Loading...
HomeMy WebLinkAboutAgreement A-19-200 with Locum Tenens Psychiatrist Services.pdf1 2 MASTER AGREEMENT THIS AGREEMENT is made and entered into this _ ...... Z-th.___ Agreement NO. 19-200 day of _--'-M'""a""'y ___ _ 3 2019, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, 4 hereinafter referred to as "COUNTY", and individually, each provider listed in Exhibit A, attached to 5 this Agreement and by this reference incorporated herein, collectively hereinafter referred to as 6 "CONTRACTORS" and such additional Contractors as may, from time to time during the term of this 7 Agreement, be added by COUNTY. 8 W IT N E S S E T H: 9 WHEREAS, COUNTY through its Department of Behavioral Health (DBH) has a need for 10 licensed psychiatrists in order to provide psychiatric services to patients/clients, as well as ooditional 11 services as stated herein, and 12 WHEREAS, CONTRACTORS are able and willing to source, screen, present, and coordinate 13 certain logistics for locum tenens psychiatrists needed by COUNTY. 14 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties 15 hereto agree as follows: 16 1. OBLIGATIONS OF THE CONTRACTORS 1 7 CONTRACTORS agree to provide the services described in this Agreement a5 well as 18 those services listed in Exhibit G , attached hereto and incorporated by reference herein. 19 20 21 22 23 24 25 26 27 28 A. Prior to arranging for locum tenens psychiatrist(s) to provide psychiatric services, CONTRACTORS shall, for all locum tenens psychiatrists presented by CONTRACTOR, use commercially reasonable efforts to present credentials, screen the candidates, complete background checks, obtain curriculum vitaes, and obtain reasonable evidence of licensure of locum tenens providers and provide such information to COUNTY. CONTRACTORS agree to use commercially reasonable efforts to present locum tenens psychiatrist(s) who, to the best of CONTRACTOR's knowledge, are licensed to practice in the State of California, specializing in Adult psychiatry, and who are not debarred, excluded or suspended by any local, State or Federal regulatory agency from practicing. COUNTY'S Director, Department of Behavioral Health or designee shall determine if such presented locum tenens psychiatrists are acceptable. -1 -COUNTY or PRESNO Prc~n•. Ci\ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B.When requested by COUNTY, CONTRACTORS shall present locum tenens psychiatrists who shall be required to perform medication review and new client assessments for inpatient and outpatient programs within the DBH during mutually agreed upon hours. In addition to services provided by locum tenens psychiatrists during the hours of 8:00am to 5:00pm Monday through Sunday (forty hours maximum), CONTRACTORS may also arrange for locum tenens psychiatrists to provide services on an overtime basis, to cover on-call duty and other extraordinary hours of service deemed necessary by COUNTY'S Director, Department of Behavioral Health or designee. COUNTY shall compensate CONTRACTORS for such services pursuant to Section 5 of this Agreement. C.COUNTY reserves the right to reject any psychiatrist referred by CONTRACTORS. If COUNTY'S Director, Department of Behavioral Health or designee, is not satisfied with any psychiatrist whose services are arranged by CONTRACTORS, COUNTY'S Director, Department of Behavioral Health or designee reserves the right to request the locum tenens psychiatrist(s)' removal within seven (7) days of the initial placement. CONTRACTORS agree that they will make their best effort to present COUNTY with a replacement locum tenens psychiatrist(s) within twenty (20) days of removal of the original locum tenens psychiatrist. Both COUNTY and CONTRACTORS will not remove psychiatrist(s) from assignments for illegal reasons, including but not limited to discrimination based on race or gender. COUNTY will reimburse CONTRACTORS for actual services provided by a locum tenens psychiatrist through the date of his/her removal pursuant to Section 5 of this Agreement. D.CONTRACTORS agree to provide and pay for the following: community. 1. 2. 3. Compensation for the psychiatrist(s) directly. Arrangement of transportation for the psychiatrist(s) within the Arrangement ofreasonable living accommodations for the psychiatrist(s) outside of the COUNTY work facility. 4. to the COUNTY of Fresno. Arrangement of one-time round-trip transportation for the psychiatrist(s) - 2 -COUNTY OF FRESNO Fresno, CA 1 2 E.CONTRACTORS approve COUNTY to retain income generated by services 3 provided by locum tenens psychiatrists pursuant to this Agreement. COUNTY will bill Medi-Cal, or 4 any other third-party source, for services provided by locum tenens psychiatrists to DBH clients. Such 5 revenues generated through patient services billing shall be retained by the COUNTY. 6 7 8 9 F.COUNTY does not guarantee any minimum number of psychiatrists that will be requested through CONTRACTORS in any twelve (12) month period. Requests for services will solely be based on COUNTY'S need. G.CONTRACTORS agree that the services of locum tenens psychiatrists to the 1 O COUNTY are on an as-needed basis. COUNTY shall notify CONTRACTORS via email when the 11 COUNTY desires to release a locum tenens psychiatrist due to services not being needed or for any 12 other reason. This notification shall be thirty (30) days in advance of the release date unless such 13 notification is waived by the CONTRACTORS. 14 15 2.OBLIGATIONS OF THE COUNTY A.COUNTY shall provide a reasonable office space, including a computer and 16 telephone to each psychiatrist to enable the locum tenens psychiatrists to provide psychiatric services. 17 18 19 B.COUNTY shall provide clerical staff to schedule appointments for the locum ten ens psychiatrist( s ). C.COUNTY is only obligated to make payment to CONTRACTORS when the 2 O locum tenens psychiatrist actually works at any designated DBH facility. DBH shall reimburse 21 CONTRACTORS for actual hours worked by the locum tenens psychiatrist at the agreed upon rate 22 listed by CONTRACTOR in Exhibit B. 23 D.In order to fill any psychiatrists vacancy based on urgency of COUNTY'S need, 2 4 psychiatrist availability, and other factors advantageous to the COUNTY (such factors including, but 2 5 no limited to, cost), COUNTY solely reserves the right to select a locum tenens psychiatrist from any 2 6 CONTRACTORS listed in Exhibit A, attached hereto. 27 28 E.COUNTY will bill Medi-Cal, or other third-party source, for services provided by locum tenens psychiatrists to DBH clients. - 3 -COUN1Y OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3.TERM This agreement shall become effective upon execution 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 COUNTY and CONTRACTORS no later than thirty (30) days prior to the first day of the next twelve (12) month extension period. The DBH Director or her or her designee is authorized to execute such written approval on behalf of COUNTY based on CONTRACTORS' satisfactory performance. 4.TERMINATION A.Non-Allocation of Funds -The terms of this Agreement, and the services to be provided thereunder, 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 CONTRACTORS thirty (30) days advance written noti ce. 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 COUNTY; 4)Improperly performed service by CONTRACTORS. 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 CONTRACTORS. 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 CONTRACTORS the repayment to the COUNTY of any funds disbursed to the CONTRACTORS under this Agreement, which in the judgment of the COUNTY were not expended in accordance with the terms of this Agreement. The CONTRACTORS shall promptly refund any such funds upon demand or, at the COUNTY's option, such repayment shall be deducted from future payments owing to CONTRACTORS under this Agreement. - 4 -COUN'lY OF FRESNO Fresno, CA 1 2 3 4 C.Without Cause -Under circumstances other than those set forth above, this Agreement may be terminated by CONTRACTORS or COUNTY upon the giving of thirty (30) days advance written notice of an intention to terminate. 5.COMPENSATION 5 COUNTY agrees to pay CONTRACTORS and CONTRACTORS agree to 6 receive compensation in accordance with the rates set forth within CONTRACTORS' respective Rate 7 Sheet, attached hereto as Exhibit B and incorporated herein by this reference. The daily all inclusive 8 rate shall be prorated on a Fifteen (15) minute basis in the event the locum tenens psychiatrist does not 9 provide the full eight hours of service each day to the Department. In addition, overtime, on-call duty, 1 O and mutually agreed upon extraordinary hourly rates indicated within each CONTRACTORS' 11 respective Rate Sheet shall also be prorated on a Fifteen (15) minute basis in the event the psychiatrist 12 does not provide full hours of service. COUNTY shall only pay for actual hours worked by referred 13 psychiatrists. COUNTY shall not pay CONTRACTORS when their locum tenens psychiatrist(s) takes 14 time off for vacation, sick leave, or in the event the locum tenens psychiatrist(s) works during any 15 unauthorized time. Further, in the event that the locum tenens psychiatrist(s) leaves incomplete 16 documentation , COUNTY may withhold signature on the locum tenens psychiatrist's time sheet until 1 7 such documentation is completed, provided that COUNTY has trained the locum tenens psyc hiatrist 18 on COUNTY's medical records system, COUNTY has provided locum tenens psychiatrist with ample 19 time during each shift to complete necessary documentation, and COUNTY provides CONTRACTOR 2 0 with at least two weeks' written notice of such incomplete documentation and COUNTY'S intent to 21 withhold signature, COUNTY shall inform CONTRACTOR a reasonable time prior to the end of the 22 locum tenens psychiatrist's assignment of any incomplete patient charts so that CONTRACTOR has 2 3 the opportunity to resolve the issue prior to the locum tenens psychiatrist's departure. 2 4 COUNTY agrees that the rates for individual locum tenens psychiatrist may be renegotiated 2 5 with the CONTRACTOR at any given time for each twelve (12) month term of the Agreement. These 2 6 rates shall be mutually agreed upon between the COUNTY and the CONTRACTORS in writing, and 2 7 such written agreement shall immediately become part of this Agreement, replacing Exhibit B for such 28 CONTRACTOR. The COUNTY or Director, Department of Behavioral health shall approve such - 5 -COUN1Y OF FRESNO Fresno, CA 1 changes to rates based on CONTRACTORS written request and justification. Any such renegotiated 2 rates shall not exceed the contract maximums expressed below. 3 For the period of January 1, 2018, through June 30, 2018, the maximum compensation 4 under the terms of this A greement for all CONTRACTORS total shall not exceed Two Million, Five 5 Hundred Thousand and No/100 Dollars ($2,500,000.00). 6 The maximum amount for the period of July 1, 2018 through June 30, 2019 shall not 7 exceed Seven Million and No/I 00 Dollars ($7,000,000.00). 8 The maximum amount for the period of July 1, 2019 through June 30, 2020 shall not 9 exceed Seven Million and No/100 Dollars ($7,000,000.00). 1 O The maximum amount for the period of July 1, 2020 through June 30, 2021 shall not 11 exceed Seven Million and No/I 00 Dollars ($7,000,000.00). 12 The maximum amount for the period of July 1, 2021 through June 30, 2022 shall not 13 exceed Seven Million and No/100 Dollars ($7,000,000.00). 14 The maximum amount for the period of July 1, 2022 through June 30, 2023 shall not 15 exceed Seven Million and No/100 Dollars ($7,000,000.00). 16 In no event shall the maximum contract amount for the services provided by the 17 CONTRACTOR to COUNTY under the terms and conditions of this Agreement be in excess ofThirty- 18 Seven Million, Five Hundred Thousand and No/100 Dollars ($37,500,000.00) during the total term of 19 the Agreement. 2 0 It is understood that all expenses incidental to CONTRACTORS' performance of 21 services under this Agreement shall be borne by CONTRACTOR. Payments by COUNTY shall be in 2 2 arrears, for services provided during the preceding month, within forty-five ( 45) days after receipt and 2 3 verification of CONTRACTORS invoices by COUNTY. If CONTRACTORS should fail to comply 2 4 with any provision of this Agreement, COUNTY shall be relieved of its obligation for further 2 5 compensation. 2 6 COUNTY agrees to pay and CONTRACTOR agrees to accept the compensation for a 2 7 successful Psychiatrist placement at rates specified within each CONTRACTOR(S) rate sheet, Exhibit 2 8 B.COUNTY agrees to pay CONTRACTOR for a Psychiatrist who is referred by CONTRACTOR - 6 -COUN'IY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 and is hired and placed as a permanent staff psychiatrist by the COUNTY. 6.INVOICING For all services provided under this Agreement, CONTRACTORS shall invoice COUNTY on a monthly basis, for the prior month's expenses, addressed to: Fresno County Department of Behavioral Health, Accounts Payable, P.O. Box 45003, Fresno, CA 93718, Attention: Business Office or CONTRACTORS may submit invoicing electronically tocD:::::B =H=-=--------_./ Invoices@co.fresno.ca.us. Invoice shall include dates and hours services were provided and shall be accompanied by a signed timecard from the psychiatrist showing dates and hours worked and is verified and signed off by the DBH's Medical Director. 7.INDEPENDENT CONTRACTOR 11 In performance of the work, duties, and obligations assumed by CONTRACTORS under 12 this Agreement, it is mutually understood and agreed that CONTRACTORS including any and all of 13 CONTRACTORS' officers, agents, and employees will at all times be acting and performing as 14 independent contractors, and shall act in an independent capacity and not as an officer, agent, servant, 15 employee, joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have 16 no right to control or supervise or direct the manner or method by which CONTRACTORS shall 1 7 perform their work and function. However, COUNTY shall retain the right to administer this 18 Agreement so as to verify that CONTRACTORS are performing their obligations in accordance with 19 the terms and conditions thereof. CONTRACTORS and COUNTY shall comply with all applicable 2 O provisions of law and the rules and regulations, if any, of governmental authorities having jurisdiction 21 over matters which are directly or indirectly the subject of this Agreement. 22 Because of their status as independent contractors, CONTRACTORS shall have 2 3 absolutely no right to employment rights and benefits available to COUNTY employees. 2 4 CONTRACTORS shall be solely liable and responsible for providing to, or on behalf of, their 2 5 employees all legally-required employee benefits. In addition, CONTRACTORS shall be solely 2 6 responsible and save COUNTY harmless from all matters relating to payment of CONTRACTORS 2 7 employees, including compliance with Social Security, withholding, and all other regulations 28 governing such matters. It is acknowledged that during the term of this Agreement, CONTRACTORS - 7 -COUNTY OF FRESNO Fresno, CA Fi 1 2 3 4 5 may be providing services to others unrelated to the COUNTY or to this Agreement. 8.MODIFICATION A.Any matters of this Agreement may be modified from time to time by the written consent of COUNTY and CONTRACTORS without, in any way, affecting the remainder. B.Notwithstanding the above, changes to the providers listed in Exhibit A may be 6 made in accordance with Paragraph Sixteen (16) of this Agreement. 7 C.In addition, changes to the rates identified in each CONTRACTOR'S res pective 8 Exhibit B ("Rates") may be made in accordance with Paragraph Five (5) ofthis Agreement. The rate 9 changes shall not result in any changes to the maximum compensation amount payable to 1 O CONTRACTORS. 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 9.NON-ASSIGNMENT No 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. 10. HOLD-HARMLESS CONTRACTORS agree to indemnify, save, hold harmless, and at COUNTY's request, defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including attorney's fees and court costs, damages, liabilities, claims and losses occurring or resulting to COUNTY arising from the performance, or failure to perform, of CONTRACTORS, their 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 performance, or failure to perform, of CONTRACTORS, their officers, agents or employees under this Agreement. In addition, CONTRACTORS agree to indemnify COUNTY for Federal, State of California and/or local audit exceptions resulting from CONTRACTORS' OWN noncompliance herein. 11.INSURANCE Without limiting the COUNTY's right to obtain indemnification from CONTRACTORS or any third parties, each CONTRACTOR, at its sole expense, shall maintain in full force and effect the following insurance policies throughout the term of this Agreement: - 8 -COUNlY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 A. B. C. D. E. Commercial General Liability Commercial General Liability Insurance with limits of not less than Two Million Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000). 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 the Agreement. Automobile Liability Comprehensive Automobile Liability Insurance with limits for bodily injury of 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 not less than Fifty Thousand Dollars ($50,000), or such coverage with a combined single limit of One Million Dollars ($1,000,000). Coverage should include owned and non-owned vehicles used in connection with this Agreement. Professional Liability If CONTRACTORS employ or engage licensed professional staff (e.g. MD, Ph.D., R.N., L.C.S.W., M.F.T.) in provide temporary medical services for County, 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. CONTRACTORS shall maintain in full force and effect the policy of Professional Liability for a period of not less than three (3) years from the termination date of this Agreement. Worker's Compensation A policy of Worker's Compensation Insurance as may be required by the California Labor Code. Molestation Sexual abuse / molestation liability insurance with lim its of not less than One Million Dollars ($1,000,000.00) per occurrence, Two Million Dollars ($2,000,000.00) annual aggregate. This policy shall be issued on a per occurrence basis. CONTRACTORS 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 - 9 -COUNTY OF FRESNO Fresno, CA 1 2 3 4 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. 12.CONFIDENTIALITY 5 All services performed by CONTRACTORS under this Agreement shall be in strict 6 conformance with all applicable Federal, State of California and/or local laws and regulations relating 7 to confidentiality. 8 9 13.HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT A.The parties to this Agreement shall be in strict conformance with all applicable 1 O Federal and State of California laws and regulations, which may include but shall not be limited to 11 Sections 5328, 10850, and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and 12 431.300 et seq. of Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the Califo rnia 13 Civil Code, and the Health Insurance Portability and Accountability Act (HIP AA), including but not 14 limited to Section 1320 D et seq. of Title 42, United States Code (USC) and its implementing 15 regulations, including, but not limited to Title 45, CFR, Sections 142, 160, 162, and 164, The Health 16 Information Technology for Economic and Clinical Health Act (HITECH) regarding the 1 7 confidentiality and security of patient information, and the Genetic Information Nondiscrimination 18 Act (GINA) of2008 regarding the confidentiality of genetic information. 19 Except as otherwise provided in this Agreement, CONTRACTOR, if determined 2 0 by the parties to be a Business Associate of COUNTY, may use or disclose Protected Health 21 Information (PHI) to perform functions, activities or services for or on behalf of COUNTY, as 2 2 specified in this Agreement, provided that such use or disclosure shall not violate the Health Insurance 23 Portability and Accountability Act (HIP AA), USC 1320d et seq. The uses and disclosures of PHI may 2 4 not be more expansive than those applicable to COUNTY, as the "Covered Entity" under the HIP AA 2 5 Privacy Rule ( 45 CFR 164.500 et seq.), except as authorized for management, administrative or legal 2 6 responsibilities of the Business Associate. 27 28 B.CONTRACTOR, including its subcontractors and employees, shall prot ect, from unauthorized access, use, or disclosure of names and other identifying information, including genetic -11 -COUN1Y OF FRESNO Fresno, CJ\ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 per sons 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 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 CONTRACTOR's possession in a designated record set (as defined in 45 CFR Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45 CFR Section 164.524 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 provides individual with the reasons for the delay and the date when access may be granted. PHI shall be provided in the form and format - 12 -COUN'lY OP FRESNO Frcsno,CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 requested by the individual or COUNTY. CONTRACTOR shall make any amendment(s) to PHI in a designated record set in CONTRACTOR's possession 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 DPH HIP AA 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 DPH HIPAA Representative. This written investigation and description of any reporting necessary shall be postmarked within the thirty (30) working days of the discovery of the breach to the addresses below: County of Fresno Dept. of Public Health HIP AA Representative (559)600-6439 P.O. Box 11867 Fresno, CA 93775 County of Fresno Dept. of Public Health Privacy Officer (559)600-6405 P.O. Box 11867 Fresno, CA 93775 - 13 - County of Fresno Information Technology Services Information Security Officer (559)600-5800 2048 N. Fine Street Fresno, CA 93727 COUN'IY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 H.CONTRACTOR shall make its internal practices, books, and records re lating 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 15 CONTRACTOR shall implement administrative, physical, and technical 16 safeguards as required by the HIP AA Security Rule, Subpart C of 45 CFR 164, that reasonably and 1 7 appropriately protect the confidentiality, integrity, and availability of PHI, including electronic PHI, 18 that it creates, receives, maintains or transmits on behalf of COUNTY and to prevent unauthorized 19 access, viewing, use, disclosure, or breach of PHI other than as provided for by this Agreement. 20 CONTRACTOR shall conduct an accurate and thorough assessment of the potential risks and 21 vulnerabilities to the confidential, integrity and availability of electronic PHI. CONTRACTOR shall 2 2 develop and maintain a written information privacy and security program that includes administrative, 2 3 technical and physical safeguards appropriate to the size and complexity of CONTRACTOR's 2 4 operations and the nature and scope of its activities. Upon COUNTY' s request, CONTRACTOR shall 2 5 provide COUNTY with information concerning such safeguards. 2 6 CONTRACTOR shall implement strong access controls and other security 2 7 safeguards and precautions in order to restrict logical and physical access to confidential, per sonal 28 (e.g., PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include - 14 -COUN'IY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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; 2. b. C. A dictionary word; or Stored in clear text Passwords must be: a. b. C. d. Eight (8) characters or more in length; Changed every ninety (90) days; Changed immediately if revealed or compromised; and Composed of characters from at least three (3) of the following four ( 4) groups from the standard keyboard: 1) 2) 3) 4) Upper case letters (A-Z); Lowercase letters (a-z); Arabic numerals (0 through 9); and 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: Network-based firewall and/or personal firewall; Continuously updated anti-virus software; and 1. 2. 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 PHI 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). - 15 -COUN'IY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 CONTRACTOR shall not transmit PHI 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 8 CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that 9 is suspected or known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or 10 breach of PHI by CONTRACTOR or its subcontractors in violation of the requirements of the se 11 prov1s10ns. CONTRACTOR must document suspected or known harmful effects and the outcome. 12 K.CONTRACTOR's Subcontractors 13 CONTRACTOR shall require that any of its contractors, including 14 subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created or 15 received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions, safeguards, and 16 conditions that apply to CONTRACTOR with respect to such PHI and to incorporate, when 1 7 applicable, the relevant provisions of these provisions into each subcontract or sub-award to such 18 agents or subcontractors .. 19 20 21 22 23 24 25 26 27 28 L.Employee Training and Discipline CONTRACTOR shall train and use reasonable measures to ensure compliance 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 - 16 -COUNTY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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's 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 HIP AA 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. 0. 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 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, HIP AA or the HIP AA regulations will be adequate or satisfactory for CONTRACTOR's own purposes or that any information in - 17 -COUN'IY OF FRESNO Fresno, CA 1 2 3 4 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 5 The parties acknowledge that Federal and State laws relating to electronic data 6 security and privacy are rapidly evolving and that amendment of these provisions may be required to 7 provide for procedures to ensure compliance with such developments. The parties specifically agree 8 to take such action as is necessary to amend this agreement in order to implement the standards and 9 requirements of HIP AA, the HIP AA regulations, the HITECH Act and other applicable laws relating 10 to the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days 11 written notice in the event that CONTRACTOR does not enter into an amendment providing 12 assurances regarding the safeguarding of PHI that COUNTY in its sole discretion, deems sufficient to 13 satisfy the standards and requirements of HIP AA, the HIP AA regulations and the HITECH Act. 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 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 HIP AA, the HIP AA regulations and applicable State laws. 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 HIP AA and the HIP AA regulations. T.Regulatory References A reference in the terms and conditions of these provisions to a section in the HIP AA regulations means the section as in effect or as amended. U.Survival The respective rights and obligations of CONTRACTOR as stated in this Section - 18 -COUN'IY OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 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. 14.NON-DISCRIMINATION During the performance of this Agreement CONTRACTORS shall not unlawfully discriminate against any employee or applicant for employment, or recipient of services, bec ause 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. 15.SEPARATE AGREEMENT It is mutually understood by the parties that this Agreement does not, in any way, create a joint venture among the individual CONTRACTORS. By execution of the Agreement, the CONTRACTORS understand that a separate Agreement is formed between each individual CONTRACTOR and COUNTY. 16.ADDITIONS/DELETIONS OF CONTRACTORS COUNTY's DBH Director, or designee, reserves the right at any time during the term of this Agreement to add new CONTRACTORS to those contained in Exhibit A. It is understood any such additions will not affect compensation paid to the other CONTRACTORS, and therefore such additions may be made by COUNTY without notice to or approval of other CONTRACTORS under this Agreement. 17.PROHIBITION ON PUBLICITY 2 4 None of the funds, materials, property or services provided directly or indirectly under 25 this agreement shall be used for CONTRACTORS' advertising, fundraising, or publicity (i.e. 2 6 purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. 2 7 Notwithstanding the above, publicity of the services about the availability of such specific se rvices 28 when approved in advance by COUNTY's DBH Director or designee and at a cost to be provided in a -19 -COUN'IY OF FRESNO Fresno, CA 1 revised Exhibit B for such items as written/printed materials, the use of media (i.e. radio, television, 2 newspapers) and any other related expenses(s). 3 18.COMPLIANCE 4 CONTRACTORS agree to comply with the COUNTY's Contractor Code of Conduct 5 and Ethics and the COUNTY's Compliance Program in accordance with Exhibit C, attached hereto 6 and incorporated herein by reference, to extent applicable to CONTRACTORS' services. Within thirty 7 (30)days of starting work at the Department of Behavioral Health, locum tenens psychiatrists 8 providing services shall be required to certify in writing, that he or she has received, read, understood, 9 and shall abide by the Contractor Code of Conduct and Ethics by completing "Contractor 1 O Acknowledgement and Agreement", identified in Exhibit D, attached hereto and by this reference 11 incorporated herein. CONTRACTORS understand that the promotion of and adherence to the Code of 12 Conduct is an element in evaluating the performance of CONTRACTORS and its employees, agents 13 and subcontractors. 14 Within thirty (30) days of entering into this Agreement, and annually thereafter, all locum 15 tenens psychiatrists providing services under this Agreement shall be required to complete general 16 compliance training as supplied by COUNTY and appropriate employees, agents and subcontr actors, 17 if applicable to CONTRACTOR's services, and locum tenens psychiatrists shall be required to 18 complete documentation and billing or billing/reimbursement training. As applicable, new agents and 19 subcontractors, or locum tenens psychiatrists, shall be required to attend the appropriate training 2 O within 30 days of starting work at the Department of Behavioral Health. Each individual who is 21 required to attend training shall be required to certify in writing that he or she has received the 2 2 required training. The certification shall specify the type of training received and the date received. 2 3 The certification shall be provided to the COUNTY' s Compliance Officer at 314 7 N. Millbrook, 2 4 Fresno, CA 93703. CONTRACTORS agree to reimburse COUNTY for the entire cost of any penalty 25 imposed upon COUNTY by the Federal Government as a result of CONTRACTORS' violation of the 2 6 terms of this Agreement. 19.ASSURANCES27 28 In entering into this Agreement, CONTRACTORS certify that CONTRACTORS are - 20 -COUNTY OF FRESNO Fresno, CJ\ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 not currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federa l Health Care Programs: that it has not been convicted of a criminal offense related to the provis ion 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 CONTRACTORS' or locum tenens psychiatrist whose services are coordinated through CONTRACTOR is ineligible on these grounds, COUNTY will remove CONTRACTORS from responsibility for, or involvement with, COUNTY's business operations related to the Federal Health Care Programs and shall remove such a locum tenens psychiatrist referred by the CONTRACTORS from any position in which CONTRACTORS' salary, or the items or services rendered, ordered or prescribed by CONTRACTORS, if applicable, or such locum tenens psychiatrist may be paid in whole or part, directly or indirectly, by Federal Heal th Care Programs or otherwise with Federal Funds at least until such time as CONTRACTORS or the locum tenens psychiatrist is are reinstated into participation in the Federal Health Care Programs. A.If COUNTY has notice that a locum tenens psychiatrist whose services are 15 coordinated through CONTRACTOR has been charged with a criminal offense related to any Federal 16 Health Care Program, or is proposed for exclusion during their provision of services to COUNTY, 1 7 COUNTY may request that CONTRACTORS cease providing services until resolution of the charges 18 or the proposed exclusion. 19 B.CONTRACTORS agree that all potential new employees or subcontractors of 2 0 the CONTRACTORS who, in each case, are expected to perform professional services under this 21 Agreement, or any locum tenens psychiatrist presented to COUNTY, will be queried as to whether ( 1) 2 2 they are now or ever have been excluded, suspended, debarred, or otherwise ineligible to participate in 2 3 the Federal Health Care Programs; (2) they have been convicted of a criminal offense related to the 2 4 provision of health care items or services; and or (3) they have been reinstated to participation in the 2 5 Federal Health Care Programs after a period of exclusion, suspension, debarment, or ineligibility. 26 27 28 1.In the event the potential locum tenens psychiatrist, employee or subcontractor informs CONTRACTORS 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, - 21 -COUN'IY OF FirnSNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 and CONTRACTORS hires or engages such potential locum tenens psychiatrist, employee or subcontractor, CONTRACTORS will require that said locum tenens psychiatrist, 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 reasonable adequate assurance that no excluded, suspended or otherwise ineligible locum tenens psychiatrist, employee or subcontractor of CONTRACTORS will perform work, either directly or indirectly, relating to services provided to COUNTY. Such demand for adequate assurance shall be effective upon a reasonable time frame to be determined by COUNTY to protect the interests of COUNTY consumers. C.CONTRACTORS shall verify to the best of its ability (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) 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 CONTRACTORS 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, CONTRACTORS will not permit said employee or subcontractor to perform work, either direct or indirect, relating to services provided to COUNTY. D.CONTRACTORS agree to reasonable cooperate with any reasonable requests for information from COUNTY which may be necessary to complete any internal or external audits relating to CONTRACTORS' compliance with the provisions of this Section. E.CONTRACTORS agree to reimburse COUNTY for the entire cost of any penalty imposed upon COUNTY by the Federal Government solely as a result of CONTRACTORS' violation of CONTRACTORS' obligations as described in this Section. -22 -COUN1Y OF FRESNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 20.CONFLICT OF INTEREST No officer, agent, or employee of the COUNTY who exercises any function or responsibility for planning and carrying out the services provided under this Agreement shall have any direct or indirect personal financial interest in this Agreement. The CONTRACTORS shall comply with all applicable Federal, State of California, and local conflict of interest laws, statutes, and regulations, which shall be applicable to all parties and beneficiaries under this Agreement and any officer, agent, or employee of the COUNTY. 21.REFERENCE TO LAWS AND RULES CONTRACTORS shall maintain in full force and effect and comply with any and all applicable licensing, local zoning, and State of California fire and safety ordinances and regulations. 22.COMPLIANCE WITH STATE REQUIREMENTS CONTRACTORS recognize that COUNTY operates its Department of Adult Services under an agreement with the State of California Department of Mental Health, and that under said agreement the State imposes certain requirements on the COUNTY and its subcontractors. CONTRACTORS shall adhere to all State of California requirements as applicable to CONTRACTOR's services, which may include, those identified in Exhibit E, attached hereto and by this reference incorporated herein. 23.DISCLOSURE OF SELF-DEALING TRANSACTIONS This provision is only applicable if the CONTRACTORS are operating as a cor poration (a for-profit or non-profit corporation) or if during the term of this agreement, the CONTRACTORS changes its status to operate as a corporation. Members of the CONTRACTORS' Board of Directors shall disclose any sel f-dealing transactions that they are a party to while CONTRACTORS are providing goods or performing services under this agreement. A self-dealing transaction shall mean a transaction to which the CONTRACTORS are 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 as identified in Exhibit F, attached hereto and by -23 -COUN1Y OF FimSNO Fresno, CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 this reference incorporated herein, and submitting it to the COUNTY prior to commencing with the self­ dealing transaction or immediately thereafter. 24.AUDITS AND INSPECTIONS The CONTRACTORS 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 their records and data directly related to the matters covered by this Agreement. The CONTRACTORS shall, upon request by the COUNTY, permit the COUNTY to audit and inspect all such records and data necessary to ensure CONTRACTORS' compliance with the terms of this Agreement. If this Agreement exceeds Ten Thousand and Noll 00 Dollars ($10,000.00), CONTRACTORS shall be subject to the examination and audit of the State Auditor General for a period of three (3) years after final payment under contract (California Government Code se ction 8546.7). 25.SINGLE AUDIT CLAUSE A.If CONTRACTOR expends Seven Hundred Fifty Thousand Dollars ($750,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR agrees to conduct an annual audit in accordance with the requirements of the Single Audit Standards as set forth in Office of Management and Budget (0MB) Circular A-133. CONTRACTOR shall submit said audit and management letter to COUNTY. The audit must include a statement of findings or a statement that there were no findings. If there were negative findings, CONTRACTOR must include a corrective action plan signed by an authorized individual. CONTRACTOR agrees to take action to correct any material non-compliance or weakness found as a result of such audit. Such audit shall be delivered to COUNTY's DBH Business Office, for review within nine (9) months of the end of any fiscal year in which funds were expended and/or received for the program. Failure to perform the requisite audit functions as required by this Agreement may result in COUNTY performing the necessary audit tasks, or at COUNTY's option, contracting with a public accountant to perform said audit, or, may result in the inability of COUNTY to enter into future agreements with CONTRACTOR. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR. - 24 -COUN'lY OF FRESNO Fresno, CJ\ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 B.A single audit report is not applicable if CONTRACTOR's Federal contracts do not exceed the Seven Hundred Fifty Thousand Dollars ($750,000.00) requirement or CONTRACTOR's only funding is through Drug related Medi-Cal. If a single audit is not applicable, a program audit must be performed and a program audit report with management letter shall be submitted by CONTRACTOR to COUNTY as a minimum requirement to attest to CONTRACTOR's solvency. Said audit report shall be delivered to COUNTY's DBH Business Office, for review no later than nine (9) months after the close of the fiscal year in which the funds supplied through this Agreement are expended. Failure to comply with this Act may result in COUNTY performing the necessary audit tasks or contracting with a qualified accountant to perform said audit. All audit costs related to this Agreement are the sole responsibility of CONTRACTOR who agrees to take corrective action to eliminate any material noncompliance or weakness found as a result of such audit. Audit work performed by COUNTY under this paragraph shall be billed to the CONTRACTOR at COUNTY cost, as determined by COUNTY' s Auditor-Controller/Treasurer-Tax Collector. C.CONTRACTOR shall make available all records and accounts for inspection by 15 COUNTY, the State of California, if applicable, the Comptroller General of the United States, the 16 Federal Grantor Agency, or any of their duly authorized representatives, at all reasonable times for a 1 7 period of at least three (3) years following final payment under this Agreement or the closure of all 18 other pending matters, whichever is later. 19 20 21 22 23 24 25 26 27 28 26.NOTICES The persons and their addresses having authority to give and receive notices under this Agreement include the following: COUNTY Director, Fresno County Department of Behavioral Health 4441 E. Kings Canyon Road Fresno, CA 93702 CONTRACTORS SEE EXHIBIT A Any and all notices between the COUNTY and the CONTRACTORS provided for or - 25 -COUN'IY OF FRESNO Fresno, C,\ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 permitted under this Agreement or by law shall be in writing and shall be deemed duly served when personally delivered to one of the parties, or in lieu of such personal service, when deposited in the United States Mail, postage prepaid, addressed to such party. 27.GOVERNING LAW Venue for any action arising out of or related to this Agreement shall only 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.SEVERABILITY If any non-material term, provision, covenant, or condition of this Agreement is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions shall remain in full force and effect, and shall no way be affected, impaired or invalidated. 29.SUPERSEDE This Agreement shall supersede in its entirety and render null and void the Agreement between the parties for these same services identified as County Agreement No. 18-112, effective upon execution. 30.ENTIRE AGREEMENT This Agreement, including all Exhibits constitutes the entire agreement between the CONTRACTORS 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. Ill Ill Ill Ill Ill Ill Ill - 26 -COUN'lY OF FRESNO Fresno, CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as o f the day and year 2 first hereinabove written. 3 4 5 6 7 8 9 1 0 1 1 12 13 14 15 16 17 18 19 2 0 2 1 2 2 2 3 24 25 26 27 2 8 A TTEST: CONTRACTORS: PLEASE SEE SIGNATURE PAGES ATTACHED Fund/Subclass: 000 l /10000 Organization: 56302999 56302175 56302246 Account/Program: 7295/0 COUNTY OF FRESNO By :::?; 2 +:=> Nathan Magsig, Chairman of the Board of Supervisors of the County of Fresno ATTEST: BERNICE E. SEIDEL Clerk of the Board of Supervisors County of Fresno, State of California - 2 7 -COUNTY OF f-RES N O F rC$n O, C,\ 1 Jackson & Coker Locum Tenens, Inc. : By:_w_�_____;;.-.rta-�--A--- 5 6 7 8 Print Name: Dana Massey Title: Division Vice President Chairman of Board, or President or any Vice President 9 Date: 04/16/2019 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Title: ':Jtvr � Secretary (ofCorppration), or any Assistant Secretary, or Chief Financial Officer or any Assistant Treasurer Date: __ 4...:...11_'3 ..__/ '};()_1_'1 _____ _ Mailing Address: 3000 Old Alabama Road Suite 119-608 Alpharetta, GA 30022 Phone No.: 800-272-2707 - 1 -COUNTY OF FRESNO Fresno, CA LOCUM TENENS PROVIDER LIST Jackson & Coker Locum Tenens, Inc. 3000 Old Alabama Road, Suite 119-608 Alpharetta, GA 30022 Michael Baker (866)999-8396 mbaker@jackson&coker.com Exhibit A Fresno Countv Mental Health compliance Program f}ONTRACTOR CODE OF CONDUCT AND ETHICS GxhibltC Pagc1 of I Fresno County Is firmly committed to full compliance wilh all appllcable laws, regulations, rules and guldellnes that apply to !he provision and payment of menta l health services. Mental heallh contractors end lhe manner In which they conducl themselves are a vital part of this commitment. Fresno County has established this Conlraclor Code of Conduct and Ethics wilh which contractor and ils employees and subcontractors shall comply. Contractor shall require Its employees and subcontractors to attend a compnance \raining lhal 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 rorm and return lhls form to the Compliance Officer or deslgnee, Contractor and Its emp1oyees and subcontractors shall: 1.Comply with au applicable laws, regulaUons, rules or guidelines when providing and billing formental health services. 2.Conduct themselves honestly, falrly, courteously and with a high degree of Integrity In theirprofessional dealings related to their contract with the County and avoid any conduct thatcould reasonably be expected to reflect adversely upon the Integrity of the County. 3.Treat County employees, oonsumers and other mental health contractors fairly and withrespecl. 4.NOT engage In any activity In violation of the County's Compliance Program, nor engage Inany other conduct which violates any appllcable law, regulation, rule or guideline. 5, Take precaullons to ensure that claims are prepared and submitted accurately, timely and are consistent with all appllcable laws, regulaUons, rule. or guidelines. 6.Ensure that no false, fraudulent, Inaccurate or nctltlous clalms for payment or reimbursementof any kind are submilled. 7.BUI only for eligible services actually rendered and fully documented. Use bllllng codes lhataccurately describe the services provided.· 8.Act promptly lo Investigate and correct problems If errors In claims or billings are discovered. 9.Promptly report to the Compliance Officer any suspected vlolatlon(s) of this Code or Conduct and Ethics by County employees or other mental health contractors, or report any aclivily that they believe may violate the standards of the Compliance Program, or any other applicablelaw, regulation, rule or guideline. Fresno County prohiblls retaliation against any person making a report. Any person engagin g in any form of retallatlon will be subject to dlsciplinaryor other appropriate action by the County, Contractor may report anonymously. 10.Consult with the Compliance Officer Ir you have any· questions or are uncertain ol any Compliance Program standard or any other appllcable law, regulation, rule or guideline. 11.Immediately notify the Compliance Officer If they become or may become an Ineligible Person and therefore excluded from partlclpaUon In the Federal health care programs. Rev Elfei;: 7n4/05 0388 cdbh Fresno countv Mental Health Program Contractor Acknow(edgment and Agreement Name { J LMFT $1 gnat u re: New Contr Adi ReYt ◄127/09 0388 d dbh ST ATE MENTAL HEAL TH REQUIREMENTS Exhibit E Exhibit 1 of 2 I, CONTROL REQUIREMENTS The COUNTY and its subcontractors shall provide serl'ices in accordance wirh all applicable Federal nnd Stale st111u1cs alld rcaufadons. 2. PROFESSIONAL LICENSURE All (professional level) persons employed by !he COUNTY Mcnlol Henlth Progrnm (directly or llirough contracr) providing Short-Doyle/Medi-Cal services have met 11pplicable professional liccn,ure requirements pursuanl to Business und Professions and Welfare and lnstl!Ulions Codes. J. CONFIDENTIALITY 4. CONTRACTOR shall conform to nnd COt/NTY shall mouitoreompliance wilb llll State of California and Federal slatu1es and regulations rea.irding confidentiality, including but not limited to confldentiality of infonnatlon tcquircmcnts at 42, Code of Federal Regulations sections 2.1 u1 seq; California Welfare 11nd Institutions Code, sections 14100.2, 11977, 11812, 5328; Division I 0.5 llJld I 0.6 of the California Health and Safety Code; Title 22, California Code of Regulations, section 51009; and Oivislon I, Part2.6, Chap1ors 1-7 oflhe California Civil Code. NON-DJSCRlMlNATlQN A. Eligiblljty for ServicM CON'fRACTOR sball prepare and make available to COUNTY and to 1hc public all eligibility requiremenls to participate In the program pion set forth in the Agreement. No person shall, because of C(hnio group identifico.llon, age, gender, color, disobillty, medico I condition, national origin, race, ancestry, marllal status, religion, religious creed, polltlcal belief or sexual prcfctence be excluded from partlcip111ion, be denied benefits of, or be subject to discrimination under aJIY program or activity receiving Fcdenil ot State of California assiSlance. B. Etnoloyment Opportunity CONTRACTOR shall comply with COUNTY policy, and 1he Equal Employment Opportunity Commission guidelines, which forbids diseriminotion against any person on the grounds ofracc, color, natlonol origin, sc.>c, celigion. age, dlsablllty status, or sexual preference in employment practices. Such practices include retirement, recruitment advertising, hiring, layoff, lcnninotion, upgrad ing, demotion, transfer, 037• fdbh Exhibit E Page 2 of 2 rates of pay or other forms of compensation, use of facilities, and other terms end condlllons of employment. C. S11sgeo~jgn orcomocoso~oo If an allegation of discrimination occurs, COUNTY may withhold all further runds, unlll CONTRACTOR. can show clear and convincing evidence 10 the satisfaction of COUNTY that funds provided under this Agreement were nol used in connection wilh the alleged discrimination. D. Nepgtism Except by consent of COUNTY 's Depailnlent of Bcbavlorel Health Director, or designec, no person sh111i be employed by CONTRACTOR. who is 1-tlotcd hy blood or mMfage 10, onYho is a member of the Boord or Directors or an officer or CONTRACTOR. 5,; PATIENTS' RIGHTS CONTRACTOR i.holl comply with oppliCllble laws and regulations, including but not limited to, laws, rcgulutions, and State policies rela\lng to patients' rights 0J74 rdbh SELF-OEAUNGTRANSACTTON DISCLOSURE FORM ExhibltF Page 1 of2 In order to conduct business with the County of Fresno (hereinafter referred to as "County"), members or a contractor's board of directors (hereinafter referred to as "County Contractor"), must dlsc:lose any self-dealing transactions that they are a party to while providing goods, performing services, or both for the County. A self•deallng transaction Is dellned below: "A self-dealing cronsocc/on means a transaction co which the corporoclon is o patcy ond In which one or more of its directors hos a material financial Interest" The definition above will be utlli?ed for purposes of completing this disclosure form. INSifiUCTIQNS {l) 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. Al 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)Oescrlbe In detail why the self•deallng 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 (31 and (4). 0374 k dbh (l) Company &o-.rd Member Information: Name: I I Date:I Job TIUe1 I I I (2) Company/Age ncy Name and Address: (3) Dllclosure !Please de scribe the nature of the selr•de;,llng transai;tlon you are a party to) ExhlbltF Page2of2 (4) Explain why this self-dealing transaction Is consistent with the requirements of Corporations Code sm (al (Sl Authorlted Signature • Sfanalure:I I Date: I 0374 k dbh I. SERVICES EXHIBITG Page 1 of 2 A.Upon request of COUNTY's Director, Department of Behavioral Health, or designee, CONTRACTOR shall identify, recruit and present Psychiatrist candidates who to CONTRACTOR's reasonable knowledge satisfy the criteria as established by the COUNTY's Director, Department of Behavioral Health, or designee. COUNTY's Department of Behavioral Health shall arrange interviews with candidates and advance timely offers when appropriate. Prior to arranging for candidates, CONTRACTOR shall use commercially reasonable efforts to present credentials, screen the candidates complete background checks, facilitate interviews, provide curriculum vitaes and reference checks, as well as obtain reasonable evidence of licensure of candidates and NPI registration. CONTRACTOR agrees to use commercial reasonable efforts to present psychiatrist(s) who to the best of CONTRACTOR's knowledge, may be acceptable to COUNTY'S Director, Department of Behavioral Health, or designee. B.COUNTY and CONTRACTOR acknowledge that this is not an exclusive agreement to provide placement services. If CONTRACTOR identifies a candidate about whom COUNTY has already received information from another placement source, COUNTY'S Director, Department of Behavioral Health or designee shall notify CONTRACTOR, in writing, within ten (10) business da ys after receiving the referral from CONTR ACTOR. CONTRACTOR is not obligated to recruit those candidates with whom COUNTY has already made contact from another placement service or recruitment source. If COUNTY does not notify CONTRACTOR as required under this section and COUNTY enters into an employment, independent CONTRACTOR, or other working relationship with any such candidate, COUNTY shall be obligated to pay CONTRACTOR's then accrued fees and expenses related to finding said candidate. COUNTY agrees not to refer any candidates presented by CONTRACTOR to another hiring entity or placement service. II.PLACEMENT FEE A placement fee shall be paid by COUNTY to CONTRACTOR once a working agreement has been reached between the COUNTY and a candidate presented by CONTRACTOR. It is understood between the parties hereto, that said placement fee shall be as stated in this Agreement and applicable Attachments. The placement fee listed in the Agreement is inclusive of all travel, lodging, meals and any other re lated costs. All said related costs shall require the prior approval of the COUNTY Direc tor, Department of Behavioral Health, or designee. It is understood between the parties hereto that COUNTY shall only pay this placement fee if a candidate is hired by COUNTY. Ill. REPLACEMENT GUARANTEE If a psychiatrist hired through CONTRACTOR, during the term of this Agreement, fails to commence services as agreed between said psychiatrist and COUNTY"s Director, Department of Behavioral Health or designee or leaves within Ninety (90) days of the date psychiatrist commences services, then CONTRACTOR shall use EXHIBIT G Page 2 of 2 best efforts to recruit a replacement candidate for the initial psychiatrist at no additional charge,