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HomeMy WebLinkAbout32151Agreement No. 15-316 AGREEMENT 1 2 THIS AGREEMENT is made and entered into this _ __,__I ~_,_+h-'--'--'--day of :ruJ V 3 2015, by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California, 4 hereinafter referred to as "COUNTY", and each provider listed in Exhibit A, attached to this 5 Agreement and by this reference incorporated herein, and collectively herein&fter referred to as 6 "CONTRACTOR(S)" and such additional Contractors as may, from time to time during the term of this 7 Agreement, be added by COUNTY's Director, Department of Behavioral Health or designee in 8 accordance with this Agreement. 9 W I T N E S S E T H: 10 WHEREAS, the County of Fresno has residents who are designated to be placed at or are being 11 discharged from locked facilities including but not limited to State Mental Health hospitals, Institutions 12 for Mental Disease (IMD) and locked Mental Health Resource Centers (MHRC); and 13 WHEREAS, the Welfare and Institutions Code, section 5458(c) describes the Transitional 14 Residential Program as a program of services provided to persons who may be expected to move 15 towards a more independent living situation; and 16 WHEREAS, COUNTY, through its Department of Behavioral Health (DBH) desires to contract 17 with licensed transitional mental health residential facilities qualified to provide such services. 18 NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties 19 hereto agree as follows: 20 21 1. SERVICES A. CONTRACTOR shall perform all services and fulfill all responsibilities as 22 identified in Exhibit B, "Transitional Social Rehabilitation Program Services and Requirements," 23 attached hereto and by this reference incorporated herein. 24 B. Upon expiration or termination of this Agreement for any reason, 25 CONTRACTOR(S) agrees to assist COUNTY's DBH in the placement of COUNTY's clients who can 26 no longer remain at CONTRACTOR(S)' facilities. 27 C. CONTRACTOR(S) shall provide transportation services for COUNTY clients to 28 and from appointments and activities, as needed. - 1 -COUNTY OF FRESNO Fresno. CA 1 2 3 4 5 6 7 8 9 10 11 D. For admission and discharge, COUNTY shall be responsible for and arrange transportation to and from CONTRACTOR(S)' facilities. E. CONTRACTOR(S) shall give COUNTY representatives, including but not limited to Case Managers and Deputy Conservators, reasonable access to COUNTY clients, their records and medical records, to aid in optimizing treatment for COUNTY clients. These COUNTY representatives shall be allowed to be involved in periodic meetings with treatment staff of the facility when COUNTY clients, their treatment and progress are discussed. F. CONTRACTOR(S) shall possess and maintain all licenses, permit approvals, certificates, waivers and exceptions necessary as further described in Section Eighteen (18) of this Agreement. 2. TERM 12 This Agreement shall become effective on the 1st day of July, 2015 and shall terminate 13 on the 30th day of June, 2018. 14 This Agreement shall then automatically be extended for two (2) additional twelve (12) 15 month periods upon the same terms and conditions herein set forth, unless written notice of non- 16 renewal is given by CONTRACTOR(S) or COUNTY or COUNTY's DBH Director or designee no 17 later than sixty ( 60) days prior to the expiration of the Agreement term. 18 19 3. TERMINATION A. Non-Allocation of Funds-The terms ofthis Agreement, and the services to be 20 provided thereunder, are contingent on the approval of funds by the appropriating government agency. 21 Should sufficient funds not be allocated, the services provided may be modified, or this Agreement 22 terminated at any time by giving CONTRACTOR(S) thirty (30) days advance written notice. 23 24 25 26 27 28 B. Breach of Contract-COUNTY may immediately suspend or terminate this Agreement in whole or in part, where in the determination of COUNTY there is: 1) An illegal or improper use of funds; 2) 3) 4) A failure to comply with any term of this Agreement; A substantially incorrect or incomplete report submitted to COUNTY; Improperly performed service. - 2 -COUNTY OF FRESNO Fresno. CA 1 /// 2 5) Suspension or revocation of the license by any regulatory agency of the 3 State of California to operate the facility. 4 In no event shall any payment by COUNTY constitute a waiver by COUNTY of 5 any breach of this Agreement or any default which may then exist on the part ofCONTRACTOR(S). 6 Neither shall such payment impair or prejudice any remedy available to COUNTY with respect to the 7 breach or default. COUNTY shall have the right to demand ofCONTRACTOR(S) the repayment to 8 COUNTY of any funds disbursed to CONTRACTOR(S) under this Agreement, which in the judgment 9 of COUNTY were not expended in accordance with the terms of this Agreement. CONTRACTOR(S) 10 shall promptly refund any such funds upon demand or, at COUNTY's option; such repayment shall be 11 deducted from future payments owing to CONTRACTOR(S) under this Agreement. 12 c. Without Cause-Under circumstances other than those set forth above, this 13 Agreement may be terminated by CONTRACTOR(S) or COUNTY upon the giving of thirty (30) days 14 advance written notice of an intention to terminate. 15 16 4. COMPENSATION A. COMPENSATION FOR ROOM AND BOARD 17 For each COUNTY client that has Social Security Insurance (SSI), COUNTY 18 and CONTRACTOR(S) agree that the basic SSI monthly rate for Transitional Social Rehabilitation 19 Program (TSRP) service recipients, as determined by the Social Security Administration and the State 20 of California Department of Health Care Services, shall be provided to CONTRACTOR(S)' for room 21 and board services. CONTRACTOR shall seek payment of SSI for room and board services from the 22 DBH's Public Guardian Office (PGO) Division, who administers SSI monies on behalf of the clients. 23 The parties acknowledge that said SSI monies for SSI recipients are not part of the funds provided 24 through this Agreement. 25 For each COUNTY client that is not an SSI recipient, COUNTY and 26 CONTRACTOR(S) agree that the basic SSI monthly rate for room and board for TSRP service 27 recipients, as determined by the Social Security Administration and the State of California Department 28 of Health Care Services, shall be provided to CONTRACTOR(S) for room and board services. - 3 -COUNTY OF FRESNO Fresno. CA 1 CONTRACTOR(S) shall invoice COUNTY, and COUNTY shall pay CONTRACTOR(S), for these 2 room and board services. 3 COUNTY and CONTRACTOR(S) acknowledge that the rates recited in the 4 preceding paragraphs may be subject to adjustment pursuant to rates set by the State of California 5 Department of Health Care Services or the Social Security Administration as appropriate, during each 6 term of this Agreement. Rate adjustment(s) shall be approved by COUNTY's DBH Director, or 7 designee and CONTRACTOR(S), and shall become part of this Agreement. COUNTY agrees to pay 8 CONTRACTOR(S) the adjusted rate after the effective date of the adjustment is authorized by the State 9 of California Department of Health Care Services or Social Security Administration, as appropriate, 10 and CONTRACTOR(S) agree to accept such rates as ofthe effective date of such adjustment, whether 11 or not the cost of providing such services shall have exceeded the amount of the payments hereunder. 12 Any rate adjustment shall not result in an increase to the maximum amount of the Agreement as stated 13 herein. COUNTY shall notify CONTRACTOR(S) in writing of any SSI rate change within thirty (30) 14 days of COUNTY receiving notice of any rate change from the State of California Department of 15 Health Care Services or Social Security Administration. 16 B. COMPENSATION FOR TSRP SERVICES 17 In addition to Section 4.A. above, COUNTY agrees to pay and 18 CONTRACTOR(S) agree to accept compensation for TSRP services provided to COUNTY clients 19 whether or not the client is covered by SSI, Medi-Cal, private insurance, or has no other coverage, at 20 the daily rate as specified in Exhibit A for each of CONTRACTOR' (S) facilities. 21 CONTRACTOR(S) understand that COUNTY may seek reimbursement from 22 any applicable third party payor (e.g., Medicare, Medi-cal or other insurance) for TSRP services 23 rendered by CONTRACTOR(S) and paid for by COUNTY. CONTRACTOR(S) shall be responsible 24 for preparation and submission to COUNTY of Medi-Cal billing information, and/or other third party 25 payor information as it relates to COUNTY's clients, which information COUNTY will utilize to seek 26 reimbursement for payments it has made to CONTRACTOR(S). 27 28 c. GENERAL PROVISIONS The maximum amount of compensation paid by COUNTY for clients receiving - 4 -COUNTY OF FRESNO Fresno. CA 1 TSRP services pursuant to Section 4.A and 4.B. to all CONTRACTOR(S) collectively shall not exceed 2 One Million Two Hundred Fifty Thousand and No/100 Dollars ($1,250,000.00) during each twelve 3 (12) month period of this Agreement. The maximum compensation amount shall not exceed Six Million 4 Two Hundred Fifty Thousand and No/100 Dollars ($6,250,000.00) during the term of this Agreement. 5 It is understood that all expenses incidental to CONTRACTOR(S) performance 6 of TSRP services under this Agreement shall be borne by CONTRACTOR(S). Payments by COUNTY 7 shall be in arrears, within forty-five (45) days after receipt, verification and approval of 8 CONTRACTOR(S') invoices by COUNTY'S DBH, for services provided during the preceding month. 9 In addition, it is understood by CONTRACTOR(S) that at the discretion of COUNTY's DBH Director 10 or designee, COUNTY reserves the right to deny payment of any additional invoices received ninety 11 (90) days after the expiration of each term of this Agreement or termination of this Agreement. If 12 CONTRACTOR(S) should fail to comply with any provision of this Agreement, COUNTY shall be 13 relieved of its obligation for further compensation. 14 5. INVOICING 15 CONTRACTOR(S) shall invoice COUNTY's DBH for each COUNTY client, by the 16 tenth (1oth) of each month for actual expenses incurred and services rendered in the previous month, to: 17 DBH-Invoices@co.fresno.ca.us or addressed to Fresno County Department of Behavioral Health, 18 Accounts Payable, P.O. Box 45003, Fresno, CA 93702. Invoices shall include date(s) of stay, client 19 name, Date of Birth (DOB), Social Security number, and facility name and location. No 20 reimbursement for services shall be made until invoices are received and reviewed by COUNTY's 21 DBH. 2 2 At the discretion of COUNTY's D BH Director or designee, if an invoice is incorrect or 23 is otherwise not in proper form or substance, COUNTY shall have the right to withhold payment as to 24 only that portion of the invoice that is incorrect or improper and CONTRACTOR agrees to continue to 25 provide services for a period of ninety (90) days and, if after the ninety (90) day period, the invoice(s) 26 is still not corrected to COUNTY's DBH satisfaction, COUNTY may elect to terminate this Agreement 27 with individual CONTRACTOR(S), pursuant to the termination provisions stated in Section Three (3) 28 ofthis Agreement. -5 -COUNTY OF FRESNO Fresno. CA 1 I 6. INDEPENDENT CONTRACTOR 2 In performance of the work, duties, and obligations assumed by CONTRACTOR(S) 3 under this Agreement, it is mutually understood and agreed that CONTRACTOR(S), including any and 4 all of CONTRACTOR(S ') officers, agents, and employees will at all times be acting and performing as 5 independent contractors, and shall act in an independent capacity and not as an officer, agent, servant, 6 employee, joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no 7 right to control or supervise or direct the manner or method by which CONTRACTOR(S) shall perform 8 their work and function. However, COUNTY shall retain the right to administer this Agreement so as 9 to verify that CONTRACTOR(S) are performing their obligations in accordance with the terms and 10 conditions thereof. CONTRACTOR(S) and COUNTY shall comply 11 with all applicable provisions of law and the rules and regulations, if any, of governmental authorities 12 having jurisdiction over matters which are directly or indirectly the subject thereof. 13 Because of their status as independent contractors, CONTRACTOR(S) shall have 14 absolutely no right to employment rights and benefits available to COUNTY employees. 15 CONTRACTOR(S) shall be solely liable and responsible for providing to, or on behalf of, their 16 employees all legally-required employee benefits. In addition, CONTRACTOR(S) shall be solely 17 responsible and save COUNTY harmless from all matters relating to payment ofCONTRACTOR(S') 18 employees, including compliance with Social Security, withholding, and all other regulations governing 19 such matters. It is acknowledged that during the term ofthis Agreement, CONTRACTOR(S) may be 20 providing services to others unrelated to the COUNTY or to this Agreement. 21 7. SEPARATE AGREEMENT 22 It is mutually understood by the parties that this Agreement does not, in any way, create 23 a joint venture among the individual CONTRACTOR(S). By execution of the Agreement, the 24 CONTRACTOR(S) understand that a separate Agreement is formed between each individual 25 Contractor and COUNTY. 8. MODIFICATION 26 27 A. Any matters of this Agreement may be modified from time to time by the written 28 consent of all the parties without, in any way, affecting the remainder. - 6 -COUNTY OF FRESNO Fresno. CA 1 B. Notwithstanding the above, changes to the providers listed in Exhibit A may be 2 made in accordance with Section Nineteen (19) of this Agreement. 3 c. Additionally, changes to the licensed residential supplemental rate, as dictated by 4 the State of California, may be made in accordance with Section Four (4) of this Agreement. Such 5 licensed residential supplemental rate changes shall not result in any changes to the maximum 6 compensation amount payable to CONTRACTOR(S). 7 9. NON-ASSIGNMENT 8 No party shall assign, transfer or subcontract this Agreement nor their rights or duties 9 under this Agreement without the prior written consent of the other party. 10 10. HOLD-HARMLESS 11 CONTRACTOR(S) agree to indemnify, save, hold harmless, and at COUNTY's request, 12 defend the COUNTY, its officers, agents and employees from any and all costs and expenses, including 13 attorney's fees and court costs, damages, liabilities, claims and losses occurring or resulting to 14 COUNTY in connection with the performance, or failure to perform, by CONTRACTOR(S), their 15 officers, agents or employees under this Agreement, and from any and all costs and expenses, including 16 attorney fees and court costs, damages, liabilities, claims and losses occurring or resulting to any 17 person, firm or corporation who may be injured or damaged by the performance, or failure to perform, 18 ofCONTRACTOR(S), their officers, agents or employees under this Agreement. In addition, 19 CONTRACTOR(S) agree to indemnify COUNTY for Federal, State of California and/or local audit 20 exceptions resulting from noncompliance herein on the part of the CONTRACTOR(S). 21 11. INSURANCE 22 Without limiting the COUNTY's right to obtain indemnification from 23 CONTRACTOR(S) or any third parties, CONTRACTOR(S), at its sole expense, shall maintain in full 24 force and effect the following insurance policies throughout the term of this Agreement: 25 26 27 28 A. Commercial General Liability Commercial General Liability Insurance with limits of not less than One Million Dollars ($1 ,000,000) per occurrence and an annual aggregate of Two Million Dollars ($2,000,000). This policy shall be issued on a per occurrence basis. COUNTY may require specific coverage including completed operations, product liability, contractual liability, Explosion, Collapse, and Underground - 7 -COUNTY OF FRESNO Fresno. CA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 B. (XCU), fire legal liability or any other liability insurance deemed necessary because of the nature ofthe Agreement. Automobile Liability Comprehensive Automobile Liability Insurance with limits for bodily injury of not less than Two Hundred Fifty Thousand Dollars ($250,000) per person, Five Hundred Thousand Dollars ($500,000) per accident and for property damages of not less than Fifty Thousand Dollars ($50,000), or such coverage with a combined single limit of Five Hundred Thousand Dollars ($500,000). Coverage should include owned and non-owned vehicles used in connection with this Agreement. C. Professional Liability D. IfCONTRACTOR(S) employs licensed professional staff(e.g. Ph.D., R.N., L.C.S.W., M.F.T.) in providing services, Professional Liability Insurance with limits of not less than One Million Dollars ($1 ,000,000) per occurrence, Three Million Dollars ($3,000,000) annual aggregate. CONTRACTOR agrees that it shall maintain, at its sole expense, in full force and effect for a period of three (3) years following the termination of this Agreement, one or more policies of professional liability insurance with limits of coverage as specified herein. 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 the COUNTY, its officers, agents and employees shall be excess only and not contributing with insurance provided under the CONTRACTOR(S) policies herein. This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written notice given to COUNTY. Within thirty (30) days from the date CONTRACTOR(S) signs this Agreement, CONTRACTOR(S) shall provide certificates of insurance and endorsements as stated above for all of the foregoing policies, as required herein, to the County of Fresno, 4441 E. Kings Canyon, Fresno, California, 93702, Attention: Contracts Section, stating that such insurance coverage's have been - 8 -COUNTY OF FRESNO Fresno. CA 1 obtained and are in full force; that the County of Fresno, its officers, agents and employees will not be 2 responsible for any premiums on the policies; that such Commercial General Liability insurance names 3 the County of Fresno, its officers, agents and employees, individually and collectively, as additional 4 insured, but only insofar as the operations under this Agreement are concerned; that such coverage for 5 additional insured shall apply as primary insurance and any other insurance, or self-insurance, 6 maintained by the COUNTY, its officers, agents and employees, shall be excess only and not 7 contributing with insurance provided under the CONTRACTOR(S') policies herein; and that this 8 insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written 9 notice given to COUNTY. 10 In the event CONTRACTOR(S) fails to keep in effect at all times insurance coverage as 11 herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate 12 this Agreement upon the occurrence of such event. 13 All policies shall be with admitted insurers licensed to do business in the State of 14 California. Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of 15 A FSC VIII or better. 16 12. CONFIDENTIALITY 17 All services performed by CONTRACTOR under this Agreement shall be in strict 18 conformance with all applicable Federal, State of California and/or local laws and regulations relating 19 to confidentiality. 20 21 13. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT A. The parties to this Agreement shall be in strict conformance with all applicable 22 Federal and State of California laws and regulations, including but not limited to Sections 5328, 10850, 23 and 14100.2 et seq. ofthe Welfare and Institutions Code, Sections 2.1 and 431.300 et seq. ofTitle 42, 24 Code ofFederal Regulations (CFR), Section 56 et seq. ofthe California Civil Code, Sections 11977 25 and 11812 of Title 22 of the California Code of Regulations, and the Health Insurance Portability and 26 Accountability Act (HIPAA), including but not limited to Section 1320 D et seq. of Title 42, United 27 States Code (USC) and its implementing regulations, including, but not limited to Title 45, CFR, 28 - 9 -COUNTY OF FRESNO Fresno. CA 1 Sections 142, 160, 162, and 164, and The Health Information Technology for Economic and Clinical 2 Health Act (HITECH) regarding the confidentiality and security of patient information. 3 Except as otherwise provided in this Agreement, CONTRACTOR, as a Business 4 Associate of COUNTY, may use or disclose Protected Health Information (PHI) to perform functions, 5 activities or services for or on behalf of COUNTY, as specified in this Agreement, provided that such 6 use or disclosure shall not violate the Health Insurance Portability and Accountability Act (HIP AA), 7 USC 1320d et seq. The uses and disclosures of PHI may not be more expansive than those applicable 8 to COUNTY, as the "Covered Entity" under the HIP AA Privacy Rule ( 45 CFR 164.500 et seq), except 9 as authorized for management, administrative or legal responsibilities of the Business Associate. 10 B. CONTRACTOR shall protect, from unauthorized access, use, or disclosure of 11 names and other identifying information concerning persons receiving services pursuant to this 12 Agreement, except where permitted in order to carry out data aggregation purposes for health care 13 operations [45 CFR Sections 164.504 (e)(2)(i), 164.504 (3)(2)(ii)(A), and 164.504 (e)(4)(i)]-This 14 pertains to any and all persons receiving services pursuant to a COUNTY funded program. 15 CONTRACTOR shall not use such identifying information for any purpose other than carrying out 16 CONTRACTOR's obligations under this Agreement. 17 C. CONTRACTOR shall not disclose any such identifying information to any 18 person or entity, except as otherwise specifically permitted by this Agreement, authorized by law, or 19 authorized by the client/patient. 20 D. For purposes of the above sections, identifying information shall include, but not 21 be limited to name, identifying number, symbol, or other identifying particular assigned to the 22 individual, such as finger or voice print, or a photograph. 23 E. CONTRACTOR shall provide access, at the request of COUNTY, and in the 24 time and manner designated by COUNTY, to PHI in a designated record set (as defined in 45 CFR 25 Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45 CFR 26 Sectionl64.524 regarding access by individuals to their PHI. 27 CONTRACTOR shall make any amendment(s) to PHI in a designated record set 28 at the request of COUNTY, and in the time and manner designated by COUNTY in accordance with 45 -10 -COUNTY OF FRESNO Fresno. CA 1 CFR Section 164.526. 2 CONTRACTOR shall provide to COUNTY or to an individual, in a time and 3 manner designated by COUNTY, information collected in accordance with 45 CFR Section 164.528, to 4 permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI in 5 accordance with 45 CFR Section 164.528. 6 F. CONTRACTOR shall report to COUNTY, in writing, any knowledge or 7 reasonable belief that there has been unauthorized access, viewing, use, disclosure, or breach of 8 Protected Information not permitted by this Agreement, and any breach of unsecured PHI of which it 9 becomes aware, immediately and without reasonable delay and in no case later than two (2) business 10 days of discovery. Immediate notification shall be made to COUNTY's Information Security Officer 11 and Privacy Officer and COUNTY's Department of Behavioral Health HIP AA Representative, within 12 two (2) business days of discovery. The notification shall include, to the extent possible, the 13 identification of each individual whose unsecured PHI has been, or is reasonably believed to have been, 14 accessed, acquired, used, disclosed, or breached. CONTRACTOR shall take prompt corrective action 15 to cure any deficiencies and any action pertaining to such unauthorized disclosure required by 16 applicable Federal and State Laws and regulations. CONTRACTOR shall investigate such breach and 17 is responsible for all notifications required by law and regulation or deemed necessary by COUNTY 18 and shall provide a written report ofthe investigation and reporting required to COUNTY's 19 Information Security Officer and Privacy Officer and COUNTY's Department of Behavioral Health 20 HIP AA Representative. This written investigation and description of any reporting necessary shall be 21 postmarked within the thirty (30) working days of the discovery ofthe breach to the addresses below: 22 23 24 25 26 County of Fresno Dept. of Behavioral Health HIP AA Representative (559) 600-9180 4441 E. Kings Canyon Fresno, CA 93 702 County of Fresno Dept. of Public Health Privacy Officer (559) 445-3249 1221 Fulton Mall Fresno, CA 93 728 County of Fresno Information Technology Services Information Security Officer (559) 494-3255 2048 N. Fine Street Fresno, CA 93727 G. CONTRACTOR shall make its internal practices, books, and records relating to 27 the use and disclosure of PHI received from COUNTY, or created or received by the CONTRACTOR 28 -11 -COUNTY OF FRESNO Fresno. CA 1 on behalf of COUNTY, available to the United States Department of Health and Human Services upon 2 demand. 3 H. Safeguards 4 CONTRACTOR shall implement administrative, physical, and technical 5 safeguards as required by 45 CFR 164.308, 164.310, and 164.312 that reasonably and appropriately 6 protect the confidentiality, integrity, and availability of PHI, including electronic PHI, that it creates, 7 receives, maintains or transmits on behalf of COUNTY; and to prevent access, use or disclosure of PHI 8 other than as provided for by this Agreement. CONTRACTOR shall develop and maintain a written 9 information privacy and security program that includes administrative, technical and physical 10 safeguards appropriate to the size and complexity of CONTRACTOR's operations and the nature and 11 scope of its activities. Upon COUNTY's request, CONTRACTOR shall provide COUNTY with 12 information concerning such safeguards. 13 CONTRACTOR shall implement strong access controls and other security 14 safeguards and precautions in order to restrict logical and physical access to confidential, personal (e.g., 15 PHI) or sensitive data to authorized users only. Said safeguards and precautions shall include 16 the following administrative and technical password controls for all systems used to process or store 17 confidential, personal, or sensitive data: 18 19 1. Passwords must not be: a. Shared or written down where they are accessible or recognizable 20 by anyone else; such as taped to computer screens, stored under keyboards, or visible in a work area; b. c. A dictionary word; or Stored in clear text 21 22 23 24 25 26 27 2. Passwords must be: a. b. c. d. 28 groups from the standard keyboard: Eight (8) characters or more in length; Changed every ninety (90) days; Changed immediately if revealed or compromised; and Composed of characters from at least three of the following four -12 -COUNTY OF FRESNO Fresno. CA Upper case letters (A-Z); Lowercase letters (a-z); 1 2 3 4 1) 2) 3) 4) Arabic numerals (0 through 9); and Non-alphanumeric characters (punctuation symbols). 5 CONTRACTOR shall implement the following security controls on each 6 workstation or portable computing device (e.g., laptop computer) containing confidential, 7 personal, or sensitive data: Network-based firewall and/or personal firewall; Continuously updated anti-virus software; and 8 9 10 I. 2. 3. Patch management process including installation of all operating 11 system/software vendor security patches. 12 CONTRACTOR shall utilize a commercial encryption solution that has received 13 FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable 14 electronic media (including, but not limited to, compact disks and thumb drives) and on portable 15 computing devices (including, but not limited to, laptop and notebook computers). 16 CONTRACTOR shall not transmit confidential, personal, or sensitive data viae- 17 mail or other internet transport protocol unless the data is encrypted by a solution that has been 18 validated by the National Institute of Standards and Technology (NIST) as conforming to the Advanced 19 Encryption Standard (AES) Algorithm. 20 I. Mitigation of Harmful Effects 21 CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that 22 is known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or breach of PHI by 23 CONTRACTOR or its subcontractors in violation of the requirements ofthese provisions. 24 J. Contractor's Subcontractors 25 CONTRACTOR shall ensure that any of its contractors, including 26 subcontractors, if applicable, to whom CONTRACTOR provides PHI received from or created or 27 received by CONTRACTOR on behalf of COUNTY, agree to the same restrictions and conditions that 28 apply to CONTRACTOR with respect to such PHI; and to incorporate, when applicable, the relevant -13 -COUNTY OF FRESNO Fresno. CA 1 provisions of these provisions into each subcontract or sub-award to such agents or subcontractors .. 2 K. Employee Training and Discipline 3 CONTRACTOR shall train and use reasonable measures to ensure compliance 4 with the requirements ofthese provisions by employees who assist in the performance of functions or 5 activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such 6 employees who intentionally violate any provisions of these provisions, including termination of 7 employment. 8 L. Termination for Cause 9 Upon COUNTY's knowledge of a material breach of these provisions by 10 CONTRACTOR, COUNTY shall either: 11 1. Provide an opportunity for CONTRACTOR to cure the breach or end the 12 violation and terminate this Agreement if CONTRACTOR does not cure the breach or end the violation 13 within the time specified by COUNTY; or 14 2. Immediately terminate this Agreement if CONTRACTOR has breached a 15 material term of these provisions and cure is not possible. 16 3. If neither cure nor termination is feasible, the COUNTY Privacy Officer 17 shall report the violation to the Secretary ofthe U.S. Department of Health and Human Services. 18 M. Judicial or Administrative Proceedings 19 COUNTY may terminate this Agreement in accordance with the terms and 20 conditions ofthis Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in a 21 criminal proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH Act; or (2) 22 a finding or stipulation that the CONTRACTOR has violated a privacy or security standard or 23 requirement of the HITECH Act, HIP AA; or other security or privacy laws in an administrative or civil 24 proceeding in which the CONTRACTOR is a party. 25 N. Effect of Termination 26 Upon termination or expiration of this Agreement for any reason, 27 CONTRACTOR shall return or destroy all PHI received from COUNTY (or created or received by 28 CONTRACTOR on behalf of COUNTY) that CONTRACTOR still maintains in any form, and shall -14 -COUNTY OF FRESNO Fresno. CA 1 retain no copies of such PHI. If return or destruction of PHI is not feasible, it shall continue to extend 2 the protections of these provisions to such information, and limit further use of such PHI to those 3 purposes that make the return or destruction of such PHI infeasible. This provision shall apply to PHI 4 that is in the possession of subcontractors or agents, if applicable, of CONTRACTOR. If Contractor 5 destroys the PHI data, a certification of date and time of destruction shall be provided to the COUNTY 6 by CONTRACTOR. 7 0. Disclaimer 8 COUNTY makes no warranty or representation that compliance by 9 CONTRACTOR with these provisions, the HITECH Act, HIP AA or the HIP AA regulations will be 10 adequate or satisfactory for CONTRACTOR's own purposes or that any information in 11 CONTRACTOR's possession or control, or transmitted or received by CONTRACTOR, is or will be 12 secure from unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely 13 responsible for all decisions made by CONTRACTOR regarding the safeguarding of PHI. 14 P. Amendment 15 The parties acknowledge that Federal and State laws relating to electronic data 16 security and privacy are rapidly evolving and that amendment of these provisions may be required to 17 provide for procedures to ensure compliance with such developments. The parties specifically agree to 18 take such action as is necessary to amend this agreement in order to implement the standards and 19 requirements of HIP AA, the HIP AA regulations, the HITECH Act and other applicable laws relating to 20 the security or privacy of PHI. COUNTY may terminate this Agreement upon thirty (30) days written 21 notice in the event that CONTRACTOR does not enter into an amendment providing assurances 22 regarding the safeguarding of PHI that COUNTY in its sole discretion, deems sufficient to satisfy the 23 standards and requirements of HIP AA, the HIP AA regulations and the HI TECH Act. 24 Q. No Third-Party Beneficiaries 25 Nothing express or implied in the terms and conditions of these provisions is 26 intended to confer, nor shall anything herein confer, upon any person other than COUNTY or 27 CONTRACTOR and their respective successors or assignees, any rights, remedies, obligations or 28 liabilities whatsoever. -15 -COUNTY OF FRESNO Fresno. CA 1 R. Interpretation 2 The terms and conditions in these provisions shall be interpreted as broadly as 3 necessary to implement and comply with HIP AA, the HIP AA regulations and applicable State laws. 4 The parties agree that any ambiguity in the terms and conditions of these provisions shall be resolved in 5 favor of a meaning that complies and is consistent with HIP AA and the HIP AA regulations. 6 s. Regulatory References 7 A reference in the terms and conditions of these provisions to a section in the 8 HIP AA regulations means the section as in effect or as amended. 9 T. Survival 10 The respective rights and obligations of CONTRACTOR as stated in this Section 11 shall survive the termination or expiration ofthis Agreement. 12 U. No Waiver of Obligations 13 No change, waiver or discharge of any liability or obligation hereunder on any 14 one or more occasions shall be deemed a waiver of performance of any continuing or other obligation, 15 or shall prohibit enforcement of any obligation on any other occasion. 16 14. DATA SECURITY 17 For the purpose of preventing the potential loss, misappropriation or inadvertent access, 18 viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse 19 of COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that 20 enter into a contractual relationship with the COUNTY for the purpose of providing services under this 21 Agreement must employ adequate data security measures to protect the confidential information 22 provided to CONTRACTOR by the COUNTY, including but not limited to the following: 23 A. CONTRACTOR-Owned Mobile, Wireless, or Handheld Devices 24 CONTRACTOR may not connect to COUNTY networks via personally-owned 25 mobile, wireless or handheld devices, unless the following conditions are met: 26 1) 27 telecommuting purposes; 28 2) CONTRACTOR has received authorization by COUNTY for Current virus protection software is in place; -16 COUNTY OF FRESNO Fresno. CA 1 2 3 B. 3) 4) Mobile device has the remote wipe feature enabled; and A secure connection is used. CONTRACTOR-Owned Computers or Computer Peripherals 4 CONTRACTOR may not bring CONTRACTOR-owned computers or computer 5 peripherals into the COUNTY for use without prior authorization from the COUNTY's Chief 6 Information Officer, and/or designee(s), including but not limited to mobile storage devices. If data is 7 approved to be transferred, data must be stored on a secure server approved by the COUNTY and 8 transferred by means of a Virtual Private Network (VPN) connection, or another type of secure 9 connection. Said data must be encrypted. 10 C. COUNTY -Owned Computer Equipment 11 CONTRACTOR or anyone having an employment relationship with the 12 COUNTY may not use COUNTY computers or computer peripherals on non-COUNTY premises 13 without prior authorization from the COUNTY's Chieflnformation Officer, and/or designee(s). 14 D. CONTRACTOR may not store COUNTY's private, confidential or sensitive 15 data on any hard-disk drive, portable storage device, or remote storage installation unless encrypted. 16 E. CONTRACTOR shall be responsible to employ strict controls to ensure the 17 integrity and security of COUNTY's confidential information and to prevent unauthorized access, 18 viewing, use or disclosure of data maintained in computer files, program documentation, data 19 processing systems, data files and data processing equipment which stores or processes COUNTY data 20 internally and externally. 21 F. Confidential client information transmitted to one party by the other by means of 22 electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128 23 BIT or higher. Additionally, a password or pass phrase must be utilized. 24 G. CONTRACTOR is responsible to immediately notify COUNTY of any 25 violations, breaches or potential breaches of security related to COUNTY's confidential information, 26 data maintained in computer files, program documentation, data processing systems, data files and data 27 processing equipment which stores or processes COUNTY data internally or externally. 28 -17 -COUNTY OF FRESNO Fresno. CA 1 H. COUNTY shall provide oversight to CONTRACTOR's response to all incidents 2 arising from a possible breach of security related to COUNTY's confidential client information 3 provided to CONTRACTOR. CONTRACTOR will be responsible to issue any notification to affected 4 individuals as required by law or as deemed necessary by COUNTY in its sole discretion. 5 CONTRACTOR will be responsible for all costs incurred as a result of providing the required 6 notification. 7 15. CONFLICT OF INTEREST 8 No officer, agent, or employee of COUNTY who exercises any function or 9 responsibility for planning and carrying out the services provided under this Agreement shall have any 10 direct or indirect personal financial interest in this Agreement. CONTRACTOR(S) shall comply with 11 all Federal, State of California, and local conflict of interest laws, statutes, and regulations, which shall 12 be applicable to all parties and beneficiaries under this Agreement and any officer, agent, or employee 13 ofCOUNTY. 14 16. REFERENCE TO LAWS AND RULES 15 CONTRACTOR(S) facilities shall maintain in full force and effect and comply with any 16 and all licensing, local zoning, and State fire and safety ordinances and regulations. 17 17. NON-DISCRIMINATION 18 During the performance of this Agreement CONTRACTOR shall not unlawfully 19 discriminate against any employee or applicant for employment, or recipient of services, because of 20 race, religion, color, national origin, ancestry, physical disability, medical condition, marital status, age 21 or gender, pursuant to all applicable State and Federal statutes and regulations. 22 18. LICENSES 23 CONTRACTOR(S) shall throughout the term of this Agreement, maintain all necessary 24 licenses, permits approvals, certificates, waivers and exceptions necessary for the provision of the 25 services hereunder and required by the laws and regulations of the United States, State of California, 26 County of Fresno, and any other applicable governmental agencies. In addition, CONTRACTOR(S) 27 shall throughout each term ofthis Agreement ensure that all of its personnel performing services under 28 this Agreement are licensed and/or certified and shall maintain such licensure and/or certification -18 -COUNTY OF FRESNO Fresno. CA 1 throughout each term of this Agreement where required, to lawfully perform their duties. 2 CONTRACTOR(S) shall notify COUNTY immediately in writing of its inability to 3 obtain or maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions 4 irrespective of the pendency of any appeal related thereto. Additionally, CONTRACTOR(S) shall 5 comply with all other applicable laws, rules or regulations, as any may now exist or be hereafter 6 changed. CONTRACTOR(S) shall maintain copies of all licenses, certifications, etc., noted above and 7 shall allow COUNTY's DBH to review these documents upon request. 8 19. ADDITIONS/DELETIONS OF CONTRACTORS 9 COUNTY's DBH Director, or designee, reserves the right at any time during the term of 10 this Agreement to add new CONTRACTOR(S) to those contained in Exhibit A. It is understood any 11 such additions will not affect compensation paid to the other CONTRACTOR(S), and therefore such 12 additions may be made by COUNTY without notice to or approval of other CONTRACTOR(S) under 13 this Agreement. These same provisions shall apply to the deletion of any CONTRACTOR(S) 14 contained in Exhibit A, except that deletions shall be by written mutual agreement between the 15 COUNTY and the particular CONTRACTOR(S) to be deleted, or shall be in accordance with the 16 provisions of Section Three (3) of this Agreement. 17 20. COMPLAINTS 18 CONTRACTOR(S) shall log all complaints and the disposition of all complaints from a 19 client or a client's family. CONTRACTOR(S) shall provide a summary ofthe complaint log entries 20 concerning COUNTY-sponsored clients to COUNTY at monthly intervals, by the tenth (101h) day of 21 the following month, in a format that is mutually agreed upon. Said monthly summaries shall be 22 submitted to the DBH's Placement Coordinator. CONTRACTOR(S) shall post signs informing clients 23 of their right to file a complaint or grievance. CONTRACTOR(S) shall also notify COUNTY of all 24 incidents reportable to state licensing bodies that affect COUNTY clients within twenty-four (24) hours 25 of receipt of a complaint. 26 Within fifteen (15) days after each incident or complaint affecting COUNTY-sponsored 27 clients, CONTRACTOR shall provide COUNTY with the complaint and CONTRACTOR(S)'s 28 disposition of, or corrective action taken to resolve the complaint. -19 -COUNTY OF FRESNO Fresno. CA 1 Within fifteen (15) days after CONTRACTOR(S) submits a corrective action plan to a 2 California State licensing and/or accrediting body concerning any sentinel event, as that term is defined 3 by the licensing or accrediting agency, and within fifteen (15) days after CONTRACTOR(S) receives a 4 corrective action order from a California State licensing and /or accrediting body to address a sentinel 5 · event, CONTRACTOR(S) shall provide a summary of such plans and orders to COUNTY. 6 21. COMPLIANCE WITH STATE MEDI-CAL REQUIREMENTS 7 CONTRACTOR(S) shall be required to maintain organizational provider certification 8 by host-county. A copy ofthis bi-annual renewal certificate must be furnished to COUNTY within 9 thirty (30) days of receipt of certificate from host-county. CONTRACTOR(S) must meet Medi-Cal 10 organization provider standards as listed on Exhibit C, Medi-Cal Organizational Provider Standards, 11 attached hereto and incorporated herein. 12 22. COMPLIANCE WITH STATE REQUIREMENTS 13 CONTRACTOR(S) recognize that COUNTY operates its Department of Behavioral 14 Health under an agreement with the State of California Department of Mental Health, and that under 15 said agreement the State imposes certain requirements on COUNTY and its subcontractors. 16 CONTRACTOR(S) shall adhere to all State requirements, including those identified in Exhibit D, 17 attached hereto and by this reference incorporated herein. 23. APPLICABLE RECORDS 18 19 A. Medical Records -CONTRACTOR shall maintain adequate medical records 20 on each individual client which shall include diagnostic studies, individual treatment plan, and records 21 of services provided by the various professional personnel in sufficient detail to make possible an 22 evaluation of services, and contain all the data necessary in reporting to the State, including records of 23 client interviews and progress notes. All such records shall be maintained pursuant to applicable laws 2 4 concerning confidentiality and, in the case of Mental Health records, California Welfare and 25 Institutions Code, section 5328, et al, and Title 45, Code of Federal Regulations, section 205.50. All 26 medical records shall be considered the property of COUNTY and shall be retained by the COUNTY at 27 the termination or expiration of this Agreement. The CONTRACTOR may retain copies of these 28 records at the time of termination or expiration if they so choose. -20 -COUNTY OF FRESNO Fresno. CA 1 B. Case Management: CONTRACTOR shall maintain adequate case management 2 records on each individual client which shall include client assessment, individual program plan, and 3 records of services provided by the various professional and para-professional personnel in sufficient 4 detail to make possible an evaluation of services, and contain all the data necessary in reporting to the 5 State, including records of client interviews and progress notes. All such records shall be maintained 6 pursuant to applicable laws concerning confidentiality and, in the case of Mental Health records, 7 California Welfare and Institutions Code, section 5328, et al, and Title 45, Code of Federal 8 Regulations, section 205.50. All case management records shall be considered the property of 9 COUNTY and shall be retained by the COUNTY at the termination or expiration of this Agreement. 10 The CONTRACTOR may retain copies of these records at the time of termination if they so choose. 11 c. Financial Records-Statistical data shall be kept and reports made as required by 12 the DBH Director or designee and the State. All such records shall be available for inspection by the 13 designated auditors of COUNTY or State at reasonable times during normal business hours. Upon 14 expiration or termination of this Agreement, CONTRACTOR shall prepare and submit to COUNTY a 15 final cost report relative to services provided under this Agreement. 16 24. REPORTING 17 CONTRACTOR shall provide at COUNTY's request, any required reports to COUNTY 18 which may include performance outcome measurement reports as communicated by the County to 19 CONTRACTOR 20 25. MONITORING 21 CONTRACTOR(S) agree to extend to COUNTY's DBH and the State Department of 22 Mental Health, or their designees, the right to review and monitor records, programs or procedures, at 23 any time, in regard to clients, as well as the overall operation of CONTRACTOR(S)' programs in order 24 to ensure compliance with the terms and conditions of this Agreement. 25 26. AUDITS AND INSPECTIONS 26 CONTRACTOR(S) shall at any time during business hours, and as often as COUNTY 27 may deem necessary, make available to COUNTY for examination all of their records and data with 28 respect to the matters covered by this Agreement. CONTRACTOR(S) shall, upon request by -21 -COUNTY OF FRESNO Fresno. CA 1 COUNTY, permit COUNTY to audit and inspect all such records and data necessary to ensure 2 CONTRACTOR(S') compliance with the terms ofthis Agreement. 3 Ifthis Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), 4 CONTRACTOR(S) shall be subject to the examination and audit of the State Auditor General for a 5 period ofthree (3) years after final payment under contract (California Government Code section 6 8546.7). 7 27. PROHIBITION ON PUBLICITY 8 None of the funds, materials, property or services provided directly or indirectly under 9 this Agreement shall be used for CONTRACTOR(S)'advertising, fundraising, or publicity (i.e., 10 purchasing of tickets/tables, silent auction donations, etc.) for the purpose of self-promotion. 11 Notwithstanding the above, publicity of the services described in Section One (1) ofthis Agreement 12 shall be allowed as necessary to raise public awareness about the availability of such specific services 13 when approved in advance by COUNTY's DBH Director, or designee and at a cost to be provided in 14 writing for such items as written/printed materials, the use of media (i.e., radio, television, newspapers) 15 and any other related expense(s). 16 28. NOTICES 17 The persons having authority to give and receive notices under this Agreement and their 18 addresses include the following: 19 20 21 22 COUNTY Director, Fresno County Department of Behavioral Health 4441 E. Kings Canyon Road Fresno, CA 93 702 CONTRACTOR(S) SEE EXHIBIT A 23 Any and all notices between COUNTY and CONTRACTOR(S) provided for or 24 permitted under this Agreement or by law shall be in writing and shall be deemed duly served when 25 personally delivered to one of the parties, or in lieu of such personal service, when deposited in the 26 United States Mail, postage prepaid, addressed to such party. 27 28 29. GOVERNING LAW -22 -COUNTY OF FRESNO Fresno. CA 1 The parties agree that for the purposes of venue, performance under this Agreement is to 2 be in Fresno County, California. 3 The rights and obligations of the parties and all interpretation and performance of this 4 Agreement shall be governed in all respects by the laws of the State of California. 5 30. ENTIRE AGREEMENT 6 This Agreement and all exhibits attached hereto, constitutes the entire Agreement 7 between CONTRACTOR(S) and COUNTY with respect to the subject matter hereof and supersedes all 8 previous agreement negotiations, proposals, commitments, writings, advertisements, publications, and 9 understandings of any nature whatsoever unless expressly included in this Agreement. 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 -23 -COUNTY OF FRESNO Fresno. CA 1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and 2 year first hereinabove written. 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 ATTEST: SEE ATTACHED SIGNATURE PAGES BERNICE E. SEIDEL, Clerk Board of Supervisors By: PLEASE SEE ADDITIONAL SIGNATURE PAGE ATTACHED -24 -COUNTY OF FRESNO Fresno. CA 1 APPROVED AS TO LEGAL FORM: DANIEL C. CEDERBORG, COUNTY COUNSEL 2 ~ By: ~li'-----V---~+-~---- 5 6 APPROVED AS TO ACCOUNTING FORM: VICKI CROW, C.P.A., AUDITOR-CONTROLLER/ 7 TREASURER-TAX COLLECTOR 8 9 By ~ ( C.cP>/!f 10 . (}' 11 REVIEWED AND RECOMMENDED FOR 12 APPROVAL: 13 14 By:_Af~£2~ 15 Dawan Utech7,DireCt{)f Department of Behavioral Health 16 17 18 19 20 21 22 23 24 25 26 27 28 Fund/Subclass: Organization: Account/Program: Fiscal Year (FY) FY 2015-16 FY 2016-17 FY 2017-18 FY 2018-19 FY 2019-20 0001110000 56302175 7294/0 Max Total $1,250,000.00 $1,250,000.00 $1,250,000.00 $1,250,000.00 $1,250,000.00 -25 -COUNTY OF FRESNO Fresno. CA MASTER AGREEMENT TRANSITIONAL SERVICES RESIDENTIAL PROGRAM LIST OF CONTRACTED FACILITES Anne Sippi Clinic Treatment Group Attn: Nick Damian 18200 Hwy 178 Bakersfield, CA 93306 Facilities: FY 2015-16 ~ 1"1'7.80 I( Exhibit A -1 Page 1 of 3 1. Anne Sippi Clinic, Los Angeles 2457 Endicott St. $_ per night per person Los Angeles, CA 90032 Phone (323) 227-5252 2. Anne Sippi Clinic, Kern County 18200 Highway 178 Bakersfield, CA 93306 Phone (661) 871-9697 0359 dbh a (revised FY 2012-13) ...$a3S• 1 1(1 .Q. $_per night per person REVIEWED AND RECOMMENDED FOR APPROVAL: By: '-£ , ez:d} ~ ,~ t>Vian~ Department of Behavioral Health FY 2015-16 (4/30/15) Exhibit A-1 Page2 of3 CONTRACTOR: ANNE SIPPI CLINIC TREATMENT GROUP By: p ~ ', Print Nam~~;:\(-~4. ~'~"- " Title: C.~.::._ r 0 {!£ .r.._ .J,.;flvt 3 ~ f. t:"'-..,., Chairman of the Bo rd, or President, or any Vice-President or Director of Operations By: __::_:__~-!:1..=-=-..:'----'B=o=-s==-....;£,'--.. -•~;r--P J.. tl Title: ~ v· .. c....f.o v ---=~-=~~~----~--------Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: Phone: Email: Contact: Fund: Anne Sippi Clinic Treatment Group 18200 Hwy 178 Bakersfield, CA 93306 (661) 871-9697 Nick_damian@yahoo.com Nick Damian, COO Organization: 0001/10000 56302175 7294/0 Account/Program: FY 2015-16 {4/30/15) Exhibit A.w I Page 3 of 3 MASTER AGREEMENT TRANSITIONAL SERVICES RESIDENTIAL PROGRAM LIST OF CONTRACTED FACILITES FY 2015-16 Crestwood Behavioral Health, Inc. Attn: George C. Lytal, President & CEO 520 Capitol Mall, Suite 800 Sacramento, CA 95814 Facilities: Exhibit A ~2. Page 1 of 3 1. Crestwood Bakersfield Bridge Program 6600 Eucalyptus Drive $168 per night per person Bakersfield, CA 93306 (661) 363-0124 2. Crestwood Fresno Bridge Program 153 N. "U" Street Fresno, CA 93701 (559) 445-9094 0359 dbh a (revised FY 2012-13) $168 per night per person REVIEWED AND RECOMMENDED FOR APPROVAL: By: -hA~l/]~ D~an Ut~;i7" Department of Behavioral Health FY 2015-16 (4/30/15) ExhibitA-2 Page 2 of 3 CONTRACTOR: CRESTWOOD BEHAVORIAL HEALTH, INC. Title: President & CEO By: Chairman of the Board, or President, or any Vice-President or Director of Operations Print Name: Title: Controller Secretary (of Corporation), or any Assistant Secretary, or Chief Financial Officer, or any Assistant Treasurer/Facility Administrator Mailing Address: Phone: Email: Contact: Fund: Crestwood Behavioral Health, Inc. 520 Capitol Mall, Suite 800 Sacramento, CA 95814 (916) 471-2240 gzeyen@cbhi.net Gary Zeyen Organization: 0001/10000 56302175 7294/0 Account/Program: FY 2015-16 (4/30/15) Exhibit A -J-.. Page 3 of 3 TRANSITIONAL SOCIAL REHABILITATION PROGRAM SERVICES AND REQUIREMENTS SCOPE OF WORK Exhibit 8 Page 1 of 12 I. PROGRAM STANDARDS AND REQUIREMENTS (A) To be certified as a Transitional Social Rehabilitation Program, a program shall provide: (1) Services that provide a therapeutic environment in which clients are supported in their efforts to acquire and apply interpersonal and independent living skills. The program shall also assist the client in developing a personal community support system to substitute for the program's supportive environment, to minimize the risk of hospitalization, and enhance the capability for independent living upon discharge from the program. The planned length of stay in the program shall be in accordance with the client's assessed need, with the goal of transitioning the client to a lower level of care within one (1) year; however, a length of stay not exceeding a maximum total of 18 months is permitted to ensure successful completion or the treatment plan and appropriate referral. The reasons for a length of stay beyond one (1) year shall be documented in the client's case record. (2) A minimum staffing ratio of at least one (1) full-time equivalent direct care staff for each 2.5 clients served. Greater number of staff shall be present during times when there are greater numbers or clients in programmed activities. Staff schedules shall be determined by the program based on the number of clients in the program during specific hours of the day, level of care provided by the program, and the range of services provided within the facility. All scheduled hours in the facility shall be considered part of this required full-time equivalent staffing ratio. II. SERVICE REQUIREMENTS (A) Structured day and evening services shall be available seven (7) days a week. Services in all programs shall include but not be limited to: (1) Individual and group counseling; (2) Crisis intervention; (3) Planned activities; Revised 6/16/15 Exhibit 8 Page 2 of 12 (4) Counseling with available members of the client's family, when indicated in the client's treatment/rehabilitation plan; (5) The development of community support systems for clients to maximize their utilization of non-mental health community resources, including educational opportunities; (6) Pre-vocational or vocational counseling; (7) Client advocacy, including assisting clients to develop their own advocacy skills; (8) An activity program that encourages socialization, program and community involvement, which links the client to resources that are available after leaving the program; and (9) Use of the residential environment to assist clients in the acquisition, testing, and lor refinement of community living and interpersonal skills. (B) In addition to the services in Section (II A), Transitional Social Rehabilitation Programs shall provide services that emphasize the development of vocational skills and linkages to services offering employment or job placement. Ill. MEDICAL REQUIREMENTS Medical and psychiatric policies and practices of all programs shall be in writing and shall include, but not be limited to: (A) A plan for the monitoring of medications by a person licensed to prescribe or dispense prescription drugs; {B) Screening for medical complications which may contribute to disability conducted by a physician, nurse practitioner or physician assistant and a plan for follow-up. 1. The screening for medical complications shall occur within 30 calendar days prior to or after admission. 2. If a client refuses a screening for medical complications, the program shall document the refusal in the client case record. (C) Client education, provided by licensed program staff or licensed consultants, about the role of medications and their potential side effects, with the goal of client becoming responsible for his or her own medication; (D) Entries in client case records indicating all prescribed and non-prescribed medications; (E) Provisions for program staff to discuss medication issues with a person licensed to prescribe or dispense prescription drugs; (F) Provisions for secure central storage of medication, including medication requiring appropriate refrigeration when necessary; and, Revised 6/16/15 Exhibit 8 Page 3 of 12 (G) Encouragement to clients, when part of the treatment/rehabilitation plan, to be personally responsible for holding, managing and safeguarding all of their medications. IV. TREATMENT/REHABILITATION PLAN AND DOCUMENT REQUIREMENTS (A) Each program shall have an admission agreement, signed on entry by the client or an authorized representative, describing the services to be provided and the expectations and rights of the client regarding house rules, client involvement in the program, and fees. The client shall receive a copy of the signed admission agreement. (8) There shall be a written assessment of each client on admission that includes at least: (1) Health and psychiatric histories; (2) Psychosocial skills; (3) Social support skills; (4) Current psychological, educational, vocational, and other functional limitations; (5) Medical needs, as reported; and, (6) Meal planning, shopping and budgeting skills. A copy of each executed assessment shall be provided to the DBH's Placement Coordinator along with monthly invoicing. (C) Program staff and client shall work together to develop a written treatment rehabilitation plan specifying goals and objectives as well as identifying the staff and client responsibilities for their achievement. Clients shall be involved in an ongoing review of progress towards reaching established goals and be involved in the planning and evaluation or their treatment goals. The plan shall contain at least the following elements: (1) Statement of specific rehabilitation plan at least every 30 days. (2) Description of specific services to address identified treatment needs (3) Documentation of reviews by staff and client of the treatment I rehabilitation plan at lease every 30 days. (4) Anticipated length of stay needed to accomplish identified goals, and methods to evaluate the achievement of these goals. (D) If an individual treatment/rehabilitation plan requires services to be provided by another program or agency, there shall be documented evidence in the client's case record of communication between all persons responsible for the treatment/rehabilitation plan. Revised 6/16/15 Exhibit B Page 4 of 12 (E) The agency or program shall arrange for clients to attend community programs when needs are identified in the treatment/rehabilitation plan that cannot be met by the facility, but can be met in the community. (F) There shall be a written discharge summary prepared by staff and client, which includes an outline of services provided, goals accomplished, reason and plan for discharge, and referral follow-up plans. A copy of each discharge summary shall be provided to the DBH's Placement Coordinator along with monthly invoicing. (G) The admission assessment, treatment/rehabilitation plan, and discharge summary shall be prepared by staff who has received training in the development and preparation of these documents. (H) {I) (J) 1. Training required to be provided by the facility shall include: (a) A minimum of one hour of instruction on the development and preparation of the admission assessment. (b) A minimum of one hour of instruction on the development and preparation of the treatment/rehabilitation plan. (c) A minimum of one hour of instruction on the development and preparation of the discharge summary. (d) Subject matter for all training provided for in this subsection shall include the expected content of documentation, methods used to prepare the document, timeframes for completion of documentation, and consultative sources to be utilized in preparing the document. 2. Training provided for in this subsection shall consist of one or more of the following presentation methods: (a) Formal classroom instruction; (b) Oral presentation; (c) Videotape, film or audiovisual presentation; (d) Audio-tape presentation; or {e) Performing the duties, on the job, under the direct supervision of the instructor. Admission and discharge criteria of all programs shall be written and shall be consistent with program goals. The program shall have written policies and procedures for orienting new clients to the facility programs. The range of services provided shall be discussed prior to admission with the prospective client or an authorized representative so that the program's services are clearly understood. Re'-1\~~ 6/16/15 Exhibit B Page 5 of 12 V. CLIENT INVOLVEMENT REQUIREMENTS (A) Each client shall be involved in the development and implementation of his/her treatment/rehabilitation plan. (B) Clients shall be involved, depending on capability, in the operation of the household. This shall include participation in the formulation and monitoring of house rules, as well as in the daily operation of the facility, including but not limited to cooking, cleaning, menu planning and activity planning. (C) Clients shall be encouraged to participate in program evaluations and reviews. VI. PHYSICAL ENVIRONMENT REQUIREMENTS (A) The program shall meet the facility requirements of Section 5453 (a) of the Welfare and Institutions (W&I) Code. (B) Program location shall allow for access by clients to community resources and public transportation. VII. STAFF CHARACTERISTICS, QUALIFICATIONS AND DUTY REQUIREMENTS (A) The program shall meet the staffing requirements of Section 5453 (b) of the Welfare and Institutions Code. (B) The program shall document the use of multidisciplinary professional consultation and staff when necessary to meet the specific diagnostic and treatment needs of the clients. (C) Paraprofessionals and persons who have been clients of mental health services shall be utilized as volunteers in the program when consistent with the program design and services provided. (D) All social rehabilitation facilities shall have a program director. The program director shall be on the premises the number hours necessary to manage and administer the program component or the facility in compliance with applicable laws and regulations. (E) The program director of a certified Transitional Residential Treatment Program or a Certified Long Term Residential Treatment Program shall have the following qualifications prior to employment: Revised 6/16/15 (1) A Bachelor's Degree in Psychology, Social Work or any other major which includes at least 24 semester units in one or more of the following subjects areas: (a) Psychology (b) Social Work (c) Sociology (d) Behavioral Sciences (e) Psychiatric Nursing; and Exhibit 8 Page 6 of 12 (2) One (I) year of full-time work experience in community program that serves clients who have a mental illness. Such experience must be in the direct provision of services to clients, of which four (4) months must be in a position of supervising direct care staff. (3) As an alternative to the Bachelor's Degree and experience required in paragraphs (I) and (2) of this subsection, a total of three years of experience in providing direct services in the community to persons with mental illness, of which six (6) months must be in a position of supervising direct care staff, and graduation from high school or possession of a GED may be substituted. (F) All direct care staff shall have graduated from high school or possess a GED and have a minimum or one (I) year or full-time experience, or its part-time equivalent, working in a program serving people with mental disabilities, Such experience must be in the direct provision of services to clients. If the employee does not have the required experience, the program shall document a specific plan of supervision and in-service training for the employee to perform the job. The plan should include but not be limited to the frequency and number of hours of training, the subjects to be covered, and a description of the supervision to be provided. (G) The program director must provide and document a specific plan of supervision and at least 20 hours of in-service training per year for the employee to ensure the ongoing qualifications of the individual to perform the job. VIII. ADMINISTRATIVE POLICIES AND PROCEDURES (A) The organizational entity legally responsible for program administration, under applicable law and regulation, shall: (1) Have written policies defining the purpose, goals, and services of the organization. (2) Establish and maintain financial records in accordance with generally accepted accounting principles and an annual budget. (B) Each program shall be directed by a designated individual who is responsible for its overall administration and management. (C) Each residential program shall have an individual(s) designated as the administrator of the facility. Revised 6/16/15 The program shall identify the qualifications, experience, skills and knowledge required of an individual who is designated the facility administrator. These requirements shall at least satisfy the minimum requirements established by the Community Care Licensing Division of the Department of Social Services for this position. Exhibit 8 Page 7 of 12 (D) The agency or program shall have a financial plan of operation that is consistent with the goals and purpose of the organization and in accordance with generally accepted accounting practices and legal requirements. IX. OTHER REQUIREMENTS The following will be required of residential facilities applying for certification as a Transitional Social Rehabilitation Facility. This will be in addition to the requirements as indicated above. A. STAFFING REQUIREMENTS (1) Facilities must have psychiatric professional licensed staff either through direct employment or contracted by the facility. (2) Facilities must have nursing staff. (3). Facilities must inform Department of Behavioral Health within 24 hours of any staff changes that may affect this contract. (4). Facility will have adequate number of staff to monitor clients during the sleeping hours. (5). The content of group or individual sessions shall be within the scope of practice of the individual providing that service. (6). Staff assigned to assist in physically restraining clients must receive prior training from appropriate agencies. (7). Physical restraints placed on clients must be under direct supervision of a licensed mental health professional. (8). Transitional facilities shall limit the admission of clients to adults only (ages 18-59). B. ADMINISTRATIVE REQUIREMENTS ( 1) If the legal owner/administrator of the facility is a Corporation, notes from meetings may be requested by Department of Behavioral Health and these records shall be made available to the Department of Behavioral Health to the extent possible. (2) Facilities shall have capabilities to transmit documents to and from Department of Behavioral Health. (3) Confidentiality of client's records shall be maintained at all times whether in written or verbal form in compliance with HIPPA and other federal, State or local regulations or statutes. C. ADMINISTRATIVE COMPLIANCE (1) Administrator of Transitional Facilities shall inform the designated case managers 30 days prior to the expiration of the Needs and Appraisal. The monthly invoicing that CONTRACTORS submit to COUNTY shall include a due date for each client's Needs and Appraisal. Revised 6/16/15 Exhibit B Page 8 of 12 (2) The Facility Treatment Plan shall be developed and implemented within five (5) days after the Needs and Appraisal is updated. (3) The monthly summaries for each client must include progress notes from direct care staff, licensed clinicians and psychiatrists including medication information. (4) The facility shall develop and implement documentation demonstrating the client's participation in activities provided by the facility. (5) The facility shall maintain record of the training provided to clients including attendance of off-site day programs. (6) Training activities as outlined for clients shall be time limited and measurable. (7) Training for clients shall be developed with the goal of stabilizing the client in order to transition to a lower level. Any services and training provided by the facility shall be approved by the DBH designated case manager. (8) Documentation shall be consistent with the goals identified in the Needs/Appraisal and Facility Treatment Plan. (9) Monthly notes shall be made available to OBH staff for review in a reciprocal manner between DBH and the contracted facility. D. SPECIFIC SERVICES (1) Training in hygiene and grooming may include hands-on assistance when needed. (2) In cases of incontinence, clients shall be physically assisted if needed. (3) Training in budgeting shall include clients keeping and maintaining records of transactions. (4) Clients shall be afforded the opportunity to learn cooking skills under the direction of appropriate staff. (5) Clients shall be encouraged to learn independent living skills with personal assistance when warranted. (6) Facilities shall provide special diets as prescribed by the treating physician. (7) Clients shall be trained to access support systems in the community. (8) Facilities shall develop and implement plans for community re-integration. (9) Facilities shall provide individual sessions to assist clients to develop appropriate skills in social interactions using "Normal" settings. (10) Efforts shall be made to normalize the client's living arrangements at all times. (11) Training shall be provided to clients to use transportation systems. (12) Training in medication shall be provided to clients by licensed staff. (13) Individual sessions shall be implemented to counsel clients to attain general insight into their mental illness by licensed staff. Revised 6/16/15 ADDITIONAL REQUIREMENTS Exhibit B Page 9 of 12 The Contractor for the Transitional Social Rehabilitation Program will provide services for clients who have severe and persistent mental illness who have experienced a decrease in social functioning to the extent that they are in a crisis or need a therapeutic community to facilitate movement to more independent living. The objectives of the program are to intervene in a crisis, support community integration, and serve as an alternative to hospitalization. The goal is to rehabilitate the client in order to decrease the need for future hospitalizations. I. TRANSITIONAL PROGRAM To be certified as a Transitional Social Rehabilitation Program, a facility shall provide: A therapeutic residential community including a range of social rehabilitation activities for individuals who are in remission from an acute stage of _illness, and interim support to facilitate movement towards the highest possible level of functioning. Clients may receive day, outpatient and other treatment services outside the transitional residence. The planned length of stay shall be in accordance with the client's assessed needs, but under no circumstances may the length of stay extend beyond 18 months. Additional staff shall be on duty during program hours to provide specialized services and structured evening services. When there is only one (1) staff on the premises, there needs to be staff on call who can report for duty within 60 minutes after being contacted if needed. The staffing ratio is one (1) full time staff to 2.5 clients. The Transitional program is designed for clients who are discharged from or are being admitted to State Mental Hospitals, IMDs or locked MHRCs. II. ADMISSION CRITERIA Transitional Social Rehabilitation Program is an intense, high expectation program designed to assist a person to develop self-help skills that will enable them to function independently in the community. The following is the admission criteria: 1. All clients must have received treatment or evaluation prior to admission and have a current open mental health chart with the Fresno County, Department of Behavioral Health. 2. All clients will have a primary diagnosis of mental disability. (The psychiatric diagnosis must reflect a severe, persistent mental illness or a maladaptive reaction to a mental health crisis. The primary diagnosis cannot be dementia, mental retardation, or substance abuse/dependence). 3. Clients must be Fresno County residents. 4. Clients must be between the ages of 18 and 59. 5. Clients must be recovered from acute psychiatric symptoms, such as being injurious to self or others, and/or destructive to property. 6. Clients must be in need of residential treatment services to assist them gain the ability to function in a less restrictive living situation. Revised 6/16/15 Exhibit B Page 10 of 12 7. Clients who are waiting placement in a more structured, supportive, stable safe group living environment in order to transition back into the community. Ill. LICENSING AGENCIES 1. STATE DEPARTMENT OF SOCIAL SERVICES 2. STATE DEPARTMENT OF HEALTH CARE SERVICES IV. LICENSING REGULATIONS 1. TITLE 22, California Code of Regulations 2. Health and Safety Code Section 1500-1519 3. Section 1500. This chapter shall be known and may be cited as the California Community Care Facilities Act. 4. Welfare and Institutions Code V. REPORTS The selected vendor(s) will be required to submit periodic reports as required by the State or the County. VI. CULTURAL AND LINGUISTIC ACCESS TO SERVICES Contractor will abide by regulations governed by Section 601 of Title VI of the Civil Rights Act of 1964, 42 U.S.C. Section 2000 et. seq. States: "No person in the United States shall on the grounds of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance." The Contractor will have interpreter services available to any person seeking information or receiving services in the Contractor's facilities who is limited-English proficient (LEP) or non-English speaking. VII. METHODS The client centered therapeutic services are closely supervised and highly structured individual and group goal-directed techniques that focus on symptom reduction. Interventions may include any number of the following: Anger management, assertiveness training, improving communication skills, community linkage, community meeting, conflict resolution, family counseling, 5150 evaluation, goal setting, grooming and hygiene, group therapy, health and nutrition, individual counseling, leisure time management, medication education, medical intervention, men's group, money management, placement planning, problem solving, psychiatric services, psycho- education, social skills training, stress management, developing support networks, values clarification, and women's group. Revised 6/16/15 Exhibit B Page 11 of 12 VIII. GOALS The clients seek a higher level of adaptive functioning, social integration, and an active role in their treatment regimen while participating in the program. The goal is to reduce the need for future psychiatric hospitalizations and to reintegrate back into the community at the client's highest level of independence. IX. MEDI-CAL Clients are not required to have Medi-Cal or any other form of health insurance as a prerequisite to receiving services at contracted facility. However, clients must have the County Uniform Method of Determining Ability to Pay (UMDAP) eligibility verified prior to admission. X. OUTCOME MEASURES A. Program Objectives: 1. To provide presentations and educational groups for residents addressing topics related to socialization, budgeting, medication compliance, hygiene, finances and basic living skills on a weekly basis. 2. Ensure that program management staff participates in education and training activities to strive for the best practice model of services. 3. Assist with personal care and other times required to successfully live in the community. 4. Assist with the development of a client's community living skills. 5. Provide transportation services to clients as needed to obtain services identified in their services plan. B. Performance Outcomes, Indicators and Targets: 1. Outcome: It is expected that clients will maintain housing without having to be hospitalized or returned to an IMD facility within 90 days of enrollment. Target: At least 80% of clients placed will not need to be hospitalized or returned to an IMD facility within 90 days of enrollment. 2. Outcome: It is expected that client's inpatient psychiatric hospitalization rate and IMD bed days will be reduced: Indicator: Reduction in the aggregate number of inpatient psychiatric hospitalization days and IMD bed days since enrollment compared with twelve months prior to enrollment in the program. Target: 70% reduction. An annual report regarding the performance outcomes, indicators and targets shall be provided to the DBH in accordance with paragraph 22 of this Agreement. Revised 6/16/15 C. Requirements: Exhibit B Page 12 of 12 1. Maintain a record on each resident to include admission assessment, diagnosis and personal services plan, monthly review, progress notes and discharge summary 2. Report all incidents to County liaison representative immediately 3. Written incident reports will be done in cases when clients engage in illegal activity, self-injury or property destruction or violence towards others. Said incident reports shall be communicated to the DBH's Placement Coordinator in a format that is mutually agreed upon. Incident reports shall be provided to the DBH's Placement Coordinator monthly along with invoicing 4. Complete daily census records will be maintained and sent to the liaison representative monthly. 5. Prepare such reports in accordance of this Agreement and other reports as may be required to fulfill the terms of the Agreement. These may include but are not limited to: Revised 6116/15 (a) Quarterly reports of accomplishments of objectives (b) Demographic profiles as requested (c) Other reports as requested Medi-Cal Organizational Provider Standards EXHIBIT C Page 1 of2 1. The organizational provider possesses the necessary license to operate, if applicable, and any required certification. 2. The space owned, leased or operated by the provider and used for services or staff meets local fire codes. 3. The physical plant of any site owned, leased, or operated by the provider and used for services or staff is clean, sanitary and in good repair. 4. The organizational provider establishes and implements maintenance policies for any site owned, leased, or operated by the provider and used for services or staff to ensure the safety and well being of beneficiaries and staff. 5. The organizational provider has a current administrative manual which includes: personnel policies and procedures, general operating procedures, service delivery policies, and procedures for reporting unusual occurrences relating to health and safety issues. 6. The organizational provider maintains client records in a manner that meets applicable state and federal standards. 7. The organization provider has staffing adequate to allow the County to claim federal financial participation for the services the Provider delivers to beneficiaries, as described in Division 1, Chapter 11, Subchapter 4 of Title 9, CCR, when applicable. 8. The organizational provider has written procedures for referring individuals to a psychiatrist when necessary, or to a physician, if a psychiatrist is not available. 9. The organizational provider has as head of service a licensed mental health professional of other appropriate individual as described in Title 9, CCR, Sections 622 through 630. 10. For organizational providers that provide or store medications, the provider stores and dispenses medications in compliance with all pertinent state and federal standards. In particular: A. All drugs obtained by prescription are labeled in compliance with federal and state laws. Prescription labels are altered only by persons legally authorized to do so. B. Drugs intended for external use only or food stuffs are stored separately from drugs for internal use. C. All drugs are stored at proper temperatures, room temperature drugs at 59-86 degrees F and refrigerated drugs at 36-46 degrees F. D. Drugs are stored in a locked area with access limited to those medical personnel authorized to prescribe, dispense or administer medication. 0359 dbh c EXHIBIT C Page 2 of2 E. Drugs are not retained after the expiration date. IM multi-dose vials are dated and initialed when opened. F. A drug log is maintained to ensure the provider disposes of expired, contaminated, deteriorated and abandoned drugs in a manner consistent with state and federal laws. G. Policies and procedures are in place for dispensing, administering and storing medications. 11. For organizational providers that provide day treatment intensive or day rehabilitation, the provider must have a written description of the day treatment intensive and/or day treatment rehabilitation program that complies with State Department of Mental Health's day treatment requirements. The COUNTY shall review the provider's written program description for compliance with the State Department of Mental Health's day treatment requirements. 12. The COUNTY may accept the host county's site certification and reserves the right to conduct an on-site certification review at least every three years. The COUNTY may also conduct additional certification reviews when: 0359 dbh c • The provider makes major staffing changes. • The provider makes organizational and/or corporate structure changes (example: conversion from a non-profit status). • The provider adds day treatment or medication support services when medications shall be administered or dispensed from the provider site. • There are significant changes in the physical plant of the provider site (some physical plant changes could require a new fire clearance). • There is change of ownership or location. • There are complaints against the provider. • There are unusual events, accidents, or injuries requiring medical treatment for clients, staff or members of the community. MENTAL HEALTH STATE REQUIREMENTS EXHIBIT Exhibit D Page 1 of 2 1. CONTROL REQUIREMENTS The COUNTY and its subcontractors shall provide services in accordance with all applicable Federal and State statutes and regulations. 2. PROFESSIONAL LICENSURE All (professional level) persons employed by the COUNTY Mental Health Program (directly or through contract) providing Short-Doyle/Medi-Cal services have met applicable professional licensure requirements pursuant to Business and Professions and Welfare and Institutions Codes. 3. CONFIDENTIALITY CONTRACTOR shall conform to and COUNTY shall monitor compliance with all State of California and Federal statutes and regulations regarding confidentiality, including but not limited to confidentiality of information requirements at 42, Code of Federal Regulations sections 2.1 et seq; California Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 ofthe California Health and Safety Code; Title 22, California Code of Regulations, section 51 009; and Division 1, Part 2.6, Chapters 1-7 of the California Civil Code. 4. NON-DISCRIMINATION A. Eligibility for Services CONTRACTOR shall prepare and make available to COUNTY and to the public all eligibility requirements to participate in the program plan set forth Paragraph One (1) of the Agreement No person shall, because of ethnic group identification, age, gender, color, disability, medical condition, national origin, race, ancestry, marital status, religion, religious creed, political belief or sexual preference be excluded from participation, be denied benefits of, or be subject to discrimination under any program or activity receiving Federal or State of California assistance. B. Employment Opportunity 0358 e dbh CONTRACTOR shall comply with COUNTY policy, and the Equal Employment Opportunity Commission guidelines, which forbids discrimination against any person on the grounds of race, color, national origin, sex, religion, age, disability status, or sexual preference in employment practices. Such practices include retirement, recruitment advertising, hiring, layoff, termination, upgrading, demotion, transfer, rates of pay or other forms of compensation, use of facilities, and other terms and conditions of employment. Exhibit D Page 2 of 2 C. Suspension of Compensation If an allegation of discrimination occurs, COUNTY may withhold all further funds, until CONTRACTOR can show clear and convincing evidence to the satisfaction of COUNTY that funds provided under this Agreement were not used in connection with the alleged discrimination. D. Nepotism Except by consent of COUNTY's Department of Behavioral Health Director, or designee, no person shall be employed by CONTRACTOR who is related by blood or marriage to, or who is a member of the Board of Directors or an officer of CONTRACTOR. 5. PATIENTS' RIGHTS CONTRACTOR shall comply with applicable laws and regulations, including but not limited to, laws, regulations, and State policies relating to patients' rights 0358 e dbh