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CONTRACT NUMBER:
DEPARTMENT: Mental Health
COMPANY: Fresno County Department of Behavioral Health
TYPE OF AGREEMENT: Inpatient Services
THIS AGREEMENT is made and entered into by and between the County of Merced, a political
subdivision of the State of California, (hereinafter referred to as “MERCED”), and the COUNTY OF
FRESNO, a political subdivision of the State of California, (hereinafter referred to as “FRESNO”).
WHEREAS, MERCED, through its Mental Health Department, operates a Psychiatric Health
Facility (PHF); and
WHEREAS, FRESNO, through its Department of Behavioral Health, has need for additional
mental health facilities and psychiatric services for the treatment of their consumers; and
WHEREAS, MERCED, upon availability, can provide such facilities and psychiatric services as
needed by FRESNO; and
WHEREAS, the parties desire to set forth herein the terms and conditions under which said
services shall be furnished; and
NOW, THEREFORE, in consideration of their mutual covenants and promises herein contained,
the parties hereto agree as follows:
1. RESPONSIBILITIES OF MERCED
a. MERCED shall make beds available at MERCED’S Psychiatric Health Facility (PHF) to
FRESNO consumers for the treatment of adults based upon availability and upon approval by
MERCED’S Director of Mental Health, or designee.
b. MERCED shall admit FRESNO consumers through MERCED’S Emergency Services or
PHF staff.
c. MERCED’S Utilization Review (UR) staff will monitor FRESNO consumers at
MERCED’S PHF on an ongoing basis to determine medical necessity.
d. MERCED, when available, may provide consumers, as clinically indicated, with all
required and related psychiatric medical services including, but not limited to, laboratory service,
radiology service, E.E.G.s, E.K.G.s and pharmacy service. MERCED shall provide these services in
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accordance with the MERCED Mental Health Medication Monitoring Screening Criteria Manual without
any other prior authorization process. Such services may be provided through independent contractors,
but if so done, MERCED shall remain responsible for the monitoring of such subcontractors and the
work thereof.
e. Where special medical, surgical or other additional services are deemed appropriate,
the authorization of FRESNO shall be obtained. FRESNO shall provide reimbursement for all
authorized special services not covered by another payer source. Notification shall be given to
FRESNO when reasonably possible if consumers are moved off the psychiatric ward or are the subject
of, or have committed any unusual incidents.
f. Facility: MERCED shall maintain a facility which will provide an environment conducive
to the treatment of FRESNO consumers. This facility shall include, but not be limited to, adequate
room, patient bed space, and individual storage for patient use, telephone service, and patient access
to the Patient’s Rights Advocate, family members and visitors. Monolingual non-English speaking
patients shall have access to bilingual staff services. The consumers will receive face-to-face contact
daily with a psychiatrist. MERCED’S psychiatrist will document medical necessity daily.
g. Protection of Rights: MERCED agrees to protect the rights of FRESNO consumers
admitted for services in compliance with State and Federal law, including, but not limited to, Welfare
and Institutions Code Section 5325, especially with regard to administration of psychotropic medication
and use of seclusion. When necessary, FRESNO shall obtain appropriate court orders.
h. Admission for Services: The decision to admit FRESNO consumers referred by
designated FRESNO staff (“representative”) for treatment is at the sole discretion of MERCED. Prior to
admission into MERCED’S PHF, FRESNO’S representative shall sign and immediately return to
MERCED a “Service and Payment Authorization Form”, attached hereto as Exhibit A, indicating that
FRESNO is responsible for all costs associated with the placement of the consumer in MERCED’S PHF
(rates in EXHIBIT A are subject to adjustment in accordance with SECTION 5.) Once FRESNO
consumers are admitted by MERCED into the PHF, MERCED shall provide FRESNO consumers
twenty-four (24) hour hospitalization for seventy-two (72) hour involuntary evaluation and treatment
pursuant to Welfare and Institutions Code Section 5150 et seq., and any further period of involuntary
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treatment as required if appropriate after consultation between the parties.
Treatment services provided by MERCED shall include intake, history and physical
examination, assessment, counseling, activities, room and board, security, and such medical care as is
directly incidental to the provision of psychiatric services (e.g., pharmacy services and medications and
laboratory services necessary for the prescription and administration of medications). FRESNO shall
use its best efforts to provide MERCED with such patient information as is reasonably necessary to aid
MERCED in providing treatment to FRESNO consumers.
i. MERCED shall, if reasonably possible, provide prior notification to FRESNO’S
representative of any early discharge, especially if a consumer leaves prior to the full 72-hour stay.
j. MERCED shall notify FRESNO’S representative within twenty-four (24) hours when a
FRESNO consumer no longer requires acute psychiatric inpatient services and is in need of placement.
2. RESPONSIBILITIES OF FRESNO
a. FRESNO shall make requests for admission by phone to MERCED’S PHF designated
staff at (209) 381-6879.
b. FRESNO, or its designee, shall provide required consumer transportation to and from
MERCED’S PHF for those consumers who are FRESNO residents. If FRESNO consumer has
family/significant others, the MERCED staff may contact family/significant others to arrange for
transportation upon discharge.
c. FRESNO shall not request admission for FRESNO jail inmates to MERCED’S PHF.
d. Should a FRESNO patient admitted to MERCED’S PHF require one-to-one supervision,
MERCED shall provide one-to-one supervision through its security sub-contractor. MERCED shall
notify FRESNO of the need for services. FRESNO and MERCED will mutually agree on the need for
one-to-one supervision on a patient-specific basis prior to the provision of such service, and upon
agreement, FRESNO shall reimburse MERCED for the cost to provide one-to-one supervision for each
FRESNO patient for which pre-approval has been given.
3. JOINT RESPONSIBILITIES
The decision to discharge FRESNO consumers from MERCED’S PHF shall be by MERCED
providers after efforts to contact for consultation with the FRESNO representative. The FRESNO
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representative may participate in discharge planning at their discretion and as indicated.
A Discharge Summary for FRESNO consumers of inpatient psychiatric services shall be
provided to FRESNO staff. This data shall consist of the following: (1) completed discharge form, (2)
patient history, (3) physical exam results, and (4) any laboratory work performed. The discharge
summary shall be provided to FRESNO no later than fourteen (14) working days after the date the
FRESNO consumer is discharged from MERCED’S facility. MERCED shall also provide FRESNO
additional records and data, including, but not limited to, treatment costs data, as may be required by
FRESNO for the preparation of the patient for post-hospitalization placement and/or preparation of
required reports. MERCED shall permit qualified FRESNO staff to document in MERCED’S records
pertinent data necessary for each FRESNO consumer’s care and funding within the provisions and
limitations of HIPAA. All such documentation shall clearly identify the entries as FRESNO staff.
Records access for FRESNO staff shall be limited to FRESNO consumers.
4. TERM
The term of this Agreement shall begin the 1st day of July, 2016 and continue until the 30th day of
June 2019, unless sooner terminated in accordance with Sections 9, 10 or 11, herein below.
This Agreement, subject to satisfactory outcomes performance and subject to available State
funding each year, shall automatically be extended for two (2) additional twelve (12) month periods
upon the same terms and conditions set forth, unless written notice of non-renewal is given by
FRESNO or MERCED or FRESNO’s Department of Behavioral Health Director or designee, not later
than thirty (30) days prior to the close of the current Agreement term.
5. RATES
MERCED rates for services provided pursuant to the terms and conditions of this Agreement are
as follows:
Psychiatric Health Facility (PHF) Rate per Consumer (Acute and Non-Acute):
For services performed for Patients admitted pursuant to this Agreement, Merced shall bill Fresno
those rates set forth in Merced County Code Section 9.48.030, as amended from time to time. In
addition, Merced shall bill to Fresno an administrative overhead charge of 15% for all services provided
under this Agreement (Acute and Non-Acute). Merced shall reduce such charges by an amount equal to
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reimbursements received from the State Medi-Cal or any other payer sources associated with such
charges.
The rate structure utilized for this Agreement is inclusive of all services defined as psychiatric
inpatient services in Title 9, Chapter 11 of the Welfare and Institutions Code and does not include non-
hospital based physician or psychological services. It is understood by FRESNO and MERCED that
MERCED’S Published PHF Charge is established based on actual costs reported in MERCED’S most
recent Cost Report submitted to the State Department of Health Care Services. The rate structure shall
adjust automatically upon amendment of Merced County Code Section 9.48.030. Rate adjustments
shall be effective upon approval by the Merced County Board of Supervisors. Any rate adjustments for
services not covered by Merced County Code Section 9.48.030 shall be adjusted using a formal
amendment approved by FRESNO and MERCED. MERCED will notify FRESNO of any rate
adjustment(s) in writing and provide a revised Exhibit A, and said rate adjustment(s) and revised Exhibit
A shall be subject to approval by FRESNO’s Department of Behavioral Health Director, or designee, and
MERCED and become part of this Agreement. Any rate adjustment(s) shall not result in an increase to
the maximum compensation of the Agreement stated in Section 6 (c).
Other Rates:
FRESNO agrees to pay MERCED SEVENTY SIX DOLLARS AND NO CENTS ($76.00) per exam
for history and physical examinations performed at the facility by MERCED’S sub-contractor, in
accordance with regulations (one exam per consumer per admission).
If it is determined that a FRESNO client is in need of special one-to-one supervision services,
MERCED shall obtain prior authorization from FRESNO. When MERCED provides one-to-one
supervision services, FRESNO shall reimburse MERCED at the actual hourly salary rate of the
MERCED staff providing the service. MERCED shall invoice FRESNO for this service and rate.
6. COMPENSATION/CONTRACT MAXIMUM
FRESNO agrees to pay MERCED and MERCED agrees to receive payment for services
provided to FRESNO consumers authorized for treatment under this Agreement as follows:
a. In the event that FRESNO has reimbursed MERCED for services and then verifies to
MERCED that a non-Medi-Cal eligible consumer has current or retroactive Medi-Cal eligibility that pays
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for inpatient hospital services and the verification is within the allowable Medi-Cal billable timeframe,
MERCED shall credit FRESNO on the next month’s invoice the amount subsequently reimbursed to
MERCED from the State Medi-Cal billing process for that consumer.
b. For the period of July 1, 2016 to June 30, 2019, MERCED shall bill FRESNO for all
acute and non-acute days incurred at $1072.00 per client per day, minus any reimbursements received
from the State Medi-Cal billing process or any other payer sources, plus the Administrative Overhead
Charge of $160.80 per client per day as set forth in Section 5, “Rates”.
c. Bed day shall be defined as use of a MERCED PHF inpatient psychiatric bed at 12:00
midnight. Day of discharge shall not be billed. However, a bed day may be billed if the beneficiary is
admitted and discharged during the same day provided that such admission and discharge is not within
24 hours of prior discharge. This per diem rate is considered to be payment in full, subject to third party
liability and patient share of costs for psychiatric inpatient hospital services to a consumer.
d. FRESNO agrees to pay MERCED SEVENTY SIX DOLLARS AND NO CENTS ($76.00)
per exam for history and physical examinations performed at the facility by MERCED’S sub-contractor,
in accordance with regulations (one exam per consumer per admission).
e. If it is determined that a FRESNO client is in need of special one-to-one supervision
services, MERCED shall obtain prior authorization from FRESNO. When MERCED provides one-to-one
supervision services, FRESNO shall reimburse MERCED at the actual hourly salary rate of the
MERCED staff providing the service. MERCED shall invoice FRESNO for this service and rate.
f. The total amount of services provided under this Agreement shall not exceed SEVENTY
FIVE THOUSAND DOLLARS AND NO CENTS ($75,000.00) for each twelve-month period during the
entire Term of this Agreement.
7. INVOICING
MERCED Fiscal Services shall attempt to invoice FRESNO by the 10th of each month following
the month in which the invoiced services were rendered. Invoices to Fresno shall be addressed to the
following:
///
///
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Fresno County Mental Health Plan
Fresno County Department of Behavioral Health
4409 E. Inyo Avenue, Mod A
Fresno, CA 93702
Services not billed by the 10th day of the following month must be invoiced within ninety (90)
days of the date the service is provided. Payment by FRESNO shall be within forty-five (45) days of
receipt of MERCED’S invoices.
8. NOTICES
All notices, requests, demands or other communications under this Agreement shall be in
writing.
Notice shall be sufficiently given for all purposes as follows:
A. Personal Delivery. When personally delivered to the recipient, notice is effective upon
delivery.
B. First Class Mail. When mailed first class to the last address of the recipient known to
the party giving notice, notice is effective three (3) mail delivery days after deposit in a United States
Postal Service office or mailbox.
C. Certified Mail. When mailed by certified mail, return receipt requested, notice is effective
upon receipt, if delivery is confirmed by return receipt.
D. Overnight Delivery. When delivered by an overnight delivery service, charges prepaid
or charged to the sender’s account, notice is effective on delivery, if delivery is confirmed by the delivery
service.
E. Electronic Transmission. When sent by facsimile transmission or by internet connection
to the last noticed facsimile or internet location provided by the recipient to the party giving notice,
notice is effective upon receipt, provided that a duplicate copy of the notice is promptly given by first
class mail or certified mail or by overnight delivery to the receiving party. Any notice given by electronic
transmission shall be deemed received on the recipient’s next business day if received after 5:00 P.M.
(recipient’s time) or on a non-business day of the recipient.
Any correctly addressed notice that is refused, unclaimed or undeliverable because of an act or
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omission of the party to be notified shall be deemed effective as of the first date that the notice was
refused, unclaimed or deemed undeliverable by the postal authorities, messengers or overnight delivery
service.
Information for notice to the parties to this Agreement at the time of endorsement of this
Agreement is as follows:
MERCED COUNTY FRESNO COUNTY
Director Director
Merced County Mental Health Fresno County
P.O. Box 2087 Department of Behavioral Health
Merced, CA 95344 4441 E. Kings Canyon Avenue
(209) 381-6813 Fresno, CA 93702
Fax (209) 725-8628 (559) 600-9193
Fax (559) 600-7674
Any party may change its address or electronic addresses by giving the other party notice of the
change, in any manner permitted by this Agreement.
9. CONDITION SUBSEQUENT/NON-APPROPRIATION OF FUNDING
The services and compensation received by MERCED and FRESNO pursuant to this
Agreement is based on the continued receipt of local, state and/or federal funding for this purpose. In
the event that funding is terminated, in whole or in part, for any reason, this Agreement and all
obligations of the parties arising from this Agreement shall be immediately discharged. MERCED
agrees to inform FRESNO and FRESNO shall inform MERCED no later than ten (10) calendar days
after receiving notification that funding will be terminated and provide the final date for which funding
will be available. Under these circumstances, all billing or other claims for compensation or
reimbursement by MERCED arising out of performance of this Agreement must be submitted to
FRESNO sixty (60) days after the final date for which funding is available.
In the event that funding for these services is delayed by the State Controller, FRESNO may
defer payment to MERCED. The amount of the deferred payment shall not exceed the amount of
funding delayed by the State Controller to FRESNO. The period of time of the deferral by FRESNO
shall not exceed the period of time of the State Controller’s delay of payment to FRESNO plus forty-five
(45) days. Deferred payment shall be paid with additional interest in accord with the interest paid on
the State deferred payments, if any.
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10. TERMINATION FOR CONVENIENCE
This Agreement, notwithstanding anything to the contrary herein above or hereinafter set forth,
may be terminated by MERCED or FRESNO at any time without cause or legal excuse by providing the
other party with sixty calendar (60) days advance written notice of such termination. Upon the effective
date of termination, MERCED will cease to provide services as identified in this Agreement, and
FRESNO shall have no further liability to MERCED except for payment for actual services incurred
during the performance hereunder, which will be billed no later than sixty (60) days after termination.
Such liability is limited to the time specified in said notice and for services not previously reimbursed by
FRESNO. Such liability is further limited to the extent such costs are actual, necessary, reasonable,
and verifiable costs and have been incurred by MERCED prior to, and in connection with, discontinuing
the work hereunder.
11. TERMINATION FOR CAUSE
If FRESNO materially defaults in the performance of or repeatedly fails to comply with any of its
payment obligations under this Agreement, or otherwise breaches this Agreement (a "Default"),
MERCED may, in addition to any other remedies it may have, provide FRESNO with notice of Default in
the manner set forth under Section 8, "NOTICES", specifying the provision(s) or term(s) of this
Agreement that FRESNO has failed to comply with or breached. In the event of any proceeding by or
against FRESNO, including but not limited to bankruptcy, insolvency, appointment of a receiver or
trustee, or an assignment for the benefit of creditors, MERCED may exercise at its election its right of
termination under this Section.
12. MODIFICATION OF THE AGREEMENT
Notwithstanding any of the provisions of this Agreement, the parties may agree to amend this
Agreement. No alteration or variation of the terms of this Agreement shall be valid unless made in
writing and signed by the parties hereto. No oral understanding or agreement not incorporated herein
shall be binding on any of the parties hereto.
13. CONTINUITY OF CARE
Upon termination of this Agreement for any reason, MERCED and FRESNO shall ensure an
orderly transition of care for patients under treatment.
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14. INSURANCE
Without limiting each county's right to obtain indemnification from the other or from any third
parties, each party, at its sole expense, shall maintain in full force and effect their participation in 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. Each party may at any time request
verification of continued coverage with CSAC for excess liability and demonstrate their ability to meet
the Self-Insured Retention liability coverage.
Each county upon request will provide proof that their own insurance pooling agreement shall
provide coverage of at least one million dollars ($1,000,000) per occurrence and three million dollars
($3,000,000) aggregate per year. This coverage shall apply to general and automobile liability.
Transportation in connection with this Agreement shall be by vehicles owned by MERCED, FRESNO,
or by sub-contractors with Comprehensive Automobile Liability Insurance with limits for bodily injury of
not less than Two Hundred Fifty Thousand Dollars ($250,000) per person, Five Hundred Thousand
Dollars ($500,000) per accident and for property damages of not less than Fifty Thousand Dollars
($50,000), or such coverage with a combined single limit of Five Hundred Thousand Dollars ($500,000).
Professional Liability. When the parties employ licensed professional staff (e.g., Ph.D., R.N.,
L.C.S.W., M.F.T.) in connection with this agreement, each party shall provide Professional Liability
Insurance with limits of not less than One Million Dollars ($1,000,000) per occurrence, and Three Million
Dollars ($3,000,000) annual aggregate coverage for their own professional staff.
Workers Compensation. Each party shall maintain a policy of worker’s compensation insurance
as required by the California Labor Code in an amount of at least one million dollars ($1,000,000).
This required insurance coverage shall not be cancelled or changed without a minimum of thirty
(30) days advance written notice given to the other party. Either party may require the other to provide
proof of professional and workers’ compensation coverage.
In the event that either party fails to keep in effect at all times insurance coverage as herein
provided, the other party may, in addition to other remedies it may have, suspend or terminate this
Agreement upon the occurrence of such event. Policies other than self-insurance and joint powers
coverage shall be with admitted insurers licensed to do business in the State of California. Insurance
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purchased shall be from companies possessing a current A.M. Best, Inc. rating of A FSC VII or better.
15. INDEMNIFICATION
MERCED agrees to indemnify, save, hold harmless, and at FRESNO'S request, defend
FRESNO, its officers, agents, and employees from any and all costs and expenses, including Attorney’s
fees and court cost, damages, liabilities, claims, and losses occurring or resulting to FRESNO in
connection with the performance, or failure to perform, by MERCED, 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 corporation who may be injured or damaged by
the performance, or failure to perform, of MERCED, its officers, agents, or employees under this
Agreement.
FRESNO agrees to indemnify, save, hold harmless, and at MERCED'S request, defend
MERCED, its officers, agents, and employees from any and all costs and expenses, including
Attorney’s fees and court cost, damages, liabilities, claims, and losses occurring or resulting to
MERCED in connection with the performance, or failure to perform, by FRESNO, 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 corporation who may be injured or
damaged by the performance, or failure to perform, of FRESNO, its officers, agents, or employees
under this Agreement.
16. INDEPENDENT CONTRACTOR
In performance of the work, duties, and obligations assumed by the parties under this
Agreement, it is mutually agreed and understood that each party, including its officers, agents,
subcontractors 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 other party. Furthermore, the parties shall have no right to control or
supervise or direct the manner or method by which the other party shall perform its work and function.
However, each party shall retain the right to administer this Agreement so as to verify that the other
party is performing its obligations in accordance with the terms and conditions specified herein.
MERCED and FRESNO shall comply with all applicable provisions of law and the rules and regulations,
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if any, of governmental authorities having jurisdiction over matters which are directly or indirectly the
subject of this Agreement.
Because of each party’s status as independent contractors, employees of MERCED or FRESNO
shall have absolutely no right to employment rights and benefits available from the other entity.
MERCED and FRESNO shall be solely liable and responsible for providing to, or on behalf of, its
employees all legally required employee benefits. In addition, MERCED shall be solely responsible and
save FRESNO harmless from all matters relating to payment of MERCED'S employees, including
compliance with Social Security withholding and State withholding. FRESNO shall save MERCED
harmless from all matters relating to payment of FRESNO employees, including compliance with social
security withholding and State withholding.
FRESNO shall ensure that all personnel used as contractors, sub-contractors and employees to
perform the services reserved for FRESNO, are aware that MERCED is not responsible for any benefits
or coverage for their efforts.
17. RECORDS AND INSPECTIONS
MERCED shall maintain full and accurate records with respect to all matters covered under this
Agreement. To the extent permitted by law, FRESNO shall have free access at all proper times or until
the expiration of four (4) years after the furnishing of services to such records, and the right to examine
and audit the same and to make transcripts therefrom, and to inspect all data, documents, proceedings,
and activities pertaining to this Agreement.
If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), FRESNO and
MERCED shall be subject to the examination and audit of the State Auditor for a period of three (3)
years after final payment under contract (Government Code Section 8546.7).
18. CONFIDENTIALITY
FRESNO and MERCED agree to protect the rights of consumers and shall comply with
applicable laws and regulations, including but not limited to California Welfare and Institution Code
Section 5328; and 45 Code of Federal Regulations, (C.F.R.) Section 205.50; 42 C.F.R. Part 2 and 45
C.F.R. Parts 160 and 164, and to the HITECH Act in 42 C.F.R., Chapter 156, regarding the
confidentiality of patient information.
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Neither party shall use identifying information for any purpose other than carrying out their
respective obligations under this contract. Neither party shall disclose, except as otherwise specifically
permitted by the contract or as authorized by the client/patient, any such identifying information to
anyone other than the State without prior written authorization from the State in accordance with State
and Federal laws.
For the purposes of the above paragraphs, identifying information will include, but not be limited
to: name, identifying number, symbol, or other identifying particular assigned the individual. FRESNO
and the MERCED agree to comply with the provisions of Public Law 104-191, known as The Health
Insurance Portability and Accountability Act of 1996 (HIPAA).
19. COMPLIANCE AND INTEGRATED ETHICS
MERCED is committed to adhere to its adopted code of ethics to ensure that business is
conducted in an ethical and professional manner; and is consistent with the mission statement: “To
provide effective, accessible, and culturally competent Mental Health and Alcohol & Drug Services in
order to enhance the health welfare and quality of life in Merced County.”
The MERCED Mental Health Department’s Compliance and Integrated Ethics Plan (CIEP) is
necessary to ensure compliance with federal, state, and local laws, rules, and regulations regarding
professional conduct and to ensure that the conduct of employees reflects the principles of the
Department to treat consumers, the general public, and other employees with integrity, honesty,
courtesy, fairness, and respect.
FRESNO agrees to establish ethical standards for all staff employed by FRESNO. These
standards shall include compliance with state and federal regulations for safeguarding client
information. FRESNO agrees to orientate and train staff to enforce established ethical standards.
FRESNO agrees to establish written policies and procedures that ensure organizational and individual
compliance.
20. FEDERALLY EXCLUDED INDIVIDUALS AND ENTITIES
Employees of FRESNO or MERCED who, because of convictions or because of current or past
failures to comply with federal program requirements, become designated as ineligible persons or are
identified for exclusion from involvement in federal programs, shall be removed from responsibility or
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participation in or involvement with all aspects of this federally funded program, until such time as the
person or entity is no longer identified on the exclusion lists.
Both parties shall be responsible to perform ongoing exclusion reviews of current employees to
ensure that neither party hires or contracts with any individual or entity under sanction or exclusion by
the federal government. Both parties agree to provide written certification under penalty of perjury that
no current employee, subcontractor, entity or agent is on the list of Excluded Individuals and Entities of
the Office of the Inspector General (U.S. Department of Health and Human Services) or the General
Services Administration's Excluded Parties Listing System (42 USC 1320). Failure to comply shall be
grounds for immediate termination of this Agreement.
21. QUALITY OF SERVICE
FRESNO and MERCED shall perform all services provided under this Agreement with care, skill,
and diligence, and in accordance with the applicable professional standards currently recognized by
each profession. FRESNO and MERCED shall comply with all applicable Federal, State, and Local
laws, ordinances, codes, and regulations in performing services under this Agreement.
22. APPLICABLE LAW; VENUE
All parties agree that this Agreement and all documents issued or executed pursuant hereto and
the rights and obligations of the parties there under and hereunder are subject to and governed by the
laws of the State of California in all respects as to interpretation, effect and performance.
Notwithstanding any other provisions of this Agreement, any dispute concerning any question of
fact or law arising under this Agreement or any litigation or arbitration arising out of this Agreement,
shall be tried in Merced County, unless the parties agree otherwise or are otherwise required by law.
FRESNO and MERCED shall adhere to Title XIX of the Social Security Act and conform to all
applicable Federal and State statutes and regulations.
23. ENTIRE AGREEMENT
This Agreement and any additional or supplementary document or documents incorporated
herein by specific reference contain all the terms and conditions agreed upon by the parties hereto, and
no other contracts, oral or otherwise, regarding the subject matter of this Agreement or any part thereof
shall have any validity or bind any of the parties hereto.
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24. COUNTY NOT OBLIGATED TO THIRD PARTIES
MERCED shall not be obligated or liable hereunder to any party other than FRESNO. FRESNO
shall not be obligated or liable hereunder to any party other than MERCED.
25. STANDARDS OF PRACTICE
Standards of practice of MERCED and FRESNO shall be determined by the professional
standards for the employees and officers of MERCED and FRESNO in their trade or field of expertise
and all applicable provisions of law and other rules and regulations of any and all governmental
authorities relating to provision of services as defined in this Agreement.
26. COMPLIANCE WITH STATE LAWS AND REGULATIONS
FRESNO and MERCED agree to comply with all State laws and regulations that pertain to
health and safety, labor, minimum wage, fair employment practice, equal opportunity, and all other
matters applicable to FRESNO and MERCED, their sub-grantees, contractors or subcontractors, and
their work.
27. PERSONNEL
FRESNO and MERCED represent that each has, or will secure at its own expense, all personnel
required in performing the services under this Agreement. All of the services required hereunder will be
performed by the assigned party or under its supervision, and all personnel engaged in the work shall
be qualified to perform such services.
28. NOTIFICATION TO MENTAL HEALTH STAFF
MERCED shall notify FRESNO of all unusual or actual incidents (i.e., suspected abuse, injuries,
and deaths) affecting FRESNO clients within twenty-four hour (24) of occurrence and provide FRESNO
with a copy of all investigation reports concerning incidents and the disposition of, or corrective action
taken to resolve the complaint. FRESNO shall provide client case history as appropriate for disposition.
29. NONDISCRIMINATION IN EMPLOYMENT, SERVICES, BENEFITS AND FACILITIES
Both FRESNO and MERCED shall comply with all applicable federal, state, and local Anti-
discrimination laws, regulations, and ordinances and shall not unlawfully discriminate, deny family care
leave, harass, or allow harassment against any employee, applicant for employment, employee or
agent of FRESNO or MERCED, or recipient of services contemplated to be provided or provided under
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this Agreement, because of race, ancestry, marital status, color, religious creed, political belief,
national origin, ethnic group identification, gender, sexual orientation, age (over 40), medical condition
(including HIV and AIDS), or physical or mental disability. Each party shall ensure that the evaluation
and treatment of its employees and applicants for employment, and recipients of services are free from
such discrimination and harassment.
Each party represents that it is in compliance with and agrees that it will continue to comply with
the Americans with Disabilities Act of 1990 (42 U.S.C. § 12101 et seq.), the Fair Employment and
Housing Act (Government Code § 12900 et seq.), and ensure a workplace free of sexual harassment
pursuant to Government Code 12950; and regulations and guidelines issued pursuant thereto.
Each party agrees to compile data, maintain records and submit reports to permit effective enforcement
of all applicable antidiscrimination laws and this provision.
MERCED shall include this nondiscrimination provision in all subcontracts related to this
Agreement and when applicable give notice of these obligations to labor organizations with which they
have Agreements.
Notwithstanding other provisions of the section, MERCED and FRESNO shall each require a
determination of medical necessity pursuant to Title 9, CCR, Section 1820.205, Section 1830.205, or
Section 1830.210, prior to providing covered services to a consumer.
30. CAPTIONS
The captions of each paragraph in this Agreement are inserted as a matter of convenience and
reference only, and in no way define, limit, or describe the scope or intent of this Agreement or in any
way affect it.
31. SEVERABILITY
If a court of competent jurisdiction holds any provision of this Agreement to be illegal,
unenforceable or invalid, in whole or in part, for any reason, the validity and enforceability of the
remaining provisions, or portion of them, will not be affected.
32. LICENSE AND PERMITS
FRESNO and MERCED shall ensure that their agents, employees, representatives and
subcontractors possess and maintain all necessary licenses, permits, certificates and credentials
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required by the laws of the United States, the State of California, County of Merced and all other
appropriate governmental agencies. Failure to maintain such licenses, permits, certificates, and
credentials shall be deemed a breach of this Agreement and constitutes grounds for the termination of
this Agreement by MERCED or FRESNO, as appropriate.
33. RECORDS
Both parties agree to extend to MERCED’S Director of Mental Health Department, and
FRESNO’S County Behavioral Health Director, or designees, and the State Department of Health Care
Services, or their designees, the right to review records, in regard to FRESNO consumers placed in
MERCED’S facilities, in order to ensure compliance with the terms and conditions of this Agreement.
Both parties shall maintain statistical records in the manner provided by the State Health and Welfare
Agency and shall make such records available to either party as required by the MERCED’S Director,
FRESNO’S County Behavioral Health Director, the California State Health Department, and the
California State Health and Welfare Agency.
Both parties shall grant to each other, the State of California, Auditor General, (if applicable) the
Federal grantor agency, the Comptroller General of the United States, or any of their duly authorized
representatives access to any books, documents, papers and records of FRESNO and MERCED which
are directly pertinent to this Agreement for the purpose of making audits, examinations, excerpts,
transactions, program compliance and evaluation of consumer complaints. FRESNO and MERCED
must retain all such required records for five (5) years after FRESNO makes final payment and all other
pending matters are closed.
Clinical records of each consumer shall be the property of MERCED’S Mental Health
Department and shall be maintained for seven (7) years or until audit findings are resolved, whichever
occurs later.
Review as provided by this Section 34 and by these parties or agencies shall otherwise conform
to all appropriate confidentiality statutes.
34. REPORTS AND INFORMATION
To the extent permitted by law, MERCED shall furnish FRESNO reports as FRESNO may
request pertaining to the work or services undertaken pursuant to this Agreement. The costs and
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obligations incurred or to be incurred in connection therewith shall be borne by FRESNO, unless
otherwise provided in this Agreement.
35. BREACH OF CONTRACT
Upon breach of this Agreement by one party, the other party shall have all remedies available to
both in equity and/or law necessary to recover and satisfy the other party’s obligations.
36. DUPLICATE COUNTERPARTS
This Agreement may be executed in duplicate counterparts, each of which shall be deemed a
duplicate original. The Agreement shall be deemed executed when it has been signed by both parties.
[Signature page follows]
EXHIBIT A
January 2016
Mental Health Services
P.O. Box 2087 Merced, CA 95344-1046
DEPARTMENT OF MENTAL HEALTH (209) 381-6800
www.co.merced.ca.us
Service and Payment Authorization Form
I authorize the admission of (patient’s name) ______________________________________,
a ______________________ County resident for psychiatric hospitalization at Marie Green Psychiatric
Center located at 300 E. 15th Street in Merced, California.
_______________________ County will be responsible for the following:
1) Transportation of the patient to and from Marie Green Psychiatric Center.
2) Payment of Services rendered to the client at the rate of $1,072.00 per client per day plus $160.80
per client per day Administrative Overhead costs during the period of July 1, 2016 to June 30, 2021.
3) If the Client has Medi-Cal, placing County will be responsible to cover all charges not reimbursed by
the State or other payer source.
4) Placement of patient post discharge.
5) Provision of at least one guard if necessary.
6) Ensure that all medications are sent with patient and/or reimburse the cost of any medical medication
ordered or provided during the patient’s stay at Marie Green Psychiatric Center.
7) Payment of $76 for History and Physical, if ordered by the attending psychiatrist.
Authorization Approved Authorization Denied
By: ______________________________ ____________________ County
(Please Print)
Signature: __________________________________
Please provide reason(s) if authorization is denied.
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Document completed by: _______________________________
MCDMH Staff