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A G R E E M E N T
THIS AGREEMENT is made and entered into this ____ day of _______ 2016, by and between the
COUNTY OF FRESNO, a political subdivision of the State of California, hereinafter referred to as
"COUNTY", and each Provider listed in Exhibit A, “DMC Services Vendor List,” attached hereto and by
this reference incorporated herein, collectively hereinafter referred to as "PROVIDER", and such additional
PROVIDER as may, from time to time during the term of this Agreement, be added by COUNTY.
Reference in this Agreement to “party” or “parties” shall be understood to refer to COUNTY and each
PROVIDER, unless otherwise specified.
W I T N E S S E T H:
WHEREAS, COUNTY is authorized through its State-County Contract with the California
Department of Health Care Services, hereinafter referred to as State or DHCS, to subcontract for Drug
Medi-Cal services in Fresno County; and
WHEREAS, PROVIDER(S) are certified by the State to provide services required by the
COUNTY, pursuant to the terms and conditions of this Agreement.
NOW, THEREFORE, in consideration of their mutual covenants and conditions, the parties
hereto agree as follows:
1.SERVICES
A.PROVIDER shall provide Drug Medi-Cal substance use disorder services at State
certified locations to eligible beneficiaries in Fresno County, as identified in this Agreement, including all
Exhibits, COUNTY’s Request for Statement of Qualifications (RFSQ) # 952-5448 dated February 22,
2016; Addendum No. One (1) dated March 1, 2016; and Addendum No. Two (2) dated March 8, 2016,
hereinafter collectively referred to as COUNTY Revised RFSQ #952-5448, and PROVIDER’s response to
said RFSQ #952-5448, dated March 21, 2016, all incorporated herein by reference and made part of this
Agreement.
B.In the event of any inconsistency among these documents, the inconsistency shall be
resolved by giving precedence in the following order of priority: 1) to this Agreement, including any
Exhibits and amendments attached hereto; 2) to the Revised RFSQ No. 952-5448, and; 3) to the Response
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to the Revised RFSQ. A copy of COUNTY’s Revised RFSQ #952-5448, and PROVIDER’s response shall
be retained and made available during the term of this Agreement by COUNTY’s Purchasing Division.
C. PROVIDER(S) serving clients referred by Drug Court or Probation shall carry out
the following:
1. Comply with reporting requirements of Court or Probation relating to client
status change and treatment progress; and
2. Conduct client intake within forty-eight (48) hours of referral or contact.
D. PROVIDER shall comply with all of the provisions set forth in the State-County
Contract, made available by the Department of Behavioral Health (DBH), Contracts Division - Substance
Use Disorder (SUD) Services at the following web address and by this reference incorporated herein.
http://www.co.fresno.ca.us/DepartmentPage.aspx?id=21309
PROVIDER is referred to therein as “Subcontractor” and COUNTY is referred to
therein as “Contractor.”
E. PROVIDER’s administrative level agency representative, who is duly authorized to
act on behalf of the PROVIDER, must attend regularly scheduled monthly Behavioral Health Board
Substance Use Disorder Committee meetings and regularly scheduled PROVIDER meetings.
F. PROVIDER shall maintain, at PROVIDER’s cost, a computer system compatible
with COUNTY’s Substance Abuse Information System (SAIS) for the provision of submitting information
required under the terms and conditions of this Agreement. PROVIDER shall complete required SAIS data
entry as follows: Registrations and admissions must be complete within five (5) business days of program
completion or dismissal.
G. PROVIDER shall follow the guidelines in the “Youth Treatment Guidelines,”
available at the DHCS web address at: http://www.dhcs.ca.gov/individuals/Pages/youthSUDservices.aspx
and by this reference incorporated herein, in developing and implementing youth treatment programs
funded under this Agreement until such time new Youth Treatment Guidelines are established and adopted.
No formal amendment of this contract is required for new guidelines to apply.
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H. PROVIDER’s staff may also be required to attend meetings and trainings on an as-
needed basis, which may include but are not limited to SUD treatment and fiscal trainings provided by the
State of California.
2. TERM
The term of this Agreement shall be for a period of one (1) year, commencing on the 1st day
of July, 2016 through and including the 30th day of June, 2017. This Agreement may be extended for two
(2) additional twelve (12) month periods upon written approval of both parties no later than thirty (30) days
prior to the first day of the next twelve (12) month extension period. The DBH Director, or her designee, is
authorized to execute such written approval on behalf of COUNTY based on PROVIDER’S satisfactory
performance.
3. TERMINATION
A. NON-ALLOCATION OF FUNDS – The terms of this Agreement, and the services
to be provided thereunder, are contingent on the approval of funds by the appropriating government agency.
Should sufficient funds not be allocated, the services provided may be modified, or this Agreement
terminated, at any time by giving the PROVIDER thirty (30) days advance written notice.
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) A failure to comply with any term of this Agreement;
3) A substantially incorrect or incomplete report submitted to COUNTY;
4) Improperly performed service.
In no event shall any payment by COUNTY constitute a waiver by COUNTY of any breach
of this Agreement or any default which may then exist on the part of the PROVIDER. Neither shall such
payment impair or prejudice any remedy available to COUNTY with respect to the breach or default.
COUNTY shall have the right to demand of the PROVIDER the repayment to COUNTY of any funds
disbursed to the PROVIDER under this Agreement, which in the judgment of COUNTY were not
expended in accordance with the terms of this Agreement. The PROVIDER shall promptly refund any
such funds upon demand.
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C. WITHOUT CAUSE – Under circumstances other than those set forth above, this
Agreement may be terminated by COUNTY or any one (1) PROVIDER upon giving thirty (30) days
advance written notice.
4. COMPENSATION
A. COMPENSATION – In no event shall reimbursement for services performed by
PROVIDER under this Agreement exceed the reimbursement rate set forth in the State-County Contract
for each term of this Agreement. It is understood that all expenses incidental to PROVIDER’S
performance of services under this Agreement shall be borne by PROVIDER.
1) Reimbursement for Drug Medi-Cal Services is limited to the maximum
allowable rates set by the State, “Proposed Drug Medi-Cal Rates for Fiscal Year 2016-17” attached
hereto and by this reference incorporated herein as Exhibit B, and updated annually.
2) COUNTY shall reimburse Narcotic Treatment Program (NTP)
PROVIDERS the lesser of the Unified Statewide Monthly Reimbursement (USMR) rate or the
PROVIDER’s usual or customary charge to the public.
3) COUNTY shall reimburse non-NTP PROVIDER(S) the lesser of the
projected cost of services or the State maximum rate allowance.
4) Payments by COUNTY shall be in arrears, for services provided during the
preceding month, within forty-five (45) days after receipt, verification and approval of PROVIDER’s
invoices by COUNTY’s DBH. If payment for services is denied or disallowed by State, and
subsequently resubmitted to COUNTY by PROVIDER, payment will not be issued to PROVIDER until
COUNTY has received reimbursement from State for said services.
B. COMPLIANCE – If PROVIDER should fail to comply with any provision of this
Agreement, COUNTY shall be relieved of its obligation for further compensation. PROVIDER’s and
COUNTY’s obligations under this section shall survive the termination of this Agreement with respect
to services provided during the term of this Agreement without regard to the cause of termination of this
Agreement.
C. QUALITY ASSURANCE – For services rendered herein, PROVIDER shall
assure that an on-going quality assurance component is in place and is occurring. PROVIDER shall
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assure that clinical records for each participant are of such detail and length that a review of said record
will verify that appropriate services were provided. If the record is unclear, incomplete, and/or indicates
that appropriate services were not provided, COUNTY reserves the right to withhold payment for the
applicable unit(s) of service.
D. PUBLIC INFORMATION – PROVIDER 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 – PROVIDER 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 – PROVIDER 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.
5. INVOICING
COUNTY agrees to pay PROVIDER and PROVIDER agrees to receive compensation at
State established Medi-Cal rates as follows: prior to PROVIDER submitting invoices for reimbursement,
PROVIDER will submit records to COUNTY’s DBH Director or her designee for review. Once it has
been determined that the records meet the criteria of billable services according to applicable regulations,
COUNTY’s DBH Director or her designee will notify the PROVIDER that services are approved for
reimbursement. PROVIDER shall enter billing information into the COUNTY’s Substance Abuse
Information System (SAIS) by the fifteenth (15th) of every month. PROVIDER may submit supplemental
billings after the original deadlines if good cause exists. A Good Cause Certification form must be included
with the late billing. Replacement billing for Drug Medi-Cal services must be submitted no later than six
(6) months from the date of the denial.
6. PROHIBITION ON PUBLICITY
None of the funds, materials, property or services provided directly or indirectly under this
Agreement shall be used for PROVIDER’s advertising, fundraising, or publicity (i.e., purchasing of
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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 to be provided for such items as written/printed
materials, the use of media (i.e., radio, television, newspapers) and any other related expense(s).
7. INDEPENDENT CONTRACTOR
In performance of the work, duties and obligations assumed by PROVIDER under this
Agreement, it is mutually understood and agreed that PROVIDER, including any and all of the
PROVIDER's officers, agents, and employees will at all times be acting and performing as an independent
contractor, and shall act in an independent capacity and not as an officer, agent, servant, employee, joint
venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no right to control or
supervise or direct the manner or method by which PROVIDER shall perform its work and function.
However, COUNTY shall retain the right to administer this Agreement so as to verify that PROVIDER is
performing its obligations in accordance with the terms and conditions thereof.
PROVIDER and COUNTY shall comply with all applicable provisions of law and the rules
and regulations, if any, of governmental authorities having jurisdiction over matters the subject thereof.
Because of its status as an independent contractor, PROVIDER shall have absolutely no right
to employment rights and benefits available to COUNTY employees. PROVIDER shall be solely liable
and responsible for providing to, or on behalf of, its employees all legally-required employee benefits. In
addition, PROVIDER shall be solely responsible and save COUNTY harmless from all matters relating to
payment of PROVIDER's employees, including compliance with Social Security withholding and all other
regulations governing such matters. It is acknowledged that during the term of this Agreement,
PROVIDER may be providing services to others unrelated to the COUNTY or to this Agreement.
8. 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. PROVIDER shall comply with all Federal, State of
California, and local conflict of interest laws, statutes, and regulations, which shall be applicable to all
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parties and beneficiaries under this Agreement and any officer, agent, or employee of COUNTY.
9. DISCLOSURE OF SELF-DEALING TRANSACTIONS
This provision is only applicable if the PROVIDER is operating as a corporation (a for-profit
or non-profit corporation) or if during the term of this agreement, the PROVIDER changes its status to
operate as a corporation.
Members of the PROVIDER’s Board of Directors shall disclose any self-dealing
transactions that they are a party to while PROVIDER is providing goods or performing services under this
Agreement. A self-dealing transaction shall mean a transaction to which the PROVIDER is a party and in
which one or more of its directors has a material financial interest. Members of the Board of Directors shall
disclose any self-dealing transactions that they are a party to by completing and signing a Self-Dealing
Transaction Disclosure Form (Exhibit C) and submitting it to the COUNTY prior to commencing with the
self-dealing transaction or immediately thereafter.
10. 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.
Notwithstanding the above, changes to Section 1, SERVICES, as needed to accommodate
changes in State and Federal Law relating to mental health and substance use disorder treatment may be
made with the signed written approval of COUNTY’s DBH Director or her designee and respective
PROVIDER(S) through an amendment approved by County Counsel and Auditor.
11. NON-ASSIGNMENT
Neither party shall assign, transfer or sub-contract this Agreement nor their rights or duties
under this Agreement without the prior written consent of the other party.
12. HOLD HARMLESS
PROVIDER agrees to indemnify, save, hold harmless, and at COUNTY'S request, defend
the COUNTY, its officers, agents, and employees from any and all costs and expenses, damages, liabilities,
claims, and losses occurring or resulting to COUNTY in connection with the performance, or failure to
perform, by PROVIDER, its officers, agents, or employees under this Agreement, and from any and all
costs and expenses, damages, liabilities, claims, and losses occurring or resulting to any person, firm, or
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corporation who may be injured or damaged by the performance, or failure to perform, of PROVIDER, its
officers, agents, or employees under this Agreement.
PROVIDER agrees to indemnify COUNTY for Federal, State of California audit
exceptions resulting from noncompliance herein on the part of the PROVIDER.
13. INSURANCE
Without limiting the COUNTY's right to obtain indemnification from PROVIDER or any
third parties, PROVIDER , at its sole expense, shall maintain in full force and effect, the following
insurance policies or a program of self-insurance, including but not limited to, an insurance pooling
arrangement or Joint Powers Agreement (JPA) throughout the term of the Agreement:
A. COMMERCIAL GENERAL LIABILITY
Commercial General Liability Insurance with limits of not less than One Million Dollars
($1,000,000.00) per occurrence and an annual aggregate of Two Million Dollars ($2,000,000.00). This
policy shall be issued on a per occurrence basis. COUNTY may require specific coverages including
completed operations, products liability, contractual liability, Explosion-Collapse-Underground, fire legal
liability or any other liability insurance deemed necessary because of the nature of this contract. In addition
to the Commercial General Liability coverage, PROVIDER shall provide an insurance policy for sexual
abuse and molestation liability with these same limits.
B. 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 ($100,000.00), 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.
C. PROFESSIONAL LIABILITY
If PROVIDER 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
agrees that it shall maintain, at its sole expense, in full force and effect for a period of three (3) years
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following the termination of this Agreement, one or more policies of professional liability insurance with
limits of coverage as specified herein.
D. WORKER'S COMPENSATION
A policy of Worker's Compensation insurance as may be required by the California Labor
Code.
PROVIDER 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 PROVIDER'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 PROVIDER signs this Agreement, PROVIDER shall
provide certificates of insurance and endorsements as stated above for all of the foregoing policies, as
required herein, to the County of Fresno, Department of Behavioral Health, Contracts Division - Substance
Use Disorder Services at 3133 N. Millbrook Ave., Fresno, California, 93703, Attention: SUD Services
Staff Analyst, stating that such insurance coverages 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 with insurance provided under PROVIDER’s policies herein; and
that this insurance shall not be cancelled or changed without a minimum of thirty (30) days advance,
written notice given to COUNTY.
In the event any PROVIDER fails to keep in effect at all times insurance coverage as herein
provided, COUNTY may, in addition to other remedies it may have, suspend or terminate this Agreement
with PROVIDER upon the occurrence of such event.
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All policies shall be with admitted insurers licensed to do business in the State of California.
Insurance purchased shall be from companies possessing a current A.M. Best, Inc. rating of A FSC VII or
better.
14. SUBCONTRACTS
PROVIDER shall be required to assume full responsibility for all services and activities
covered by this Agreement, whether or not PROVIDER is providing services directly. Further,
PROVIDER shall be the sole point of contact with regard to contractual matters, including payment of any
and all charges resulting from this Agreement.
If PROVIDER 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 caused by PROVIDER 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.
PROVIDER shall be responsible to COUNTY for the proper performance of any subcontract. Any
subcontractor shall be subject to the same terms and conditions that PROVIDER is subject to under this
Agreement.
It is expressly recognized that PROVIDER 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 met.
If PROVIDER hires an independent contract physician, PROVIDER shall require and
ensure that such independent contract physician carries Professional Liability (Medical Malpractice)
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.
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15. NO THIRD PARTY BENEFICIARIES
It is understood and agreed by and between the parties that the services provided by
PROVIDER for COUNTY herein are solely for the benefit of the COUNTY, and that 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.
16. REPORTS—SUBSTANCE USE DISORDER SERVICES
PROVIDER(S) shall submit all information and data required by State, including, but not
limited to the following:
1. Drug and Alcohol Treatment Access Report (DATAR) 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; and
2. CalOMS Treatment – Submit CalOMS treatment admission, discharge, annual
update, and “provider activity report” record in an electronic format through COUNTY’s SAIS system,
and on a schedule as determined by the COUNTY which complies with State requirements for data
content, data quality, reporting frequency, reporting deadlines, and report method and due no later than
five (5) days after the preceding month. All CalOMS admissions, discharges, and annual updates must
be entered into the COUNTY’s CalOMS system within twenty-four (24) hours of occurrence; and
3. PROVIDER(S) shall submit to COUNTY monthly fiscal and all program reports,
including Provider Waiting List Record (WLR), within twenty (20) days of the end of each month.
4. Americans with Disabilities (ADA) – Annually, upon request by DBH,
PROVIDER(S) shall complete a system-wide accessibility survey in a format determined by DBH for
each service location and modality and shall submit an ADA Accessibility Certification and Self-
Assessment, including an Implementation Plan, for each service location.
5. Cost Reports – On an annual basis for each fiscal year ending June 30th
PROVIDER(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
date. Submittal must also include any requested support documents such as general ledgers. All reports
submitted by PROVIDER(S) to COUNTY must be typewritten. COUNTY will issue instructions for
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completion and submittal of the annual cost report, including the relevant cost report template(s) and
due dates within forty-five (45) days of each fiscal year end. All cost reports must be prepared in
accordance with Generally Accepted Accounting Principles. Unallowable costs such as lobbying or
political donations must be deducted from the cost report and all invoices. If the PROVIDER(S) does
not submit the cost report by the due date, including any extension period granted by the COUNTY, the
COUNTY may withhold payment of pending invoices until the cost report(s) has been submitted and
clears COUNTY desk audit for completeness and accuracy.
A. DMC - A DMC cost report must be submitted in a format prescribed by the
DHCS for the purposes of Short Doyle Medi-Cal reimbursement of total costs for all programs.
PROVIDER(S) shall report costs under their approved legal entity number established during the DMC
certification process. Total units of service reported on the cost report will be compared to the units of
services entered by PROVIDER(S) into COUNTY’s data system. PROVIDER(S) will be required to
correct discrepancies and resubmit to COUNTY prior to COUNTY’s final acceptance of the cost report.
B. OTHER FUNDING SOURCES – PROVIDER(S) will be required to
submit a cost report on a form(s) approved and provided by the COUNTY to reflect actual costs and
reimbursement for services provided through funding sources other than DMC. Contracts that include a
negotiated rate per unit of service will be reimbursed only for the costs of approved units of service up
to the negotiated unit of service rate approved in the Agreement, regardless of the contract maximum. If
the cost report indicates an amount due to COUNTY, PROVIDER(S) shall submit payment with the
report. If an amount is due to PROVIDER(S) COUNTY shall reimburse PROVIDER within forty-five
(45) days of receiving and accepting the year-end cost report.
C. MULTIPLE FUNDING SOURCES – PROVIDER(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 PROVIDER(S) agree to settle dollar amounts disallowed
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or settled in accordance with DHCS and COUNTY audit settlement findings. 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 PROVIDER(S) until resolution of the appeal.
In the event that PROVIDER(S) fails to provide such reports or other information required
hereunder, it shall be deemed sufficient cause for the COUNTY to withhold monthly payments until there
is compliance. In addition, the PROVIDER shall provide written notification and explanation to the
COUNTY within fifteen (15) days of any funds received from another source to conduct the same services
covered by this Agreement.
17. EVALUATION – MONITORING
OUTCOMES – COUNTY’s DBH Director, or her designee, and DHCS or their designees
shall monitor and evaluate the performance of PROVIDER 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 PROVIDER. PROVIDER shall participate in the evaluation of the program as
needed, at the discretion of COUNTY.
COUNTY shall recapture from PROVIDER the value of any services or other expenditures
determined to be ineligible based on the COUNTY or State monitoring results. At the discretion of the
COUNTY, recoupment can be made through a future invoice reduction or reimbursement by the
PROVIDER.
PROVIDER shall participate in a review of the program at least yearly or more frequently,
or as needed, at the discretion of COUNTY. The PROVIDER agrees to supply all information requested
by the COUNTY, DHCS, and/or the subcontractor during the program evaluation, monitoring, and/or
review.
18. DATA SECURITY
For the purpose of preventing the potential loss, misappropriation or inadvertent access,
viewing, use or disclosure of COUNTY data including sensitive or personal client information; abuse of
COUNTY resources; and/or disruption to COUNTY operations, individuals and/or agencies that enter into
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a contractual relationship with the COUNTY for the purpose of providing services under this Agreement
must employ adequate data security measures to protect the confidential information provided to
PROVIDER by the COUNTY, including but not limited to the following:
A. PROVIDER-OWNED MOBILE, WIRELESS, OR HANDHELD DEVICES
PROVIDER may not connect to COUNTY networks via personally-owned mobile,
wireless or handheld devices, unless the following conditions are met:
1) PROVIDER has received authorization by COUNTY for telecommuting
purposes;
2) Current virus protection software is in place;
3) Mobile device has the remote wipe feature enabled; and
4) A secure connection is used.
B. PROVIDER-OWNED COMPUTERS OR COMPUTER PERIPHERALS
PROVIDER may not bring PROVIDER-owned computers or computer peripherals
into the COUNTY for use without prior authorization from the COUNTY’s Chief Information Officer,
and/or designee(s), including but not limited to mobile storage devices. If data is approved to be
transferred, data must be stored on a secure server approved by the COUNTY and transferred by means of
a Virtual Private Network (VPN) connection, or another type of secure connection. Said data must be
encrypted.
C. COUNTY-OWNED COMPUTER EQUIPMENT
PROVIDER or anyone having an employment relationship with the COUNTY may
not use COUNTY computers or computer peripherals on non-COUNTY premises without prior
authorization from the COUNTY’s Chief Information Officer, and/or designee(s).
D. PROVIDER may not store COUNTY’s private, confidential or sensitive data on any
hard-disk drive, portable storage device, or remote storage installation unless encrypted.
E. PROVIDER shall be responsible to employ strict controls to ensure the integrity and
security of COUNTY’s confidential information and to prevent unauthorized access, viewing, use or
disclosure of data maintained in computer files, program documentation, data processing systems, data files
and data processing equipment which stores or processes COUNTY data internally and externally.
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F. Confidential client information transmitted to one party by the other by means of
electronic transmissions must be encrypted according to Advanced Encryption Standards (AES) of 128 BIT
or higher. Additionally, a password or pass phrase must be utilized.
G. PROVIDER is responsible to immediately notify COUNTY of any violations,
breaches or potential breaches of security related to COUNTY’s confidential information, data maintained
in computer files, program documentation, data processing systems, data files and data processing
equipment which stores or processes COUNTY data internally or externally.
H. COUNTY shall provide oversight to PROVIDER’s response to all incidents arising
from a possible breach of security related to COUNTY’s confidential client information provided to
PROVIDER. PROVIDER will be responsible to issue any notification to affected individuals as required
by law or as deemed necessary by COUNTY in its sole discretion. PROVIDER will be responsible for all
costs incurred as a result of providing the required notification.
19. PERINATAL SERVICES
PROVIDER shall comply with the requirements for "Perinatal Services Network
Guidelines 2014," available at the DHCS web address at:
http://www.dhcs.ca.gov/individuals/Pages/OWPS-SUD.aspx and by this reference incorporated herein,
and the State-County Contract between DHCS and the COUNTY until such time new Perinatal Services
Network Guidelines and the State-County Contract are updated and adopted. No formal amendment of
this contract is required for new guidelines to apply.
PROVIDER shall comply with federal and state mandates to provide alcohol and other
drug treatment services deemed medically necessary for Medi-Cal eligible: (1) pregnant and postpartum
women, and (2) youth under age 21 who are eligible under the Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT) Program.
PROVIDER shall require that counselors of perinatal DMC services are properly certified
to provide these services and comply with the requirements contained in Title 22, Section 51 341 .I,
Services for Pregnant and Postpartum Women and Title 9 commencing with section 10360.
///
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20. INTERIM SERVICES
PROVIDER must adhere to the State-County Contract requirement to provide Interim
Services in the event that an individual must wait to be placed in treatment.
Interim Substance Abuse 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 the 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.
21. REFERENCES TO LAWS AND RULES
In the event any law, regulation, or policy referred to in this Agreement is amended during
the term thereof, the parties hereto agree to comply with the amended provision as of the effective date of
such amendment.
22. STATE ALCOHOL AND DRUG REQUIREMENTS
A. INDEMNIFICATION
The PROVIDER agrees to indemnify, defend and save harmless the State, its
officers, agents and employees from any and all claims and losses accruing or resulting to any and all
contractors, subcontractors, materialmen, laborers and any other person, firm or corporation furnishing or
supplying work, services, materials or supplies in connection with the performance of this Agreement and
from any and all claims and losses accruing or resulting to any person, firm or corporation who may be
injured or damaged by the PROVIDER in the performance of this Agreement.
B. INDEPENDENT CONTRACTOR
The PROVIDER and the agents and employees of PROVIDER, in the performance
of this Agreement, shall act in an independent capacity and not as officers or employees or agents of State
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of California.
C. CONTROL REQUIREMENTS
This Agreement is subject to all applicable Federal and State laws, regulations and
standards. PROVIDER(S) shall establish written procedures consistent with State-County Contract
requirements. 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.
D. CONFIDENTIALITY
PROVIDER 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 Part 2, Title 42, Code of Federal Regulations; California
Welfare and Institutions Code, sections 14100.2, 11977, 11812, 5328; Division 10.5 and 10.6 of the
California Health and Safety Code; Title 22, California Code of Regulations, section 51009; and Division
1, Part 2.6, Chapters 1-7 of the California Civil Code.
E. REVENUE COLLECTION POLICY
PROVIDER shall conform to all policies and procedures regarding revenue
collection issued by the State under the provisions of the Health and Safety Code, Division 10.5.
F. EXPENDITURE OF STATE GENERAL AND FEDERAL FUNDS
PROVIDER 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.
G. ACCESS TO SERVICES
PROVIDER shall provide accessible and appropriate services in accordance with
Federal and State statutes and regulations to all eligible persons.
H. REPORTS
PROVIDER agrees to participate in surveys related to the performance of this
Agreement and expenditure of funds and agrees to provide any such information in a mutually agreed upon
format.
I. AUDITS
All State and Federal funds furnished to the PROVIDER(S) pursuant to this
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Agreement along with related patient fees, third party payments, or other related revenues and funds
commingled with the foregoing funds are subject to audit by the State. The State may audit all alcohol and
drug program revenue and expenditures contained in this Agreement for the purpose of establishing the
basis for the subsequent year's negotiation.
J. RECORDS MAINTENANCE
1) PROVIDER shall maintain books, records, documents, and other evidence
necessary to monitor and audit this Agreement.
2) PROVIDER shall maintain adequate program and fiscal records relating to
individuals served under the terms of this Agreement, as required, to meet the needs of the State in
monitoring quality, quantity, fiscal accountability, and accessibility of services. Information on each
individual shall include, but not be limited to, admission records, patient and participant interviews and
progress notes, and records of service provided by various service locations, in sufficient detail to make
possible an evaluation of services provided and compliance with this Agreement.
23. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
COUNTY and PROVIDER each consider and represent themselves as covered entities as
defined by the U.S. Health Insurance Portability and Accountability Act of 1996, Public Law 104-
191(HIPAA) and agree to use and disclose protected health information as required by law.
COUNTY and PROVIDER acknowledge that the exchange of protected health
information between them is only for treatment, payment, and health care operations.
COUNTY and PROVIDER intend to protect the privacy and provide for the security of
Protected Health Information (PHI) pursuant to the Agreement in compliance with HIPAA, 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 HIPAA Regulations, the Privacy Rule and the Security Rule require
PROVIDER 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) of the Code of
Federal Regulations (CFR).
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24. CULTURAL COMPETENCY
As related to Cultural and Linguistic Competence:
A. Compliance with Title 6 of the Civil Rights Act of 1964 (42 U.S.C. Section 2000d,
and 45 C.F.R. Part 80) and Executive Order 12250 of 1979 which prohibits recipients of federal financial
assistance from discriminating against persons based on race, color, national origin, sex, disability or
religion. This is interpreted to mean that a limited English proficient (LEP) individual is entitled to equal
access and participation in federally funded programs through the provision of comprehensive and quality
bilingual services.
B. Policies and procedures for ensuring access and appropriate use of trained
interpreters and material translation services for all LEP consumers, including, but not limited to, assessing
the cultural and linguistic needs of its consumers, training of staff on the policies and procedures, and
monitoring its language assistance program. The PROVIDER’s procedures must include ensuring
compliance of any sub-contracted providers with these requirements.
C. PROVIDER assurances that minors shall not be used as interpreters.
D. PROVIDER shall provide and pay for interpreting and translation services to persons
participating in PROVIDER’s services who have limited or no English language proficiency, including
services to persons who are deaf or blind. Interpreter and translation services shall be provided as
necessary to allow such participants meaningful access to the programs, services and benefits provided by
PROVIDER. Interpreter and translation services, including translation of PROVIDER’s “vital documents”
(those documents that contain information that is critical for accessing PROVIDER’s services or are
required by law) shall be provided to participants at no cost to the participant. PROVIDER shall ensure
that any employees, agents, subcontractors, or partners who interpret or translate for a program participant,
or who directly communicate with a program participant in a language other than English, demonstrate
proficiency in the participant's language and can effectively communicate any specialized terms and
concepts peculiar to PROVIDER’s services.
E. In compliance with the State mandated Culturally and Linguistically Appropriate
Services standards as published by the Office of Minority Health, PROVIDER must submit to COUNTY
for approval, within 60 days from date of contract execution, PROVIDER’s plan to address all fifteen
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national cultural competency standards as set forth in the “National Standards on Culturally and
Linguistically Appropriate Services” (CLAS), attached hereto as Exhibit D, and incorporated herein by this
reference. County’s annual on-site review of PROVIDER shall include collection of documentation to
ensure all national standards are implemented. As the national competency standards are updated,
PROVIDER’s plan must be updated accordingly.
F. PROVIDER shall complete and submit county-issued CLAS self-assessment
annually. PROVIDER shall update CLAS plan as necessary.
25. SINGLE AUDIT CLAUSE
A. If PROVIDER expends Seven Hundred Fifty Thousand Dollars ($750,000.00) or
more in Federal and Federal flow-through monies, PROVIDER agrees to conduct an annual audit in
accordance with the requirements of the Single Audit Standards as set forth in 2CFR Part 200.
PROVIDER 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,
PROVIDER must include a corrective action plan signed by an authorized individual. PROVIDER 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 Department of Behavioral Health, Business Office for review within
nine (9) months of the end of any fiscal year in which funds were expended and/or received for the
program. Failure to perform the requisite audit functions as required by this Agreement may result in
COUNTY performing the necessary audit tasks, or at COUNTY’s option, contracting with a public
accountant to perform said audit, or, may result in the inability of COUNTY to enter into future agreements
with PROVIDER. All audit costs related to this Agreement are the sole responsibility of PROVIDER.
B. A single audit report is not applicable if PROVIDER’s Federal contracts do not
exceed the Seven Hundred Fifty Thousand Dollars ($750,000.00) requirement or PROVIDER’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 PROVIDER to
COUNTY as a minimum requirement to attest to PROVIDER’s solvency. Said audit report shall be
delivered to COUNTY’s Department of Behavioral Health, Business Office for review, no later than nine
(9) months after the close of the fiscal year in which the funds supplied through this Agreement are
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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 PROVIDER 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 PROVIDER at COUNTY’s cost, as determined by COUNTY’s Auditor-
Controller/Treasurer-Tax Collector.
C. PROVIDER 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.
26. TAX EQUITY AND FISCAL RESPONSIBILITY ACT
To the extent necessary to prevent disallowance of reimbursement under section 1861(v) (1)
(I) of the Social Security Act, (42 U.S.C. § 1395x, subd. (v)(1)[I]), until the expiration of four (4) years
after the furnishing of services under this Agreement, PROVIDER 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 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 PROVIDER under this Agreement.
PROVIDER further agrees that in the event PROVIDER 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.
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27. COMPLIANCE WITH LAWS AND POLICIES
PROVIDER 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.
PROVIDER shall comply with any other Federal and State laws or guidelines applicable to PROVIDER’s
performance under this Agreement or any local ordinances, regulations, or policies applicable. Such
provisions include, but are not restricted to:
A. PROVIDER shall provide that each client's ability to pay for services is determined
by the use of the method approved by COUNTY.
B. PROVIDER shall establish and use COUNTY’s approved method of determining
and collecting fees from clients.
C. PROVIDER shall furnish client records in accordance with the applicable Federal
and State regulations, and with the Standards for Alcohol and Drug Treatment Programs set forth by the
State Department of Alcohol and Drug Programs, including in such records a treatment plan for each client,
and evidence of each service rendered.
D. PROVIDER shall submit accurate, complete and timely claims and cost reports,
reporting only allowable costs.
E. PROVIDER shall comply with statistical reporting and program evaluation systems
as provided in State of California regulations and in this Agreement.
F. PROVIDER shall comply with requirements contained in the State-County Contract
with DHCS by this reference incorporated herein, until such time that a new State-County Contract is
established. Upon amendment of the State-County Contract, the terms of the amended Contract shall
automatically be incorporated into this Agreement.
28. FEDERAL CERTIFICATIONS
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS
A. DBH and PROVIDER recognize that Federal assistance funds will be used under the
terms of this Agreement. For purposes of this section, DBH will be referred to as the "prospective
recipient".
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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, 1988 Federal Register (pages 19160-19211).
1) The prospective recipient of Federal assistance funds certifies 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 this Agreement,
that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,
suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless
authorized by the Federal department or agency with which this transaction originated.
3) Where the prospective recipient of Federal assistance funds is unable to
certify to any of the statements in this certification, such prospective participant shall attach an explanation
to this Agreement.
4) The PROVIDER shall provide immediate written notice to DBH if at any
time PROVIDER 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 "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.
29. CLEAN AIR AND WATER
In the event funding under this Agreement exceeds one hundred thousand dollars
($100,000.00), the PROVIDER must comply with all applicable standards, orders, or requirements issued
under section 306 of the Clean Air Act (42 U.S.C. 1857 (h)), section 506 of the Clean Water Act (33 U.S.C.
1368), Executive Order 11738, and Environmental Protection Agency Regulations (40 CFR part 32).
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30. SMOKING PROHIBITION REQUIREMENTS
PROVIDER shall comply with Public Law 103-227, also known as the Pro-Children Act of
1994 (20 USC Section 6081, et seq.), and with California Labor Code Section 6404.5, the California
Smoke-Free Workplace Law.
31. ENERGY EFFICIENCY
The PROVIDER must comply with the mandatory standards and policies relating to energy
efficiency which are contained in the state energy conservation plan issued in compliance with Energy
Policy and Conservation Act (Pub. L. 94 163).
32. NON-DISCRIMINATION PROVISION
A. ELIGIBILITY FOR SERVICES – PROVIDER shall prepare, prominently post in its
facility, and make available to the DBH Director or her designee and to the public all eligibility
requirements to participate in the program funded under this Agreement. PROVIDER shall not unlawfully
discriminate in the provision of services because of race, religious creed, color, national origin, ancestry,
physical disability, mental disability, medical condition, genetic information, marital status, sex, gender,
gender identity, gender expression, age, sexual orientation, or military or veteran status as provided by State
of California and Federal law in accordance with Title VI of the Civil Rights Act of 1964 (42 USC section
2000(d)); Age Discrimination Act of 1975 (42 USC section 1681); Rehabilitation Act of 1973 (29 USC
section 794); Education Amendments of 1972 (20 USC section 1681); Americans with Disabilities Act of
1990 (42 USC section 12132); Title 45, Code of Federal Regulations, Part 84; provisions of the Fair
Employment and Housing Act (California Government Code section 12900); and regulations promulgated
thereunder (Title 2, CCR, section 7285.0); Title 2, Division 3, Article 9.5 of the California Government
Code commencing with section 11135; and Title 9, Division 4, Chapter 6 of the California Code of
Regulations commencing with section 10800.
B. EQUAL OPPORTUNITY – PROVIDER 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. PROVIDER shall
not discriminate against any employee or applicant for employment because race, religious creed, color,
national origin, ancestry, physical disability, mental disability, medical condition, genetic information,
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marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military or veteran
status. 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. PROVIDER 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. PROVIDER 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 PROVIDER can show by clear and convincing 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 PROVIDER who is related by blood or marriage to or who is a member of the Board
of Directors or an officer of PROVIDER.
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 PROVIDER’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 PROVIDER has provided a facility accessible to the
physically disabled.
33. ASSURANCES
In entering into this Agreement, PROVIDER certifies that it is not currently excluded,
suspended, debarred, or otherwise ineligible to participate in the Federal Health Care Programs; that it has
not been convicted of a criminal offense related to the provision of health care items or services; nor has it
been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension,
debarment, or ineligibility. If COUNTY learns, subsequent to entering into a contract, that PROVIDER is
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ineligible on these grounds, COUNTY will remove PROVIDER from responsibility for, or involvement
with, COUNTY’s business operations related to the Federal Health Care Programs and shall remove such
PROVIDER from any position in which PROVIDER’s compensation, or the items or services rendered,
ordered or prescribed by PROVIDER may be paid in whole or part, directly or indirectly, by Federal
Health Care Programs or otherwise with Federal Funds at least until such time as PROVIDER is reinstated
into participation in the Federal Health Care Programs. Further the PROVIDER agrees to the Disclosure of
Criminal History and Civil Actions and Certification regarding debarment suspension and other
responsibility matters primary covered transactions; PROVIDER must sign an appropriate Certification
regarding debarment, suspension, and other responsibility matters, attached hereto as Exhibit E,
incorporated herein by reference and made part of this Agreement.
A. If COUNTY has notice that PROVIDER 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,
PROVIDER 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 PROVIDER cease providing services until resolution of the charges or the proposed exclusion.
B. PROVIDER agrees that all potential new employees of PROVIDER or
subcontractors of PROVIDER who, in each case, are expected to perform professional services under this
Agreement, will be queried as to whether (1) they are now or ever have been excluded, suspended,
debarred, or otherwise ineligible to participate in the Federal Health Care Programs; (2) they have been
convicted of a criminal offense related to the provision of health care items or services; and or (3) they have
been reinstated to participation in the Federal Health Care Programs after a period of exclusion, suspension,
debarment, or ineligibility.
1) In the event the potential employee or subcontractor informs PROVIDER
that he or she is excluded, suspended, debarred or otherwise ineligible, or has been convicted of a criminal
offense relating to the provision of health care services, and PROVIDER hires or engages such potential
employee or subcontractor, PROVIDER will ensure that said employee or subcontractor does no work,
either directly or indirectly relating to services provided to COUNTY.
2) Notwithstanding the above, COUNTY at its discretion may terminate this
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Agreement in accordance with Section Three (3) TERMINATION of this Agreement, or require adequate
assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible employee or
subcontractor of PROVIDER 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. PROVIDER 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
participation in the Federal Health Care Program after a period of exclusion, suspension, debarment, or
ineligibility. In the event any existing employee or subcontractor informs PROVIDER 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, PROVIDER will
ensure that said employee or subcontractor does no work, either direct or indirect, relating to services
provided to COUNTY.
1) PROVIDER agrees to notify COUNTY immediately during the term of this
Agreement whenever PROVIDER learns that an employee or subcontractor who, in each case, is providing
professional services under this Agreement is excluded, suspended, debarred or otherwise ineligible to
participate in the Federal Health Care Programs, or is convicted of a criminal offense relating to the
provision of health care services.
2) Notwithstanding the above, COUNTY at its discretion may terminate this
Agreement in accordance with the Section Three (3) TERMINATION of this Agreement, or require
adequate assurance (as defined by COUNTY) that no excluded, suspended or otherwise ineligible
employee or subcontractor of PROVIDER will perform work, either directly or indirectly, relating to
services provided to COUNTY. Such demand for adequate assurance shall be effective upon a time frame
to be determined by COUNTY to protect the interests of COUNTY consumers.
D. PROVIDER agrees to cooperate fully with any reasonable requests for information
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from COUNTY which may be necessary to complete any internal or external audits relating to this
Agreement.
E. PROVIDER agrees to reimburse COUNTY for the entire cost of any penalty
imposed upon COUNTY by the Federal Government as a result of PROVIDER’s violation of
PROVIDER’s violation of the terms of this Agreement.
34. AUDITS AND INSPECTIONS
The PROVIDER shall at any time during business hours, and as often as the COUNTY may
deem necessary, make available to the COUNTY for examination all of its records and data with respect to
the matters covered by this Agreement. The PROVIDER shall, upon request by the COUNTY, permit the
COUNTY to audit and inspect all of such records and data necessary to ensure PROVIDER’s compliance
with the terms of this Agreement.
If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), PROVIDER
shall be subject to the examination and audit of the Auditor General for a period of three (3) years after final
payment under contract (Government Code Section 8546.7).
Notwithstanding the provisions stated in Section Two (2) TERM of this Agreement, it is
acknowledged by the parties hereto that this Agreement shall continue in full force and effect until all audit
procedures and requirements as stated in this Agreement have been completed to the review and
satisfaction of COUNTY. PROVIDER shall bear all costs in connection with or resulting from any audit
and/or inspections including, but not limited to, actual costs incurred and the payment of any expenditures
disallowed by either COUNTY, State, or Federal governmental entities, including any assessed interest and
penalties.
35. RECORDS
A. RECORD ESTABLISHMENT AND MAINTENANCE – PROVIDER shall
establish and maintain records in accordance with State and Federal rules and regulations in addition to
those requirements prescribed by COUNTY with respect to all matters covered by this Agreement. Except
as otherwise authorized by COUNTY, PROVIDER shall retain all other records for a period of five (5)
years after receiving the final payment under this Agreement or the earlier termination of this Agreement,
or until State and/or Federal audit findings applicable to such services are resolved, whichever is later.
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B. DOCUMENTATION – PROVIDER shall maintain adequate records in sufficient
detail to make possible an evaluation of services, and contain all the data necessary in reporting to the State
of California and/or Federal agency. All client records shall be maintained pursuant to applicable State of
California and Federal requirements concerning confidentiality.
C. REPORTS – PROVIDER shall submit to COUNTY monthly fiscal and all program
reports as further described in Section Fifteen (15) REPORTS – Substance Use Disorder Services.
PROVIDER shall submit a complete and accurate year-end cost report for each fiscal year affected by this
Agreement, following the end of each fiscal year affected by this Agreement. PROVIDER 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 PROVIDER to COUNTY must
be typewritten.
D. SUSPENSION OF COMPENSATION – In the event that PROVIDER 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 of
PROVIDER invoices by COUNTY’S DBH Contracts Division - SUD Services. If payment for services
are denied or disallowed by State; and subsequently resubmitted to COUNTY by PROVIDER, the
disallowed portion will be withheld from the next reimbursement to the PROVIDER until COUNTY has
received reimbursement from State for said services.
F. CLIENT CONFIDENTIALITY – PROVIDER 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 Code of Federal Regulations § 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.
36. NOTICES
The persons and their addresses having authority to give and receive notices under this
Agreement include the following:
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COUNTY PROVIDER
Director, Fresno County See Exhibit A
Department of Behavioral Health
4441 East Kings Canyon
Fresno, CA 93702
Any and all notices between the COUNTY and the PROVIDER provided for or permitted
under this Agreement or by law shall be in writing and shall be deemed duly served when personally
delivered to one of the parties, or in lieu of such personal services, when deposited in the United States
Mail, postage prepaid, addressed to such party.
37. CHANGE OF LEADERSHIP/MANAGEMENT
Any and all notices between COUNTY and PROVIDER(S) provided for or permitted under
this Agreement or by law, shall be in writing and shall be deemed duly served when personally delivered to
one of the parties, or in lieu of such personal service, when deposited in the United States Mail, postage
prepaid, addressed to such party.
In the event of any change in the status of PROVIDER’s leadership or management,
PROVIDER 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. “Leadership
or management” shall include any employee, member, or owner of PROVIDER 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 PROVIDER’s finances.
38. CHARITABLE CHOICE
PROVIDER 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 PROVIDER must be voluntary as well as separate in time and location from County
funded activities and services. PROVIDER shall inform County as to whether it is faith-based. If
PROVIDER identifies as faith-based it must submit to DBH Contracts Division - SUD Services a copy of
its policy on referring individuals to alternate treatment PROVIDER, and include a copy of this policy in its
client admission forms. The policy must inform individuals that they may be referred to an alternative
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provider if they object to the religious nature of the program, and include a notice to SUD Services.
Adherence to this policy will be monitored during annual site reviews, and a review of client files. If
PROVIDER identifies as faith-based, by July 1 of each year PROVIDER will be required to report to SUD
Services the number of individuals who requested referrals to alternate providers based on religious
objection.
39. LICENSING-CERTIFICATES
Throughout each term of this Agreement, PROVIDER and PROVIDER’s staff shall
maintain all necessary licenses, permits, approvals, certificates, waivers and exemptions necessary for the
provision of the services hereunder and required by the laws and regulations of the United States of
America, State of California, the County of Fresno, and any other applicable governmental agencies.
PROVIDER shall notify COUNTY immediately in writing of its inability to obtain or maintain such
licenses, permits, approvals, certificates, waivers and exemptions irrespective of the pendency of any
appeal related thereto. Additionally, PROVIDER and PROVIDER’s staff shall comply with all applicable
laws, rules or regulations, as may now exist or be hereafter changed.
40. AOD CERTIFICATION
A. The COUNTY requires all COUNTY contracted providers of Alcohol and Other
Substance Use Disorder treatment services to obtain the California Department of Health Care Services
(DHCS) Alcohol and Other Drug Program (AOD) Certification. The AOD Certification Standards will
apply to all residential and outpatient treatment modalities. The purpose of the AOD Certification
Standards is to ensure an acceptable level of service quality is provided to program participants.
B. PROVIDER shall provide proof of a completed application for AOD Certification to
the County within thirty (30) days from the execution date of this Agreement with the COUNTY. A copy
of the AOD Certification shall be submitted to the COUNTY when approved by the California Department
of Alcohol Drug Programs.
C. This AOD Certification requirement applies to every treatment facility operated by
the PROVIDER. PROVIDER whose agencies are nationally accredited with the Joint Commission on
Accreditation of Health Care Organizations (JCAHO) or the Commission on Accreditation of
Rehabilitative Facilities (CARF) are exempt from this requirement of AOD Certification. PROVIDER
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shall submit a copy of their JCAHO or CARF accreditation to the COUNTY within thirty (30) days from
the date this Agreement is executed. PROVIDER shall notify COUNTY if at any time their JCAHO or
CARF accreditation lapses or becomes invalid due to any reason during the term of this Agreement.
PROVIDER shall apply with DHCS for AOD Certification if their JCAHO or CARF accreditation lapses
or becomes invalid and shall submit a copy of the completed application for AOD Certification to the
COUNTY within thirty (30) days from the date the JCAHO or CARF accreditation lapses or becomes
invalid.
D. COUNTY shall terminate this Agreement immediately in the event any of the
following occurs:
1) PROVIDER fails to submit a copy of the completed application for AOD
Certification, or a copy of either their JCAHO or CARF accreditation within thirty (30) days from the
execution date of this Agreement with the COUNTY.
2) PROVIDER’s application for AOD Certification is denied by DHCS.
3) PROVIDER fails to submit to the COUNTY a copy of the AOD Certification
within thirty (30) days after being approved by the DHCS, or certification is not maintained throughout the
contract period.
4) PROVIDER fails to apply for AOD Certification with DHCS or fails to
submit to the COUNTY a copy of the completed application for AOD Certification within thirty (30) days
after the JCAHO or CARF accreditation lapses or becomes invalid.
41. COMPLAINTS
PROVIDER shall log complaints and the disposition of all complaints from a consumer or a
consumer's family. PROVIDER shall provide a summary of the complaint log entries concerning
COUNTY-sponsored consumers to COUNTY at monthly intervals by the fifteenth (15th) day of the
following month, in a format that is mutually agreed upon. PROVIDER shall post signs informing
consumer of their right to file a complaint or grievance. PROVIDER shall notify COUNTY of all incidents
reportable to state licensing bodies that affect COUNTY consumers within twenty-four (24) hours of
receipt of a complaint.
Within fifteen (15) days after each incident or complaint affecting COUNTY-
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sponsored consumers, PROVIDER shall provide COUNTY with information relevant to the complaint,
investigative details of the complaint, the complaint and PROVIDER's disposition of, or corrective action
taken to resolve the complaint.
42. DRUG FREE WORKPLACE
PROVIDER shall comply with the requirements of the Drug-Free Work Place Act
of 1990 (California Government Code section 8350).
43. CHILD ABUSE REPORTING
PROVIDER shall utilize a procedure acceptable to the COUNTY to ensure that all of
PROVIDER’s employees, volunteers, consultants, subcontractors or agents performing services under this
Agreement shall report all known or suspected child abuse or neglect to one or more of the agencies set
forth in Penal Code section 11165.9. This procedure shall include having all of PROVIDER’s employees,
volunteers, consultants, subcontractors or agents performing services under this Agreement sign a statement
that he or she knows of and will comply with the reporting requirements set forth in Penal Code section
11166. The statement to be utilized by PROVIDER for reporting is set forth in Exhibit F, “Notice of Child
Abuse Reporting,” attached hereto and by this reference incorporated herein.
44. TRAFFICKING IN PERSONS PROVISIONS
PROVIDER shall conform to all Federal statutes and regulations prohibiting trafficking in
persons, as well as trafficking-related activities, including, but not limited to the trafficking of persons
provisions in Section 106(g) of the Trafficking Victims Protection Act of 2000 (TVPA).
PROVIDER, PROVIDER’s employees, subrecipients, and subrecipients’ employees may
not:
A. Engage in severe forms of trafficking in persons during the period of time that the
award is in effect;
B. Procure a commercial sex act during the period of time that the award is in effect; or
C. Use forced labor in the performance of the award or subawards under the award.
This agreement may be unilaterally terminated, without penalty, if PROVIDER or a
subrecipient that is a private entity is determined to have violated a prohibition of the TVPA or has an
employee who is determined by the DBH Director or her designee to have violated a prohibition of the
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TVPA through conduct that is either associated with performance under the award or imputed to the
PROVIDER or their subrecipient using the standards and due process for imputing the conduct of an
individual to an organization that are provided in 2 C.F.R. Part 180, “OMB Guidelines to Agencies on
Government-wide Debarment and Suspension (Nonprocurement).
PROVIDER must inform the DBH Director or her designee immediately of any information
received from any source alleging a violation of a prohibition of the TVPA.
45. DISCLOSURE OF OWNERSHIP AND/OR CONTROL INTEREST
INFORMATION
This provision is only applicable if PROVIDER is a disclosing entity, fiscal agent, or
managed care entity as defined in Code of Federal Regulations (C.F.R), Title 42 § 455.101 455.104,
and 455.106(a)(1),(2).
In accordance with C.F.R., Title 42 §§ 455.101, 455.104, 455.105 and 455.106(a)(1),(2),
the following information must be disclosed by PROVIDER by completing Exhibit G “Disclosure of
Ownership and Control Interest Statement,” attached hereto and by this reference incorporated herein.
PROVIDER shall submit this form to the Department of Behavioral Health within thirty (30) days of the
effective date of this Agreement. Submissions shall be scanned pdf copies and are to be sent via email
to DBHAdministration@co.fresno.ca.us attention: Contracts Administration.
A. Name and address of any person(s) whether it be an individual or corporation with
an ownership or controlling interest in the disclosing entity or managed care entity.
1) Address must include the primary business address, every business location
and P.O. Box address(es).
2) Date of birth and Social Security Number for individuals.
3) Tax identification number for other corporations or entities with ownership
or controlling interest in the disclosing entity.
B. Any subcontractor(s) in which the disclosing entity has five (5) percent or more
interest.
C. Whether the person(s) with an ownership or controlling interest of the disclosing
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entity is related to another person having ownership or controlling interest as a parent, spouse, sibling or
child. Including whether the person(s) with ownership or controlling interest of the disclosing entity is
related to a person (parent, spouse, sibling or child) with ownership or has five (5) percent or more
interest in any of its subcontractors.
D. Name of any other disclosing entity in which an owner of the disclosing entity has
an ownership or control interest.
E. The ownership of any subcontractor with whom the provider has had business
transactions totaling more than $25,000 during the 12-month period ending on the date of the request;
and
F. Any significant business transactions between the provider and any wholly owned
supplier, or between the provider and any subcontractor, during the 5-year period ending on the date of
the request.
G. Any person(s) with an ownership or control interest in the provider, or agent or
managing employee of the provider; and
1) Has been convicted of a criminal offense related to that person's
involvement in any program under Medicare, Medicaid, or the title XX services program since the
inception of those programs.
H. The ownership of any subcontractor with whom the provider has had business
transactions totaling more than $25,000 during the 12-month period ending on the date of the request;
and
I. Any significant business transactions between the provider and any wholly
owned supplier, or between the provider and any subcontractor, during the 5-year period ending on the
date of the request.
46. CONTROL REQUIREMENTS
Performance under this Agreement is subject to all applicable Federal and State laws,
regulations and standards. In accepting the State drug and alcohol combined program allocation
pursuant to California Health and Safety Code section 11757, PROVIDER shall establish written
accounting procedures consistent with applicable Federal and State laws, regulations and standards, and
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shall be held accountable for audit exceptions taken by the State or COUNTY for failure to comply with
these requirements. These requirements include, but may not be limited to, those set forth in this
Agreement, and:
A. Division 10.5 of the California Health and Safety Code;
B. California Government Code sections 16366.1 through 16367.9 and 53130
through 53138;
C. Title 9, Division 4 of the California Code of Regulations;
D. 42 United States Code (U.S.C.) section 300x-5;
E. 31 U.S.C. sections 7501-7507 (Single Audit Act of 1984; Single Audit Act
Amendments of 1996);
F. 2CFR Part 200 (Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards); and
G. Title 45, Part 96, Subparts B, C and L of the Code of Federal Regulations (Block
Grants).
47. ADDITIONS/DELETIONS OF PROVIDER(S)
COUNTY’s DBH Director or her designee reserves the right at any time during the term of
this Agreement to add new PROVIDER(S) to those listed in Exhibit A, “DMC Services Vendor List.” It is
understood any such additions will not affect compensation paid to the other PROVIDER(S), and therefore
such additions may be made by COUNTY without notice to or approval from other PROVIDER(S) under
this Agreement. These same provisions shall apply to the deletion of any PROVIDER listed in Exhibit A,
“DMC Services Vendor List,” except that deletions shall be made by written mutual agreement between the
COUNTY and the particular PROVIDER to be deleted, or shall be in accordance with the provisions of
Section Three (3) TERMINATION of this Agreement.
48. SEPARATE AGREEMENT
It is mutually understood by the parties that this Agreement does not, in any way, create a
joint venture among PROVIDER(S). By execution of this Agreement, PROVIDER(S) understands that
a separate Agreement is formed between each individual PROVIDER and COUNTY.
///
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49. GOVERNING LAW
Venue for any action arising out of or related to this Agreement shall only be in Fresno
County, California.
The rights and obligations of the parties and all interpretation and performance of this
Agreement shall be governed in all respects by the laws of the State of California.
50. ENTIRE AGREEMENT
This Agreement, including all Exhibits, COUNTY’s Revised RFSQ No. 952-5448 and
PROVIDER’s responses thereto, constitutes the entire Agreement between PROVIDER and COUNTY
with respect to the subject matter hereof and supersedes all previous agreement negotiations, proposals,
commitments, writings, advertisements, publications, and understandings of any nature whatsoever unless
expressly included in this Agreement.
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1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first
2 hereinabove written.
3
4 ATTEST:
5
6 COUNTY OF FRESNO
7
8 By £ ;r.{L.~~
Ernest Buddy Mendes, Chairman
9 Board of Supervisors
10
11 Date:--=~~..uo..."'--,;;....;..:~.....;.;;;._.;...;:..:;__
12
13
14 BERNICE E. SEIDEL, Clerk
Board of Supervisors
Date: :rLVr..~ ,. f& \ \ ;)J) \ l 0
PROVIDER(S):
SEE EXHIBIT A
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PLEASE SEE ADDITIONAL
SIGNATURE PAGES ATTACHED
-38-
123456789101 11213141516171819202122232425262728APPROVEDASTOLEGALFORM:DANIELC.CEDERBORG,COUNTYCOUNSELAPPROVEDASTOACCOUNTINGFORM:VICKICROW,C.P.A.,AUDITOR-CONTROLLER/TREASURER-TAXCOLLECTOR/By:‘Jyj*V,REVIEWEDANDRECOMMENDEDFORAPPROVAL:DAWANUTECHT,DirectorDepartmentofBehavioralHealthThefollowingisforCOUNTY’Suse:Fund/Subelass:0001/10000Organization:56302081Account/Program:7295/0yi-39-
123456789101 11213141516171819202122232425262728Provider:CENTRALCALIFORNIARECOVERY,INC.PrintName:U^AC^LT7LTTitle:Date:ChairmanoftheBoard,President,orVicePresident!6>By^7/PrintName:.Ubd-lfE^Title:^CAJ3(ftAv\Secretary(ofCorporation),AssistantSecretary,ChiefFinancialOfficer,orAssistantTreasurerDate:4^"J L/(p-40-
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I2345678910111213141516171819202122232425262728Provider:FRESNONEWCONNECTIONS,INC.By.PrintName:Title:6>*AChairmanoftheBoard,President,orVicePresident'&ADate:By-0PrintName:|^V>'C^K.V^Title:Y<ASecretary(ofCorporation),AssistantSecretary,ChiefFinancialOfficer,orAssistantTreasurerDate:£'S~l(&-43-
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DMC Services Vendor List
Page 1 of 2
Vendor Phone Site Location
Central California Recovery, Inc.
Remit to:
1100 W. Shaw Ave., #130
Fresno, CA 93711
(559)273-2942 1100 W. Shaw Ave. #130
Fresno CA 93711
Delta Care, Inc.
Remit to:
4705 N. Sonora Ave., Suite 113
Fresno, CA 93722
(559)276-7558 4705 N. Sonora Ave.
Fresno, CA 93722
Fresno New Connections, Inc.
4411 N. Cedar Ave. #118
Fresno, CA 93726
(559)248-1548 4411 N. Cedar Ave.
Fresno, CA 93726
King of Kings Community Center,
Inc.
Remit to:
2302 Martin Luther King Jr. Blvd.
Fresno, CA 93706
(559)442-0400 2302 Martin Luther King Jr. Blvd.
Fresno, CA 93706
Kings View Corporation
Remit to:
1410 F St., Suite 101
Fresno, CA 93706
(559)875-6300 1822 Jensen Ave. #122
Sanger, CA 93657
Mental Health Systems, Inc.
Remit to:
9465 Farnham Street
San Diego, CA 92123
(559)225-9117 3122 N Millbrook Ave.
Fresno, CA 93703
4939 E. Yale Ave.
Fresno, CA 93727
Panacea Inc.
Remit to:
3512 N. Millbrook Ave. Suite D
Fresno, CA 93703
(559)241-0364 3512 N. Millbrook Ave. Suite D
Fresno, CA 93703
4928 E. Clinton Ave. #108
Fresno, CA 93727
Exhibit A
DMC Services Vendor List
Page 2 of 2
Promesa Behavioral Health, Inc.
Remit to:
7120 N. Marks Ave. Suite 110
Fresno, CA 93711
(559) 439-5437 2910 & 2920 E. Olive Ave.
Fresno, CA 93701
741 Tulare St.
Parlier, CA 93648
1258 E. Belmont Ave.
Mendota, CA 936401
211 Smoot Ave.
Mendota, CA 93640
1282 E. Belmont Ave.
Mendota, CA 93640
6052 S. Juanche St.
Tranquillity, CA 93668
19191 W. Excelsior Ave.
Five Points, CA 93624
Turning Point of Central California,
Inc.
Remit to:
P.O. Box 7447
Visalia, CA 93290
(559) 225-1464 3636 N. First St. Suites 135 & 154
Fresno, CA 93726
WestCare California, Inc.
Remit to:
P.O. Box 12107
Fresno, CA 93776
(559) 237-3420 611 E. Belmont Ave.
Fresno, CA 93701
1550 Herndon Ave.
Clovis, CA 93611
818 L St.
Sanger, CA 93657
Exhibit A
Exhibit
Department of Health Care Services
Non-Perinatal DMC
FY 2016-17
Description Unit of Service (UOS)UOS Rate**
Narcotic Treatment Program (NTP) - Methadone Daily $11.95
NTP - Individual Counseling One 10-minute Increment $13.90
NTP - Group Counseling One 10-minute Increment $3.05
Intensive Outpatient Treatment Face-to-Face Visit $59.13
Naltrexone (NAL) (*)Face-to-Face Visit $19.06
Outpatient Drug Free (ODF) Individual Counseling Face-to-Face Visit (Per Person)$69.50
ODF Group Counseling Face-to-Face Visit (Per Person)$27.46
Perinatal DMC
FY 2016-17
Description Unit of Service (UOS)UOS Rate**
Narcotic Treatment Program (NTP) - Methadone Daily $13.80
NTP - Individual Counseling One 10-minute Increment $18.43
NTP - Group Counseling One 10-minute Increment $6.07
Intensive Outpatient Treatment Face-to-Face Visit $82.54
Residential Treatment Daily $80.92
Outpatient Drug Free (ODF) Individual Counseling Face-to-Face Visit (Per Person)$92.13
ODF Group Counseling Face-to-Face Visit (Per Person)$54.63
* From FY 2002-03 through FY 2008-09, Naltrexone was frozen at $21.19 (the FY 1999-2000 approved
rate). Counties and service providers have not provided, submitted claims, nor reported cost for this
service since FY 1997-98. For FY 2009-10, the $21.19 frozen rate was reduced by 10 percent to
$19.07. Therefore, $19.07 is used as the developed rate. Removing county administration expenses from
the cost data reduced the rate to $19.06.
**FY 2009-2010 rates were adjusted by the cumulative growth in the Implicit Price Deflator, in accordance with
Welfare & Institutions Code Section 14021.9(b). The 11.2 percent combined deflator is 2.4 percent for the
change from FY 2009-10 to FY 2010-11, plus 2.8 percent for the change from FY 2010-11 to FY 2011-12,
plus 1.9 percent for the change from FY 2011-12 to FY 2012-13, plus 1.3 percent for the change from
FY 2012-13 to FY 2013-14, plus 0.9 percent for the change from FY 2013-14 to FY 2014-15, plus 1.9
percent from FY 2014-15 to FY 2015-16, plus 1.8 percent from FY 2015-16 to FY 2016-17.
Proposed Drug Medi-Cal Rates For Fiscal Year 2016-17
Substance Use Disorders - Program, Policy and Fiscal Division
B
Page 1 of 1
Exhibit C
Page 1 of 2
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as “County”),
members of a contractor’s board of directors (hereinafter referred to as “County Contractor”), must
disclose any self-dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self-dealing transaction is defined below:
“A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest”
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1)Enter board member’s name, job title (if applicable), and date this disclosure is being made.
(2)Enter the board member’s company/agency name and address.
(3)Describe in detail the nature of the self-dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a.The name of the agency/company with which the corporation has the transaction; and
b.The nature of the material financial interest in the Corporation’s transaction that the
board member has.
(4)Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5)Form must be signed by the board member that is involved in the self-dealing transaction
described in Sections (3) and (4).
Exhibit C
Page 2 of 2
(1)Company Board Member Information:
Name: Date:
Job Title:
(2)Company/Agency Name and Address:
(3)Disclosure (Please describe the nature of the self-dealing transaction you are a party to):
(4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a):
(5)Authorized Signature
Signature: Date:
National Standards for Culturally and Linguistically
Appropriate Services (CLAS) in Health and Health Care
The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care
disparities by establishing a blueprint for health and health care organizations to:
Principal Standard:
1.Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse
cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.
Governance, Leadership, and Workforce:
2.Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy,
practices, and allocated resources.
3.Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are
responsive to the population in the service area.
4.Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and
practices on an ongoing basis.
Communication and Language Assistance:
5.Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at
no cost to them, to facilitate timely access to all health care and services.
6.Inform all individuals of the availability of language assistance services clearly and in their preferred language,
verbally and in writing.
7.Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals
and/or minors as interpreters should be avoided.
8.Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the
populations in the service area.
Engagement, Continuous Improvement, and Accountability:
9.Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them
throughout the organization’s planning and operations.
10.Conduct ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into
measurement and continuous quality improvement activities.
11.Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health
equity and outcomes and to inform service delivery.
12.Conduct regular assessments of community health assets and needs and use the results to plan and implement
services that respond to the cultural and linguistic diversity of populations in the service area.
13.Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural
and linguistic appropriateness.
14.Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent,
and resolve conflicts or complaints.
15.Communicate the organization’s progress in implementing and sustaining CLAS to all stakeholders, constituents, and
the general public.
Exhibit D
Page 1 of 2
QMH U-S.Department of
Health and Human Services
Office of Minority Heolth
www.ThinkCulturalHeaIth.hhs.gov
THINK *CULTURALHEALTHIt *
l
The Case for the Enhanced National CLAS Standards
Of all the forms of inequality, injustice in health care is the most shocking and inhumane.
— Dr. Martin Luther King, Jr.
Health equity is the attainment of the highest level of health for all people (U.S. Department of Health and Human
Services [HHS] Office of Minority Health, 2011). Currently, individuals across the United States from various cultural
backgrounds are unable to attain their highest level of health for several reasons, including the social determinants of
health, or those conditions in which individuals are born, grow, live, work, and age (World Health Organization, 2012),
such as socioeconomic status, education level, and the availability of health services (HHS Office of Disease Prevention
and Health Promotion, 2010). Though health inequities are directly related to the existence of historical and current
discrimination and social injustice, one of the most modifiable factors is the lack of culturally and linguistically appropriate
services, broadly defined as care and services that are respectful of and responsive to the cultural and linguistic needs of
all individuals.
Health inequities result in disparities that directly affect the quality of life for all individuals. Health disparities adversely
affect neighborhoods, communities, and the broader society, thus making the issue not only an individual concern but
also a public health concern. In the United States, it has been estimated that the combined cost of health disparities and
subsequent deaths due to inadequate and/or inequitable care is $1.24 trillion (LaVeist, Gaskin, & Richard, 2009).
Culturally and linguistically appropriate services are increasingly recognized as effective in improving the quality of care
and services (Beach et al., 2004; Goode, Dunne, & Bronheim, 2006). By providing a structure to implement culturally and
linguistically appropriate services, the enhanced National CLAS Standards will improve an organization’s ability to address
health care disparities.
The enhanced National CLAS Standards align with the HHS Action Plan to Reduce Racial and Ethnic Health Disparities
(HHS, 2011) and the National Stakeholder Strategy for Achieving Health Equity (HHS National Partnership for Action to
End Health Disparities, 2011), which aim to promote health equity through providing clear plans and strategies to guide
collaborative efforts that address racial and ethnic health disparities across the country. Similar to these initiatives, the
enhanced National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care
disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and
linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the
United States.
Bibliography:
Beach, M. C., Cooper, L. A., Robinson, K. A., Price, E. G., Gary, T. L., Jenckes, M. W., Powe, N.R. (2004). Strategies for improving minority healthcare quality. (AHRQ
Publication No. 04-E008-02). Retrieved from the Agency of Healthcare Research and Quality website:
http://www.ahrq.gov/downloads/pub/evidence/pdf/minqual/minqual.pdf
Goode, T. D., Dunne, M. C., & Bronheim, S. M. (2006). The evidence base for cultural and linguistic competency in health care. (Commonwealth Fund Publication No. 962).
Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/usr_doc/Goode_evidencebasecultlinguisticcomp_962.pdf
LaVeist, T. A., Gaskin, D. J., & Richard, P. (2009). The economic burden of health inequalities in the United States. Retrieved from the Joint Center for Political and Economic
Studies website: http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%2
0Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf
National Partnership for Action to End Health Disparities. (2011). National stakeholder strategy for achieving health equity. Retrieved from U.S. Department of Health and
Human Services, Office of Minority Health website: http://www.minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286
U.S. Department of Health and Human Services. (2011). HHS action plan to reduce racial and ethnic health disparities: A nation free of disparities in health and health care.
Retrieved from http://minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Healthy people 2020: Social determinants of health. Retrieved
from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39
U.S. Department of Health and Human Services, Office of Minority Health (2011). National Partnership for Action to End Health Disparities. Retrieved from
http://minorityhealth.hhs.gov/npa
World Health Organization. (2012). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en/
Exhibit D
Page 2 of 2
QMH U-S.Department of
Health and Human Services
Office of Minority Heolth
www.ThinkCulturalHeaIth.hhs.gov
THINK *CULTURALHEALTHIt *
l
Exhibit E
Page 1 of 3
C:\USERS\YLEWIS\DESKTOP\RFPS\DMC AND NON-DMC OP RFSQ\MASTER AGREEMENTS\DMC MASTER\EXHIBITS\EXHIBIT E - DISCLOSURE
CRIMINAL HISTORY & CIVIL ACTIONS.DOC
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.
Exhibit E
Page 2 of 3
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CRIMINAL HISTORY & CIVIL ACTIONS.DOC
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.
Exhibit E
Page 3 of 3
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CRIMINAL HISTORY & CIVIL ACTIONS.DOC
CERTIFICATION
(1)The prospective primary participant certifies to the best of its knowledge and belief, that it,
its owners, officers, corporate managers and partners:
(a)Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded by any Federal department or agency;
(b)Have not within a three-year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State
or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
(c)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)
Exhibit F
NOTICE OF CHILD ABUSE REPORTING LAW
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 sheriff’s 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
Page 1 of 1
Exhibit G
Page 1 of 2
DISCLOSURE OF OWNERSHIP AND CONTROL INTEREST STATEMENT
I. Identifying Information
Name of entity D/B/A
Address (number, street) City State ZIP code
CLIA number Taxpayer ID number (EIN) Telephone number
( )
II. Answer the following questions by checking “Yes” or “No.” If any of the questions are answered “Yes,” list names and
addresses of individuals or corporations under “Remarks” on page 2. Identify each item number to be continued.
A. Are there any individuals or organizations having a direct or indirect ownership or control interest
of five percent or more in the institution, organizations, or agency that have been convicted of a criminal
offense related to the involvement of such persons or organizations in any of the programs established
YES NO
by Titles XVIII, XIX, or XX? ......................................................................................................................... ❒ ❒
B. Are there any directors, officers, agents, or managing employees of the institution, agency, or
organization who have ever been convicted of a criminal offense related to their involvement in such
programs established by Titles XVIII, XIX, or XX? ...................................................................................... ❒ ❒
C. Are there any individuals currently employed by the institution, agency, or organization in a managerial,
accounting, auditing, or similar capacity who were employed by the institution’s, organization’s, or
agency’s fiscal intermediary or carrier within the previous 12 months? (Title XVIII providers only) ........... ❒ ❒
III. A. List names, addresses for individuals, or the EIN for organizations having direct or indirect ownership or a controlling
interest in the entity. (See instructions for definition of ownership and controlling interest.) List any additional names
and addresses under “Remarks” on page 2. If more than one individual is reported and any of these persons are
related to each other, this must be reported under “Remarks.”
NAME ADDRESS EIN
B. Type of entity: ❒ Sole proprietorship ❒ Partnership ❒ Corporation
❒ Unincorporated Associations ❒ Other (specify)
C. If the disclosing entity is a corporation, list names, addresses of the directors, and EINs for corporations
under “Remarks.”
D. Are any owners of the disclosing entity also owners of other Medicare/Medicaid facilities?
(Example: sole proprietor, partnership, or members of Board of Directors) If yes, list names, addresses
of individuals, and provider numbers. ..........................................................................................................
❒ ❒
NAME ADDRESS PROVIDER NUMBER
Exhibit G
Page 2 of 2
YES NO
IV. A. Has there been a change in ownership or control within the last year? ....................................................... ❒ ❒
If yes, give date.
B. Do you anticipate any change of ownership or control within the year?....................................................... ❒ ❒
If yes, when?
C. Do you anticipate filing for bankruptcy within the year?................................................................................ ❒ ❒
If yes, when?
V. Is the facility operated by a management company or leased in whole or part by another organization?.......... ❒ ❒
If yes, give date of change in operations.
VI. Has there been a change in Administrator, Director of Nursing, or Medical Director within the last year?......... ❒ ❒
VII. A. Is this facility chain affiliated? ...................................................................................................................... ❒ ❒
(If yes, list name, address of corporation, and EIN.)
Name EIN
Address (number, name) City State ZIP code
B. If the answer to question VII.A. is NO, was the facility ever affiliated with a chain?
(If yes, list name, address of corporation, and EIN.)
Name EIN
Address (number, name) City State ZIP code
Whoever knowingly and willfully makes or causes to be made a false statement or representation of this statement, may be
prosecuted under applicable federal or state laws. In addition, knowingly and willfully failing to fully and accurately disclose the
information requested may result in denial of a request to participate or where the entity already participates, a termination of
its agreement or contract with the agency, as appropriate.
Name of authorized representative (typed) Title
Signature Date
Remarks