HomeMy WebLinkAbout32114Agreement No. 15-245
1 AGREEMENT
2 THIS AGREEMENT is made and entered into this 1.611J day of June, 2015, by and between the
3 COUNTY OF FRESNO, a Political Subdivision ofthe State of California, hereinafter referred to as
4 "COUNTY", and each provider listed in Exhibit A, attached hereto by this reference incorporated herein,
5 collectively hereinafter referred to as "CON1RACTOR(S)", and such additional CONTRACTOR(S) as
6 may, from time to time during the term of this Agreement, be added by COUNTY. Reference in this
7 Agreement to "party" or "parties" shall be understood to refer to COUNTY and each CONTRACTOR,
8 unless otherwise specified.
9 WIT N E S S E T H:
1 0 WHEREAS, COUNTY is authorized through its Negotiated Net Amount (NNA) Agreement With
11 the State of California; hereinafter referred to as STATE, Department of Health Care Services (DHCS), to
12 subcontract for Substance Use Disorder treatment services in Fresno County; and
13 WHEREAS, CONTRACTOR(S) shall provide residential detoxification/stabilization services
14 required by COUNTY, pursuant to the terms and conditions of this Agreement.
15 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties hereto
16 agree as follows:
17 1. SERVICES
18 CONTRACTOR(S) shall perform all services and fulfill all responsibilities set forth
19 in COUNTY's Request for Application (RFA), attached hereto as Exhibit Band incorporated herein by
20 reference and made part of this Agreement, and CONTRACTOR(S) Application(s) in response to
21 COUNTY's Request for Application, attached hereto as Exhibit C and incorporated herein by reference and
22 made part of this Agreement. In the event of any inconsistency among these documents, the inconsistency
23 shall be resolved by giving precedence in the following order of priority: (1) to this Agreement, (2) to
24 Exhibit B, and (3) to Exhibit C.
25 CONTRACTOR(S) shall provide residential detoxification/stabilization services
26 at locations in Fresno County to eligible male and female residents of Fresno County. These services shall
27 include:
28 1. Residential Detoxification Phase (day 1-3)
-1-
1 2. Residential Stabilization Phase (day 4-14)
2 CONTRACTOR(S) shall ensure that patients requiring a higher level of continuing
3 care, are referred to residential and/or outpatient for further stabilization services after day fourteen (14).
4 CONTRACTOR(S) shall provide and measure the following Outcomes:
5 1. 50% of all clients admitted for services shall be engaged in Detoxification
6 services for a minimum of three (3) days.
7 2. 50% of those clients treated for detoxification for services for a minimum of three
8 (3) days will be admitted to the next level of care (stabilization/residential/outpatient) as appropriate.
9 CONTRACTOR(S) shall maintain, at CONTRACTOR(S)' cost, a computer system
10 with Windows 2000 or above, compatible with COUNTY's Substance Abuse Information System (SAIS);
11 and high-speed internet connection for the purposes of submitting information required under the terms and
12 conditions of this Agreement.
13 CONTRACTOR(S) shall submit all information and data required by State,
14 including, but not limited to the following:
15 1. Cost Reports for each Fiscal Year to be submitted no later than forty-five (45)
16 days following the end of each fiscal year affected by this Agreement.
17 2. California Outcomes Measurement System (CalOMS) data
18 CONTRACTOR(S) agrees to submit all data requested in (1) and (2), in the manner
19 identified or on forms provided by the State or COUNTY.
20 2. TERM
21 This Agreement shall become effective on July 1, 2015 and shall terminate on the
22 30th day of June, 2018. Thereafter, this Agreement shall renew for two (2) additional twelve (12) month
23 periods upon mutual consent ofthe parties, unless written notice of non-renewal is given by either
24 CONTRACTOR(S) or COUNTY or COUNTY's DBH Director or her designee, at least thirty (30) days
25 prior to the end of the then current term.
26
27
3. TERMINATION
A. Non-Allocation of Funds-The terms of this Agreement and the services to
28 be provided hereunder are contingent on the approval of funds by the appropriating government agency.
-2-
1 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
2 terminated at any time by giving CONTRACTOR(S) thirty (30) days advance notice.
3 B. Breach of Contract-COUNTY may immediately suspend or terminate this
4 Agreement in whole or in part, where in the determination of COUNTY there is:
5
6
7
8
9
1)
2)
3)
4)
An illegal or improper use of funds;
A failure to comply with any term of this Agreement;
A substantially incorrect or incomplete report submitted to
COUNTY; or
Improperly performed services.
10 In no event shall any payment by COUNTY constitute a waiver by COUNTY of any
11 breach of this Agreement or any default which may then exist on the part ofCONTRACTOR(S). Neither
12 shall such payment impair or prejudice any remedy available to COUNTY with respect to the breach or
13 default. COUNTY shall have the right to demand of CONTRACTOR(S) the repayment to COUNTY of any
14 funds disbursed to CONTRACTOR(S) under this Agreement, which in the judgment of COUNTY were not
15 expended in accordance with the terms of this Agreement. CONTRACTOR(S) shall promptly refund any
16 such funds upon demand or, at COUNTY's option; such repayment shall be deducted from future payments
17 owing to CONTRACTOR(S) under this Agreement.
18
19
20
21
22
23
24
25
26
27
28
C. Without Cause -Under circumstances other than those set forth above, this
Agreement may be terminated by CONTRACTOR(S) or COUNTY upon the giving ofthirty (30) days
advance written notice of an intention to terminate. CONTRACTOR(S) may terminate with appropriate
thirty (30) days advance written notice of intent to terminate transmitted by CONTRACTOR(S) to
COUNTY by Certified U.S. Mail, Return Receipt Requested, addressed to the office of COUNTY as
follows:
Ill
Ill
Director (or designee)
County of Fresno
Department of Behavioral Health
P.O. Box 45003
Fresno, CA 93718-9886
-3-
1 4. COMPENSATION
2 A. For claims submitted for actual services rendered under this Agreement
3 COUNTY agrees to pay CONTRACTOR(S) and CONTRACTOR(S) agrees to receive compensation for
4 costs associated with the delivery of Residential Detoxification/Stabilization Services provided by
5 CONTRACTOR(S) in accordance with the cost per bed slot, maximum annual compensation and number of
6 allocated bed slots specified in Exhibit C. The total daily allocated beds under this Agreement shall not
7 exceed nine (9). In no event shall the total compensation for actual services performed under this
8 Agreement for Fiscal Year 2015-16 exceed Two Hundred Sixteen Thousand Seven Hundred Forty-Four and
9 NollOO Dollars ($216,744.00). In no event shall the total compensation for actual services performed under
10 this Agreement for Fiscal Year 2016-i 7 exceed Two Hundred Nineteen Thousand Nine Hundred Ninety-
11 Five and Noll 00 Dollars ($219,995.00). In no event shall the total compensation for actual services
12 performed under this Agreement for Fiscal Year 2017-18 exceed Two Hundred Twenty-Three Thousand
13 Two Hundred Ninety-Five and Noll 00 Dollars ($223,295.00). In no event shall the total compensation for
14 actual services performed under this Agreement for Fiscal Year 2018-19 exceed Two Hundred Twenty-Six
15 Thousand Six Hundred Forty-Four and Noll 00 Dollars ($226,644.00). In no event shall the total
16 compensation for actual services performed under this Agreement for Fiscal Year 2019-20 exceed Two
17 Hundred Thirty Thousand Forty -Four and Noll 00 Dollars ($230,044.00). Annual reimbursement per bed
18 per day shall not exceed the CONTRACTOR(S) daily rate established in Exhibit C regardless of the total
19 maximum compensation of this Agreement.
20 It is understood that all expenses incidental to CONTRACTOR(S)'
21 performance of services under this Agreement shall be borne by CONTRACTOR(S).
22 "Daily allocated beds" is defined as the number of beds allocated to this
23 Agreement on a daily basis or is defined as the number of participants that can be served per day. In no event
24 shall the total compensation for actual services exceed the rate established in Exhibit Cup to the maximum
25 contract amount listed. Annual increases of no more than 1.5% of the previous year's cost per daily bed rate
26 will be reimbursed to CONTRACTOR(S) who requested it per Exhibit B.
27 B. The maximum compensation as identified in this Agreement may be reduced
28 based upon State, Federal, and local funding availability. In the event of such action, the COUNTY's DBH
-4-
1 Director or her designee shall notify the CONTRACTOR(S) in writing of the reduction in the maximum
2 amount within thirty (30) days.
3 In the event that funding for these services is delayed by the State Controller,
4 COUNTY may defer payment to CONTRACTOR(S). The amount of the deferred payment shall not exceed
5 the amount of the funding delayed by the State Controller to the COUNTY. The period oftime of the
6 deferral by COUNTY shall not exceed the period of time the State Controller's delay of payment to
7 COUNTY plus forty-five (45) days.
8 C. Payments-CONTRACTOR(S) may not exceed the maximum allocated bed
9 days approved in Exhibit C. CONTRACTOR(S) shall complete the year end cost report in accordance to
1 0 Section 29 REPORTS-SUBSTANCE USE DISORDER SERVICES of this Agreement at the end of each
11 fiscal year to actual cost and reimbursement for services provided. Regardless of the contract maximum,
12 CONTRACTOR(S) will be reimbursed only for costs up to the negotiated bed day rate herein. Within forty-
13 five ( 45) days of the reconciliation by COUNTY, CONTRACTOR(S) shall make payment to COUNTY or
14 COUNTY shall reimburse CONTRACTOR(S) as appropriate.
15 Payment by COUNTY shall be in arrears, based on CONTRACTOR(S)'
16 monthly invoices submitted for services provided during the preceding month, within forty-five ( 45) days
17 after receipt and verification of CONTRACTOR(S)' monthly invoices by COUNTY's DBH Contracts
18 Division-SUD Services. Monthly invoicing shall be submitted as described in Section Five (5)
19 INVOICING herein.
20 For services rendered herein, CONTRACTOR(S) shall assure that an
21 ongoing quality assurance component is in place and is occurring. CONTRACTOR(S) shall assure that
22 records for each participant are of such detail and length that a review of said record will verify that
23 appropriate services were provided. If the record is unclear, incomplete, and/or indicates that appropriate
24 services were not provided, COUNTY reserves the right to withhold payment for the applicable unit(s) of
25 service. It is understood that all expenses incidental to CONTRACTOR(S)' performance of services under
26 this Agreement shall be borne by CONTRACTOR(S). If CONTRACTOR(S) should fail to comply with any
27 provision ofthis Agreement, COUNTY shall be relieved of its obligation for further compensation.
28 CONTRACTOR(S)' and COUNTY's obligations under this section shall survive the termination or
-5-
1 expiration of this Agreement with respect to services provided during the term of this Agreement without
2 regard to the cause of termination of this Agreement.
3
4
5
6
7
8
9
10
11
12
13
D. Public Information -CONTRACTOR(S) shall disclose its funding source in
all public information, however, this requirement of disclosure of funding source shall not be required in
spot radio or television advertising.
E. Lobbying Activity -CONTRACTOR(S) shall not directly or indirectly use
any of the funds provided under this Agreement for publicity, lobbying, or propaganda purposes
designed to support or defeat legislation pending before the Congress of the United States or the
Legislature of the State of California.
F. Political Activity-CONTRACTOR(S) shall not directly or indirectly use
any of the funds under this Agreement for any political activity or to further the election or defeat of any
candidate for public office.
G. Funding Sources -It shall be the obligation of CONTRACTOR(S) to
14 determine and claim all revenue possible from private pay sources and third party payers.
15 CONTRACTOR(S) shall not use any funds under this Agreement for services covered by Drug Medi-Cal
16 or other health insurance for eligible beneficiaries. CONTRACTOR(S) shall claim all Drug Medi-Cal
17 covered services for eligible beneficiaries through the Drug Medi-Cal claiming process. COUNTY will
18 only reimburse CONTRACTOR(S) for services rendered that are not covered by Drug Medi-Cal, other
19 insurance or other revenue sources.
20 CONTRACTOR(S) shall not use any funds under this Agreement to the
21 extent that a participant is eligible for Medi-Cal, insurance or other revenue reimbursement for services
22 rendered.
23 Any revenues generated by CONTRACTOR(S) in excess of the amounts
24 budgeted in this Agreement, may be utilized to expand/enhance the services during COUNTY's fiscal
25 years in which revenues are collected or in the following COUNTY fiscal year. Additional revenues will
26 be considered separate and distinct from COUNTY's payment to CONTRACTOR(S). The manner and
27 means of service expansion/enhancement shall be subject to the prior written approval of COUNTY's
28
-6-
1 DBH Director or her designee. CONTRACTOR(S) shall disclose all sources of revenue to COUNTY.
2 Under no circumstances will COUNTY funded staff time be used for fund-raising purposes.
3 H. Cost of Living Adjustment-CONTRACTOR(S) shall not utilize any
4 funds provided under this Agreement for cost ofliving adjustments to CONTRACTOR(S)' employee
5 compensation in excess of what is approved in the budget submitted with the RF A response.
6 I. CONTRACTOR(S) agrees to limit annual administrative costs paid
7 through this Agreement to a maximum of fifteen percent (15%) of the total annual program budget.
8 Administrative costs include all non-direct service personnel such as executive directors, clerical staff and
9 fiscal staff and identified corporate overhead. Employee benefits shall not exceed twenty percent (20%) of
10 total salaries for those employees working under this Agreement. Benefits shall include health insurance,
11 retirement, life insurance, and other optional benefits. Failure to conform to this provision will be grounds
12 for contract termination at the option of the County of Fresno, DBH Director or her designee. This Section
13 Four (4) COMPENSATION shall in no way be construed to classify CONTRACTOR(S) or
14 CONTRACTOR(S)' officers, agents and employees as an officer, agent, servant, employee, joint venture,
15 partner, or associate of COUNTY, pursuant to Section Six (6) INDEPENDENT CONTRACTORS.
16 5. INVOICING
17 CONTRACTOR(S) shall invoice COUNTY in arrears by the twentieth (20th) of
18 each month for actual expenses incurred and serviced rendered in the previous month to:
19 sas@co.fresno.ca.us with a copy of the invoice also sent to the assigned DBH Contracts Division-SUD
20 Services Staff Analyst. Invoices shall include all corresponding documentation of services provided.
21 Supporting documentation shall include but is not limited to program activity log, receipts, invoices
22 received and documented administrative/overhead costs.
23 Invoices and supporting documentation shall reflect services supported by the
24 invoiced expenditures and be in a form and in such detail as acceptable to COUNTY's DBH Contracts
25 Division-SUD Services. No reimbursement for services shall be made until invoices, and any required
26 reports, described further in Section Twenty-nine (29) REPORTS-SUBSTANCE USE DISORDER
27 SERVICES of this Agreement, are received and reviewed by COUNTY's DBH Contracts Division-
28 SUD Services.
-7-
1 At the discretion of COUNTY's DBH Director or her designee, if an invoice is
2 incorrect or is otherwise not in proper form or substance, COUNTY's DBH Director or her designee
3 shall have the right to withhold payment as to only that portion of the invoice that is incorrect or
4 improper after five (5) days prior notice to CONTRACTOR(S). CONTRACTOR(S) agrees to continue to
5 provide services for a period of ninety (90) days after notification of an incorrect or improper invoice. If
6 after the ninety (90) day period, the invoice(s) is still not corrected to COUNTY's DBH-SUD Services
7 satisfaction, COUNTY's DBH Director or her designee may elect to terminate this Agreement, pursuant
8 to the termination provisions state in Section Three (3) TERMINATION of this Agreement. In addition,
9 for invoices received ninety (90) days after the expiration of each term of this Agreement or termination
10 ofthis Agreement, at the discretion of COUNTY's DBH Director or her designee, the COUNTY shall
11 have the right to deny payment of any additional invoices received.
12 6. INDEPENDENT CONTRACTORS
13 In performance ofthe work, duties, and obligations assumed by
14 CONTRACTOR(S) under this Agreement, it is mutually understood and agreed that CONTRACTOR(S),
15 including any and all of CONTRACTOR(S)' officers, agents and employees will at all times be acting
16 and performing as an independent contractor, and shall act in an independent capacity and not as an
17 officer, agent, servant, employee, joint venture, partner, or associate of the COUNTY. Furthermore,
18 COUNTY shall have no right to control or supervise or direct the manner or method by which
19 CONTRACTOR(S) shall perform its work and function. However, COUNTY shall retain the right to
20 administer this Agreement so as to verify that CONTRACTOR(S) is performing its obligations in
21 accordance with the terms and conditions thereof. CONTRACTOR(S) and COUNTY shall comply with
22 all applicable provisions of law and the rules and regulations, of any, of governmental authorities having
23 jurisdiction over matters which are directly or indirectly the subject of this Agreement.
24 Because of its status as an independent contractor, CONTRACTOR(S) shall have
25 absolutely no right to employment rights and benefits available to COUNTY employees.
26 CONTRACTOR(S) shall be solely liable and responsible for providing to, or on behalf of, its employees
27 all legally-required employee benefits. In addition, CONTRACTOR(S) shall be solely responsible and
28 save COUNTY harmless from all matters relating to payment of CONTRACTOR(S)' employees,
-8-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
including compliance with Social Security, withholding, and all other regulations governing such
matters. It is acknowledged that during the term of this Agreement, CONTRACTOR(S) 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.
CONTRACTOR(S) hereby agrees that changes to the compensation under this
Agreement may be necessitated by a reduction in funding from State and/or Federal sources. The
COUNTY's DBH Director or her designee may modify the maximum compensation depending on State
and Federal funding availability, as stated in Section Four (4) COMPENSATION in this Agreement.
CONTRACTOR(S) further understands that this Agreement is subject to any restrictions, limitations, or
enactments of all legislative bodies which affect the provision, term or funding of this Agreement in any
manner.
8. 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 COUNTY.
9. HOLD HARMLESS
Each CONTRACTOR agrees to indemnify, save, hold harmless, and at
19 COUNTY's request, defend COUNTY, its officers, agents, and employees from any and all costs and
20 expenses, damages, liabilities, claims, and losses occurring or resulting to COUNTY in connection with
21 the performance, or failure to perform, by each CONTRACTOR, their officers, agents, or employees
22 under this Agreement, and from any and all costs and expenses, damages, liabilities, claims, and losses
23 occurring or resulting to any person, firm, or corporation who may be injured or damaged by the
24 performance, or failure to perform, of each CONTRACTOR, their officers, agents or employees under
25 this Agreement.
26 Each CONTRACTOR agrees to indemnify COUNTY for Federal, State of
27 California audit exceptions resulting from noncompliance herein on the part of the CONTRACTOR.
28 Ill
-9-
1 10. COMPLAINTS
2 CONTRACTOR(S) shall log complaints and the disposition of all complaints from
3 a client or client's family. CONTRACTOR(S) shall provide a summary ofthe complaint log entries
4 concerning COUNTY-sponsored clients to COUNTY at monthly intervals by the fifteenth (15 1h) day of
5 the following month, in a format that is mutually agreed upon. CONTRACTOR(S) shall post signs
6 informing consumers of their right to file a complaint or grievance. CONTRACTOR(S) shall notify
7 COUNTY of all incidents reportable to state licensing bodies that affect COUNTY consumers within
8 twenty-four (24) hours ofreceipt of a complaint.
9 Within fifteen ( 15) days after each incident or complaint affecting COUNTY-
1 0 sponsored clients, CONTRACTOR shall provide COUNTY with information relevant to the complaint,
11 investigative details of the complaint, the complaint and CONTRACTOR's disposition of, or corrective
12 action taken to resolve the complaint.
13 11. INSURANCE
14 Without limiting the COUNTY's right to obtain indemnification from
15 CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force
16 and effect, the following insurance policies throughout the term of this Agreement:
17
18
19
20
21
22
23
24
25
26
27
28
A.
B.
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
Two Million Dollars ($2,000,000). This policy shall be issued on a per
occurrence basis. In addition to the Commercial General Liability
coverage, CONTRACTOR shall provide an insurance policy for sexual
abuse and molestation liability with these same limits.
Automobile Liability
Comprehensive Automobile Liability Insurance with limits for bodily
injury of not less than Five Hundred Thousand Dollars ($500,000.00) per
person, One Million Dollars ($1 ,000,000.00) per accident and for
property damages of not less than One Hundred Thousand Dollars
($1 00,000.00), or such coverage with a combined single limit of One
Million Dollars ($1 ,000,000.00). Coverage should include owned and
non-owned vehicles used in connection with this Agreement.
-10-
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
C.
D.
Professional Liability
IfPROVIDER(S) employs licensed professional staff, (e.g., Ph.D., R.N.,
L.C.S.W., L.M.F.T.) in providing services, Professional Liability
Insurance with limits of not less than One Million Dollars
($1 ,000,000.00) per occurrence, Three Million Dollars ($3,000,000.00)
annual aggregate. PROVIDER(S) 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. This
requirement shall survive the termination of this Agreement.
Worker's Compensation
A policy of Worker's Compensation insurance as may be required by the
California Labor Code. CONTRACTOR(S) 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 COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under 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(S) executes this Agreement,
CONTRACTOR(S) shall provide certificates of insurance and endorsement as stated above for all of
the foregoing policies, as required herein, to the County of Fresno, Department of Behavioral Health,
Contracts Division-Substance Use Disorder Services 3133 N. Millbrook Ave, Fresno, CA 93703,
Attention: DBH-SUD Services Staff Analyst, stating that such insurance coverage 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 COUNTY, its officers, agents and employees, shall be excess only and not contributing
-11-
1 with insurance provided under CONTRACTOR(S)' policies herein; and that this insurance shall not be
2 cancelled or changed without a minimum of thirty (30) days advance, written notice given to
3 COUNTY.
4 In the event CONTRACTOR(S) fails to keep in effect at all times insurance coverage as
5 herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
6 this Agreement upon the occurrence of such event.
7 All policies shall be with admitted insurers licensed to do business in the State of
8 California. Insurance purchased shall be purchased from companies possessing a current A.M. Best,
9 Inc. rating of A FSC VII or better.
10 12. DATA SECURITY
11 For the purpose of preventing the potential loss, misappropriation or inadvertent
12 access, viewing, use or disclosure of COUNTY data including sensitive or personal client information;
13 abuse of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies
14 that enter into a contractual relationship with the COUNTY for the purpose of providing services under
15 this Agreement must employ adequate data security measures to protect the confidential information
16 provided to CONTRACTOR by the COUNTY, including but not limited to the following:
17
18
A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices
CONTRACTOR(S) may not connect to COUNTY networks via
19 personally-owned mobile, wireless or handheld devices, unless the following conditions are met:
20 1) CONTRACTOR(S) has received authorization by COUNTY for
21 telecommuting purposes;
22
23
24
25 B.
2)
3)
Current virus protection software is in place;
Mobile device has the remote wipe feature enabled; and
4) A secure connection is used.
CONTRACTOR-Owned Computers or Computer Peripherals
26 CONTRACTOR may not bring CONTRACTOR-owned computers or
27 computers or computer peripherals into the COUNTY for use without prior authorization from the
28 COUNTY's Chief Information Officer, and/or designee, including but not limited to mobile storage
-12-
1 devices. If data is approved to be transferred, data must be stored on a secure server approved by the
2 COUNTY and transferred by means of a Virtual Private Network (VPN) connection, or another type of
3 secure connection. Said data must be encrypted.
4 C. COUNTY -Owned Computer Equipment
5 CONTRACTOR(S) or anyone having an employment relationship with
6 the COUNTY, may not use COUNTY computers or computer peripherals on non-COUNTY premises
7 without prior authorization from the COUNTY's Chieflnformation Officer, and/or designee.
8 D. CONTRACTOR may not store COUNTY's private, confidential or
9 sensitive data on any hard-disk drive, portable storage device, or remote storage installation unless
1 0 encrypted.
11 E. CONTRACTOR shall be responsible to employ strict controls to ensure
12 the integrity and security of COUNTY's confidential information and to prevent authorized access,
13 viewing, use or disclosure of data maintained in computer files, program documentation, data
14 processing systems, data files and data processing equipment which stores or processes COUNTY data
15 internally or externally.
16 F. Confidential client information transmitted to one party by the other by
17 means of electronic transmissions must be encrypted according to Advanced Encryption Standards
18 (AES) of 128 BIT or higher. Additionally, a password or pass phrase must be utilized.
19 G. CONTRACTOR is responsible to immediately notify COUNTY of any
20 violations, breaches or potential breaches of security related to COUNTY's confidential information,
21 data maintained in computer files, program documentation, data processing systems, data files and data
22 processing equipment which stores or processes COUNTY data internally or externally.
23 H. COUNTY shall provide oversight to CONTRACTOR(S)' response to all
24 incidents arising from a possible breach of security related to COUNTY's confidential client
25 information provided to CONTRACTOR. CONTRACTOR will be responsible to issue any notification
26 to affected individuals as required by law or as deemed necessary by COUNTY in its sole discretion.
27 CONTRACTOR will be responsible for all costs incurred as a result of providing the required
28 notification.
-13-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
13. SUBCONTRACTS
CONTRACTOR(S) shall be required to assume full responsibility for all services
and activities covered by this Agreement, whether or not CONTRACTOR(S) is providing services
directly. Further, CONTRACTOR(S) shall be the sole point of contact with regard to contractual
matters, including payment of any and all charges resulting from this Agreement.
If CONTRACTOR(S) should propose to subcontract with one or more third
parties to carry out a portion of services covered by this Agreement, any such subcontract shall be in
writing and approved as to form and content by COUNTY's DBH Director or her designee prior to
execution and implementation. COUNTY's DBH Director or her designee shall have the right to reject
any such proposed subcontract. Any such subcontract together with all activities by or cause by
CONTRACTOR(S) shall not require compensation greater than the total budget contained herein. An
executed copy of any such subcontract shall be received by COUNTY before any implementation and
shall be retained by COUNTY. CONTRACTOR(S) shall be responsible to COUNTY for the proper
performance of any subcontract. Any subcontractor shall be subject to the same terms and conditions
that CONTRACTOR(S) is subject to under this Agreement.
It is expressly recognized that CONTRACTOR(S) cannot engage in the practice
of medicine. If any medical services are to be provided in connection with the services under this
Agreement, such medical services shall be performed by an independent contract physician. In this
instance, the requirements of the Confidential Medical Information Act (Civil Code 56 et seq.) shall be
20 met.
21 If CONTRACTOR(S) hires an independent contract physician,
22
23
24
25
26
27
28
CONTRACTOR(S) shall require and ensure that such independent contract physician carries
Professional Liability (Medical Malpractice) Insurance, with limits of not less than One Million and
No/100 Dollars ($1,000,000.00) per occurrence, Three Million and No/100 Dollars ($3,000,000.00)
annual aggregate.
14. NO THIRD PARTY BENEFICIARIES
It is understood and agreed by and between the parties that the services provided
by CONTRACTOR(S) for COUNTY herein are solely for the benefit of the COUNTY, and that
-14-
1
2
3
4
5
6
7
8
9
10
11
12
nothing in this Agreement is intended to confer on any person other than the parties hereto any right
under or by reason of this Agreement.
15. COMPLIANCE WITH LA WSIPOLICIES
CONTRACTOR(S) shall comply with all applicable rules and regulations set
forth in Titles 9 and 22 of the California Code of Regulations, and California Health and Safety Code
Section 11750 et seq. CONTRACTOR(S) shall comply with any other Federal and State laws or
guidelines applicable to CONTRACTOR(S)' performance under this Agreement or any local
ordinances, regulations, or policies applicable. Such provisions include, but are not restricted to:
A. CONTRACTOR(S) agrees to limit administrative cost to a maximum of
fifteen percent (15%) ofthe total program budget and to limit employee benefits to a maximum of
twenty percent (20%) of total salaries for those employees working under this Agreement during the
term of this Agreement. Failure to conform to this provision will be grounds for contract termination at
13 the option of COUNTY.
14 B. CONTRACTOR(S) shall submit accurate, complete and timely claims
15
16
17
18
19
20
21
22
23
and cost reports, reporting only allowable costs.
C. CONTRACTOR(S) shall comply with statistical reporting and program
evaluation systems as provided in State of California regulations and in this Agreement.
16. CONFLICT OF INTEREST
No officer, agent, or employee of 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. CONTRACTOR(S) shall comply with
all 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
24 of COUNTY.
25 17. DRUG-FREE WORKPLACE
26 CONTRACTOR(S) shall comply with the requirements of the Drug-Free Work
27 Place Act of 1990 (California Government Code Section 8350).
28 Ill
-15-
1
2
18. NON-DISCRIMINATION
A. Eligibility for Services-CONTRACTOR(S) shall prepare, prominently
3 post in its facility, and make available to the DBH Director or her designee and to the public all
4 eligibility requirements to participate in the program funded under this Agreement. CONTRACTOR(S)
5 shall not unlawfully discriminate in the provision of services because of race, color, creed, national
6 origin, gender, age, or physical or mental disability as provided by State of California and Federal law
7 in accordance with Title VI ofthe Civil Rights Act of 1964 (42 USC Section 2000(d)); Age
8 Discrimination Act of 1976 ( 42 USC Section 1681 ); Rehabilitation Act of 1973 (29 USC Section 794);
9 Education Amendments of 1972 (20 USC Section 1681 ); Americans with Disabilities Act of 1990 ( 42
10 USC Section 12131 ); Title 45, Code of Federal Regulations, Part 84; provision of the Fair Employment
11 and Housing Act (California Government Code Section 12900); and regulations promulgated
12 thereunder (Title 2, CCR, Section 7285.0); Title 2, Division 3, Article 9.5 ofthe California
13 Government Code commencing with section 1113 5; and Title 9, Division 4, Chapter 6 of the California
14 Coe of Regulations commencing with section 10800.
15
16
17
18
19
20
21
22
23
24
25
26
27
28
B. Equal Opportunity-CONTRACTOR(S) shall comply with California
Government Code, Section 12990 and California Code of Regulations, Title II, Division 4, Chapter 5,
in matters related to the development, implementation, and maintenance of a nondiscrimination
program. CONTRACTOR(S) shall not discriminate against any employee or applicant for employment
because of race, religion, color, national origin, physical or mental disability, marital status, gender, or
age. Such practices include retirement, recruitment, advertising, hiring, layoff, termination, upgrading,
demotion, transfer, rates of pay or other forms of compensation, use of facilities, and other terms and
conditions of employment. CONTRACTOR(S) agrees to post in conspicuous places, notices available
to all employees and applicants for employment setting forth the provisions of the Equal Opportunity
Act (42 USC Section 2000(e)) in conformance with federal Executive Order No. 11246.
CONTRACTOR(S) agrees to comply with the provisions of the Rehabilitation Act of 1973 (29 USC
Section 794).
C. Suspension of Compensation-If an allegation of discrimination occurs,
DBH may withhold all further funds, until CONTRACTOR(S) can show by clear and convincing
-16-
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
evidence to the satisfaction of DBH that funds provided under this Agreement were not used in
connection with the alleged discrimination.
D. Nepotism-Except by consent of the DBH Director or her designee, no
person shall be employed by CONTRACTOR(S) who is related by blood or marriage to or who is a
member ofthe Board of Directors or an officer ofCONTRACTOR(S).
E. New Facilities and Disability Access-New facilities shall be wheelchair
accessible and provide access to the disabled, consistent with Title 9, California Code of Regulations,
Section 10820. If a new facility will be utilized, a plan ensuring accessibility to the disabled must be
developed. DBH shall assess, monitor, and document CONTRACTOR(S)' compliance with the
Rehabilitation Act of 1973 and Americans with Disabilities Act of 1990 to ensure that
recipients/beneficiaries and intended recipients/beneficiaries of services are provided services without
regard to physical or mental disability and that CONTRACTOR(S) has provided a facility accessible to
the physically disabled.
19. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
COUNTY and CONTRACTOR each consider and represent themselves as covered
entities as defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law
1 04-191 (HIP AA) and agree to use and disclose protected health information as required by law.
COUNTY and CONTRACTOR acknowledge that the exchange of protected health
information between them is only for treatment, payment, and health care operations.
COUNTY and CONTRACTOR intend to protect the privacy and provide for the security
of Protected Health Information (PHI) pursuant to the Agreement in compliance with HIP AA, the
Health Information Technology for Economic and Clinical Health Act, Public Law 111-005 (HITECH),
and regulations promulgated thereunder by the U.S. Department of Health and Human Services (HIPAA
Regulations) and other applicable laws.
As part of the HIP AA Regulations, the Privacy Rule and the Security Rule require CONTRACTOR to
enter into a contract containing specific requirements prior to the disclosure of PHI, as set forth in, but
not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) ofthe Code of Federal
Regulations (CFR).
-17-
1
2
3
20. STATE ALCOHOL AND DRUG REQUIREMENTS
A. INDEMNIFICATION
CONTRACTOR(S) agrees to indemnify, defend and save harmless the
4 State, its officers, agents and employees from any and all claims and losses occurring or resulting to
5 any and all contractors, subcontractors, material men, laborers and any other person, firm or
6 corporation furnishing or supplying work, services, materials or supplies in connection with the
7 performance of this Agreement and from any and all claims and losses occurring or resulting to any
8 person, firm or corporation who may be injured or damaged by the CONTRACTOR(S) in the
9 performance of this Agreement.
10
11
B. INDEPENDENT CONTRACTOR
CONTRACTOR(S) and the agents and employees of CONTRACTOR(S),
12 in the performance of this Agreement, shall act in an independent capacity and not as officers or
13 employees or agents of the State of California.
14
15
16
17
18
19
20
C. CONTROL REQUIREMENTS
This Agreement is subject to all applicable Federal and State laws,
regulations and standards. CONTRACTOR(S) shall establish written procedures consistent with the
State NNA requirements. The provisions ofthis Agreement are not intended to abrogate any provisions
of law or regulation existing or enacted during the term of this Agreement.
D. NON-DISCRIMINATION PROVISION
1) Eligibility for Services
21 CONTRACTOR(S) shall prepare and make available to COUNTY
22 and to the public all eligibility requirements to participate in the program plan set for in
23 CONTRACTOR(S)' response to the RF A. No person shall, because of ethnic group identification, age,
24 sex, color, disability, medical condition, national origin, race, ancestry, marital status, religion,
25 religious creed, political belief or sexual preference be excluded from participation, be denied benefits
26 of, or be subject to discrimination under any program or activity receiving Federal or State of
27 California assistance.
28 Ill
-18-
1
2
3
4
5
6
7
8
9
10
11
12
13
2) Employment Opportunity
CONTRACTOR(S) 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, rates of pay or other forms of compensation, use of
facilities, and other terms and conditions of employment.
3) Suspension of Competition
If an allegation of discrimination occurs, COUNTY may withhold
all further funds, until CONTRACTOR(S) 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.
4) Nepotism
14 Except by consent of COUNTY's DBH Director or her designee,
15 no person shall be employed by CONTRACTOR(S) who is related by blood or marriage to, or who is a
16 member ofthe Board of Directors or an officer ofCONTRACTOR(S).
17
18
E. CONFIDENTIALITY
CONTRACTOR(S) shall conform to and COUNTY shall monitor
19 compliance with all State of California and Federal statutes and regulations regarding confidentiality,
20 including but not limited to confidentiality of information requirements at Part 2, Title 42, Code of
21 Federal Regulations; California Welfare and Institutions Code, Sections 14100.2, 11977, 11812, 5328;
22 Division 10.5 and 10.6 of the California Health and Safety Code; Title 22, California Code of
23 Regulations, Section 51009; and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code.
24 F. REVENUE COLLECTION POLICY
25 CONTRACTOR(S) shall conform to all policies and procedures
26 regarding revenue collection issued by the State under the provisions of the Health and Safety Code,
27 Division 1 0.5.
28 G. EXPENDITURE OF STATE GENERAL AND FEDERAL FUNDS
-19-
1
2
3
4
CONTRACTOR(S) agrees that all funds paid out by the State shall be
used exclusively for providing alcohol and/or drug program services, administrative costs, and
allowable overhead.
H. ACCESS TO SERVICES
5 CONTRACTOR(S) shall provide accessible and appropriate services in
6 accordance with Federal and State statutes and regulations to all eligible persons.
7 I. REPORTS
8 CONTRACTOR(S) agrees to participate in surveys related to the
9 performance of this Agreement and expenditure of funds and agrees to provide any such information in
10 a mutually agreed upon format.
11
12
J. AUDITS
All State and Federal funds furnished to the CONTRACTOR(S) pursuant
13 to this Agreement along with required COUNTY match, related patient and participant fees, third-party
14 payments, or other related revenues and funds commingled with the foregoing funds are subject to
15 audit by the State. The State may audit all alcohol and drug program revenue and expenditures
16 contained in this Agreement for the purpose of establishing the basis for the subsequent year's
17 negotiation.
18
19
K. RECORDS MAINTENANCE
1) CONTRACTOR(S) shall maintain books, records, documents, and
20 other evidence necessary to monitor and audit this Agreement.
21 2) CONTRACTOR(S) shall maintain adequate program and fiscal
22 records relating to individuals served under the terms of this Agreement, as required, to meet the needs
23 of the State in monitoring quality, quantity, fiscal accountability, and accessibility of services.
24 Information of each individual shall include, but not be limited to, admission records, patient and
25 participant interviews and progress notes, and records of service provided by various service locations
26 in sufficient detail to make possible an evaluation of services provided and compliance with this
27 Agreement.
28 Ill
-20-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
21. FEDERAL CERTIFICATIONS
1. CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
INELIGIBLITY AND VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS
A. DBH-SUD Services and CONTRACTOR(S) recognize that
Federal assistance funds will be used under the terms of this Agreement. For purposes of this
paragraph, CONTRACTOR(S) will be referred to as the "prospective recipient."
B. This certification is required by the regulations implementing
Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants'
Responsibilities. The regulations were published as Part VII of the May 26, 1088 Federal Register
(pages 19160-19211 ).
1) The prospective recipient of Federal assistance funds
certified by entering this Agreement, that neither it nor its principals are presently debarred, suspended,
proposed for debarment, declared ineligible or voluntarily excluded from participation in this
transaction by any Federal department or agency.
2) The prospective recipient of funds agrees by entering into
16 this Agreement, that it shall not knowingly enter into any lower tier covered transaction with a person
17 who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this
18 covered transaction, unless authorized by the Federal department or agency with which this transaction
19 originated.
20 3) Where the prospective recipient of Federal assistance funds
21 is unable to certify to any of the statements in this certification, such prospective participant shall
22 attach an explanation to this Agreement.
23 4) The prospective recipient shall provide immediate written
24
25
26
27
28
notice to DBH -SUD Services if at any time prospective recipient learns that its certification in this
clause of this Agreement was erroneous when submitted or has become erroneous by reason of
changed circumstances.
5) The prospective recipient further agrees that by entering
into this Agreement, it will include a clause identical to this clause of this Agreement, and titled
-21-
1
2
3
4
5
6
7
8
"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier
Covered Transactions," in all lower tier covered transactions and in all solicitations for lower tier
covered transactions.
6) The certification in this clause of this Agreement is a
material representation of fact upon which reliance was placed by COUNTY when this transaction was
entered into.
2. AUDIT
CONTRACTOR(S) shall grant DBH-SUD Services, State of California
9 (if applicable), the Federal grantor agency, the Comptroller General of the United States, or any of
10 their duly authorized representatives access to any books, documents, papers, and records of the
11 CONTRACTOR(S) which are directly pertinent to this Agreement for the purpose of audits,
12 examinations, excerpts and transactions. The CONTRACTOR(S) must retain all such required records
13 for three (3) years after CONTRACTOR(S) makes final payment and all other pending matters are
14 closed.
15 3. CLEAN AIR AND WATER
16 In the event funding under this Agreement exceeds One Hundred
17 Thousand and No/1 00 Dollars ($1 00,000.00), the CONTRACTOR(S) must comply with all applicable
18 standards, orders, or requirements issued under Section 306 of the Clean Air Act ( 42 USC 1857(h)),
19 Section 506 ofthe Clean Water Act (33 USC 1368), Executive Order 11738, and Environmental
20 Protection Agency Regulations ( 40 CFR, Part 32).
21 4. ENERGY EFFICIENCY
22 The CONTRACTOR(S) must comply with the mandatory standards and
23 policies relating to energy efficiency which are contained in the state energy conservation plan issued
24 in compliance with Energy Policy and Conservation Act (Pub. L. 94-163).
25 5. REPORTING REQUIREMENTS, COPYRIGHT AND PATENTS
26 The awarding agency's reporting requirements are stated in this
27 Agreement. The awarding agency's requirements and regulations pertaining to copyright and rights in
28
-22-
1
2
3
data, and patent rights with respect to any discovery or invention which arise or is developed in the
course of or under this Agreement (if any), are likewise stated in this Agreement.
22. REFERENCES TO LAWS AND RULES
4 In the event any law, regulation, or policy referred to in this Agreement is
5 amended during the term thereof, the parties hereto agree to comply with the amended provision as of
6 the effective date of such amendment.
7 23. LICENSES/CERTIFICATES
8 Throughout each term of this Agreement, CONTRACTOR(S) and
9 CONTRACTOR(S)' staff shall maintain all necessary licenses, permits, approvals, certificates, waivers
1 0 and exemptions necessary for the provision of the services hereunder and required by the laws and
11 regulations of the United States of America, State of California, the County of Fresno, and any other
12 applicable governmental agencies. CONTRACTOR(S) shall notify COUNTY immediately in writing
13 of its inability to obtain or maintain such licenses, permits, approvals, certificates, waivers and
14 exemptions irrespective of the pendency of any appeal related thereto. Additionally,
15 CONTRACTOR(S) and CONTRACTOR(S)' staff shall comply with all applicable laws, rules or
16 regulations, as may now exist or be hereafter changed.
17 24. CHILD ABUSE REPORTING
18 CONTRACTOR(S) shall utilize a procedure acceptable to the COUNTY to
19 ensure that all of CONTRACTOR(S)' employees, volunteers, consultants, subcontractors or agents
20 performing services under this Agreement shall report all known or suspected child abuse or neglect to
21 one or more ofthe agencies set forth in Penal Code Section 11165.9. This procedure shall include
22 having all of CONTRACTOR(S)' employees, volunteers, consultants, subcontractors or agents
23 performing services under this Agreement sign a statement that he or she knows of and will comply
24 with the reporting requirements set forth in Penal Code Section 11166. The statement to be utilized by
25 CONTRACTOR(S) for reporting is set forth in Exhibit D attached hereto and by this reference
26 incorporated herein.
27 Ill
28 Ill
-23-
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
25. CHARITABLE CHOICE
CONTRACTOR(S) may not discriminate in its program delivery against a client
or potential client on the basis of religion or religious belief, a refusal to hold a religious belief, or a
refusal to actively participate in a religious practice. Any specifically religious activity or service made
available to individuals by the CONTRACTOR(S) must be voluntary as well as separate in time and
location from COUNTY funded activities and services. CONTRACTOR(S) shall inform COUNTY as
to whether it is faith-based. If CONTRACTOR(S) identifies as faith-based it must submit to DBH-
SUD Services a copy of its policy on referring individuals to alternative treatment. CONTRACTOR(S)
must include a copy of this policy in its client admission forms. The policy must inform individuals
that they may be referred to an alternative provider if they object to the religious nature of the program,
and include a notice to DBH -SUD Services. Adherence to this policy will be monitored during
annual site reviews, and a review of client files. If CONTRACTOR(S) identifies as faith-based, by July
1 of each year CONTRACTOR(S) will be required to report to DBH-SUD Services the number of
individuals who requested referrals to alternative providers based on religious objection.
26. EVALUATION/MONITORING
Outcomes-COUNTY's DBH Director or her designee and the DHCS, or their
designee shall monitor and evaluate the performance of CONTRACTOR(S) under this Agreement to
determine to the best possible degree the success or failure of the services provided under this
Agreement. At the discretion of the COUNTY, a subcontractor may be obtained by the COUNTY to
independently evaluate and monitor the performance of the CONTRACTOR(S). CONTRACTOR(S)
shall participate in the evaluation of the program as needed, at the discretion of COUNTY.
COUNTY shall recapture from CONTRACTOR(S) the value of any services or
other expenditures determined to be ineligible based on the COUNTY or State monitoring results. At
the discretion ofthe COUNTY, recoupment can be made through a future invoice reduction or
reimbursement by the CONTRACTOR(S).
CONTRACTOR(S) shall participate in a review of the program at least yearly or
more frequently, as needed, at the discretion ofthe COUNTY. The CONTRACTOR(S) agrees to
-24-
1 supply all information requested by the COUNTY, DHCS and/or the subcontractor during the program
2 evaluation, monitoring, and/or review.
3 27.
4
5 comply with:
6
CULTURAL COMPETENCY
As related to Cultural and Linguistic Competence, CONTRACTOR(S) shall
A. Title 6 of the Civil Rights Act of 1964 ( 42 USC Section 200d, and 45
7 CFR, Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial
8 assistance from discrimination against persons based on race, color, national origin, sex, disability or
9 religion. This is interpreted to mean that a limited English proficient (LEP) individual is entitled to
10 equal access and participation in federally funded programs that the provision of comprehensive and
11 quality bilingual services.
12 B. Policies and procedures for ensuring access and appropriate use oftrained
13 interpreters and material translation services for all LEP consumers, including, but not limited to,
14 assessing the cultural and linguistic needs of its consumers, training of staff on the policies and
15 procedures, and monitoring its language assistance program. The CONTRACTOR(S)' procedures must
16 include ensuring compliance of any sub-contracted providers with these requirements.
17 C. CONTRACTOR(S) shall not use minors as interpreters.
18 D. CONTRACTOR(S) shall provide and pay for interpreting and translation
19 services to persons participating in CONTRACTOR(S)' services who have limited or no English
20 language proficiency, including services to person who are deaf or blind. Interpreter and translation
21 services shall be provided as necessary to allow such participants meaningful access to the programs,
22 services and benefits provided by CONTRACTOR(S). Interpreter and translation services, including
23 translation of CONTRACTOR(S)' "vital documents" (those documents that contain information that is
24 critical for accessing CONTRACTOR(S)' services or are required by law) shall be provided to
25 participants at no cost to the participant. CONTRACTOR(S) shall ensure that any employees, agents,
26 subcontractors, or partners who interpret or translate for a program participant, or who directly
27 communicate with a program participant in a language other than English, demonstrate proficiency in
28
-25-
1 the participant's language and can effectively communicate any specialized terms and concepts
2 peculiar to CONTRACTOR(S)' services.
3 E. In compliance with the State mandated Culturally and Linguistically
4 Appropriate Services standards as published by the Office of Minority Health, CONTRACTOR(S)
5 must submit to COUNTY for approval, within 60 days from date of contract execution,
6 CONTRACTOR(S)' plan to address all fifteen national cultural competency standards as set forth in
7 the "National Standards on Culturally and Linguistically Appropriate Services (CLAS)" attached here
8 as Exhibit E and incorporated herein by reference. COUNTY's annual on-site review of
9 CONTRACTOR(S) shall include collection of documentation to ensure all national standards are
10 implemented. CONTRACTOR(S) may solicit complementary assistance from On Track Consulting
11 (http://ontrackconsulting.org/news/culturally-linguistically-appropriate-services/) for training in plan
12 development. As the national competency standards are updated, CONTRACTOR(S)' plan must be
13 updated accordingly.
14
15
28. RECORDS
A. Record Establishment and Maintenance-CONTRACTOR(S) shall
16 establish and maintain records in accordance with State and Federal rules and regulations in addition to
17 those requirements prescribed by COUNTY with respect to all matters covered by this Agreement.
18 Except as otherwise authorized by COUNTY, CONTRACTOR(S) shall retain all other records for a
19 period of five ( 5) years after receiving the final payment under this Agreement or the earlier
20 termination of this Agreement, or until State and Federal audit findings applicable to such services are
21 resolved, whichever is later.
22 B. Documentation-CONTRACTOR(S) shall maintain adequate records in
23 sufficient detail to make possible an evaluation of services, and contain all the data necessary in
24 reporting to the State of California and/or Federal agency. All client records shall be maintained
25 pursuant to applicable State of California and Federal requirements concerning confidentiality.
26 C. Reports -CONTRACTOR(S) shall submit to COUNTY monthly fiscal
27 and all program reports as further described in Section Twenty-Nine (29) REPORTS-SUBSTANCE
28 USE DISORDER SERVICES and as indicated in Exhibit A. Following the end of each fiscal year
-26-
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
affected by this Agreement, CONTRACTOR(S) shall also furnish to COUNTY such statements,
records, reports, data, and information as COUNTY may request pertaining to matters covered by this
Agreement. All reports submitted by CONTRACTOR(S) to COUNTY must be typewritten.
D. Suspension of Compensation-In the event that CONTRACTOR(S) fail
to provide reports specified in this Agreement, it shall be deemed sufficient cause for COUNTY to
withhold payments until there is compliance.
E. Disallowances-Payments by COUNTY shall be in arrears, for services
provided during the preceding month, within forty-five ( 45) days after receipt, verification and
approval ofCONTRACTOR(S)' invoices by COUNTY DBH-SUD Services. Ifpayment for services
are denied or disallowed by State, and subsequently resubmitted to COUNTY by CONTRACTOR(S)',
the disallowed portion will be withheld from the next reimbursement to the CONTRACTOR(S) until
COUNTY has received reimbursement from State for said services.
F. Client Confidentiality-CONTRACTOR(S) shall conform to and
COUNTY shall monitor compliance with all State and Federal statutes and regulations regarding
confidentiality, including but not limited to confidentiality of information requirements of 42 CFR §
2.1 et seq., Welfare and Institutions Code §§5328, 10850 and 14100.2, Health and Safety Code§§
11977 and 11812, Civil Code, Division 1, Part 2.6, and 22 California Code of Regulations § 51009.
29. REPORTS-SUBSTANCE USE DISORDER SERVICES
CONTRACTOR(S) shall submit all information and data required by State,
including, but not limited to the following:
1. Drug and Alcohol Treatment Access Report (DAT AR) and Provider
Waiting List Record (WLR) in an electronic format provided by the State and due no later than five (5)
days after the preceding month.
2. CONTRACTOR(S) shall submit to COUNTY monthly fiscal and all
program reports within twenty (20) days of the end of each month.
3. Cost Reports-On an annual basis for each fiscal year ending June 30th
CONTRACTOR(S) shall submit a complete and accurate detailed cost report(s). Cost reports must be
submitted to the COUNTY as a hard copy with a signed cover letter and an electronic copy by the due
-27-
1 date. Submittal must also include any requested support documents such as general ledgers. All reports
2 submitted by CONTRACTOR(S) to COUNTY must be typewritten. COUNTY will issue instructions for
3 completion and submittal of the annual cost report, including the relevant cost report template(s) and due
4 dates within forty-five ( 45) days of each fiscal year end. All cost reports must be prepared in accordance
5 with Generally Accepted Accounting Principles. Unallowable costs such as lobbying or political
6 donations must be deducted from the cost report and all invoices. If the CONTRACTOR(S) does not
7 submit the cost report by the due date, including any extension period granted by the COUNTY, the
8 COUNTY may withhold payment of pending invoices until the cost report(s) has been submitted and
9 clears COUNTY desk audit for completeness and accuracy.
10 A. DMC -A DMC cost report must be submitted in a format
11 prescribed by the DHCS for the purposes of Short Doyle Medi-Cal
12 reimbursement of total costs for all programs. CONTRACTOR(S)
13 shall report costs under their approved legal entity number
14 established during the DMC certification process. Total units of
15 service reported on the cost report will be compared to the units of
16 services entered by CONTRACTOR(S) into COUNTY's data
17 system. CONTRACTOR(S) will be required to correct
18 discrepancies and resubmit to COUNTY prior to COUNTY's final
19 acceptance of the cost report.
20 B. OTHER FUNDING SOURCES-CONTRACTOR(S) will
21 be required to submit a cost report on a form( s) approved and
22 provided by the COUNTY to reflect actual costs and
23 reimbursement for services provided through funding sources other
24 than DMC. Contracts that include a negotiated rate per unit of
25 service will be reimbursed only for the costs of approved units of
26 service up to the negotiated unit of service rate approved in the
27 Agreement, regardless of the contract maximum. If the cost report
28 indicates an amount due to COUNTY, CONTRACTOR(S) shall
-28-
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
C.
submit payment with the report. If an amount is due to
CONTRACTOR(S), COUNTY shall reimburse CONTRACTOR
within forty-five (45) days of receiving and accepting the year-end
cost report.
MULTIPLE FUNDING SOURCES -CONTRACTOR(S) who has
multiple agreements for the same services provided at the same
location where at least one of the Agreements is funded through
DMC and the other funding is other federal or county realignment
funding will be required to complete DMC cost reports and
COUNTY approved cost reports. Such Agreements will be settled
for actual costs in accordance with Medicaid reimbursement
requirements as specified in Title XIX or Title XXI of the Social
Security Act; Title 22, and the State's Medicaid Plan.
During the term of this Agreement and thereafter, COUNTY and
CONTRACTOR(S) agree to settle dollar amounts disallowed or settled in accordance with DHCS and
COUNTY audit settlement findings related to the DMC and realignment reimbursements. DHCS audit
process is approximately eighteen (18) to thirty-six (36) months following the close of the State fiscal
year. COUNTY may choose to appeal DHCS settlement results and therefore reserves the right to defer
payback settlement with CONTRACTOR(S) until resolution of the appeal.
30. PROPERTY OF COUNTY
A. All purchases over Five Thousand and Noll 00 Dollars ($5,000.00) shall
be identified as fixed assets and shall be maintained in COUNTY's Asset Management System. Certain
purchases under Five Thousand and Noll 00 Dollars ($5,000.00) including but not limited to
computers, copiers, televisions, cameras, and other sensitive items as determined by COUNTY's DBH
Director or designee made during the life of this Agreement shall be identified as assets that can be
inventoried and maintained in COUNTY's DBH Asset Inventory System. These assets shall be
retained by COUNTY, as COUNTY property, in the event this Agreement is terminated or upon
expiration of this Agreement. CONTRACTOR(S) agrees to participate in an annual inventory of all
-29-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
COUNTY fixed and inventoried assets are returned to COUNTY possession at the termination or
expiration of this Agreement. CONTRACTOR(S) is responsible for returning to COUNTY all
COUNTY-owned fixed and inventoried assets, or the monetary value of said assets if unable to
produce the assets at the expiration or termination of this Agreement.
CONTRACTOR(S) further agrees to the following:
I. To maintain all items of equipment in good working order and
condition, normal wear and tear is expected;
2. To label all items of equipment, to perform periodic inventories as
required by COUNTY and to maintain an inventory list showing where and how the equipment is
being used, in accordance with procedures developed by COUNTY. All such lists shall be submitted to
COUNTY within ten (1 0) days of any request therefore; and
3. To report in writing to COUNTY immediately after discovery, the
loss or theft of any items of equipment. For stolen items, the local law enforcement agency must be
contacted and a copy of the police report submitted to COUNTY.
31. PROHIBITION ON PUBLICITY
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 of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion.
Notwithstanding the above, publicity of the services described in Section One (1) SERVICES of this
Agreement shall be allowed as necessary to raise public awareness about the availability of such
specific services when approved in advance by the DBH Director or her designee and at a cost as
provided in Exhibit C for such items as written/printed materials, the use of media (i.e. radio,
television, newspapers) and any other related expense(s).
32. AUDITS AND INSPECTIONS
25 CONTRACTOR(S) shall at any time during business hours, and as often as
26 COUNTY may deem necessary, make available to COUNTY for examination all of its records and
27 data with respect to the matters covered by this Agreement. CONTRACTOR(S) shall, upon request by
28
-30-
1 COUNTY, permit COUNTY to audit and inspect all such records and data necessary to ensure
2 CONTRACTOR(S)' compliance with the terms of this Agreement.
3 If this Agreement exceeds Ten Thousand and Noll 00 Dollars ($1 0,000.00),
4 CONTRACTOR(S) shall be subject to the examination and audit of the State Auditor General for a
5 period of three (3) years after final payment under contract (California Government Code section
6 8546.7).
7 Notwithstanding the provisions state in Section Two (2) TERM of this
8 Agreement, it is acknowledged by the parties hereto that this Agreement shall continue in full force
9 and effect until all audit procedures and requirements as state in this Agreement have been completed
10 to the review and satisfaction of COUNTY. CONTRACTOR(S) shall bear all costs in connection with
11 or resulting from any audit and/or inspections including, but not limited to, actual costs incurred and
12 the payment of any expenditures disallowed by either COUNTY, State or Federal governmental
13 entities, including any assess interest and penalties.
14 33. NOTICES
15 The persons at the below addresses have authority to give and receive notices
16 under this Agreement:
17
18
19
20
COUNTY CONTRACTOR(S)
Director, Fresno County See Exhibit A
Department of Behavioral Health
4441 East Kings Canyon
Fresno, CA 93702
21 Any and all notices between COUNTY and CONTRACTOR(S) provided for or
22 permitted under this Agreement or by law shall be in writing and shall be deemed duly served when
23 personally delivered to one of the parties, or in lieu of such personal services, when deposited in the
24 United States Mail, postage prepaid, addressed to such party.
25 34. CHANGE OF LEADERSHIP/MANAGEMENT
26 Any and all notices between COUNTY and CONTRACTOR(S) provided for or
27 permitted under this Agreement or by law, shall be in writing and shall be deemed duly serviced when
28
-31-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
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.
In the event of any change in the status of CONTRACTOR(S)' leadership or
management, CONTRACTOR(S) shall provide written notice to COUNTY within thirty (30) days
from the date of change. Such notification shall include any new leader or manager's name, address
and qualifications. The terms "Leadership" or "Management" shall include any employee, member, or
owner of CONTRACTOR(S) who either:
A. Directs individuals providing services pursuant to this Agreement;
B. Exercises control over the manner in which services are provided;
or
c. Has authority over CONTRACTOR(S)' finances.
35. GOVERNING LAW
The parties agree that for the purpose of venue, performance under this
Agreement is 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.
36. AOD CERTIFICATION
A. The COUNTY requires all COUNTY -contracted providers of Alcohol
19 and Other Substance Use Disorder treatment services to obtain the California Department of Health
20 Care Services (DHCS) Alcohol and Other Drug Program (AOD) Certification. The AOD Certification
21 Standards will apply to all residential and outpatient treatment modalities. The purpose of the AOD
22 Certification Standards is to ensure an acceptable level of service quality is provided to program
23 participants.
24 B. CONTRACTOR(S) shall provide proof of a completed application for
25 AOD Certification to the County within thirty (30) days from the execution date of this Agreement. A
26 copy of the AOD Certification shall be submitted to the COUNTY when approved by the DHCS.
27 C. This AOD Certification requirement applies to every primary treatment
28 facility operated by the CONTRACTOR(S). CONTRACTOR(S) is not required to obtain a separate
-32-
1 AOD Certification for satellite sites associated with CONTRACTOR(S)' primary treatment facility.
2 Satellite sites are expected to operate within the same AOD Certification guidelines and maintain the
3 same standards as the CONTRACTOR(S)' related primary site. CONTRACTOR(S)' whose agencies
4 are nationally accredited with the Joint Commission on Accreditation of Health Care Organizations
5 (JCAHO) or the Commission on Accreditation of Rehabilitative Facilities (CARP) are exempt from
6 this requirement of AOD Certification. CONTRACTOR(S) shall submit a copy of their JCAHO or
7 CARP accreditation to the COUNTY within thirty (30) days from the date this Agreement is executed.
8 CONTRACTOR(S) shall notify COUNTY if at any time their JCAHO or CARP accreditation lapses or
9 becomes invalid and shall submit a copy of the completed application for AOD Certification to the
10 COUNTY within thirty (30) days from the date the JCAHO or CARP accreditation lapses or becomes
11 invalid.
12 D. COUNTY shall terminate this Agreement immediately in the event any of
13 the following occurs:
14 a) CONTRACTOR(S) fail to submit a copy of the completed
15 application for AOD Certification, or a copy of either their JCAHO or CARP accreditation within
16 thirty (30) days from the execution date ofthis Agreement with the COUNTY.
17 b) CONTRACTOR(S)' application for AOD Certification is denied
18 by the DHCS.
19 c) CONTRACTOR(S) fails to submit to the COUNTY a copy of the
20 AOD Certification within thirty (30) days after being approved by the DHCS, or certification is not
21 maintained throughout the contract period.
22 d) CONTRACTOR(S) fails to apply for AOD Certification with
23 DHCS or fails to submit to the COUNTY a copy of the completed application for AOD Certification
24 within thirty (30) days after the JCAHO or CARP accreditation lapses or becomes invalid.
25 37. ASSURANCES
26 In entering into this Agreement, CONTRACTOR(S) certifies that it is not
27 currently excluded, suspended, debarred, or otherwise ineligible to participate in the Federal Health
28 Care Programs; that it has not been convicted of a criminal offense related to the provision of health
-33-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
care items or services; nor has it been reinstated to participate 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(S) is ineligible on these grounds, COUNTY will remove
CONTRACTOR(S) from responsibility for, or involvement with, COUNTY's business operations
related to the Federal Health Care Programs and shall remove such CONTRACTOR(S) from any
position in which CONTRACTOR(S) salary, or the items or services rendered, order or prescribed by
CONTRACTOR(S) may be paid in whole or in part, directly or indirectly, by Federal Health Care
Programs or otherwise with Federal Funds at least until such time as CONTRACTOR(S) is reinstated
into participation in the Federal Health Care Programs.
A. If COUNTY has notice that CONTRACTOR(S) has been charged with a
criminal offense related to any Federal Health Care Program, or is proposed for exclusion during the
term on any contract, CONTRACTOR(S) 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(S) cease providing services until
resolution of the charges or the proposed exclusion.
B. CONTRACTOR(S) agrees that all potential new employees of
17 CONTRA TOR(S) or subcontractors who, in each case, are expected to perform professional services
18 under this Agreement, will be queried as to whether (1) they are now or ever have been excluded,
19 suspended, debarred or otherwise ineligible to participate in the Federal Health Care Program; (2) they
20 have been convicted of a criminal offense related to the provision of health care items or services;
21 and/or (3) they have been reinstated to participate in the Federal Health Care Programs after a period of
22 exclusion, suspension, debarment or ineligibility.
23 1. In the event the potential employee or subcontractor informs
24 CONTRACTOR(S) that he or she is excluded, suspended, debarred or otherwise ineligible, or has been
25 convicted of a criminal offense relating to the provision of health care services, and
26 CONTRACTOR(S) hires or engages such potential employee or subcontract, CONTRACTOR(S) will
27 ensure that said employee or subcontractor does not work, either directly or indirectly, relating to
28 services provided to COUNTY.
-34-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
2. Notwithstanding any other provision of this Agreement,
COUNTY at its discretion may terminate this Agreement in accordance with Section Three (3)
TERMINATION thereof, or require adequate assurance (as defined by COUNTY) that no excluded,
suspended or otherwise ineligible individual 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(S) 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) 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 participate 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(S) 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(S) will ensure that said employee or
subcontractor does no work, either directly or indirectly, relating to services provided to COUNTY.
1. CONTRACTOR(S) agrees to notify COUNTY
immediately during the term of this Agreement whenever CONTRACTOR(S)' engagement partner
under this Agreement 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 any other provision of this Agreement,
25 COUNTY at its discretion may terminate this Agreement in accordance with Section Three (3)
26 TERMINATION thereof, or require adequate assurance (as defined by COUNTY) that no excluded,
27 suspended or otherwise ineligible individual performs work, either directly or indirectly, relating to
28
-35-
1 services provided to COUNTY. Such demand for adequate assurance shall be effective upon a time
2 frame to be determined by COUNTY to protect the interest of COUNTY and COUNTY's consumers.
3 D. CONTRACTOR(S) agrees to cooperate fully with any reasonable
4 requests for information from COUNTY which may be necessary to complete any internal or external
5 audits relating to this Agreement.
6 E. CONTRACTOR(S) agrees to reimburse COUNTY for the entire cost of
7 any penalty imposed upon COUNTY by the Federal Government as a result of CONTRACTOR(S)
8 violation of the terms of this Agreement.
9 38. CONTROL REQUIREMENTS
10 Performance under this Agreement is subject to all applicable Federal and State
11 laws, regulations and standards. In accepting the State drug and alcohol combined program allocation
12 pursuant to California Health and Safety Code Section 11757, CONTRACTOR(S) shall establish
13 written accounting procedures consistent with applicable Federal and State laws, regulations and
14 standards, and shall be held accountable for audit exceptions taken by the State or COUNTY for failure
15 to comply with these requirements. These requirements include, but may not be limited to, those set
16 forth in this Agreement, and:
17
18
19
20
21
22
23
24
25
26
27
28
A.
B.
C.
D.
E.
F.
G.
Division 10.5 of the California Health and Safety Code;
California Government Code Sections 16366.1 through 16367.9 and
53130 through 53138;
Title 9, Division 4 of the California Code of Regulations;
42 United States code (USC) Section 300x-5;
31 USC Sections 7501-7507 (Single Audit Act of 1984; Single Audit Act
Amendments of 1996);
Office ofManagement and Budget (OMB) Circular A-133 (Audits of
State, Local Governments and Non-Profit Organizations); and
Title 45, Part 96, Subparts B, C and L of the Code of Federal Regulations
(Block Grants).
-36-
1 CONTRACTOR(S) shall submit, if applicable, a copy of its single audit report
2 and management letter, performed in accordance with the Single Audit Act of 1984 (31 USC Section
3 7502) and subject to the terms of OMB Circular A-133 to the County of Fresno. A single audit report is
4 not applicable if all of CONTRACTOR(S)' federal contracts do not exceed Five Hundred Thousand
5 and No/1 00 Dollars ($500,000.00) or CONTRACTOR(S)' only funding is through Drug related Medi-
6 Cal. If a single audit is not applicable, a program audit must be performed and a program audit report
7 with management letter shall be submitted. Such audit report shall be delivered to COUNTY's DBH-
8 SUD Services for review no later than six (6) months after the close of the CONTRACTOR(S)' fiscal
9 year in which the funds supplied through this Agreement are expended. Failure to comply with this Act
1 0 may result in COUNTY performing the necessary audit tasks or contracting with a qualified accountant
11 to perform the audit. All audit costs related to this Agreement are the sole responsibility of
12 CONTRACTOR(S) who agrees to take corrective action to eliminate any material noncompliance or
13 weakness found as a result of such audit. Audit work performed by COUNTY under this section shall
14 be billed to CONTRACTOR(S) at COUNTY's cost as determined by COUNTY's Auditor-
15 Controller/Treasurer-Tax Collector. To maintain the integrity of the audits, CONTRACTOR(S) is
16 required to change its auditor (Certified Public Accountant) at least every three (3) years.
17 39. DISCLOSURE-CRIMINAL HISTORY AND CIVIL ACTIONS
18 CONTRACTOR(S) is required to disclose if any of the following conditions
19 apply to them, their owners, officers, corporate managers and partners:
20 A. Within the three-year period preceding this Agreement, they have been
21 convicted of, or have a civil judgment rendered against them for:
22 1. Fraud or criminal offense in connection with obtaining, attempting
23 to obtain, or performing a public (federal, state or local) transaction or contract under a public
24 transaction;
25
26
27 of records; or
28
2.
3.
4.
Violation of a federal or state antitrust statute;
Embezzlement, theft, forgery, bribery, falsification or destruction
False statements or receipt of stolen property.
-37-
1 B. Within a three-year period preceding this Agreement, they have had a
2 public transaction (federal, state or local) terminated for cause or default.
3 Disclosure of the above information will not automatically eliminate
4 CONTRACTOR(S) from further business consideration. The information will be considered as part of
5 the determination of whether to continue and/or renew the contract and any additional information or
6 explanation that a CONTRACTOR(S) elects to submit with the disclosed information will be
7 considered. If it is later determined that the CONTRACTOR(S) failed to disclose required information,
8 any contract awarded to such CONTRACTOR(S) may be immediately voided and terminated for
9 material failure to comply with the terms and conditions of the award.
10 CONTRACTOR(S) must sign an appropriate "Certification Regarding
11 Debarment, Suspension, and Other Responsibility Matters," Exhibit F, attached hereto and by this
12 reference incorporated herein. Additionally, CONTRACTOR(S) must immediately advise the
13 COUNTY in writing if, during the term ofthe Agreement (I) CONTRACTOR(S) becomes suspended,
14 debarred, excluded or ineligible for participation in federal or state funded programs or from receiving
15 federal funds as listed in the excluded parties list system (http:/ /www.epls.gov) or (2) any of the above-
16 listed conditions become applicable to CONTRACTOR(S). The CONTRACTOR(S) will indemnify,
17 defend and hold the COUNTY harmless for any loss or damage resulting from a conviction,
18 debarment, exclusion, ineligibility or other matter listed in the signed Certification Regard Debarment,
19 suspension, and Other Responsibility Matters.
20 40. DISCLOSURE OF SELF -DEALING TRANSACTIONS
21 This provision is only applicable ifthe CONTRACTOR(S) is operating as a
22 corporation (a for-profit or non-profit corporation) or if during the term of this Agreement the
23 CONTRACTOR(S) changes its status to operate as a corporation.
24 Members of the CONTRACTOR(S)' Board of Directors shall disclose any self-
25 dealing transactions that they are a party to while CONTRACTOR(S) is providing goods or performing
26 services under this Agreement. A self-dealing transaction shall mean a transaction to which the
27 CONTRACTOR(S) is party and in which one or more of its directors has a material financial interest.
28 Members of the Board of Directors shall disclose any self-dealing transactions that they are a party to
-38-
1 by completing and signing a Self-Dealing Transaction Disclosure Form (Exhibit G) and submitting it
2 to the COUNTY prior to commencing with the self-dealing transaction or immediately thereafter.
3 41. SMOKING PROHIBITION REQUIREMENTS
4 CONTRACTOR(S) shall comply with Public Law 103-227, also known as the
5 Pro-Children Act of 1994 (20 USC Section et seq.), and with California Labor Code Section 6404.5,
6 the California Smoke-Free Workplace Law.
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
42. INTERIM SERVICES
CONTRACTOR(S) must adhere to the Negotiated Net Amount contract
requirement to provide interim services in the event that an individual must wait to be placed in
treatment.
Interim Substance Use Disorder Services means services that are provided until
an individual is admitted to a substance abuse treatment program. The purposes of the services are to
reduce the adverse health effects of such abuse, promote the health of the individual and reduce the
risk of transmission of disease. At a minimum, interim services include counseling and education about
HIV and tuberculosis (TB ), about the risks of needle-sharing, the risks of transmission to sexual
partners and infants, and about steps that can be taken to ensure that HIV and TB transmission does not
occur, as well as referral for HIV or TB treatment services, if necessary. For pregnant women, interim
services also include counseling on the effects of alcohol and drug use on the fetus, as well as referral
for prenatal care.
Records must indicate evidence that interim services have been provided and
documentation will be reviewed for compliance.
43. SEPARATE AGREEMENT
It is mutually understood by the parties that this Agreement does not, in any way,
create a joint venture among CONTRACTOR(S). By execution ofthis Agreement, CONTRACTOR(S)
understands that a separate Agreement is formed between each individual CONTRACTOR and
COUNTY.
Ill
Ill
-39-
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
44. SINGLE AUDIT CLAUSE
A. If CONTRACTOR(S) expends Five Hundred Thousand and No/1 00
Dollars ($500,000.00) or more in Federal and Federal flow-through monies, CONTRACTOR(S) agrees
to conduct an annual audit in accordance with the requirements of the Single Audit Standards as set
forth in Office of Management (OMB) Circular A-133. CONTRACTOR(S) 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(S) must include a corrective
action plan signed by an authorized individual. CONTRACTOR(S) 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 Finance 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(S). All audit costs related
to this Agreement are the sole responsibility of CONTRACTOR(S).
B. A single audit report is not applicable if CONTRACTOR(S)' Federal
contracts do not exceed the Five Hundred Thousand and Noll 00 Dollars ($500,000.00) 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(S) to COUNTY as a minimum requirement to attest to
CONTRACTOR(S)' solvency. Said audit report shall be delivered to COUNTY's DBH Finance 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(S) 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 section shall be billed to the CONTRACTOR(S)
at COUNTY's cost, as determined by COUNTY's Auditor-Controller/Treasurer-Tax Collector.
-40-
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
C. CONTRACTOR(S) shall make available all records and accounts for
inspection by COUNTY, the State of California, if applicable, the Comptroller General of the United
States, the Federal Grantor Agency or any of their duly authorized representatives, at all reasonable
times for a period of at least three (3) years following final payment under this Agreement or the
closure of all other pending matters, whichever is later.
45. TAX EQUITY AND FISCAL RESPONSIBILITY ACT
To the extent necessary to prevent disallowance of reimbursement under Section
1861(v)(l)(I) ofthe Social Security Act, (42 USC§ 1395x, subd. (v)(l)[I]), until the expiration offour
(4) years after the furnishing of services under this Agreement, CONTRACTOR(S) shall make
available, upon written request ofthe Secretary ofthe United States Department of Health and Human
Services, or upon request of the Comptroller General of the United States General Accounting Office,
or any of their duly authorized representatives, a copy of this Agreement and such books, documents
and records as are necessary to certify the nature and extent of the costs of these services provided by
CONTRACTOR(S) under this Agreement.
CONTRACTOR(S) further agrees that in the event CONTRACTOR(S) carries
out any of its duties under this Agreement through a subcontract, with a value or cost of Ten Thousand
and No/100 Dollars ($10,000.00) or more over a twelve (12) month period, with a related organization,
such Agreement shall contain a clause to the effect that until the expiration of four ( 4) years after the
furnishing of such services pursuant to such subcontract, the related organizations shall make available,
upon written request of the Secretary of the United States Department of Health and Human Services,
or upon request of the Comptroller General of the United States General Accounting Office, or any of
their duly authorized representatives, a copy of such subcontract and such books, documents and
records of such organization as are necessary to verify the nature and extent of such costs.
46. ENTIRE AGREEMENT
This Agreement, including all RFA's, Amendments and Exhibits attached hereto,
constitutes the entire Agreement between the CONTRACTOR(S) and COUNTY with respect to the
subject matter hereof and supersedes all previous negotiations, proposals, commitments, writings,
-41-
1 advertisements, publications, and understandings of any nature whatsoever unless expressly included
2 in this Agreement.
3 Ill
4 Ill
5 Ill
6 Ill
7 Ill
8 Ill
9 Ill
10 Ill
11 Ill
12 Ill
13 Ill
14 Ill
15 Ill
16 Ill
17 Ill
18 Ill
19 Ill
20 Ill
21 Ill
22 Ill
23 Ill
24 Ill
25 Ill
26 Ill
27 Ill
28 Ill
-42-
1 IN WI1NESS WHEREOF, the parties hereto have executed this Agreement as of the day
2 and year first hereinabove written. ,
3
4
5
6
7
8
9
10
ATTEST:
COUNTY OF FRESNO
B y:--\\;;}I.A..DL..\~p..JL-"'--=-"--____._...!<....>!~~'11
Deborah A. Poochigian, Chair.
Boa of Supervisors
11 BERNICE E. SEIDEL, Clerk
Board of Supervisors
Date: :rWr-0 .. /Lo, ~015
PROVIDER(S):
SEEEXHffiiTA
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
PLEASE SEE ADDITIONAL
SIGNATURE PAGES ATTACHED
-43-
1 APPROVED AS TO LEGAL FORM:
2 DANIEL C. CEDERBORG, COUNTY COUNSEL
: By:.~~~·~-~f-· --~------------
6
APROVED AS TO ACCOUNTING FORM:
7 VICKI CROW, C.P.A., AUDITOR-CONTROLLER!
8 TREASURER-TAX COLLECTOR
9
1 o By=-~-~.!tL.J,.:.~~.:::.....:Lc=--~~C:::....J..j ..::._t·c;./ ____ _
11
12
13 REVIEWED AND RECOMMENDED FOR
14 APPROVAL:
15
By: _ __.!..~-=--~...:.___~-----
16 Dawan Utecht, Director
17 Department of Behavioral Health
18
19
Fund/Subclass: 000 Ill 0000
20 Organization:
FY 2015-2016
21 FY 2016-2017
FY 2017-2018
22 FY2018-2019
23 FY 2019-2020
24
25 Account/Program:
26
27
28 JC
56302081
($216,744.00)
($219,995.00)
($223,295.00)
($226,644.00)
($230,044.00)
7294/0
-44-
Provider: COMPREHENSIVE ADDICTION PROGRAMS, INC
~
--:. p ·-:J>·, ~J-...r-
Title: tx'~ c:._ .... ./~"""'
Chairman ofthe Board, President or Vice President
9 oate: __ <s_-_--=6:___-_/_~_-__
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
8&4~~
Print Name: . J~ tf1t/ ~Eu!tf4f-
Title:_A_~ __ ·,_J.:___..:._e._"'-_·\-______ _
Secretary (of Corporation), Assistant Secretary,
Chief Financial Officer or Assistant Treasurer
Date: __ S_,__(o_·-_J.-__0_' _5 __ _
-45-
PROVIDERS
FRESNO COUNTY
Exhibit A
Page 1 of 1
RESIDENTIAL DETOXIFICATION/STABILIZATION
1. Comprehensive Addiction Program, Inc.
2445 W. Whites Bridge Ave
Fresno, CA 93706
Attn: Executive Director
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
EXHIBIT-B
Page 1 of6
COUNTY OF FRESNO
REQUEST FOR APPLICATION
RESIDENTIAL DETOXIFICATION/STABILIZATION SERVICES
CLOSING DATE OF APPLICATION WILL BE AT 2:00 P.M., ON 03/11/2015
DEPARTMENT OF BEHAVIORAL HEALTH
SUBSTANCE USE DISORDER SERVICES
515 S. CEDAR AVE, BUILDING 320
FRESNO, CA 93702
FAX: (559) 600-6089
ATTN:
JOSE CONCHAS JR., STAFF ANALYST
(559) 600-6059
EXHIBIT-B
Page 2 of6
RESIDENTIAL DETOXIFICATION/STABILIZATION SERVICES
SCOPE OF WORK
ALCOHOL AND DRUG-FREE
RESIDENTIAL DETOXIFICATION/STABILIZATION
SERVICES (UP TO 14 DAYS)
(Note: This Request for Application (RFA) is not a competitive bidding process. The County
intends to contract with all applicants that meet the requirements of the RFA.)
Overview
The incidence of substance use in Fresno County is significant. In 2014, Fresno County
experienced 8,386 client admissions into substance use disorder treatment programs; of these,
5,459 (65%) were males, 2,925 (35%) females. Clients under 18 years of age represented 20%
of all admissions, 18-30 30%, 31-40 22%,41-50 15%, 51-60 10%, and 61 years and older 2%.
The primary drug of choice for the majority of admissions was methamphetamines (29%),
followed by marijuana/hashish (24%), heroin (21 %), alcohol (17%), other opiates or synthetics
(4%), cocaine/crack (2%), and oxycodone/oxycontin (2%).
Research demonstrates that detoxification as a stand alone service is not effective. To
produce long-lasting and positive results, detoxification must be considered the entry point to
further services. Therefore, the overarching goal and outcome measurement of this program
will be to transition the client from detoxification/stabilization to the appropriate next level of
care (i.e. residential or outpatient treatment services).
II Target Population
To the greatest extent possible, the target population for this program shall include, but not be
limited to:
• Underserved populations such as the disabled and low-income individuals;
• Adults (18 years of age and older) who are substance abusers;
• Adults who have co-occurring substance use/dependence and mental health disorders;
and
• Adults referred from local hospital emergency departments and/or Fresno County's
mental health crisis/stabilization unit.
Ill Service Expectations
The County will only contract with non-profit agencies licensed to provide residential
substance use disorder treatment services, as well as licensed to provide residential
detoxification services. For agencies not currently licensed to provide residential
EXHIBIT-B
Page 3 of6
detoxification services, a plan and timeline in which the agency will obtain licensure for
residential detoxification must be included in the response. Residential detoxification licensure
must be obtained by the effective date of the agreement which is expected to be July 1, 2015.
The successful applicant(s) will provide licensed residential detoxification and stabilization (up
to 14 days) services as described herein. Services provided under this agreement shall be
delivered at a site(s) located in Fresno County for alcohol and other drug abusing/dependent
adult male and female (18 years of age and older) residents of Fresno County. Applicant
must be willing to consider flexibility regarding coordination or co-location with a Sobering
Center. The successful applicant(s) will provide program participants with adequate food, a
safe environment, and a clean bed and shower facility. Services shall be in compliance with
the State of California Alcohol and Other Drug Programs License and Certification Standards
published on March 15, 2004:
http://www.dhcs.ca.gov/provgovpart/Documents/AOD Certification Standards.pdf.
The County of Fresno is in the process of developing a broad continuum of services at
different levels of care. The residential detoxification/stabilization services are one element of
that continuum; therefore, agencies must be willing to be flexible with partnering and
coordinating with other providers and services which are part of that continuum.
These services are designed to assist adult alcohol/drug using residents of Fresno County by
providing:
1. Referrals from the detoxification services to the appropriate level of care and ancillary
services;
2. A safe withdrawal from alcohol and other drug(s) of dependence, including 24-hour
supervision in a safe and clean environment;
3. Access to resources to maintain good hygiene during the detoxification and
stabilization process;
4. Nutritious meals and in-between meal snacks;
5. A withdrawal that is humane and protects the participant's dignity; and
6. Alcohol/drug education and intervention for individuals receiving services.
The level of intoxication, drug(s) of choice and physical impairments will determine a
participant's length of stay.
The successful applicant(s) shall have written protocols that prescribe the length of stay
derived from the assessment. These protocols shall be included in the application.
The successful applicant(s) shall demonstrate linkages to treatment services, such as
residential and outpatient programs. The successful applicant(s) shall have in place
Memorandums of Understanding (MOUs) with treatment service providers affirming that
clients will be referred for on-going services, if appropriate. These MOUs shall be submitted
with the application.
EXHIBIT-B
Page 4 of6
Applicant MUST include with application a specific plan to ensure client transition to
next level of care.
The program shall maintain a complete daily census of all participants served and all
statistical information required by Fresno County. In addition, the program shall maintain
complete records of services, and provide all the data necessary in reporting to the State of
California, referral sources and County including waiting list information, records of individual
counseling and progress notes.
The program shall fully describe its existing procedure for continuous quality management and
improvement with supporting documentation, as well as an evaluation component to
determine the effectiveness of the services provided to each participant.
The application shall include costs for both residential detoxification and stabilization services:
(1) Cost per day for Residential Detoxification Phase (day 1-3)
(2) Cost per day for Residential Stabilization Phase (day 4-14)
It is the expectation/assumption that the costs for the stabilization phase would be less than
daily costs incurred during the detoxification phase. Reimbursement for services shall not
exceed the cost per day established in the executed agreement. Applicants have the option
to receive an annual cost of living of no more than 1.5% of the previous year's cost per bed
slot. To receive this increase, applicants must request and justify it in their application
narrative.
It has been noted that many clients transferring from detoxification services into residential
and/or outpatient treatment services are not "ready" to be fully engaged in the treatment
program, due to the debilitating effects of their recent alcohol and other drug use and their
subsequent lifestyle, including deprivation of adequate and nutritious food and sufficient
sleep/rest. Therefore, the stabilization phase shall be designed to provide the client with
adequate and nutritious food and plenty of sleep and rest, while providing sufficient
intervention activities that promote the desired goal of a successful transfer to the next level of
care.
IV AWARD CRITERIA:
CAPABILITY AND QUALIFICATIONS
EXHIBIT-B
Page 5 of6
A. The County will contract with all applicants that meet the RFA requirements for a total of
approximately 6-8 Residential Detoxification/Stabilization beds, and will determine the
allocation for each agency. In addition, the County may contract for four (4) supplementary
beds to be used exclusively for clients referred from local Hospital Emergency
Departments and/or Fresno County's mental health crisis/stabilization unit. Providers
must address the following:
1) Do the service descriptions address all the areas identified in the RFA? Will
the proposed services satisfy County's needs and to what degree (see Sections
I, II, and Ill for County's needs)? Does the application include a specific plan
ensuring the transition of clients into the next appropriate level of care?
2) Applicants' knowledge or awareness of the problems associated with providing
the services proposed and knowledge of laws, regulations, statutes and
effective operating principles required to provide this service. Applicant must
possess a license number issued by the effective date of the agreement.
3) The amount of demonstrated experience in providing the services desired in a
California County.
COPIES: Submit one original, and one copy, of your request for application no later than the
RFA closing date and time as stated on the front of this document to County of Fresno
Department of Behavioral Health, Contracts Division -Substance Use Disorder Services (DBH
-SUDS), 515 S. Cedar Ave., Building 320, Fresno, CA 93702.
ISSUING AGENT: This RFA has been issued by County of Fresno Department of Behavioral
Health, Contracts Division -Substance Use Disorder Services (DBH-SUDS). DBH-SUDS
shall be the vendor's sole point of contact with regard to the RFA, its content, and all issues
concerning the RFA.
INTERPRETATION OF RFA: Vendors must make careful examination of the requirements,
specifications and conditions expressed in the RFA and fully inform themselves as to the
quality and character of services required. Any change in the RFA will be made only by written
addendum, duly issued by DBH-SUDS. DBH-SUDS will not be responsible for any other
explanations or interpretations.
RIGHT TO REJECT REQUEST FOR APPLICATION: DBH-SUDS reserves the right to reject
any and all RFA'S and to waive informalities or irregularities in the RFA.
PROCEDURE FOR REQUEST FOR APPLICATION: The Fresno County Alcohol and Drug
Program Administrator, or designee, will implement the following process by which County
staff will solicit and accept new applications from prospective Residential
Detoxification/Stabilization program providers.
On an annual basis prior to July 1, DBH-SUDS will review applications and program activity
to determine whether a need exists for additional program services and/or providers for
Residential Detoxification/Stabilization.
TERM: The initial agreement shall begin July 1, 2015 through June 30, 2018 with two (2)
additional twelve ( 12) month renewal periods upon mutual consent of the parties.
EXHIBIT-B
Page 6 of6
TERMINATION: This agreement may be terminated by the County at any time upon a 30-day
written notice.
Exhibit C
APPLICATION FOR RESIDENTIAL DETOXIFICATION/STABILIZATION SERVICES
County of Fresno, Department of Behavioral Health, Contracts Division -Substance Use
Disorder Services
Applicant Name: Comprehensive Addiction Programs Inc Mailing Address (if different):
Address: 2445 W. Whites Bridge Ave Address:
City: Fresno State: CA City: State:
Telephone: 559-264-5096 Zip Code: 93706 Telephone: Zip Code:
Application Filed by {check all that apply):
0 Sole Proprietor 0 Corporation 0 For-Profit
0 Partnership 0 Non-Profit 0 County-Operated
Provider shall agree to comply with the Request for Application Residential Detoxification/Stabilization Services scope
of work and requirements of the RFA .
. Please attach ci narrative response to Adciundin"Exhiblt B. S'ectfon IVA ward Criteria,·
RESIDENTIAL DETOXIFICATION/STABILIZATION SERVICES FOR COUNTY USE ONLY
Proposed number of beds available per day: 9 Amount requested by provider: $ -
Number of proposed annual bed days (Units of Approved maximum contract
Service): 3285 amount for FY 2015-16:
Cost per bed day (Units of Service): $65.98
PROGRAM INFORMATION
Program Name: Comprehensive Addiction Programs Remit to Address {if different):
Address: 2445 W. Whites Bridge Ave. Address:
City: Fresno State: CA City: State:
Telephone: 559-264-5096 Zip Code: 93706 Telephone: Zip Code:
Name(s) and locatlon(s) of other proposed residential detoxification/stabilization service sites owned or operated by the applicant(s):
Name Address City State Zip Code
Not Applicable
Name Address City State Zip Code
Not Applicable
Program Director: _M:.;_:.;;_ik~e~R.;;;o:::::th~---------Telephone: (559) 264-5096 X19
Si&nature:~·~(-~?-··. -··---··-·-.. Date: March 10, 2015
Comprehensive Addiction Programs, Inc.
SERVICE EXPECTATIONS II
1
Exhibit C
RESIDENTIAL DETO~ICATION STABILIZATION SERVICES
1. Service Description
The detoxification and stabilization program ("detox") i~ designed to address theneeds of
individuals seeking to withdraw from alcohol and/or drug addiction and prepare for entry
into a treatment and recovery program. All services will be provided in the context of a
safe, health-promoting environment with qualified care and monitoring 24 hours per day,
7 days per week. The facility, staff and services will be in full compliance with the State
of California Alcohol and Other Drug Programs License and Certification Standards, as
are all CAP programs.
A. Facility, Staffing and Services
The facility will consist of two 4-bed rooms for each women and men, each with a full
shower and bathroom, separated by a community day room. The space includes a staff
office, waitingroom, kitchen/dining area and laundry facilities. The site is on the same
property as CAP's residential treatment program and is gated chain link fence with
privacy slats will separate detox from the other two programs, physically and visually.
Clients and family members arriving on property for detox will be escorted from the
parking lot into the detox waiting room.
Maintenance of the facility, client safety and cleanliness at all times will be the
responsibility of on-duty staff. Duties will include cleaning up spills, handling and
replacing soiled clothing and linens assuring a serene environment that includes low
lighting, quiet sounds, no visitors, and limiting sensory stimulation while clients are
withdrawing from alcohol and other drugs dependence.
Staffmg will consist of a Case Manager, scheduled Monday through Friday during the
work day, and total of ten trained monitors on combined shifts. All staff will report to a
designated CAP management for weekly staff meetings. First aid, CPR, basic health and
safety procedures, and operational trainings such as confidentiality, ethics risk
management, emergency response, and crisis de-escalation will be required.
(
(
Exhibit C
Services and length of stay at.each stage of the detox and stabilization process will be
determined by intake and assessment processes. Clinical tools will include:
0 Accucare system intake, admission, and treatment plan components
OAODHealthScreening Questionnaire,
0 Cal OMS Admission and Discharge forms
0 Addiction Severity Index
0 Daily monitoring and status evaluation logs
The timeline included ih (Attachment 1) illustrates the expected continuum of care :from
initial intake thrqugh transition to community-based services. However, the timing of
service actiVities will vary according to each client's level of intoxication, p4ysical
status, and ability to participate in the intake, admission, and withdrawal management
process. Completion ofthe activities below may occur in variable order and over a
period of time, dependent upon the client's abilities. All staff will be trained to conduct
all client contacts with respect, dignity, and the maximum amount of confidentiality.
When more than one bed in the room is occupied, folding screens will be used to assure
privacy during exams and interviews.
Detoxification:
0 Initial intake: gathering demographic information, appropriate consents, alcohol and
other drug screening and baseline testing, and confirmation of medical clearance for
detoxification, including medication protocols, if any;
0 A body scan to identify and record existing physical issues that may need . medical
attention;
0 Assistance with showering, personal hygiene, and dressing in loose, comfortable
clothing provided by the program;
0 Review of food allergies and/or intolerances and preparation of a plan for meals, snacks,
and supplemental feeding if needed;
0 Education about the withdrawal process and expectations; and
0 Establishment of a schedule for monitoring and periodic reviews of detox signs,
symptoms, and level of intensity.
On every shift, every client will be checked every half hour or every two hours,
dependent upon the level of withdrawal intensity, and the observations recorded in the
client's personaltreatment files. Progress notes (Attachment 2)will also include descriptions
(
3
Exhibit C
of all activities conducted, . e.g. hygiene, meals served, medication management, ~bulatory
status, client's ability to respond to directions, self-directedness, etc.
On a daily basis the Case Manager wiil review all progress notes, conduct a face-to-face
interview with each client, and determine whether the level of care is still appropriate.
Recommendations for continued detox or transition to stabilization will be included in each
clie~~·s progress notes and reported to the oncoming monitor during a shift-change briefing.
Changes in each client's routines, if any, will be communicated from shift to shift.
l
Stabilization and Transition:
When the Case Manager determines that the client is stable and cognizant enough to
participate, the Case Manager will assist the client with developing a stabilization and
transition plan. Each client will have adequate time for sleep, rest, and nutrition, and will
be encouraged to participate inAOD education and intervention activities (see Attachment
2). During the initial transition from detox to stabiliza~ion, several activities will occur:
0 An interim assessment will be completed to establish a new schedule for monitoring
and daily activities, based on the client's physical and mental status. The Case Manager
. will utilize Motivational Interviewing techniques to assess the client's readiness for
change.
0 Based on the assessment, the Case Manager may schedule additional individual
sessions with the client to explore the client's readiness for treatment in further detail.
0 The Case Manager and the client will work together to identify post-completion
strategies to meet collateral needs such as housing, medical care, and employment after
stabilization is completed.
0 Daily status checks and progress notes will be continued on all shifts.
When daily status checks, individuals/sessions, and progress notes indicate that the
client is ready for purposeful transition planning, to determine the most appropriate
level of care for the client,residential or outpatient.
0 If residential treatment is recommended, the Case Manager will contact community
treatment agencies regarding bed availability and make arrangements for the client's
admission as soon as the client's condition permits ..
. 0 If outpatient treatment is recommended, the Case Manager will work with the client
toselect a provider, based on the client's needs and the resources available through the
agencies with whom CAP has an agreement in place (Attachment 3).
0 The Case Manager will contact the agency and make arrangements for an onsite visit
with the client. The first outpatient visit will be scheduled and the Case Manager will
\ discuss location, date/time, travel arrangements, etc. with the client. The information will
also be provided in writing.
(
4
Exhibit C
0 The. Case Manager will discuss Bridging the Gap and/or other sponsorship programs
such as .AA or NA to determine the clienfs willingness to accept a sponsor for transition
support. If yes, then an appointment with a sponsor will be scheduled prior to discharge.
0 ~edi~t~ly prior to transfer to the next level of care, the Case Manager will provide a
satisfaction survey (Sample 1) for the client to complete, complete the final interview for
closure, and assist the client with transportation arrangements to residential treatment or
housing.
After a client is discharged from the facility, the Case Manager will complete the
discharge summary in Accucare and close the record, r~move the client's name from
the daily census, and store the closed case file in the designated secure location
2. History and Experience
Comprehensive Ad4iction Prdgrams, Inc. has over 25 years experience with
providing detoxification and stabilization services in Fresno County. Until fiscal issues
forced the program's closure in September 2009, CAP operated the only free-standing
detox unit in the county, a 15:-bed facility serving adult men and women in need of a safe
environment which they could withdraw from alcohol and/or drug intoxication. On July
1, 2011 CAP open the doors again and is still operating to this day. "
The detox facility operated as part of the state-licensed residential addiction
treatment program. It was staffed 24 hours per day, severi days per week, by
monitoring staff trained to provide the level of monitoring and services necessary for
each client, based on the needs identified at the time of intake. The facility housed
bathrooms with showers, clean bedding and clothing while they were in detox, and three
meal~ per day plus snacks, delivered from the facility dining hall.
At the time of admission, detox staff initiated an assessment that identified
l.
demographic information about the client, history of drug/alcohol use, and current
addiction issues. The assessment included client's current social and physical social
issues and conditions.
Although the detox program was a non-medical, social rehabilitation model, all
incoming clients were required to obtain medical clearance, including clearance for
any medications in their possession, from their physicians or from an appropriate
medical facility; medications approved by a physician were kept in a locked cabinet
and made ·available to the clients for self-administration at appropriate times.
Clients were monitored at all times and log entries provided ongoing information about
each client's condition and treatment plans. Individual client records were created and
'·.
cS
Exhibit C
maintained as long as the client remained. in detox. During the clients' stay in the facility,
the monitors worked with each individual to plan for transitioning out of detox into
treatment or back to community living.
Dependent upon the client's needs 'and circums~ances, the discharge plan
(Attachment C) might also include information about housing, employment, family
support networks, and recommended level of continued. treatment, e.g. residential
treatment or outpatient treatment. Formulation of discharge recommendations
l
included research to determinewhether a County-funded resitlential bed or outpatient
treatment slot was available, if appropriate for the client, and linkage to the treatment
agency. The monitors often made multiple community contacts, usually by
telephone, in an effort to link detox clients to ongoing community-based services.
Data gathering was accomplished through the use of the state's CalOMS form,
although the data were only reported to Fresno County for individuals occupying
county-funded beds.
The admission and discharge questionnaires were used to capture information
from which to develop a plan of care and discharge planning. Detox staff were able
to capture and report all information about census, bed utilization, and client
demographics as required by the agreement with Fresno County. However, the
three to five day limitation on County-funded length of stay in detox often posed a
barrier to the staffs ability to complete in-depth assessments and treatment data.
The proposed detox and stabilization program draws upon the experience and lessons
learned during the tenure of the previous CAP detox facility, and expands it by using
proven policies and practices for transition planning and intensive case management
services in thefield of addiction treatment and recovery.
3. Data Gathering and Continuous Quality Improvement
The proposed program will utilize the agency's existing online Accucare system for all
intake, admission, assessment, progress notes, treatment and transition planning and
daily census information. Accucare provides ad hoc reports as needed, whether
demographic, administrative or clinical, at the individual client levei or in the aggregate.
At a minimum, Accucare will be used to gather data regarding client referral sources,
alcohol and drug histories, client descriptive information, length of stay data, and data
(
6
Exhibit C
regarding number of treatment completions, and. transfers to other levels of care. The
program is capable of storing and reporting all information that may be requested by
Fresno County.
CAP will use existing detox policies and procedures for continuous quality
management and improvement. as the basis for developing perfqrmance and effectiveness
. ~e;asures that are specific to stabilization and transfers to lower levels of care. In addition
to quantitative data such as the number of intakes and discharges and total days stay, data
collection systems will be developed to assess the du~ity of the care provided (
Attachment D, E and F) . Compara9ve data· gathered at intake and at subsequent points
along the continuum of care will measure the program's impact on clients' readiness and
willingness to continue treatment at the next appropriate level.
Under the authority of signed consents for the release of information, CAP will also
work with its partner providers to determine whether clients follow through with
recommended services. Information will be requested regarding client participation for a
period of s i x months after discharge in an effort to determine the extent to which clients
remained in treatment after stabilization.
4. Summary and Conclusion
As has been described throughout this proposal, we believe that CAP has the history,
the experience and the commitment to once again become a qualified provider of
detoxification services to the residents of Fresno County. The opportunity to expand
services beyond the "revolving door" of three-day detoxification models brings a new,
much-needed dimension of addiction treatment and recovery support to the county.
CAP's experience with engagement and retention of clients referred to the residential
program, with a 80% completion rate, will serve as a strong foundation for engaging
detox clients and enhancing their readiness to participate in and benefit from residential
and/or outpatient services.
Comprehensive · Addiction Programs, Inc. has a history of meeting or exceeding
mandates and expectations in all of its services contracted by Fresno County, as evidenced
by the compliance report* included as (Attachment G). We have every confidence in our
ability to meet the County's needs in the proposed detoxification and stabilization program.
December 18, 2014
To whom it may concern:
· Department of Veterans Affairs
Central ~alifornia Health Care System
2615 East Clinton Avenue
Fresno, CA 93703-2286
Exhibit G
. For over ten -years, the Comprehensive Addiction Program (CAP) h~s become a valuable asset to
the Veteran's Administration Substance Use Disorder Program {SUDP), providing tremendous support to
the health and welfare of our veterans.
CAP provides a well-rounded program, touching on a varietr of topics to provide our veterans
with personal living skills that go beyond addiction, in an effort to insure success in a veteran's road to
recovery. CAP has always made itself available to the needs of the SUDP and consistently goes the extra
mile to insure the comfort of our veterans during an obvious time of duress.
Understanding that the road to recovery is often a bumpy one that progresses on an individual
basis, CAP remains flexible to the needs of our veterans, oft~n extending contracts in an effort to insure
the wellbeing of each and every individual.
The staff of CAP have always acted professionally and efficiently, maintaining consistent
communications with SUDP· Case Managers and providing a positive interaction with our veterans. We
look forward to continuing our partnership with CAP.
R~ully, ,...,~
P:aron =-.~DC,~'""\...)
Supervisory Addiction Therapist
VA Central California Healthcare System
Substance Use Disorder Program
2615 E. Clinton Avenue
CoMPREHENSIVE · Exhibit c
ADDICTION ~ Sinid973
PROGRAMS, INC. 2445 West Whites~rldge Avenue • Fresno, CA 93706;, Ph: 5591264-5096 • Fax: 5591264-1258
www.caprehab.org
February 27,2015
To whom it may co~cern,
On behalf of Co~prehensive .Addiction-Programs; Inc., I '-m pleased to provide this
Letter of Support for Turning Point of <;:entral Californ1a. CAP has been providing
Substance Use Disorder services in-Fresno Co-q.nty for-over forty .. three years. CAP and
Turning Point have w.orked together f«>r the past ·twenty years,-and that partnership has
contributed greatly to the successful outcomes of those individuals who were fortunate
enough to be provided s,ervices in caring environments. This willingness to work together
for the betterment of each ~dividual receiving treatment has enabled both programs to
provide a higher level of care.
Compr~hensive Addiction Programs, Inc. fully supports Turning Point of Central
Cafifomia's efforts to continue to work and partnership with C~mprehensive Addiction
Programs to achieve our collective goals; pr~viding those individuals suffering from
addictive disorders the absolute opportu.DitY to receive the tools necessary to achieve lasting
sobriety and a real sense of purpose.
Respectfully Submitted,
6Ls:t-#? ~
Michael C. Roth
Executive Director
Comprehensive Addiction Programs, Inc.
•"JP TURNING POINT
OF CENTRAL CALIFORNIA,INC.
258 North Blackstone A venue · Fresno, CA 93 70 l (559) 274:-0299 * FAX 268-0473
',•
Intensive Community Services & Support Team
·(ICSST)
Comprehensive Addiction Programs, Inc.
Mr. Michael Roth
2445 west Whitesbridge Avenue
Fresno, California 93706
March 3, 2015
Dear Mr. Roth:
It is with great enthusiasm that I ,am writing a letter for Comprehensive Addiction
Programs, Inc. ("CAP''). For over thirty years, CAP and Turning Point of Central
California have worked together to serve Fresno County's most vulnerable population.
Mental health and substance abuse are often coexisting·; therefore it is crucial that a
strong and comprehensive relatioJ,lShip exists between the two programs to ensure our
mutual clients receive the best possible treatment and services.
CAP has always displayed professionalisD1 and shown a great interest in serving a
population that may feel lost, alone and J:{opeless. CAP provides them with a drug free
future, a chance to have a better life and hope.
Despite the mental health challenges that our clients face, CAP.has been flexible and
accepting of them. It has been an honor to work with CAP and look forward to the future.
s~~f\~
Cheri-Lynn Wortham, MS/JD
Program Director
Exhibit C
!
j
I
I
I
i
. Exhibit C
CAP DETOX UNIT
DAILY CENSUS
DATE 2/01/2015
DAY: SUNDAY
Status ASI Refer to: ~. TIME DAYS IN DAYS
CLIENT'S NAME DONE LEFT OUT
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
9.)
10.)
11.)
12.)
13.)
14.)
Attachment 1 Phone screen Intake, assessment and monitoring Detoxification ,and Stabilization Stabilization and normalization; daily status checks, review of collateral needs. Education and intervention. 10 ASI, Reassessment, · recommendation for next level of car.e, transition plan Transition plan for Bridging The Gap and/or residential or outpatient provider Note: these activities may occur more rapidly or more slowly, dependent upon clients' individual needs, desires, responses to treatment-1 -3: Intake and initial assessment, data gathering. Continuous monitoring, meals, snacks, showers, medication management (see Exhibit X). On Day 3, status assessment and recommendation for discharge or stabilization. 4 - 8 Continued monitoring, feeding, rest, hygiene, and light activities, Case Manager initiates daily activities and status questionnaire (ExhibitX). Assessment of social and economic needs (housing, employment, transportation, support systems). AOD education -and intervention. 9 -11 AS!, strengths-based reassessment of all domains. Analysis of treatment needs and readiness, recommendation for next level of care. 11-13 At CAP, staffing with Bridging The Gap or other sponsor and representative of next care provider. If possible, visit to treatment site. Review of plan for continuing treatment, return to work, housing, family and community, sobriety support. 14 Final status questionnaire, satisfaction survey, closure of Case Manager-client relationship, release to community. ·'Warm hand off' to next level of care m X ::::r 0" ;::::;.: ()
DATE
STAFF NOTES
PARTICIPATE RECORD
NAME:~T __________ __
FIRST:--------
DATE OF LAST DRINK OR USE:------
TIME CLIENT NOTES:
1
Exhibit C
DATE:------
STAFF SIGNATURE
I I
Comprehensive Addiction Program
GROUP ACTIVITY SIGN IN ROSTER
Facilitator: --------------
Staff:
Group /Topic -----------
Type of G~oup: 0 Process
Print Name:
1.
2.
3.
4.
s.
6.
7.
8.
9.
0 Supplemental·
10. ______________________________ __
11. ____________________________ __
12. _____________________________ __
13. ______________________________ __
14. ______________________________ __
15. ______________________________ __
16. ______________________________ __
17. ______________________________ __
18. ____________________________ ___
Exhibit C
Date:
Start Time:
End Time:
Length:
0 Substance Abuse I Educational
Signatur~:
" .. -~
Comment~: _________________________________________________________ __
Notes in general:
Client sitting outside on patio appears to be calm and talking with another client.
Client is viewing a educational video call Addiction in the dayroom.
Client chose not to view educational video but is outside smoking a cigarette.
I
Client chose not to view educational video but appears to be asleep in bed.
Client was serve oatmeal and ate 100% of breakfast.
Client was serve oatmeal and ate 0% of breakfast due to him/her not liking oatmeal.
Client was serve pancakes and ate 0% of bt·eakfast, client appears to be
experiencing heroin withdrawals.
Client is viewing inspirational video call Clean & Sober.
Client chose not to view the video Clean & Sober but is outside smoking a cigarette.
Client appears to be eating snacks in the dayroom.
Client appears to be breathing and asleep in bed on his back.
Client appears to have rolled over to his left side and still sleeping.
Client appears to be restless and not able to sleep due to heroin withdrawls.
Client appears to be shaky and is experiencing alcohol withdrawls.
Exhibit C
Opening Notes:
Completed body scan on a 37 year old African American male. He is detoxing from
~20 or more of daily abuse of crack cocaine and his last use was over 12 hours ago.
Clients reports he is not on any medication or has any medical problems. He signed
all paperwork, given tour of unit, place in bed #3, and place on half hour notes for
the next 12hrs.
Residential female staff Nancy V. completed body scan on a 25 year old Caucasian
female. She is detoxing for drinking a pint or more of vodka on a daily basis for the
last 6 month or more and last drink was 2 days ago. Client is taking 5mg of
diazepam and has a medical clearance to entet· CAP detox. Her last dosage was
taking 3hrs prior before entering detox and her· next dosage will be in 5hrs. Client
has signed all paperwork, given tour of unit, placed in bed #14, and placed on half
hour notes for the next 12hrs.
Completed body scan on a 33 year old caucasian female. She was refened by Social
Worker· Vicki Luna for a detox from meth. Client last use of~ gram of.meth
(injection) was 2 days ago and was daily user for over 3 month now. Client has a
medical clearance due to being 3 month pregnant but does uot take any medication.
Client has signed all paperwork, given tour of unit, placed in bed #13, and place on
half hour notes.
Discharges:
Client received and sign for his persoual clothing.
Client received and sign for his personal property. She was referred to Spirit of
Women for substance abuse problem. Client discharge off the census and was pick
up by her sister.
Client received and sign for his personal property. He was referred to CAP
orientation for his substance abuse problem. Client is discharge off the census and
left property with a bus token.
Leaving APA (Against Program Advice)
Client approach staff and is requesting to leave detox. B.e states he has to work
tomorr·ow. Client appears to be experiencing her·oin withdt·awals at this time. Client
signed fm· his pet·sonal clothing.
Client signed for his personal pr·operty. B.e is not willing to complete detox and is
leaving against pt·ogram advice. Client is discharge off the census and left CAP
property walking.
Exhibit C
1> CENTRALLY STORED MEDICATION FACILITY NAME: CAP INSTRUCTIONS: Centrally stored medications shall be kept in a safe and locked place that is not accessible to any FACILITY. PHONE NUMBER person(s) except authorized individuals. 559-264-5096 Name: Last-FIRST-MIDDLE-ADMIN. DATE ATTENDING . STAFF SIGNITURE PHYSICIAN -Medication Strength I Instructions Control Expiration Date Prescribing Prescription Number Number of Pharmacy Name Name Quantity I Custody Date Filled Physician Refills ~ ~ I~ ~ ~ ~ -Medication Destruction Record: INSTRUCTIONS: Prescription drugs not taken with the resident upon termination of services or otherwise disposed of shall be destroyed in the facility by the administer or designated representative and witnessed by one other adult who is not a resident. Medication Name Strength I Prescription Disposal Date Date Filled Quantity Number ~ ~ ~ ~ ~ Pharmacy Signature of Name Administrator ---· · Signature of Witness Adult Non-Resident m >< ::r 0" ;:::;.: ()
• (.) c -...
U)
E
1.! en e a.
c
0 ·-1.) ·-"0
~
~ ·-U)
·C
CD .c
2! a. e
0
0
z
0
~ 0 -Q w
:ii
> -1
~
Exhibit C
,..l
.5 : :a .....
(JJ
,..l s ....
~ I
~ a:
i
E
c%
§. .,...
~
5
1a .2
'0 Q)
~
Q)
E.
~
COMPREHENSIVE ADDICTION PROGRAMS, INC.
APPLICATION: Residential Detoxifications/Stabilization Services
Regarding the Memorandum of Understanding (MOU) and contacts.
Comprehensive Addiction Programs, Inc. currently has MOD's and contacts with the
following:
• Touchstone
· •· K~iser-contact
• Westcare
• Spirit of Women
• King of Kings
• Fresno County Hispanic Commission
• DCFS-CPS
• Fresno New Connections
• Mental Health Sy~tems
• PACT/Mental Health
• E.P.U-Exceptional Parents Unlimited
• Veterans Administration -contact
• CalWORKs
e United Way
• Nuestra Casa
o Turning Point
• Eleventh Hour
e Salvation Army
• PATHS
• Poverello House
• Fresno Impact
• STOP
o Marjoree Mason Center
• CRMC
This is an abbreviated list of a few providers that we work with on an ongoing basis for
referral purposes. Any clients in need of additional cervices or services that
Comprehensive Addiction Programs, Inc. cannot accommodate are referred to the most
appropriate agency. It is Comprehensive Addiction Programs, Inc. intent and mission to
always put the needs of the client first.
Exhibit C
/
CAP DETOX EVALUATION
DATE: ___ _ LENGTH OF STAY: ·----
l.Were you informed of what to expect daily?
·. · DYes 0No
Comments: ------------------------------L-~-------------
2. What group(s) did you find most beneficial?
0Peer Support
0AOD Education
Comments:
OH&IPanel
0Book Study
----------------------------
3. The services I am received at CAP Detox helped me to deal more effectively with my current
life situations.
0Strongly Agree
0Agree
0Neutral
0Somewhat Disagree
0Strongly Disagree
Comments:. __________________________ _
4. My sleeping room was adequate, comfortable and well maintained.
0Strongly Agree
0Agree
0Neutral
0Somewhat Disagree
0Strongly Disagree
Comments: -----------------------------
Exhibit C
,,
·:,
I :
l· I ;
I .'.
I,-
l
j -
l
(_---
:·
j
) -
\ -
!
I
5. ?Jle d~ily menu items provide sufficient food for me and the quality of prepared meals met my
satisfactiOn. ·
Ostrongly Agree
0Agree
0Neutral
0Somewhat Disagree
Ostrongly Disagree
Corrinlents: ·------------------------~------------
6. CAP Detox policies are reasonable and fair.
Ostrongly Agree
0Agree
0Neutral
0Somewhat Disagree
Ostrongly Disagree
·Comments:. ___________________________ _
7. The assessment and intake process was comprehensive, efficient and welcoming.
Ostrongly Agree
0Agree
0Neutral
0Somewhat Disagree
0Strongly Disagree
Comments:. ___________________________ _
8. The counseling team has displayed compassion, knowledge and experience in their treatment
approaches.
Ostrongly Agree
0Agree
0Neutral
0Somewhat Disagree
0Strongly Disagree
Comments: ________ --:,--------------------
2
Exhibit C
13. Which shift was most helpful?
0 Morning (8am -4pm)
0 Swing Shift (4pm-12am)
0 Overnight (l2am-8am)
14. Which shift was least helpful?
0 Morning (8am -4pm)
0 Swing Shift (4pm-12am)
0 Overnight (12am-8am)
15. Overall how would you rate the quality of service you received at CAP Detox Unit?
0Excellent
0Good
0Neutral
OF air
0Poor
Comments: __________________________ _
16. What suggestion would you make to improve the CAP Detox?
Comments:. __________________________ _
17. Would you refer others to CAP for detox?
DYes 0No
Explain:----------------------:--------
For Staff Only
StaffComments:. _________________________ _
Conducted by: ___________ _
4
Exhibit C
t, JUS West Whiles bridge Road Fresno. &!JIIIomla 93706 Ph:6591264-5096 ADD\CTlON EXIT PLAN FOR DATE-------PROGRAM DETOX ASSISTANT-----------------~-L~EE_!)_s __ . -~-~·JPLANS (Who7 What7 Where? When'?) I. FOOD & HOUSING-My arrangements for eating plenty of good food and having a comfortable place to live. 2. RECOVERY PROGRAM-My arrangements for keeping sober. Having a person or persons I can Trusfl and talk honestly with about my problems. STAFF RECOMMENDATION FOR REFERRAL __________ ~---------------------------------------I ACCEPT AND AGREE TO FOLLOW THROUGH WITH TH1S REFERRAL PLAN. CLIENT SIGNATURE DATE--------------,-I REFUSE STAFF RECOMMENDATION FOR REFERRAL. THESE ARE MY PLANS: CLIENT SIGNATURE DATE STAFF SIGNATURE DATE::-----------Revised July 201 1 m >< ::r 0"' ;::+.· (')
Exit I Referrall)lan: (Data, Assessment, Plan)
Client reported that he has his own home and lives with his wife and is currently
employed. He appears to have an open mind for treatment for substance abuse
problem and shared that he has done programs in the past but never took them
seriously. Client is accepting a referral to Fresno New Connection.
Client reported that he is homeless and has no employment. He appears to be
resistant to seeking help for substance abuse problem. Client was referred to the
Ft·esno Rescue Mission for food I housing and the Poverello House for substance
problem. Client is refusing to accept staff referral.
Client is currently a CPS client and her social worker is Vicki Luna. Her referral
after completing detox is to be a dit·ect admit into Spirit of Women. Client has
agreed to follow thru with her refel'l'al and
American Ambulance:
Client approached Detox staff and r·equested for Amel'ican Ambulance to be called.
Client stated that he was having breathing problems. Detox Staff called American
Ambulance at client's request.
American Ambulance is on propet·ty providing emergency medical sen•ice for
client. E.M.T. were given a copy of client's admission form and alcohol/drug health
screen.
American Ambulance is transporting client to Fresno Community Hospital for
further emergency medical service. Detox staff instructed client that if receive a
prescription for medication that it would need to be fill before coming back to detox.
Called Fresno Community Hospital and spoke with------and they stated
client has not been seen by hospital staff.
Called Fresno Community and spoke with ------and they stated that
client was being seen by hospital staff.
Exhibit C
NOTICE OF CHILD ABUSE REPORTING LAW
Exhibit D
Page 1 ofl
The undersigned hereby acknowledges that Penal Code section 11166 and the
contractual obligations between County of Fresno (COUNTY) and PROVIDER(S)
related to provision of alcohol and drug abuse treatment services for Fresno County
residents, require that the undersigned report all known or suspected child abuse or
neglect to one or more of the agencies set forth in Penal Code (P.C.) section(§) 11165.9.
For purposes of the undersigned's child abuse reporting requirements, "child
abuse or neglect" includes physical injury inflicted by other than accidental means upon a
child by another person, sexual abuse as defined in P.C. § 11165.1, neglect as defined in
P.C. § 11165.2, willful cruelty or unjustifiable punishment as defined in P.C. § 11165.3,
and unlawful corporal punishment or injury as defined in P.C. §11165.4.
A child abuse report shall be made whenever the undersigned, in his or her
professional capacity or within the scope of his or her employment, has knowledge of or
observes a child whom the undersigned knows or reasonably suspects has been the victim
of child abuse or neglect. (P. C § 11166.) The child abuse report shall be made to any
police department or sheriffs department (not including a school district police or
security department), or to any county welfare department, including Fresno County
Department of Children and Family Services' 24 Hour CARELINE. (See PC § 11165.9.)
For purposes of child abuse reporting, a "reasonable suspicion" means that it is
objectively reasonable for a person to entertain a suspicion, based upon facts that could
cause a reasonable person in a like position, drawing, when appropriate, on his or her
training and experience, to suspect child abuse or neglect. The pregnancy of a child does
not, in and of itself, constitute a basis for reasonable suspicion of sexual abuse. (P.C.
§11166(a)(1).)
Substantial penalties may be imposed for failure to comply with these child abuse
reporting requirements.
Further information and a copy of the law may be obtained from the department
head or designee.
I have read and understand the above statement and agree to comply with the
child abuse reporting requirements.
SIGNATURE DATE
0980fadx
CULTURALLY AND UNGUISTICALL Y APPROPRIATE SERVICES
Exhibit E
Page 1 of2
CONTRACTOR shall adhere to and develop written procedures in accordance with the below standards
adapted from the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in
Health Care:
Culturally Competent Care:
1. Organizations must ensure that consumers receive from all staff members effective,
understandable, and respectful care that is provided in a manner compatible with
their cultural health beliefs and practices and preferred language.
2. Organizations must implement strategies to recruit, retain, and promote at all levels
of the organization a diverse staff and leadership that are representative of the
demographic characteristics of the service area.
3. Organizations must ensure that staff at all levels and across all disciplines receive
ongoing education and training in culturally and linguistically appropriate service
delivery.
Language Access Services:
4. Organizations must offer and provide language assistance services, including bilingual
staff and interpreter services, at no cost to consumers with limited English proficiency
at all points of contact, in a timely manner during all hours of operation.
5. Organizations must provide to consumers in their preferred language both verbal
offers and written notices informing them of their right to receive language assistance
services.
6. Organizations must assure the competence of language assistance provided to limited
English proficient consumers by interpreters and bilingual staff. Family and friends
should not be used to provide interpretation services (except on the request of the
consumer).
7. Organizations must make available easily understood patient-related materials and
post signage in the languages of the commonly encountered groups and/or groups
represented in the service area.
Organizational Supports:
8. Organizations must develop, implement, and promote a written strategic plan that
outlines clear goals, policies, operational plans, and management
accountability/oversight mechanisms to provide culturally and linguistically
appropriate services.
Exhibit E
Page 2 of2
9. Organizations must conduct initial and ongoing organizational self-assessments of
CLAS related activities and are encouraged to integrate cultural and linguistic
competence-related measures into their internal audits, performance improvement
programs, consumer satisfaction Assessments, and Outcomes-Based Evaluations.
10. Organizations must ensure that data on the individual consumer's race, ethnicity, and
spoken and written language are collected in program records, integrated into the
organizations management information systems, and periodically updated.
11. Organizations must maintain a current demographic, cultural, and epidemiological
profile of the community as well as a needs assessment to accurately plan for and
implement services that respond to the cultural and linguistic characteristics of the
service area.
12. Organizations must develop participatory, collaborative partnerships with
communities and utilize a variety of formal and informal mechanisms to facilitate
community and consumer involvement in designing and implementing CLAS-related
activities.
13. Organizations must ensure that conflict and grievance resolution processes are
culturally and linguistically sensitive and capable of identifying, preventing, and
resolving cross-cultural conflicts or complaints by consumers.
14. Organizations must regularly make available to the public information about their
progress and successful innovations in implementing these standards and to provide
public notice in their communities about the availability of this information.
15. Organizations must ensure communication regarding the organization's progress in
implementing and sustaining CLAS to all stakeholders, constituents, and general
public.
CONTRACTOR shall develop written procedures in accordance with the above standards. The
provisions of this Agreement are not intended to abrogate any provisions of law or regulation existing
or enacted during the term of this Agreement.
Exhibit F
Page 1 of3
DISCLOSURE-CRIMINAL HISTORY & CIVIL ACTIONS:
In their proposal, the bidder 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 "Bidder"):
• Within the three-year period preceding the proposal, they have been convicted of, or
had a civil judgment rendered against them for:
o 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;
o violation of a federal or state antitrust statute;
o embezzlement, theft, forgery, bribery, falsification, or destruction of records; or
o false statements or receipt of stolen property
• Within a three-year period preceding their proposal, they have had a public transaction
(federal, state, or local) terminated for cause or default.
Disclosure of the above information will not automatically eliminate a Bidder from
consideration. The information will be considered as part of the determination of whether to
award the contract and any additional information or explanation that a Bidder elects to submit
with the disclosed information will be considered. If it is later determined that the Bidder failed
to disclose required information, any contract awarded to such Bidder may be immediately
voided and terminated for material failure to comply with the terms and conditions of the
award.
Any Bidder who is awarded a contract must sign an appropriate Certification Regarding
Debarment, Suspension, and Other Responsibility Matters, pages 2 and 3 of this Exhibit,
Additionally, the Bidder awarded the contract must immediately advise the County in writing if,
during the term of the agreement: (1) Bidder becomes suspended, debarred, excluded or
ineligible for participation in federal or state funded programs or from receiving federal funds
as listed in the excluded parties list system (http://www/epls/gov); or (2) any of the above
listed conditions become applicable to Bidder. The Bidder will 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.
G:\STAFF FOLDERS\JOCONCHAS\DETOX RFAIEXHIBITSIEXHIBIT F-DISCLOSURE STATEMENT.DOC
Exhibit F
Page 2 of3
CERTIFICATION REGARDING DEBARMENT,
SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS--PRIMARY COVERED
TRANSACTIONS
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective primary participant is providing
the certification set out 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 certification 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 the 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.
G:\STAFF FOLDERSIJOCONCHAS\DETOX RFAIEXHIBITS\EXH/BIT F-DISCLOSURE STATEMENT.DOC
CERTIFICATION
Exhibit F
Page 3 of3
(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) 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 explanation to this proposal.
Signature: Date:
(Printed Name & Title) (Name of Agency or Company)
G:\STAFF FOLDERS\JOCONCHASIDETOX RFAIEXHIBITS\EXHIBIT F-DISCLOSURE STATEMENT.DOC
Exhibit G
SELF-DEAUNG TRANSAcrJON DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as "County"),
members of a contractor's board of directors (hereinafter referred to as "County Contractor"), must
disclose any self-dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self-dealing transaction is defined below:
''A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest"
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member's name, job title (if applicable), and date this disclosure is being made.
(2) Enter the board member's company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a. The name of the agency/company with which the corporation has the transaction; and
b. The nature of the material financial interest in the Corporation's transaction that the
board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(S) Form must be signed by the board member that is involved in the self-dealing transaction
described in Sections (3) and (4).
Exhibit G
(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: I Date:
I