety (90) days after each Agreement term expires or this
Agreement is terminated. If invoices, data and/or reports are not submitted within ninety (90) days
after each Agreement term expires or this Agreement is terminated, COUNTY’s DBH shall have the
right to deny payment on such invoices.
6. INDEPENDENT CONTRACTOR
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In performance of the work, duties, and obligations assumed by CONTRACTOR under
this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of
CONTRACTOR’s officers, agents, and employees will at all times be acting and performing as an
independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
employee, joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no
right to control or supervise or direct the manner or method by which CONTRACTOR shall perform its
work and function. However, COUNTY shall retain the right to administer this Agreement so as to verify
that CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof.
CONTRACTOR and COUNTY shall comply with all applicable provisions of law and the
rules and regulations, if any, of governmental authorities having jurisdiction over matters which are
directly or indirectly the subject of this Agreement.
Because of its status as an independent contractor, CONTRACTOR shall have absolutely
no right to employment rights and benefits available to COUNTY employees. CONTRACTOR shall be
solely liable and responsible for providing to, or on behalf of, its employees all legally-required employee
benefits. In addition, CONTRACTOR shall be solely responsible and save COUNTY harmless from all
matters relating to payment of CONTRACTOR’s employees, including compliance with Social Security,
withholding, and all other regulations governing such matters. It is acknowledged that during the term of
this Agreement, CONTRACTOR may be providing services to others unrelated to the COUNTY or to this
Agreement.
7. MODIFICATION
Any matters of this Agreement may be modified from time to time by the written
consent of all the parties without, in any way, affecting the remainder.
8. NON-ASSIGNMENT
Neither party shall assign, transfer or subcontract this Agreement nor their rights or
duties under this Agreement without the prior written consent of the other party.
9. HOLD-HARMLESS
In accordance with W&I Code §5259.3(c), CONTRACTOR conducting the certification
review hearing shall not be held civilly or criminally liable for any action by a person released at or
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before the end of fourteen (14) days of intensive treatment pursuant to W&I Code §5250.
CONTRACTOR agrees to indemnify, save, hold harmless, and at COUNTY's request,
defend COUNTY, its officers, agents and employees from any and all costs and expenses including
attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY in
connection with the negligent performance, or failure to perform, by CONTRACTOR, its officers, agents
or employees under this Agreement, and from any and all costs and expenses, including attorney fees
and court costs, damages, liabilities, claims and losses occurring or resulting to any person, firm or
corporation who may be injured or damaged by the negligent performance, or failure to perform, of
CONTRACTOR, their officers, agents or employees under this Agreement. CONTRACTOR further
agrees to indemnify, save, hold harmless, and at COUNTY's request, defend COUNTY, its officers,
agents and employees from any and all costs and expenses, including attorney fees and court costs,
damages, liabilities, claims and losses occurring or resulting to COUNTY in the event that any person(s)
employed or retained by CONTRACTOR to provide services pursuant this Agreement make claims that
he/she/they are employees of the COUNTY by virtue of being employed or retained by CONTRACTOR.
COUNTY agrees to indemnify, save, hold harmless, and at CONTRACTOR's request,
defend CONTRACTOR, its officers, agents and employees from any and all costs and expenses
including attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to
CONTRACTOR in connection with the negligent performance, or failure to perform, by COUNTY, its
officers, agents or employees under this Agreement, and from any and all costs and expenses, including
attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any person,
firm or corporation who may be injured or damaged by the negligent performance, or failure to perform, of
COUNTY, their officers, agents or employees under this Agreement.
CONTRACTOR agrees to indemnify COUNTY for Federal and/or State of California audit
exceptions resulting from noncompliance herein on the part of CONTRACTOR.
10. INSURANCE
Without limiting COUNTY’s right to obtain indemnification from CONTRACTOR or any
third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect the following
insurance policies throughout the term of this Agreement:
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A. Commercial General Liability
Commercial General Liability Insurance with limits of not less than One Million
Dollars ($1,000,000) per occurrence and an annual aggregate of Three Million
Dollars ($3,000,000). This policy shall be issued on a per occurrence basis.
COUNTY may require specific coverage including completed operations, product
liability, contractual liability, Explosion, Collapse, and Underground (XCU), fire
legal liability or any other liability insurance deemed necessary because of the
nature of this Agreement.
B. Automobile Liability
Insurance Services Office Form Number CA 0001 covering, Code 1 (any auto),
or if Consultant has no owned autos, Code 8 (hired) and 9 (non-owned).with
limits for bodily injury of not less than Five Hundred Thousand Dollars
($500,000) per person and with limits no less than One Million Dollars
($1,000,000) per accident for bodily injury and property damage. Coverage
should include owned, non-owned, and hired vehicles used in connection with
this Agreement.
C. Professional Liability
Professional Liability Insurance with limits of not less than One Million Dollars
($1,000,000) per occurrence, Three Million Dollars ($3,000,000) annual
aggregate. CONTRACTOR agrees that it shall maintain, at its sole expense, in
full force and effect for a period of three (3) years following the termination of
this Agreement, one or more policies of professional liability insurance with
limits of coverage as specified herein.
D. Worker’s Compensation
A policy of worker’s compensation insurance as may be required by the California
Labor Code.
CONTRACTOR shall obtain endorsements to the Commercial General Liability insurance
naming the County of Fresno, its officers, agents, and employees, individually and collectively, as
additional insured, but only insofar as the operations under this Agreement are concerned. Such
coverage for additional insured shall apply as primary insurance and any other insurance, or self-
insurance, maintained by the COUNTY, its officers, agents and employees shall be excess only and not
contributing with insurance provided under the CONTRACTOR's policies herein. This insurance shall not
be cancelled or changed without a minimum of thirty (30) days advance written notice given to COUNTY.
Within thirty (30) days from the date CONTRACTOR executes this Agreement,
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CONTRACTOR shall provide certificates of insurance and endorsements as stated above for all of the
foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health, 3133 N.
Millbrook Ave., Fresno, California, 93703.Attention: Contracts Section – Certification Review Hearing
Officer, stating that such insurance coverage’s have been obtained and are in full force; that the County
of Fresno, its officers, agents and employees will not be responsible for any premiums on the policies;
that such Commercial General Liability insurance names the County of Fresno, its officers, agents and
employees, individually and collectively, as additional insured, but only insofar as the operations under
this Agreement are concerned; that such coverage for additional insured shall apply as primary insurance
and any other insurance, or self-insurance, maintained by the COUNTY, its officers, agents and
employees, shall be excess only and not contributing with insurance provided under the
CONTRACTOR’s policies herein; and that this insurance shall not be cancelled or changed without a
minimum of thirty (30) days advance, written notice given to COUNTY.
In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate this
Agreement upon the occurrence of such event.
All policies shall be with admitted insurers licensed to do business in the State of
California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating
of A FSC VII or better.
11. NON-DISCRIMINATION
During the performance of this Agreement, CONTRACTOR shall not unlawfully
discriminate against any employee or applicant for employment, or recipient of services, because of
race, religion, color, national origin, ancestry, physical disability, medical condition, marital status, age
or gender, pursuant to all applicable State of California and Federal statutes and regulations.
12. RECORDS
CONTRACTOR shall maintain records documenting the number of hearings held at
various psychiatric hospitals/acute psychiatric facilities in the County of Fresno that are designated as
seventy-two (72) hour or twenty-three (23) hour fifty-nine minute treatment and evaluation facilities when
the mental health clients have been determined by COUNTY’s DBH, to be the responsibility of COUNTY.
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This documentation shall indicate the assigned hearings officer’s name, client’s case number, date of
hearing, location of hearing and number of hearings held by day and month. The disposition of each
hearing shall also be listed.
CONTRACTOR shall maintain all above-mentioned records and submit them, when
requested by DBH and/or DCFS. In addition, the client records shall become the property of the
COUNTY upon expiration or termination of this Agreement.
13. REPORTS
CONTRACTOR shall maintain all required documentation, prepare monthly and quarterly
reports containing the information listed under Section Twelve (12), above and submit them for DBH to
the Department of Behavioral Health, Managed Care Division at 4409 E. Inyo Street, Fresno, CA 93702,
Attn: Division Manager. CONTRACTOR shall also submit to COUNTY the quarterly report within thirty
(30) days of the end of each quarter.
In addition, CONTRACTOR agrees to provide COUNTY with any reports which may be
required by State and/or Federal agencies for compliance with this Agreement. At the expiration of each
term of this Agreement or termination of the Agreement, COUNTY may request CONTRACTOR to
participate in a written evaluation of its performance relative to this Agreement, in order for the COUNTY
to evaluate CONTRACTOR’s performance under this Agreement.
14. COMPLAINTS
CONTRACTOR shall log complaints and the disposition of all complaints from a client or a
client's family. CONTRACTOR shall provide a copy of the detailed complaint log entries concerning
COUNTY-sponsored clients to COUNTY at monthly intervals by the tenth (l0th) day of the following
month, in a format that is mutually agreed upon. In addition, CONTRACTOR shall provide details and
attach documentation of each complaint with the log. CONTRACTOR shall post signs informing clients of
their right to file a complaint or grievance. CONTRACTOR shall notify COUNTY of all incidents reportable
to State licensing bodies that affect COUNTY clients within twenty-four (24) hours of receipt of a
complaint.
Within ten (10) days after each incident or complaint affecting COUNTY clients,
CONTRACTOR shall provide COUNTY with information relevant to the complaint, investigative details of
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the complaint, the complaint and CONTRACTOR's disposition of, or corrective action taken to resolve the
complaint. In addition, CONTRACTOR shall inform every client of their rights as set forth in Exhibit B,
attached hereto and by this reference incorporated herein and made part of this Agreement.
CONTRACTOR shall file an incident report for all incidents involving clients, following the
protocol and using the worksheet identified in Exhibit C, attached hereto and by this reference
incorporated herein and made part of this Agreement.
15. LICENSES
CONTRACTOR warrants that it possesses all licenses and/or certificates required by
local, State of California and/or Federal laws and regulations for the conduct of its business and shall
operate its business in accordance with all applicable laws and regulations. CONTRACTOR further
warrants that all of its personnel performing services under this Agreement shall be licensed and/or
certified where required to lawfully perform their duties and shall maintain such licensure and/or
certifications throughout the term of this Agreement. CONTRACTOR shall maintain copies of all
licenses and/or certifications noted above and shall allow COUNTY to review these documents upon
request.
16. MONITORING
CONTRACTOR agrees to extend to COUNTY’s DBH and the State Department of Health
Care Services, Mental Health Division, or their designees, the right to review and monitor records or
procedures at any time, in regard to the hearings, as well as the operation of CONTRACTOR’s hearing
process, in order to ensure compliance with the terms and conditions of this Agreement and with all State
and Federal mandates and regulations.
17. COMPLIANCE – “CONTRACTOR CODE OF CONDUCT AND ETHICS”
CONTRACTOR agrees to comply with the COUNTY’s Contractor Code of Conduct and
Ethics and the COUNTY’s Compliance Program, identified in Exhibit D, attached hereto and by this
reference incorporated herein. Within thirty (30) days of entering into this Agreement with the
COUNTY, CONTRACTOR shall have all of CONTRACTOR’s employees, agents and subcontractors
providing services under this Agreement certify in writing, that he or she has received, read,
understood, and shall abide by the Contractor Code of Conduct and Ethics. CONTRACTOR shall
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ensure that within thirty (30) days of hire, all new employees, agents and subcontractors providing
services under this Agreement shall certify in writing that he or she has received, read, understood,
and shall abide by the Contractor Code of Conduct and Ethics by completing “Contractor
Acknowledgement and Agreement”, identified in Exhibit D. CONTRACTOR understands that the
promotion of and adherence to the Code of Conduct is an element in evaluating the performance of
CONTRACTOR and its employees, agents and subcontractors.
Within thirty (30) days of entering into this Agreement, and annually thereafter, all
employees, agents and subcontractors providing services under this Agreement shall complete
general compliance training and appropriate employees, agents and subcontractors shall complete
documentation and billing or billing/reimbursement training. All new employees, agents and
subcontractors shall attend the appropriate training within 30 days of hire. Each individual who is
required to attend training shall certify, in writing that he or she has received the required training. The
certification shall specify the type of training received and the date received. The certification shall be
provided to the COUNTY’s Compliance Officer at 3133 N. Millbrook Avenue, Fresno, California 93703.
18. ASSURANCES
In entering into this Agreement, CONTRACTOR certifies that it is not currently
excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health Care
Programs: that it has not been convicted of a criminal offense related to the provision of health care
items or services; nor has it been reinstated to participation in the Federal Health Care Programs after
a period of exclusion, suspension, debarment, or ineligibility. If COUNTY learns, subsequent to
entering into a contract, that CONTRACTOR is ineligible on these grounds, COUNTY will remove
CONTRACTOR from responsibility for, or involvement with, COUNTY’s business operations related to
the Federal Health Care Programs and shall remove such CONTRACTOR from any position in which
CONTRACTOR’s compensation, or the items or services rendered, ordered or prescribed by
CONTRACTOR may be paid in whole or part, directly or indirectly, by Federal Health Care Programs
or otherwise with Federal Funds at least until such time as CONTRACTOR is reinstated into
participation in the Federal Health Care Programs.
A. If COUNTY has notice that CONTRACTOR has been charged with a criminal
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offense related to any Federal Health Care Program, or is proposed for exclusion during the term on
any contract, CONTRACTOR and COUNTY shall take all appropriate actions to ensure the accuracy
of any claims submitted to any Federal Health Care Program. At its discretion, given such
circumstances, COUNTY may request that CONTRACTOR cease providing services until resolution
of the charges or the proposed exclusion.
B. CONTRACTOR agrees that all potential new employees of CONTRACTOR or
subcontractors of CONTRACTOR who, in each case, are expected to perform professional services
under this Agreement, will be queried as to whether (1) they are now or ever have been excluded,
suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2)
they have been convicted of a criminal offense related to the provision of health care items or
services; and or (3) they have been reinstated to participation in the Federal Health Care Programs
after a period of exclusion, suspension, debarment, or ineligibility.
1. In the event the potential employee or subcontractor informs
CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible, or has been
convicted of a criminal offense relating to the provision of health care services, and CONTRACTOR
hires or engages such potential employee or subcontractor, CONTRACTOR will ensure that said
employee or subcontractor does no work, either directly or indirectly relating to services provided to
COUNTY.
2. Notwithstanding the above, COUNTY at its discretion may
terminate this Agreement in accordance with Section Three (3) of this Agreement, or require adequate
assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee of
CONTRACTOR will perform work, either directly or indirectly, relating to services provided to
COUNTY. Such demand for adequate assurance shall be effective upon a time frame to be
determined by COUNTY to protect the interests of COUNTY consumers.
C. CONTRACTOR shall verify (by asking the applicable employees and
subcontractors) that all current employees and existing subcontractors who, in each case, are
expected to perform professional services under this Agreement (1) are not currently excluded,
suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2)
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have not been convicted of a criminal offense related to the provision of health care items or services;
and (3) have not been reinstated to participation in the Federal Health Care Program after a period of
exclusion, suspension, debarment, or ineligibility. In the event any existing employee or subcontractor
informs CONTRACTOR that he or she is excluded, suspended, debarred or otherwise ineligible to
participate in the Federal Health Care Programs, or has been convicted of a criminal offense relating
to the provision of health care services, CONTRACTOR will ensure that said employee or
subcontractor does no work, either direct or indirect, relating to services provided to COUNTY.
1. CONTRACTOR agrees to notify COUNTY immediately during
the term of this Agreement whenever CONTRACTOR learns that an employee or subcontractor who,
in each case, is providing professional services under this Agreement is excluded, suspended,
debarred or otherwise ineligible to participate in the Federal Health Care Programs, or is convicted of
a criminal offense relating to the provision of health care services.
2. Notwithstanding the above, COUNTY at its discretion may
terminate this Agreement in accordance with the Termination Section of this Agreement, or require
adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible
employee of CONTRACTOR will perform work, either directly or indirectly, relating to services
provided to COUNTY. Such demand for adequate assurance shall be effective upon a time frame to
be determined by COUNTY to protect the interests of COUNTY consumers.
D. CONTRACTOR agrees to cooperate fully with any reasonable requests for
information from COUNTY which may be necessary to complete any internal or external audits relating to
CONTRACTOR’s compliance with the provisions of this Section.
E. CONTRACTOR agrees to reimburse COUNTY for the entire cost of any penalty
imposed upon COUNTY by the Federal Government as a result of CONTRACTOR’s violation of
CONTRACTOR’s obligations as described in this Section.
19. COMPLIANCE WITH STATE REQUIREMENTS
CONTRACTOR recognizes that COUNTY operates its Mental Health programs under
an agreement with the State of California Department of Health Care Services, and that under said
agreement the State imposes certain requirements on the COUNTY and its subcontractors.
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CONTRACTOR shall adhere to all State of California requirements, including those identified in
Exhibit E, attached hereto and by this reference incorporated herein.
20. DISCLOSURE OF SELF-DEALING TRANSACTIONS
This provision is only applicable if the CONTRACTOR is operating as a corporation (a
for-profit or non-profit corporation) or if during the term of this agreement, the CONTRACTOR changes
its status to operate as a corporation.
Members of the CONTRACTOR’s Board of Directors shall disclose any self-dealing
transactions that they are a party to while CONTRACTOR is providing goods or performing services
under this Agreement. A self-dealing transaction shall mean a transaction to which the
CONTRACTOR is a party and in which one or more of its directors has a material financial
interest. Members of the Board of Directors shall disclose any self-dealing transactions that they are a
party to by completing and signing a Self-Dealing Transaction Disclosure Form (Exhibit F), attached
hereto and by this reference incorporated herein and made part of this Agreement, and submitting it to
the COUNTY prior to commencing with the self-dealing transaction or immediately thereafter.
21. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
A. The parties to this Agreement shall be in strict conformance with all applicable
Federal and State of California laws and regulations, including but not limited to Sections 5328,
10850, and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. of
Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the California Civil Code, and the
Health Insurance Portability and Accountability Act (HIPAA), including but not limited to Section 1320
D et seq. of Title 42, United States Code (USC) and its implementing regulations, including, but not
limited to Title 45, CFR, Sections 142, 160, 162, and 164, The Health Information Technology for
Economic and Clinical Health Act (HITECH) regarding the confidentiality and security of patient
information and the Genetic Information Nondiscrimination Act (GINA) of 2008 regarding the
confidentiality of genetic information.
Except as otherwise provided in this Agreement, CONTRACTOR, as a Business
Associate of COUNTY, may use or disclose Protected Health Information (PHI) to perform functions,
activities or services for or on behalf of COUNTY, as specified in this Agreement, provided that such
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use or disclosure shall not violate the HIPAA, USC 1320d et seq. The uses and disclosures of PHI
may not be more expansive than those applicable to COUNTY, as the “Covered Entity” under the
HIPAA Privacy Rule (45 CFR 164.500 et seq), except as authorized for management, administrative
or legal responsibilities of the Business Associate.
B. CONTRACTOR, including its subcontractors and employees, shall protect, from
unauthorized access, use, or disclosure of names and other identifying information, including genetic
information, concerning persons receiving services pursuant to this Agreement, except where
permitted in order to carry out data aggregation purposes for health care operations [45 CFR Sections
164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)]. This pertains to any and all persons
receiving services pursuant to a COUNTY funded program. This requirement applies to electronic
PHI. CONTRACTOR shall not use such identifying information or genetic information for any purpose
other than carrying out CONTRACTOR’s obligations under this Agreement.
C. CONTRACTOR, including its subcontractors and employees, shall not disclose
any such identifying information or genetic information to any person or entity, except as otherwise
specifically permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 or other law,
required by the Secretary, or authorized by the client/patient in writing. In using or disclosing PHI that
is permitted by this Agreement or authorized by law, CONTRACTOR shall make reasonable efforts to
limit PHI to the minimum necessary to accomplish intended purpose of use, disclosure or request.
D. For purposes of the above sections, identifying information shall include, but not
be limited to name, identifying number, symbol, or other identifying particular assigned to the
individual, such as finger or voice print, or a photograph.
E. For purposes of the above sections, genetic information shall include genetic
tests of family members of an individual or individual, manifestation of disease or disorder of family
members of an individual, or any request for or receipt of, genetic services by individual or family
members. Family member means a dependent or any person who is first, second, third, or fourth
degree relative.
F. CONTRACTOR shall provide access, at the request of COUNTY, and in the
time and manner designated by COUNTY, to PHI in a designated record set (as defined in 45 CFR
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Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45 CFR
Section164.524 regarding access by individuals to their PHI. With respect to individual requests,
access shall be provided within thirty (30) days from request. Access may be extended if
CONTRACTOR cannot provide access and provide individual with the reasons for the delay and the
date when access may be granted. PHI shall be provided in the form and format requested by the
individual or COUNTY.
CONTRACTOR shall make any amendment(s) to PHI in a designated record
set at the request of COUNTY, or individual, and in the time and manner designated by COUNTY in
accordance with 45 CFR Section 164.526.
CONTRACTOR shall provide to COUNTY or to an individual, in a time and
manner designated by COUNTY, information collected in accordance with 45 CFR Section 164.528,
to permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI in
accordance with 45 CFR Section 164.528.
G. CONTRACTOR shall report to COUNTY, in writing, any knowledge or
reasonable belief that there has been unauthorized access, viewing, use, disclosure, security incident,
or breach of unsecured PHI not permitted by this Agreement of which it becomes aware, immediately
and without reasonable delay and in no case later than two (2) business days of discovery.
Immediate notification shall be made to COUNTY’s Information Security Officer and Privacy Officer
and COUNTY’s DBH HIPAA Representative, within two (2) business days of discovery. The
notification shall include, to the extent possible, the identification of each individual whose unsecured
PHI has been, or is reasonably believed to have been, accessed, acquired, used, disclosed, or
breached.
CONTRACTOR shall take prompt corrective action to cure any deficiencies and
any action pertaining to such unauthorized disclosure required by applicable Federal and State Laws
and regulations. CONTRACTOR shall investigate such breach and is responsible for all notifications
required by law and regulation or deemed necessary by COUNTY and shall provide a written report of
the investigation and reporting required to COUNTY’s Information Security Officer and Privacy Officer
and COUNTY’s DBH HIPAA Representative. This written investigation and description of any
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reporting necessary shall be postmarked within the thirty (30) working days of the discovery of the
breach to the addresses below:
County of Fresno County of Fresno County of Fresno
Department of Behavioral Health Dept. of Public Health Information Technology Services
HIPAA Representative Privacy Officer Information Security Officer
(559) 600-6798 (559) 600-6405 (559) 600-5800
3147 N. Millbrook Ave (559) 600-6439 2048 N. Fine Ave
Fresno, CA 93703 P.O. Box 11867 Fresno, CA 93727
Fresno, CA 93721
H. CONTRACTOR shall make its internal practices, books, and records relating to
the use and disclosure of PHI received from COUNTY, or created or received by the CONTRACTOR
on behalf of COUNTY, in compliance with HIPAA’s Privacy Rule, including, but not limited to the
requirements set forth in Title 45, CFR, Sections 160 and 164. CONTRACTOR shall make its internal
practices, books, and records relating to the use and disclosure of PHI received from COUNTY, or
created or received by the CONTRACTOR on behalf of COUNTY, available to the United States
Department of Health and Human Services (Secretary) upon demand.
CONTRACTOR shall cooperate with the compliance and investigation reviews
conducted by the Secretary. PHI access to the Secretary must be provided during the
CONTRACTOR’s normal business hours, however, upon exigent circumstances access at any time
must be granted. Upon the Secretary’s compliance or investigation review, if PHI is unavailable to
CONTRACTOR and in possession of a Subcontractor, it must certify efforts to obtain the information
to the Secretary.
I. Safeguards
CONTRACTOR shall implement administrative, physical, and technical
safeguards as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that reasonably and
appropriately protect the confidentiality, integrity, and availability of PHI, including electronic PHI, that
it creates, receives, maintains or transmits on behalf of COUNTY and to prevent unauthorized access,
viewing, use, disclosure, or breach of PHI other than as provided for by this Agreement.
CONTRACTOR shall conduct an accurate and thorough assessment of the potential risks and
vulnerabilities to the confidential, integrity and availability of electronic PHI. CONTRACTOR shall
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develop and maintain a written information privacy and security program that includes administrative,
technical and physical safeguards appropriate to the size and complexity of CONTRACTOR’s
operations and the nature and scope of its activities. Upon COUNTY’s request, CONTRACTOR shall
provide COUNTY with information concerning such safeguards.
CONTRACTOR shall implement strong access controls and other security
safeguards and precautions in order to restrict logical and physical access to confidential, personal
(e.g., PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include
the following administrative and technical password controls for all systems used to process or store
confidential, personal, or sensitive data:
1. Passwords must not be:
a. Shared or written down where they are accessible or
recognizable by anyone else; such as taped to computer screens, stored under keyboards, or visible
in a work area;
b. A dictionary word; or
c. Stored in clear text
2. Passwords must be:
a. Eight (8) characters or more in length;
b. Changed every ninety (90) days;
c. Changed immediately if revealed or compromised; and
d. Composed of characters from at least three of the following four
groups from the standard keyboard:
1) Upper case letters (A-Z);
2) Lowercase letters (a-z);
3) Arabic numerals (0 through 9); and
4) Non-alphanumeric characters (punctuation symbols).
CONTRACTOR shall implement the following security controls on each
workstation or portable computing device (e.g., laptop computer) containing confidential,
personal, or sensitive data:
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1. Network-based firewall and/or personal firewall;
2. Continuously updated anti-virus software; and
3. Patch management process including installation of all operating
system/software vendor security patches.
CONTRACTOR shall utilize a commercial encryption solution that has received
FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable
electronic media (including, but not limited to, compact disks and thumb drives) and on portable
computing devices (including, but not limited to, laptop and notebook computers).
CONTRACTOR shall not transmit confidential, personal, or sensitive data via e-
mail or other internet transport protocol unless the data is encrypted by a solution that has been
validated by the National Institute of Standards and Technology (NIST) as conforming to the
Advanced Encryption Standard (AES) Algorithm. CONTRACTOR must apply appropriate sanctions
against its employees who fail to comply with these safeguards. CONTRACTOR must adopt
procedures for terminating access to PHI when employment of employee ends.
J. Mitigation of Harmful Effects
CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that
is suspected or known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or
breach of PHI by CONTRACTOR or its subcontractors in violation of the requirements of these
provisions. CONTRACTOR must document suspected or known harmful effects and the outcome.
K. CONTRACTOR’s Subcontractors
CONTRACTOR shall ensure that any of its contractors, including
subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created or
received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions, safeguards, and
conditions that apply to CONTRACTOR with respect to such PHI and to incorporate, when applicable,
the relevant provisions of these provisions into each subcontract or sub-award to such agents or
subcontractors.
L. Employee Training and Discipline
CONTRACTOR shall train and use reasonable measures to ensure compliance
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with the requirements of these provisions by employees who assist in the performance of functions or
activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such
employees who intentionally violate any provisions of these provisions, including termination of
employment.
M. Termination for Cause
Upon COUNTY’s knowledge of a material breach of these provisions by
CONTRACTOR, COUNTY shall either:
1. Provide an opportunity for CONTRACTOR to cure the breach or end the
violation and terminate this Agreement if CONTRACTOR does not cure the breach or end the violation
within the time specified by COUNTY; or
2. Immediately terminate this Agreement if CONTRACTOR has breached a
material term of these provisions and cure is not possible.
3. If neither cure nor termination is feasible, the COUNTY Privacy Officer
shall report the violation to the Secretary of the U.S. Department of Health and Human Services.
N. Judicial or Administrative Proceedings
COUNTY may terminate this Agreement in accordance with the terms and
conditions of this Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in a
criminal proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH Act; or (2) a
finding or stipulation that the CONTRACTOR has violated a privacy or security standard or
requirement of the HITECH Act, HIPAA or other security or privacy laws in an administrative or civil
proceeding in which the CONTRACTOR is a party.
O. Effect of Termination
Upon termination or expiration of this Agreement for any reason,
CONTRACTOR shall return or destroy all PHI received from COUNTY (or created or received by
CONTRACTOR on behalf of COUNTY) that CONTRACTOR still maintains in any form, and shall
retain no copies of such PHI. If return or destruction of PHI is not feasible, it shall continue to extend
the protections of these provisions to such information, and limit further use of such PHI to those
purposes that make the return or destruction of such PHI infeasible. This provision shall apply to PHI
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that is in the possession of subcontractors or agents, if applicable, of CONTRACTOR. If
CONTRACTOR destroys the PHI data, a certification of date and time of destruction shall be provided
to the COUNTY by CONTRACTOR.
P. Disclaimer
COUNTY makes no warranty or representation that compliance by
CONTRACTOR with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will be
adequate or satisfactory for CONTRACTOR’s own purposes or that any information in
CONTRACTOR’s possession or control, or transmitted or received by CONTRACTOR, is or will be
secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely
responsible for all decisions made by CONTRACTOR regarding the safeguarding of PHI.
Q. Amendment
The parties acknowledge that Federal and State laws relating to electronic data
security and privacy are rapidly evolving and that amendment of these provisions may be required to
provide for procedures to ensure compliance with such developments. The parties specifically agree
to take such action as is necessary to amend this agreement in order to implement the standards and
requirements of HIPAA, the HIPAA regulations, the HITECH Act and other applicable laws relating to
the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days written
notice in the event that CONTRACTOR does not enter into an amendment providing assurances
regarding the safeguarding of PHI that COUNTY in its sole discretion deems sufficient to satisfy the
standards and requirements of HIPAA, the HIPAA regulations and the HITECH Act.
R. No Third-Party Beneficiaries
Nothing express or implied in the terms and conditions of these provisions is
intended to confer, nor shall anything herein confer, upon any person other than COUNTY or
CONTRACTOR and their respective successors or assignees, any rights, remedies, obligations or
liabilities whatsoever.
S. Interpretation
The terms and conditions in these provisions shall be interpreted as broadly as
necessary to implement and comply with HIPAA, the HIPAA regulations and applicable State laws.
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The parties agree that any ambiguity in the terms and conditions of these provisions shall be resolved
in favor of a meaning that complies and is consistent with HIPAA and the HIPAA regulations.
T. Regulatory References
A reference in the terms and conditions of these provisions to a section in the
HIPAA regulations means the section as in effect or as amended.
U. Survival
The respective rights and obligations of CONTRACTOR as stated in this
Section shall survive the termination or expiration of this Agreement.
V. No Waiver of Obligations
No change, waiver or discharge of any liability or obligation hereunder on any
one or more occasions shall be deemed a waiver of performance of any continuing or other obligation,
or shall prohibit enforcement of any obligation on any other occasion.
22. DATA SECURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent
access, viewing, use or disclosure of COUNTY data including sensitive or personal client information;
abuse of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies
that enter into a contractual relationship with the COUNTY for the purpose of providing services under
this Agreement must employ adequate data security measures to protect the confidential information
provided to CONTRACTOR by the COUNTY, including but not limited to the following:
A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices
CONTRACTOR may not connect to COUNTY networks via personally-owned
mobile, wireless or handheld devices, unless the following conditions are met:
1) CONTRACTOR has received authorization by COUNTY for telecommuting
purposes;
2) Current virus protection software is in place;
3) Mobile device has the remote wipe feature enabled/ and
4) A secure connection is used.
B. CONTRACTOR-Owned Computers or Computer Peripherals
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CONTRACTOR may not bring CONTRACTOR-owned computers or computer peripherals into the
COUNTY for use without prior authorization from the COUNTY’s Chief Information Officer, and/or
designee(s), including but not limited to mobile storage devices. If data is approved to be transferred,
data must be stored on a secure server approved by the COUNTY and transferred by means of a
Virtual Private Network (VPN) connection, or another type of secure connection. Said data must be
encrypted.
C. COUNTY-Owned Computer Equipment
CONTRACTOR may not use COUNTY computers or computer peripherals on non-COUNTY
premises without prior authorization from the COUNTY’s Chief Information Officer, and/or designee(s).
D. CONTRACTOR may not store COUNTY’s private, confidential or sensitive data
on any hard-disk drive, portable storage device, or remote storage installation unless encrypted.
E. CONTRACTOR shall be responsible to employ strict controls to ensure the
integrity and security of COUNTY’s confidential information and to prevent unauthorized access,
viewing, use or disclosure of data maintained in computer files, program documentation, data
processing systems, data files and data processing equipment which stores or processes COUNTY
data internally and externally.
F. Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of
128 BIT or higher. Additionally, a password or pass phrase must be utilized.
G. CONTRACTOR is responsible to immediately notify COUNTY of any violations,
breaches or potential breaches of security related to COUNTY’s confidential information, data
maintained in computer files, program documentation, data processing systems, data files and data
processing equipment which stores or processes COUNTY data internally or externally.
H. COUNTY shall provide oversight to CONTRACTOR’s response to all incidents
arising from a possible breach of security related to COUNTY’s confidential client information provided
to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected individuals
as required by law or as deemed necessary by COUNTY in its sole discretion. CONTRACTOR will be
responsible for all costs incurred as a result of providing the required notification.
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23. DISCLOSURE – CRIMINAL HISTORY AND CIVIL ACTIONS
CONTRACTOR is required to disclose if any of the following conditions apply to them,
their owners, officers, corporate managers and partners (hereinafter collectively referred to as
“CONTRACTOR”):
A. Within the three-year period preceding the Agreement award, they have been
convicted of, or had a civil judgment rendered against them for:
1. Fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction;
2. Violation of a federal or state antitrust statute;
3. Embezzlement, theft, forgery, bribery, falsification, or destruction of
records; or
4. False statements or receipt of stolen property.
B. Within a three-year period preceding their Agreement award, they have had a
public transac tion (federal, state, or local) terminated for cause or default.
Disclosure of the above information will not automatically eliminate
CONTRACTOR from further business consideration. The information will be considered as part of
the determination of whether to continue and/or renew this Agreement and any additional
information or explanation that a CONTRACTOR elects to submit with the disclosed information will
be considered. If it is later determined that the CONTRACTOR failed to disclose required
information, any contract awarded to such CONTRACTOR may be immediately voided and
terminated for material failure to comply with the terms and conditions of the award.
CONTRACTOR must sign a “Certification Regarding Debarment, Suspension,
and Other Responsibility Matters- Primary Covered Transactions” in the form set forth in Exhibit G,
attached hereto and by this reference incorporated herein and made part of this Agreement.
Additionally, CONTRACTOR must immediately advise the COUNTY’s DBH in writing if, during the
term of this Agreement: (1) CONTRACTOR becomes suspended, debarred, excluded or ineligible for
participation in federal or state funded programs or from receiving federal funds as listed in the
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excluded parties’ list system (http://www.epls.gov); or (2) any of the above listed conditions become
applicable to CONTRACTOR. CONTRACTOR shall indemnify, defend and hold the COUNTY
harmless for any loss or damage resulting from a conviction, debarment, exclusion, ineligibility or
other matter listed in the signed Certification Regarding Debarment, Suspension, and Other
Responsibility Matters.
24. PUBLICITY PROHIBITION
None of the funds, materials, property or services provided directly or indirectly under
this Agreement shall be used for CONTRACTOR’s advertising, fundraising, or publicity (i.e.,
purchasing tickets/tables, silent auction donations, etc.) for the purpose of self-promotion.
Notwithstanding the above, publicity of the services described in Section One (1) of this Agreement
shall be allowed as necessary to raise public awareness about the availability of such specific services
when approved in advance by COUNTY’s DBH Director or designee for such items as written/printed
materials, the use of media (i.e., radio, television, newspapers) and any other related expense(s).
25. AUDITS AND INSPECTIONS
The CONTRACTOR shall at any time during business hours, and as often as the
COUNTY may deem necessary, make available to the COUNTY for examination all of its records and
data with respect to the matters covered by this Agreement. The CONTRACTOR shall, upon request
by the COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to
ensure CONTRACTOR’s compliance with the terms of this Agreement.
If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00),
CONTRACTOR shall be subject to the examination and audit of the State of California Auditor
General for a period of three (3) years after final payment under contract (California Government Code
section 8546.7).
26. NOTICES
The persons having authority to give and receive notices under this Agreement and their
addresses include the following:
COUNTY CONTRACTOR
Director, Fresno County J. Melton & Associates
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Department of Behavioral Health 5562 W. River Bottom Ave.
3133 N. Millbrook Ave Fresno, CA 93722
Fresno, CA 93702 (559) 259-3893
All notices between the COUNTY and CONTRACTOR provided for or permitted under
this Agreement must be in writing and delivered either by personal service, by first-class United States
mail, by an overnight commercial courier service, or by telephonic facsimile transmission. A notice
delivered by personal service is effective upon service to the recipient. A notice delivered by first-class
United States mail is effective three COUNTY business days after deposit in the United States mail,
postage prepaid, addressed to the recipient. A notice delivered by an overnight commercial courier
service is effective one COUNTY business day after deposit with the overnight commercial courier
service, delivery fees prepaid, with delivery instructions given for next day delivery, addressed to the
recipient. A notice delivered by telephonic facsimile is effective when transmission to the recipient is
completed (but, if such transmission is completed outside of COUNTY business hours, then such delivery
shall be deemed to be effective at the next beginning of a COUNTY business day), provided that the
sender maintains a machine record of the completed transmission. For all claims arising out of or related
to this Agreement, nothing in this section establishes, waives, or modifies any claims presentation
requirements or procedures provided by law, including but not limited to the Government Claims Act
(Division 3.6 of Title 1 of the Government Code, beginning with section 810).
27. GOVERNING LAW
The parties agree that, for the purposes of venue, performance under this Agreement is to
be in Fresno County, California.
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by the laws of the State of California.
28. ENTIRE AGREEMENT
This Agreement including all attached exhibits constitutes the entire Agreement
between the CONTRACTOR and COUNTY with respect to the subject matter hereof and supersedes
all previous agreement negotiations, proposals, commitments, writings, advertisements, publications
and understandings of any nature whatsoever unless expressly included in this Agreement.
1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
COUNTY OF FRESNO
By: ar~
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Print Name : J;,1 a/h J J2r do/V
Title C hr J? f ~ tJ {frCPY
Chairperson of the Board of Supervisors
of the County of Fresno
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President or Chief Executive Officer
Or any Vice President
By~~
{J ---r, · · fl
Print Name : van rce !fle Ltl!&
Title :=--4,""'"""~--e,,,£-£-...L..<~--=;;...o:;:J.:;....:.__,_"---"~
Any Assistant Secretary , or
Chief Financial Officer, or
Any Assistant Treasurer
Mailing Address:
5562 W . River Bottom Ave .
Fresno , CA 93722
Phone No. (559) 259-3893
Contact: Chief Executive Officer
FOR ACCOUNTING USE ONLY:
Fund/Subclass : 0001/10000
Organ ization: 5630
Account/Program: 7295/0
p
ATTEST:
Bernice E. Seidel ,
Clerk of the Board of Supervisors
County of Fresno, State of California
By: &.!Sll;y\ ~shDy
Deputy
J -lD-18'
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Exhibit A
Page 1 of 2
Certification Hearing Review Officer
Scope of Work
ORGANIZATION: J. Melton & Associates
ADDRESS: 5562 W. River Bottom Ave, Fresno, CA 93722
SERVICES FOR: Conduct certification Review Hearings for adults and
children involuntarily detained as required by the
Lanterman-Petris-Short Act.
CONTRACT PERIOD: July 1, 2018 – June 30, 2023
CONTRACT AMOUNT: $140,000.00 for each fiscal year
TARGET POPULATION: Adults and children involuntarily detained pursuant to the
provisions of the Lanterman-Petris-Short Act of the
California Welfare & Institutions Code.
SERVICES: Conduct Certification Hearings
1. The primary activity of the Certification Hearing Review Officer
(CONTRACTOR) is to conduct hearings of those adults, adolescents, or
children involuntarily detained due to being gravely disabled and/or danger to
self or others because of mental illness and who have been certified for
additional involuntary treatment.
2. Hearings shall be held in the manner as prescribed by section 5256 through
and including 5270.15 of the California Welfare and Institutions Code,
Division 5.
3. Certification Review Hearings shall be held within four (4) days of the initial
certification for additional involuntary hold of the person certified, unless
postponed by the request of the person or his/her attorney or advocate.
Additional certification review hearings will be held within four (4) days of
the date on which the consumer is certified for a thirty (30) day period of
intensive treatment (California Welfare and Institutions Code § 5270.15.
4. Hearings shall be held at various psychiatric hospitals/acute psychiatric
programs in the County of Fresno that are designated as Seventy-Two (72)
hour treatment and evaluation facilities.
Exhibit A
Page 2 of 2
5. CONTRACTOR shall maintain all required documentation and shall submit
any required documentation in compliance with all applicable State and
Federal confidentiality laws in the manner determined by the COUNTY.
6. CONTRACTOR will provide approximately one hundred and twenty-three
(123) hearings per month although no minimum is guaranteed.
7. COUNTY will be responsible to provide for and compensate the
CONTRACTOR for all hearings performed in accordance with Welfare and
Institutions Code sections 5250 through 5270.35 at a location/space that
allows for confidentiality and is compatible with and is least disruptive to the
treatment being provided to the Beneficiary or Recipient.
8. Review hearings will be conducted each week on Tuesday and Friday or on
other days of the week as may be necessary to complete said hearings within
State required timelines. If a hearing falls on a COUNTY observed holiday,
the CONTRACTOR will issue notification to the DBH on the alternate date
chosen. Depending on the number of hearings scheduled for the day and the
complexity of each hearing, the time taken to complete all hearings scheduled
may extend past the customary 8:00 a.m. – 5:00 p.m. business day. Each
Sterling Hearing takes approximately 25 minutes to complete.
PROJECTED OUTCOMES: Provide approximately one hundred and twenty-three
(123) review hearings per month.
Exhibit B
Page 1 of 2
Fresno County Mental Health Plan
Grievances
Fresno County Mental Health Plan (MHP) provides beneficiaries with a grievance
and appeal process and an expedited appeal process to resolve grievances and
disputes at the earliest and the lowest possible level.
Title 9 of the California Code of Regulations requires that the MHP and its fee -
for-service providers give verbal and written information to Medi-Cal beneficiaries
regarding the following:
How to access specialty mental health services
How to file a grievance about services
How to file for a State Fair Hearing
The MHP has developed a Consumer Guide, a beneficiary rights poster, a
grievance form, an appeal form, and Request for Change of Provider Form. All
of these beneficiary materials must be posted in prominent locations where Medi-
Cal beneficiaries receive outpatient specialty mental health services, including
the waiting rooms of providers’ offices of service.
Please note that all fee-for-service providers and contract agencies are required
to give their clients copies of all current beneficiary information annually at the
time their treatment plans are updated and at intake.
Beneficiaries have the right to use the grievance and/or appeal process without
any penalty, change in mental health services, or any form of retaliation. All
Medi-Cal beneficiaries can file an appeal or state hearing.
Grievances and appeals forms and self addressed envelopes must be available
for beneficiaries to pick up at all provider sites without having to make a verbal or
written request. Forms can be sent to the following address:
Fresno County Mental Health Plan
P.O. Box 45003
Fresno, CA 93718-9886
(800) 654-3937 (for more information)
(559) 488-3055 (TTY)
Provider Problem Resolution and Appeals Process
The MHP uses a simple, informal procedure in identifying and resolving provider
concerns and problems regarding payment authorization issues, other
complaints and concerns.
Exhibit B
Page 2 of 2
Informal provider problem resolution process – the provider may first speak to a
Provider Relations Specialist (PRS) regarding his or her complaint or concern.
The PRS will attempt to settle the complaint or concern with the provider. If the
attempt is unsuccessful and the provider chooses to forego the informal
grievance process, the provider will be advised to file a written complaint to the
MHP address (listed above).
Formal provider appeal process – the provider has the right to access the
provider appeal process at any time before, during, or after the provider problem
resolution process has begun, when the complaint concerns a denied or modified
request for MHP payment authorization, or the process or payment of a
provider’s claim to the MHP.
Payment authorization issues – the provider may appeal a denied or modified
request for payment authorization or a dispute with the MHP regarding the
processing or payment of a provider’s claim to the MHP. The written appeal
must be submitted to the MHP within 90 calendar days of the date of the receipt
of the non-approval of payment.
The MHP shall have 60 calendar days from its receipt of the appeal to inform the
provider in writing of the decision, including a statement of the reasons for the
decision that addresses each issue raised by the provider, and any action
required by the provider to implement the decision.
If the appeal concerns a denial or modification of payment authorization request,
the MHP utilizes a Managed Care staff who was not involved in the initial denial
or modification decision to determine the appeal decision.
If the Managed Care staff reverses the appealed decision, the provider will be
asked to submit a revised request for payment within 30 calendar days of receipt
of the decision
Other complaints – if there are other issues or complaints, which are not related
to payment authorization issues, providers are encouraged to send a letter of
complaint to the MHP. The provider will receive a written response from the
MHP within 60 calendar days of receipt of the complaint. The decision rendered
buy the MHP is final.
Exhibit C
Page 1 of 2
FFRREESSNNOO CCOOUUNNTTYY MMEENNTTAALL HHEEAALLTTHH PPLLAANN
GGRRIIEEVVAANNCCEESS AANNDD IINNCCIIDDEENNTT RREEPPOORRTTIINNGG
PPRROOTTOOCCOOLL FFOORR CCOOMMPPLLEETTIIOONN OOFF IINNCCIIDDEENNTT RREEPPOORRTT
The Incident Report must be completed for all incidents involving clients. The staff person
who becomes aware of the incident completes this for m, and the supervisor co -signs it.
When more than one client is involved in an incident, a separate form must be completed
for each client.
Where the forms should be sent - within 24 hours from the time of the incident
Incident Report should be sent to:
DBH Program Supervisor
Exhibit C
Page 2 of 2
INCIDENT REPORT WORKSHEET
When did this happen? (date/time) Where did this happen?
Name/DMH #
1. Background information of the incident:
2. Method of investigation: (chart review, face-to-face interview, etc.)
Who was affected? (If other than consumer)
List key people involved. (witnesses, visitors, physicians, employees)
3. Preliminary findings: How did it happen? Sequence of events. Be specific. If attachments are needed write
comments on an 8 1/2 sheet of paper and attach to worksheet.
Outcome severity: Nonexistent inconsequential consequential death not applicable unknown
4. Response: a) corrective action, b) Plan of Action, c) other
Completed by (print name)
Completed by (signature) Date completed
Reviewed by Supervisor (print name)
Supervisor Signature Date
Exhibit D
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 s ervices.
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 sha ll 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 appl icable 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 fi ctitious 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 D
Page 2 of 3
8. Act promptly to investigate and correct probl ems 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 discipl inary
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 guidelin e.
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 D
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 E
Page 1 of 2
STATE MENTAL HEALTH REQUIREMENTS
1. CONTROL REQUIREMENTS
The COUNTY and its subcontractors shall provide services in accordance with all
applicable Federal and State statutes and regulations.
2. PROFESSIONAL LICENSURE
All (professional level) persons employed by the COUNTY Mental Health
Program (directly or through contract) providing Short-Doyle/Medi-Cal services
have met applicable professional licensure requirements pursuant to Business and
Professions and Welfare and Institutions Codes.
3. CONFIDENTIALITY
CONTRACTOR shall conform to and COUNTY shall monitor compliance with
all State of California and Federal statutes and regulations regarding
confidentiality, including but not limited to confidentiality of information
requirements at 42, Code of Federal Regulations sections 2.1 et seq; California
Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division
10.5 and 10.6 of the California Health and Safety Code; Title 22, California Code
of Regulations, section 51009; and Division 1, Part 2.6, Chapters 1-7 of the
California Civil Code.
4. NON-DISCRIMINATION
A. Eligibility for Services
CONTRACTOR shall prepare and make available to COUNTY and to the
public all eligibility requirements to participate in the program plan set
forth in the Agreement. No person shall, because of ethnic group
identification, age, gender, color, disability, medical condition, national
origin, race, ancestry, marital status, religion, religious creed, political
belief or sexual preference be excluded from participation, be denied
benefits of, or be subject to discrimination under any program or activity
receiving Federal or State of California assistance.
B. Employment Opportunity
CONTRACTOR shall comply with COUNTY policy, and the Equal
Employment Opportunity Commission guidelines, which forbids
discrimination against any person on the grounds of race, color, national
origin, sex, religion, age, disability status, or sexual preference in
employment practices. Such practices include retirement, recruitment
advertising, hiring, layoff, termination, upgrading, demotion, transfer,
Exhibit E
Page 2 of 2
rates of pay or other forms of compensation, use of facilities, and other
terms and conditions of employment.
C. Suspension of Compensation
If an allegation of discrimination occurs, COUNTY may withhold all
further funds, until CONTRACTOR can show clear and convincing
evidence to the satisfaction of COUNTY that funds provided under this
Agreement were not used in connection with the alleged discrimination.
D. Nepotism
Except by consent of COUNTY’s Department of Behavioral Health
Director, or designee, no person shall be employed by CONTRACTOR
who is related by blood or marriage to, or who is a member of the Board
of Directors or an officer of CONTRACTOR.
5. PATIENTS' RIGHTS
CONTRACTOR shall comply with applicable laws and regulations, including but
not limited to, laws, regulations, and State policies relating to patients' rights
Exhibit F
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 corporat ion 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 a pplicable
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 F
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:
Exhibit G
Page 1 of 2
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHE R
RESPONSIBILITY MATTERS --PRIMARY COVERED TRANSACTIONS
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective primary participant is
providing the certification set ou t below.
2. The inability of a person to provide the certification required below will not
necessarily result in denial of participation in this covered transaction. The prospective
participant shall submit an explanation of why it cannot provide the certific ation set out
below. The certification or explanation will be considered in connection with the
department or agency's determination whether to enter into this transaction. However,
failure of the prospective primary participant to furnish a certification or an explanation
shall disqualify such person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon which
reliance was placed when the department or agency determined to enter into this
transaction. If it is later determined that the prospective primary participant knowingly
rendered an erroneous certification, in addition to other remedies available to the
Federal Government, the department or agency may terminate this transaction for
cause or default.
4. The prospective primary participant shall provide immediate written notice to
the department or agency to which this proposal is submitted if at any time the
prospective primary participant learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended, ineligible, participant,
person, primary covered transaction, principal, proposal, and voluntarily excluded, as
used in this clause, have th e meanings set out in the Definitions and Coverage
sections of the rules implementing Executive Order 12549. You may contact the
department or agency to which this proposal is being submitted for assistance in
obtaining a copy of those regulations.
6. Nothing contained in the foregoing shall be construed to require establishment
of a system of records in order to render in good faith the certification required by this
clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business
dealings.
Exhibit G
Page 2 of 2
CERTIFICATION
(1) The prospective primary participant certifies to the best of its knowledge and belief,
that it, its owners, officers, corporate managers and partners:
(a) Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded by any Federal department or agency;
(b) Have not within a three-year period preceding this proposal been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal
offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State or local) transaction or contract under a public transaction; violation of
Federal or State antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, or receiving
stolen property;
(c) (d) Have not within a three-year period preceding this application/proposal
had one or more public transactions (Federal, State or local) terminated for cause or
default.
(2) Where the prospective primary participant is unable to certify to any of the
statements in this certification, such prospective participant shall attach an explanati on
to this proposal.
Signature: Date:
(Printed Name & Title) (Name of Agency or
Company)