HomeMy WebLinkAboutMINUTES - 09131994 - 1.76 TO: BOARD OF SUPERVISORS
tit AO�
FROM: Mark Finucane, Health Services Directory Contra
By: Elizabeth A. Spooner, Contracts Administrato Costa
DATE: August 18, 1994 - County
SUBJECT: Approval of Standard Agreement #29-441-14 with the State
Department of Mental Health
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Chair, Board of Supervisors, to execute on
behalf of the County, Statement of Compliance, Drug Free Workplace
Certificate and Standard Agreement #29-441-14 (State #94-74101) with
the State Department of Mental Health, for the period from July 1,
1994 through June 30, 1995, in the amount of $759, 814, for
continuation of the Conditional Release Program (CONREP) .
II. FINANCIAL IMPACT:
Approval of this agreement will result in $759, 814 of State funding
for the Conditional Release Program for the period from July 1, 1994
through June 30, 1995. No County match is required.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On September 28, 1993 , the Board of Supervisors approved Standard
i Agreement #29-441-12 (as amended by Standard Agreement [Amendment]
#29-441-13) with the State Department of Mental Health for the
Conditional Release Program. The agreement provides monies with which
the County subcontracts with Many Hands, Phoenix Programs, Rubicon,
and a number of board and care homes to provide additional (CONREP)
services.
Approval of Standard Agreement #29-411-14 will continue these services
through June 30, 1995, for a caseload of 38 judicially committed
patients.
Ten signed copies of the agreement and five certified and sealed
Copies of the Board Order should be returned to the Contracts and
Grants Unit for submission to the State Department of Mental Health.
CONTINUED ON ATTACHMENT: YES SIGNATURE: Q
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMM DA ION OF BOARD OMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
Contact: Lorna Bastian ( 313-6411 )
CC: Health Services (Contracts ) ATTESTED
Auditot-Controller (Claims) Phil Batc elor. Clerk of the Board of
State Dept, of Mental Health $UpetYi�tSepdf4tAi�tynistrat�r
M382/7-88 BY a o LP��� DEPUTY
'STATE OF CALIFORNIA
NONDISCRIMINATION COMPLIANCE STATEMENT
STD.19(REV.2-934
29 - 441 - 14
COMPANY NAME
The company named above(hereinafter referred to as"prospective contractor")hereby certifies,unless
specifically exempted,compliance with Government Code Section 12990 (a-f)and California Code of
Regulations, Title 2, Division 4, Chapter 5 in matters relating to reporting requirements and the
development,implementation and maintenance of a Nondiscrimination Program.Prospective contractor
agrees not to unlawfully discriminate,harass or allow harassment against any employee or applicant for
employment because of sex, race, color, ancestry, religious creed, national origin, physical disability
(including HIV and AIDS), mental disability,medical condition(cancer), age(over 40),marital status,.
and denial of family care leave.
CERTIFICATION
I, the official named below, hereby swear that 1 am duly authorized to legally bind the prospective
contractor to the above described certification.I am fully aware that this certification, executed on the
date and in the county below,is made under penalty of perjury under the laws of the State of California.
OFFICIAL'S NAME
DATE EXECUTED . EXECUTED IN THE COUNTY OF
PROSP TIVE CO TO S SIGNATUR
PROSPECTIVE TRACTOR'S TITLE
PROSPECTIVE CONTRACTOR'S LEGAL BUSINESS NAME
i
STATE OF CP,LIFORNIA; p
STANDARD AGREEMENT- APPROVED BY THE
ATTORNEYGENERA�,_ CONTRACT NUMBER AMNO.
STD.2(REv.s-Bi) 94-74101
TAXPAYER'S FEDERAL EMPLOYER-IDENTIFICATION NUMBER
THIS AGREEMENT,made and entered into this 16th day of June _ 19 94 94-6000509W
in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting
TITLE OF OFFICER ACTING FOR STATEAGENCY 44" 14
Deputy Director Mental Health hereafter called the State,and
CONTRACTOR'S NAME
Contra Costa County Health Services Department hereafter called the Contractor.
WITNESSETH: That the Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the State hereinafter expressed,
does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor,
time for performance or completion,and attach plans and specifications,if any.)
Contractor agrees to provide the services specified
in:
Exhibit "A", Program Narrative;
Exhibit "B", Specific Provisions; and
Exhibit "C", General Provisions;
attached hereto and by this reference incorporated F.
herein.
This contract is exempt from compliance with the Public
Contract Code, the State Administrative Manual, and from
approval by the Department of General Services per
Section 4360(b) of the Welfare and ,Institutions Code.
This contract shall not be effective until it has been
approved by the Department of Mental Health.
CONTINUED ON SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER.
The provisions on the reverse side hereof constitute a part of this agreement.
IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date first above written.
STATE OF CALIFORNIA ONTRACTOR
AGENCY CONTRACTOR-fi..otherthan indiv. a(statetheca corporation.partnership,eta)
Department of Mental Health Contra sta ount
BY(AUTHORIZED S ATURE) BY{AUTHO D S RE
D
PRINTED NAME OF PERSON SIGNING PRINTED.NAM /AN Tll PE PERSO�1. 111,�_
LINDA A. POWELL, Deputy Director iChair, Board of Su ervisors�:-
TITLE ADDRESS—
Division of Administration 6511 Pine Street, Martinez_,_ CA - _94553
AMOUNT ENCUMBERED BY THIS PROGRAM/CATEGORY(CODE AND TITLE) FUND TITLE Department of General Services
DOCUMENT 20 - State Hospitals General Use Only
`+' 759,814 .00 (OPTIONAL USE)
PRIOR AMOUNT ENCUMBERED FOR
THIS CONTRACT Conditional Release Program Exempt from compliance With
$ ITEM CHAPTER STATUTE FISCAL YEAR the Public Contract Code,
TOTAL AMOUNT ENCUMBERED TO 4440-016-001 1994 94195 the State Administrative
DATE OBJECT OF EXPENDITURE(CODE AND TITLE) Manual, and from approval by
$ 1100-325-413 the Department of General
I hereby certify upon my own personal knowledge that budgeted funds T.B.A.No. B.R.NO. Services per Section 4360(b)
are available for the period and p se of the expenditure stated above. of the Welfare and
S E OF ACCOUNTING OFF15W DATE
Institutions Code.
OCT 2 0 1994
F1 CONTRACTOR STATE AGENCY DEPT.OF GEN.SER. CONTROLLER
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD.2(REV. 5-91) (REVERSE)
1. The Contractor agrees to indemnify,defend and save harm less 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 contract,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
Contractor in the performance of this contract.
2. The Contractor,and the agents and employees of Contractor,in the performance of the agreement,shall
act in an independent capacity and not as officers or employees or agents of State of California.
3. The State may terminate this agreement and be relieved of the payment of any consideration to Contractor
should Contractor fail to perform the covenants herein contained at the time and in the manner herein
provided. In the event of such termination the State may proceed with the work in any manner deemed
proper by the State. The cost to the State shall be deducted from any sum due the Contractor under this
agreement,and the balance,if any,shall be paid the Contractor upon demand.
4. Without the written consent of the State,this agreement is not assignable by Contractor either in whole
or in part.
5. Time is of the essence in this agreement.
6. No alteration or variation of the terms of this contract shall be valid unless made in writing and signed by
the parties hereto,and no oral understanding or agreement not incorporated herein,shall be binding on
any of the parties hereto.
7. The consideration to be paid Contractor, as provided herein, shall be in compensation for all of
Contractor's expenses incurred in the performance hereof, including travel and per diem, unless
otherwise expressly so provided.
91 61014
Contract : 94-74101
Contractor: Contra Costa County
Health Services Department
EXHIBIT "All
PROGRAM NARRATIVE
INTRODUCTION:
Pursuant to Section 4360 (a) and (b) of the Welfare and
Institutions Code (WIC) , the State operates the Forensic
Conditional Release Program (CONREP) to provide a statewide
system of community assessment, mental health treatment and
supervision to the judicially committed population and to
Mentally Disordered Offender (MDO) patients. The goal of the
program is to ensure greater public protection in California
communities via a system of mental health assessment, treatment,
and supervision to persons placed on outpatient status.
Section 7.. DEFINITIONS:
a. 10Patient'# means a person who is eligible for services
under the Forensic Conditional Release Program pursuant
to WIC Section 4360. Patients in the Conditional
Release Program are either judicially committed or are
mentally disordered offenders.
b. 11Judicial Commitments" include persons found Not Guilty
by Reason of Insanity pursuant to Penal Code (PC)
Section 1026 or WIC Section 702 . 3, Incompetent to Stand
Trial pursuant to PC 1370 and Mentally Disordered Sex
Offender pursuant to former WIC 6316.
C. 'Mentally Disordered Offenderso, include parolees of the
California Department of Corrections who have a special
condition of parole established by the Board of Prison
Terms (BPT) which requires mental health treatment
pursuant to PC 2964 (a) or persons placed on a civil
commitment under PC 2972 (d) .
d. 'Core Servicesil are the minimal mental health services
to be provided to CONREP patients. They are individual
contacts, group contacts, home visits, collateral
contacts, substance abuse screenings, and assessments.
e. "Supplemental Services, are other specific treatment
services which may be provided to patients as
determined on an individual basis in addition to Core
Treatment Services. Included are: 24-hour services,
outpatient (crisis intervention and medication visits) ,
day care services, or other services as negotiated.
Contract f: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 2 of 9
Program Narrative '
f. "Basic Services" are primarily liaison, evaluation and
support services which relate to patient care and
program administration. Included are: court ordered
evaluation, state hospital liaison, attendance at
Regional Coordinator's meetings and statewide meetings.
g. "Negotiated Net Amount" is the amount of the total
State payment negotiated between the State Department
of Mental Health (DMH) and the Contractor for services
specified in the contract. This amount is determined
by subtracting the amount of projected revenues from
the adjusted gross cost for those services. Negotiated
Net Amount (NNA) funds are intended to provide the
basic staff and support for program operation. The .NNA
is fixed and is not subject to subsequent adjustment to
actual cost.
h. "Negotiated Net Amount Services" are basic, core, and
supplemental services agreed upon by the State and the
Contractor, as displayed in EXHIBIT "B-111, that are
funded in aggregate by the NNA for the capacity to
deliver the total number and type of services
specified.
i. "Negotiated Rate" is the rate negotiated between the
State and the Contractor as payment for services
delivered on a unit of service basis listed in EXHIBIT
Negotiated Rate Amount (NR) is the total derived by
multiplying the NR by the units of service for all rate
services. Each NR is determined by dividing the gross
cost, less projected revenues, by the units to be .
provided.
The rate is fixed for each service type and is not
subject to subsequent adjustment to actual costs. If a
Contractor incurs unforeseen costs during the course of
the contract, DMH may consider a rate adjustment. A
written request for approval by the Regional Forensic
Coordinator is required.
The State will pay the NR per unit even if a Contractor
collects more revenues than projected.
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 3 of 9
Program Narrative
j . !Negotiated Rate Services'$ means basic, core, or
supplemental services agreed upon by the State and the
Contractor as displayed in EXHIBIT "B-111, that are
funded by NR.
k. IlRevenuell means service related income from government
(i.e. , Medicare, Champus) , as well as nongovernmental
patient related funds (i.e. , patient fees, patient
insurance) .
1. $'Dedicated Capacity" is the staffing and support
services necessary to provide the services specified in
the contract. Contractors are to maintain this NNA
funded level of staff and support, regardless of any
fluctuation in actual caseload.
M. "Negotiated Cost" is the amount agreed upon for the
costs of providing services negotiated between the
State and the Contractor.
n. "Unexpended Funds" are NNA funds contracted in a
specific fiscal year which are not spent during the
course of the contract period. Unexpended NNA funds
are exclusively for the provision of CONREP services to
the eligible patient population and are primarily for
short-term expenditures.
o. "Special Fund Account" consists of all accumulated
unexpended funds, including the amount of NNA
expenditures deemed inappropriate by audit, and the
accumulated interest accrued on the principal.
Interest shall be treated as part of the total and must
be spent on CONREP services.
Section 2, PROGRAM OBJECTIVES:
a. Dedicated Capacity
During the term of this contract, the Contractor shall
maintain the NNA resources detailed in EXHIBIT "B-1" to
exclusively provide at least the service capacity
detailed in form MH-7001 in EXHIBIT "B-111.
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 4 of 9
Program Narrative
The Contractor assumes the risk that more service
units may be required than that level agreed upon by
Contractor and State. The Contractor is responsible to
ensure that necessary services are provided during the
entire term of the contract.
The State assumes the risk that fewer service units
will need to be provided than are allowed in the NNA
Dedicated Capacity. The Department may consider an
amendment to an NNA contract during the contract period
if the six month average caseload (excluding AWOLs and
patients on Not Available status for four months or
more) has significantly exceeded the contract caseload.
It is intended that the costs of the Contractor in
maintaining this dedicated capacity shall be met by the
total funding available for these services. This total
funding shall be derived from a combination of fixed
funds (CONREP funds) and variable funds from patient
fees, patient insurance, Medicare, grants and other
miscellaneous sources. The Contractor assumes the risk
and responsibility for the collection of variable
funds. The State will pay the NNA for the dedicated
capacity. The Contractor agrees that all funds paid
out by the State pursuant to this agreement shall be
used for mental health services to CONREP patients.
Should the Contractor realize unexpended funds in the
contract, such funds shall be used to enhance services
to the eligible patient population served under this
contract. The Contractor shall submit a plan for
approval by the Regional Forensic Coordinator on the
use of these funds with the cost report, which is due 5
months after the close of the fiscal year.
b. Negotiated Rate Services
During the term of this contract, the Contractor shall
be responsible for providing necessary NR services in
accordance with the schedule of services in EXHIBIT 11B-
1", as negotiated by the State and the Contractor.
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 5 of 9
Program Narrative
Claims for reimbursement for NR services, listed in
EXHIBIT "B-111, shall be billed to the State monthly in
arrears as services are provided. The Contractor's
total funding for these services shall be based on the
rates and units of service negotiated. The State shall
pay the NR per unit even if the Contractor collects
more revenues than projected.
Contractors shall be paid for NR services based -on the
rate negotiated for each service, up to the contracted
amount for CONREP Rate Services specified in EXHIBIT
11B-111 . Changes to the service rate or the addition of
service types within the total amount for the NR
services may be made with the approval of the State
using form MH 1715, Contract Data Sheet. The
Contractor may request modification .of the NR services
until the cost report submission date.
Should the Contractor project excess utilization of
CONREP NR services beyond the contract maximum amount,
the Contractor shall contact the State within five days
of discovery. If the State determines that the
utilization of rate services is appropriate and no
viable alternatives are found, amendments to the
contract may be negotiated to the extent funds are
available.
Section 3. MINIMUM CORE SERVICE PERFORMANCE STANDARDS:
Contractor agrees to comply with such minimum core performance
standards for all patients as shall be provided for by DMH
policy. Any deviation below the core service level shall require
a prior written approved waiver from the State. In the event of
consistent and documented failure to meet core services
performance standards, the State reserves the right to enact the
fiscal sanction provisions outlined in EXHIBIT "A-111 .
Contract #: 94-74101
• Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 6 of 9
Program Narrative
Section 4, DOCUMENTATION OF SERVICES RENDERED:
All services rendered to patients shall be adequately documented
in the patient's case record. The patient's case record or
medical record shall include, but not be limited to: assessment;
quarterly reports to court; annual renewals; placement
evaluations; psychological testing results or other evaluations;
treatment plans with measurable objectives linked to offense;
progress notes to problem-based plans; and forensic data base
(CONREP referral face sheets, arrest reports, probation and
panelist reports as applicable, hospital records and CI&I rap
sheets) . Any NR services claimed which are not documented may
result in a claim adjustment, directly related to the
undocumented units of service.
Section 5, COST REPORTING:
The Contractor shall submit to the State an annual cost report
detailing units of service delivered during the contract period,
costs of delivered services, and revenue collected based on the
formats used for budgeting. The cost report is due five (5)
months after the close of the fiscal year.
Section 6, CLAIMING AND DATA REPORTING:
The Contractor shall comply with CONREP claiming and data
requirements, as detailed in State policy, to include
transmission of data, utilization of the appropriate forms and
automated billing process within the stipulated deadlines.
Section 7, EXPENDITURE PLAN for Unexpended Negotiated Net Amount
(NNA) Funds:
For each year NNA unexpended funds are realized, the Contractor
must submit form MH 1769, Plan for Expenditure of Prior Years
Unexpended NNA Funds, to the Regional Forensic Coordinator for
approval.
Contractor shall maintain an expenditure log accounting for the
use of unexpended NNA funds and the log shall be available for
inspection by the Regional Forensic Coordinator.
Upon the termination of the contract, Contractor will liquidate
the final unexpended NNA Fund Balance at the direction of the
Department of Mental Health.
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 7 of 9
Program Narrative
Section 8, ACCESS:
The Contractor agrees that the State shall have access to
facilities, programs, documents, records, staff, patients, or
other material or persons the State deems necessary to perform
monitoring and auditing of services rendered.
Section 9, STATUTES AND POLICY:
The Contractor agrees to comply with all statutes, regulations,
and State DMH policies concerning operation of CONREP.
Section 10, COMPLIANCE/AUDIT REQUIREMENTS:
The State will monitor and audit services rendered and may take
fiscal sanctions against the Contractor in accordance with the
attached EXHIBIT "A-111.
. Section 11, STAFF OUALIFICATIONS:
All employees of the Contractor or Subcontractors shall possess
clinical licensure and educational qualifications appropriate to
the scope of their practice and to meet the mental health
treatment needs of CONREP program patients.
Section 12, SERVICE AVAILABILITY:
The Contractor shall have the capacity for appropriate response
capability 24 hours a day, seven days per week. Contractor shall
submit this plan to the State annually on July first, of the
contract period.
Section 13, EQUIPMENT:
The Contractor agrees to purchase or supply equipment as
identified in EXHIBIT "B-1" unless prior approval for
modification is received from the State. Within 30 days of
equipment purchase, the Contractor shall submit to the State a
list identifying all equipment (having an asset cost of $300 or
more) purchased with funds under this contract along with
inventory number(s) or serial number(s) . The Contractor shall
tag all equipment listed on the inventory with numbered decals
provided by the State.
Contract #s 94-74101
Contractors Contra Costa County
Health Services Department
Exhibit A
Page 8 of 9
Program Narrative
Equipment funds identified in the contract for specific items
cannot be transferred, redirected or used for any other purpose
without the written approval of the Regional Forensic
Coordinator.
At the conclusion of the contractual relationship between the
State and the Contractor, the Contractor shall provide a final
inventory to the State and shall, at that time, query the State
as to the State's requirements, including the manner and method
in returning said equipment to the State. Final disposition of
such equipment shall be at State expense in accordance with
instructions from the State to be issued immediately after
receipt of the final inventory.
Section 14, PATIENT RECORDS:
The State retains title to all patient case records, patient
related reports, and any documentation which pertains to patient
services.
The maintenance and keeping of all CONREP patient records and
reports must be accomplished in a manner consistent with the
policy and procedures established by the Department of Mental
Health, Forensic Services.
Section 15, SUBCONTRACTORS:
The Contractor is responsible for all requirements under the
contract. The Contractor's liability for compliance with
provisions of DMH contract is not assignable. The policy and
procedures are the same for Subcontractors as they are for
Contractors. All subcontracts shall include a ,provision(s)
requiring compliance with the terms and conditions of the CONREP
contract.
Subcontracts shall include pertinent information, such as the
billing procedures, funding limits, reimbursement method, type of
services to be rendered, term of the contract, termination
provisions, rights and obligations of Contractor and
Subcontractors, claim submission deadline, year-end cost reports,
and such other information deemed necessary by the Contractor and
DMH. Subcontracts shall further include EXHIBITS that show
financial detail that support the Net Negotiated Rate(s)
requested.
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 9 of 9
Program Narrative
The Contractor shall submit a copy of all subcontracts to the
Department pursuant to Item I, EXHIBIT "C", of this contract. No
payment will be made by DMH for services provided by
Subcontractors prior to submission of a fully executed
subcontract to the Department.
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
EXHIBIT "A-11$
COMPLIANCE/AUDIT REQUIREMENTS
1. Core Service Compliance
The State is funding Core Services in the Conditional Release
Program primarily through Negotiated Net Amount (NNA) . Each
program will be required to ensure that staff positions funded
pursuant to NNA are reserved solely for this function
regardless of caseload size.
Contractor is required to provide the minimum mandated
services to each patient unless a waiver of this mandate for a
specific patient has been previously obtained in writing from
the State. Therefore, if a patient is AWOL, incarcerated, or
otherwise not available for treatment, the Contractor shall
notify the State of this circumstance pursuant to policy. The
State will exclude these patients for the purpose of
monitoring program performance of the minimum required Core
Services.
The State will monitor compliance with each Core Service
through various means to ensure that services are provided to
each patient.
2. Dedicated Capacity Compliance
The State will monitor Negotiated Net Service Contractors to
ensure compliance with the dedicated capacity as stipulated in
this contract. The Contractor is expected to show
documentation of dedicated capacity compliance for any given
time period. Documentation of compliance may be in the form
of time sheets for employees, scheduled appointments for each
employee, patient case records, or any other method to
validate percentages of time dedicated to the Conditional
Release Program. This information will be compared to the
contracted dedicated capacity.
3. Negotiated Rate Services Compliance
The State funds some services through Negotiated Rates
(typically Supplemental Services) . There is no payment for
services rendered unless the provider is operating under this
contract. Payment will be made based upon the contracted
negotiated rate times the number of service units rendered.
Each unit of service billed to the State must have supporting
documentation in a patient case record. Claim adjustment will
be made for services not documented. Although day treatment
services allow for a weekly summary of services rendered,
dates of a patient's attendance must be documented.
Contract #: " 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit A-1
Page 2 of 2
Compliance/Audit Requirements
4. Fiscal Sanctions
The State reserves the right to withhold NNA payments in full
or in part in the event of documented failure on the part of
the Contractor to meet any of the contract requirements.
Prior to any such withhold, the State shall send to the
Contractor a letter of intent to withhold with a
justification. The Contractor may request a meeting with the
State within ten working days of the date of the State's
letter of intent.
If the issue cannot be resolved during the meeting, the
Contractor may file a letter with the Chief, Forensic
Services, within 10 days of the meeting, appealing the
intended action of the State. If the Chief, Forensic
Services, denies the appeal, notice will be sent to the
Contractor of that fact prior to any withhold. Withholding of
payments would continue until the Contractor achieves
compliance with the requirements or until such time that the
Chief, Forensic Services, deems it appropriate to resume NNA
payments.
Contract #: 94-74101
Contractor: Contra Costa County
Health services Department
EXHIBIT RIB"
specific Provisions
1. The term of this contract shall be from 07/01/94 through
06/30/95.
2. The State has designated- Grant.Ute, LCSW, to be its Project
Coordinator. Except as otherwise provided herein all
communication concerning this contract shall be with the
Project Coordinator.
3. The total amount payable by the State to the Contractor
under this contract shall not exceed $759,814 . Of this
amount, total payments for Negotiated Net Amount (NNA)
Services shall not exceed $586,032 . The total payments for
Negotiated Rate (NR) Services - Conditional Release Program
shall not exceed $173,782 . The Contractor may, with the
written approval of the Project Coordinator, shift funds
between the contract categories of CONREP NNA and CONREP NR.
4. In consideration of the services, as specified in EXHIBIT
"A" herein, performed in a manner acceptable to the State,
the State agrees to make payment to the Contractor as
follows:
Upon the effective date of this agreement and upon the
submission of Summary Claim for Reimbursement (MH 1701) , in
triplicate, as specified herein and in accordance with the
Budget, EXHIBIT 11B-1" attached hereto and by this reference
incorporated herein, the State will make advance payment for
one month .of NNA Services as specified in the Budget.
Monthly, thereafter, Contractor may submit Summary Claim for
Reimbursement (MH 1701) , in triplicate, for advance payment
for each month of NNA Services, provided however that such
additional advance payment may not exceed $537,196.
Reimbursement for NR Services will be made using Summary
Claim for Reimbursement (MH 1701) , in triplicate, submitted
monthly in arrears, for actual expenditures in accordance
with provisions of EXHIBIT "A-111, Paragraph 3 and the
Budget, EXHIBIT 11B-111.
f
Contract #: 94-74101
Contractor: Contra Costa County
Health Services Department
Exhibit B
Page 2 of 2
Summary Claim for Reimbursement (MH 1701) shall be submitted
as follows:
The original and copy of the Summary Claim for Reimbursement
(MH 1701) shall be submitted to:
Accounting Section
Division of Administration
Department of Mental Health
1600 Ninth Street, Rm. 140
Sacramento, CA 95814
One copy of the Summary Claim for Reimbursement shall be
submitted to the Project Coordinator at:
Grant Ute, LCSW
Manager, CONREP Operations
Department of Mental Health
Forensic Services
World Trade Center, S_uite. 231
San Francisco, CA 94111
5. This agreement shall become effective on 07/01/94, but shall
not become effective unless and until approved by the
Department of Mental Health.
Department of Mental Health Forensic Services Conditional Release Program
CONREP PROGRAM - EXHIBIT B-1
NEGOTIATED NET AMOUNT AND RATE SERVICES SUMMARY
MH 7001 (05/94) Page 1
Contractor Name: Contra Costa County Type of Report Dates:
Contract No. 94-74101 _Y,-.Contract Budget Submission: 6/7/94
Fiscal Year Ending: June 30, 1995 _Year End Cost Report Amendment:
Item 1 — Units of Service Based on Caseload and Year in Program
Year One Two Three Four Five Total
A.Caseload 9 3 8 5 13 38
B. Mode and Service Function
Forensic Weekly Weekly Weekly 3 Times Once
Individual 4/Month 4/Month 4/Month /Month Monthly
Contact
15-80 432 144 384 180 156 1,296
Group Weekly Weekly Weekly Twice Once
Contact 4/Month 4/Month 4/Month Monthly Monthly
15-50 432 144 384 120 156 1,236
Home Once Once Once. Every Once
Visits= Monthly Monthly Monthly_ 6 Weeks Quarterly -
50-40 108 36 96 45 52 337
Collateral 6 Per Year 6 Per Year 6 Per Year 6 Per Year 6 Per Year
15- 10 54 18 - 48 30 78 228
Lab Once Twice Twice Once Once
Screenings Weekly Monthly Monthly Monthly Quarterly
15-21 468 72 192 60 52 844
Assessments 1 Per Year 1 Per Year 1 Per Year 1 Per Year 1 Per Year
15-30 9 3 8 5 13 38
Total Units 1,503 417 1,112 440 507 3,979
Total Amount
Item 2. Total Negotiated Net Amount Services(NNA): $586,032
Item 3. Total Negotiated Rate Services Amount(NR): 173,782
Item 4. Total Contract Amount: $759,814
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Department of Mental Health Forensic Services Conditional Release Program
CONREP PROGRAM - EXHIBIT B-1
CONDITIONAL RELEASE PROGRAM UNIT COST
MH 7003 (05194) Page 3
Contractor Name: Contra Costa County Type of Report Dates:
Contract No. 94-74101 _X_Contract Budget Submission: 6/7/94
Fiscal Year Ending: June 30, 1995 _Year End Cost Report Amendment:
UNE ITEMS Subtotal Tota!
1. Personnel Costs $428,260
2.Operating Expenses $137,193
a. Office Services&Supplies $6,000
b. Communications 10,000
c.Travel(Including Training) 11,000
d.Facility 54,749
e. Medical procedures,Supplies, Pharmacy 1,000
f. Consulting Fees
g. Emergency Life Support 1,000
h.Other: Life Support-Residential-(05/90 600 units @$24.33) 14,598
i. Other:05/85 700 units @$25.00 17,500
1. Other:Money Management(via MOU with HSD Conservatorship Unit) 3,000
k.Other: Equipment Maintenance 1,500
I. Other:-50-50-(2500 units @$6.00) 15,000 =
m.Other:Assessment Quality Control-FHC,Inc.) 1,846
3. Equipment Over$300 Per Unit $0
4. Administrative Services&Overhead (15%of Personnel Cost) $64,239
5.Total Cost of the CONREP Unit $629,692
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a. Patient Fees $250
b. Patient Insurance 0
c. Life-Support Reimbursement(05/85 and 05/90) 5,000
d. Medicare 0
e. Medical 0
I. Prior Years' Unexpended Funds 0
g.Other(Specify) 0
7. Net Cost 1 $624,442
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CONTRACT NO. : 94-74101
CONTRACTOR : Contra Costa
Hlth Serv. Dept.
EXHIBIT "C"
General Provisions
1. Contractor shall submit any subcontracts to the subcontractors shall give written notice of their
State designated Project Manager for approval. Upon obligations under this clause to labor organizations
termination of any subcontract, the State shall be with which they have a collective bargaining or
notified immediately. other agreement.
2. By signing this contract, Contractor swears under Contractor shall include the nondiscrimination and
penalty of perjury that no more than one final compliance provisions of this clause in all
unappealable finding of contempt of court by a subcontracts to perform work under the contract.
Federal court has been issued against this (SAM 1204.5)
Contractor within the immediately preceding two-year
period because of the Contractor's failure to comply 7. The State reserves the right to use and reproduce
with an order of a Federal court which orders the all reports and data, produced and delivered pursuant
Contractor to comply with an order of the National to this agreement, and reserves the right to
Labor Relations Board. (Public Contract Code Section authorize others to use or reproduce such materials.
10296)
8. Should a dispute arise under this contract,
3. This contract may be canceled at any time. by Contractor may, in addition to any other remedies
either party, by giving 30 days written notice to which may be available, provide written notice of
the other party, and may be amended upon mutual the particulars of such dispute to the Deputy
consent. Director, Division of Administration, Department of
dental Health, 1600 Ninth Street, Sacramento, CA.
4. Contractor understands that no Federal or State 95814. Such written notice must contain the
income tax will be withheld from the payments under Contract Number. Within ten days of receipt of such
this contract. However, the State is required to notice, the Deputy Director, Division of
report all payments to the Internal Revenue Service Administration shall advise Contractor of his
for tax purposes. No distinction of fee, travel or findings and a recommended means of resolving the
per diem will be made. No wage and tax statement (W- dispute. (Public Contract Code, Section 10381)
2) will be issued for the services performed under
this agreement. 9. Contractor is hereby notified that Public
5. Contractor is advised and understands that its Contract Code Section 10381 provides that
performance under this contract will be evaluated in Contractors have certain specific rights, duties,
accordance with the provisions of Public Contract and obligations when entering into consultant
Code Section 10367. services contracts with the state.
6. During the performance of this contract, 10. Travel and per diem if, authorized under this
Contractor and its subcontractors shall not agreement shall be paid in accordance with the State
unlawfully discriminate against any employee or Administrative Manual Section 1243 and the
applicant for employment because of race, religion, Department of Personnel Administration Rules and
color natural origin, ancestry, physical handicap, Regulations and as amended from time to time. No
medical condition, marital status, age (over 40), or travel outside the State of California shall be
sex. Contractors and subcontractors shall comply reimbursed unless expressly authorized herein or
with the provisions of the Fair Employment and unless prior written authorization is obtained from
Housing Act (Government Code, Section 12900 et. the State. (SAM 1242)
seq.) and the applicable regulations promulgated
thereunder (California Administrative Code, Title 2, . 11. Contractor agrees to maintain books, records,
Section 7285 et. seq.). The applicable regulations documents, and other evidence necessary to support
of the Fair Employment and Housing Commission contractor's claims for reimbursement under this
implementing Government Code Section 12990, set contract. (SAM 1272)
forth in Chapter 5 of Division 4 of Title 2 of the
California Administrative Code are incorporated into 12. Contractor agrees that the State reserves title
this contract by reference and made a part hereof as to any property purchased or financed from the
if set forth in full. Contractor and its proceeds of this contract if such property is not
CONTRACT NO. : 94-74101
CONTRACTOR : Contra Costa
Hlth Serv. Dept .
EXHIBIT "C"
General Provisions
fully consumed in the performance of this contract. 18. In accordance with the provisions of Section
This provision shall be operational even though such 1618 of the Penal Code, "The administrators and the
property may have been purchased in whole or in supervision and treatment staff of the conditional
part by Federal funds and absent a Federal release program shall not be held criminally or
requirement for transfer of title. (SAM 1269 & 8602) civilly liable for any criminal acts committed by
the persons on parole or judicial commitment status
13. Contractor agrees to place in each of its who receive supervision or treatment. This waiver
subcontracts, which are in excess of $10,000 and of liability shall apply to employees of the State
utilize State funds, a provision that: The Department of Mental Health and the agencies or
contracting parties shall be subject to the persons under contract to this department to provide
examination and audit of the Auditor General for a supervision or treatment to mentally ill parolees or
period of three years after final payment under persons under judicial commitment."
contract (GOVERNMENT CODE SECTION 10532)". The
Contractor shall also be subject to the examination 19. It is mutually understood between the parties
and audit of the Auditor General for a period of that this contract may have been written and
three years after final payment under contract executed prior to July 1, for the mutual benefit of
(GOVERNMENT CODE SECTION 10532)". both parties, in order to avoid program and fiscal
delays .which could occur if .the contract were
14. Contractor shall protect from unauthorized executed after July 1, of the State fiscal year.
disclosure, names and other identifying information
concerning persons receiving services pursuant to 20. This contract is valid and enforceable, only if
this contract, except for statistical information sufficient funds are made available by the Budget
not identifying any client. Client is defined as Act for this fiscal year for the purposes of this
"those persons receiving services pursuant to a program. In addition, this contract is subject to
Department of Mental Health funded program". any additional restrictions, limitations, or
conditions enacted by the Legislature which may
Contractor shall not use such identifying affect the provision, terms, or funding of this
information for any purpose other than carrying out contract in any manner.
the Contractor's obligations under this contract.
21. It is mutually agreed that if the Budget Act
15. Contractor shall promptly transmit to the State does not appropriate sufficient funds for the
all requests for disclosure of such identifying program, this contract shall be invalid and of no
information not emanating from the client. further force and effect. In this event, the State
shall have no further liability to pay any funds
16. Contractor shall not disclose, except as whatsoever to the Contractor or to furnish any other
otherwise specifically permitted by this contract or considerations under this contract, and the
authorized by the client, any such identifying Contractor shall not be obligated to perform any
information to anyone other than the State without provisions of this contract. 19. It is mutually
prior written authorization from the State. understood between the parties that this contract
may have been written and executed prior to July 1,
17. For purposes of this paragraph, identity shall for the mutual benefit of both parties, in order to
include but not be limited to name, identifying avoid program and fiscal delays which could occur if
number, symbol, or other identifying particular the contract were executed after July 1, of the
assigned to the individual, such as finger or voice State fiscal year.
print, or a photograph.