HomeMy WebLinkAboutMINUTES - 09121995 - C89 BOARD OF SUPERVISORS
om: Mark Finucane, Health Services Director
-Contra
Costa
DATE: August 3, 1995 County
SUBJECT: Approval of Standard Agreement #29-441-15 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 #29-441-15 (State #95-75005) with
the State Department of Mental Health, for the period from July 1,
1995 through June 30, 1996, in the amount of $745, 841, for
continuation of the Conditional Release Program (CONREP) .
II. FINANCIAL IMPACT:
Approval of this agreement will result in $745,841 of State funding
for the Conditional Release Program for the period from July 1, 1995
through June 30, 1996. No County match is required.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
On September 13, 1994, the Board of Supervisors approved Standard
Agreement #29-441-14 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 #29-441-15 will continue these services
through June 30, 1996, for a caseload of 35 judicially committed
patients.
Ten signed copies of the agreement and three 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:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
i
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
7
OF SUPERVISORS
OF
(ABSENT ) 1 HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: Z ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
O
Contact: Lorna Bastian (313-6411) F SUPERVISORS ON THE DATE SHOWN.
CC: Health Services (Contracts) ATTESTED JIA
State Dept of Mental Health Phil datchelor, Clerk of the Board of
Super►*=aad Q=ty AdW WaW
M382/7-83 BY DEPUTY
STATE OF CALIFORNIA
DRUG-FREE WORKPLACE CERTIFICATION
STD.21(NEW
9m441 - 15
COMPANY/ORGANIZATION NAME
The contractor or grant recipient named above hereby certifies compliance with Government Code
Section 8355 in matters relating to providing a drug-free workplace. The above named contractor or
grant recipient will:
1. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation,
possession,or use of a controlled substance is prohibited and specifying actions to be taken against
employees for violations, as required by Government Code Section 8355(a).
2. Establish a Drug-Free Awareness Program as required by Government Code Section 8355(b), to
inform employees about all of the following:
(a) The dangers of drug abuse in the workplace,
(b) The person's or organization's policy of maintaining a drug-free workplace,
(c) Any available counseling, rehabilitation and employee assistance programs, and
(d) Penalties that may be imposed upon employees for drug abuse violations.
3. Provide as required by Government Code Section 8355(c), that every employee who works on the
proposed contract or grant:
(a) Will receive a copy of the company's drug-free policy statement, and
(b) Will agree to abide by the terms of the company's statement as a condition of employment on
the contract or grant.
CERTIFICATION
I, the official named below,hereby swear that I am duly authorized legally to bind the contractor or
grant recipient 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
Contra Costa
CONTRACTOR or GW RECIPIENT SI R�
�ITLE "
Chair, Board of Supervisors
FEDERAL I.D.NUMBER
91 60653
STATE OF CALIFORNIA 1/0= p�
+. APPROVED BY THE
S ;►N[J: h1 p AGREEMENT- ATTORNEY GENERAL CONTRADTNUMBER AM.NO.
SM.2(REV.S•91) '' 95-75005
TAXPAYERS FEDERAL EMPLOYER IDENTIFICATION NUMSEP
THIS AGREEMENT,made and entered into this 14th day of June l9 9 5, 95-6000509W
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 STATE AGENCY
Deputy Director Mental Health hereafter called the State,and
CONTRACTOR'S NAME
Contra Costa County _ 9 ,* 3 Z 1 15- ,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
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.
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 CONTRACTOR
AGENCY CONTRACTOR(if ottw than an individual state whether a commtion,partnershp,etc.)
Department of Mental Health Cont a Costa Co. -
BY(AUTHORIZE7��1�41
BY(AUTURE)
. 1 >)(=
=:je�
PRINTED NAME OF PERSON SIGNING PRINTtO NAME D TITLE OF PERSON SIGVNG
LINDA A. POWELL DeputV Director Chair, Board of Supervisors
TITLE ADDRESS 651 Pine Street
Division of Administration Martinez. CA 94553
AMOUNT ENCUMBERED BY THIS PROGRAM/CATEGORY(CODE AND TITLE) FUND TITLE Department of General Services
DOCUMENT 20 — Long Term Care Se General Use Only
$ 745,841.00 (OPTIONAL USE)
PRIOR AMOUNT ENCUMBERED FOR Conditional Release Program Exempt from compliance with
THIS CONTRACT
$ ITEM CHAPTER STATUTE I FISCAL YEAR the Public Contract Code,
TOTAL AMOUNT ENCUMBERED TO 4440-016-001 1 BA 19951. 95/96 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 purpose the expenditure stated above. of the Welfare and
S OF ACCOUNTING OFFICER DATE Institutions Code.
OCT 1 0 1995
El CONTRACTOR F-1 STATE AGENCY DEPT.OF GEN.SER. CONTROLLER
STATE OF CALIFORNIA
STANDARD AGREEMENT �t4.
STD. 2 ,REV. 5-91) JJEVERSE)
1. The Contractor 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 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 agreementand 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.
=1. Without the written consent of the State,this agreement is not assignable b}'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 si;ned by
the parties hereto,and no rural 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 #: 95-75005
Contractor: Contra Costa county
Health Services Department
EXHIBIT 11A11
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 (MDQ) 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 1, DEFINITIONS:
a. "Patient" 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. $uudicial Commitments's include persons found Not Guilty
by Reason of Insanity pursuant to Penal Code (PC)
Section 1026 or WIC Section 702.3, Incompetent to Stand
Trial pursuant to PC 1370 and Mentally Disordered Sex
Offender pursuant to former WIC 6316.
C. '$Mentally Disordered Offenders" 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 Servicess 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's 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 #: 95-75005
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 theState 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. $'Negotiated Rate" is the rate negotiated between the
State and the Contractor as payment for services
delivered on a unit of service basis listed in EXHIBIT
Negotiated Rate Amount (NR) is the total derived by
multiplying the NR by the units of service for all rate
services. Each NR is determined by dividing the gross
cost, less projected revenues, by the units to be
provided.
The rate is fixed for each service type and is not
subject to subsequent adjustment to actual costs. If a
Contractor incurs unforeseen costs during the course of
the contract, DMH may consider a rate adjustment. A
.written request for approval by the Manager, CONREP
Operations is required.
The State will pay the NR per unit even if a Contractor
collects more revenues than projected.
Contract #: 95-75005
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page 3 of 9
Program Narrative
j . "Negotiated Rate Services') means basic, core, or
supplemental services agreed upon by the State and the
Contractor as displayed in EXHIBIT "B-111, that are
funded by NR.
k. IlRevenue" means service related income from government
(i.e. , Medicare, Champus) , as well as nongovernmental
patient related funds (i.e. , patient fees, patient
insurance) .
1. "Dedicated Capacity" is the staffing and support
services necessary to provide the services specified in
the contract. Contractors are to maintain this NNA
funded level of staff and support, regardless of any
fluctuation in actual caseload.
M. "Negotiated Cost,$ 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. IlSpecial Fund Accountle 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 11B-1" to
exclusively provide at least the service capacity
detailed in form MH-7001 in EXHIBIT 11B-111.
Contract #: 95-75005
Contractor: Contra Costa County
Realtb 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 Manageri CONREP Operations 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 "B-
1", as
1B-
as negotiated by the State and the Contractor.
Contract #: 95-75005
Contractor: Contra Costa County
Health Services Department
Exhibit A
Page S of 9
Program Narrative
Claims for reimbursement for UR 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. MINIMUMCORESERVICE 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 #: 95-75005
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 Manager, CONREP Operations 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 Manager, CONREP Operations.
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 #: 95-75005
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 94 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 OOALIFICATIONS:
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 #: 95-75005
Contractor: 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 Manager, CONREP Operations.
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 #: 95-75005
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 #: 95-75005
Contractor: Contra Costa County
Health Services Department
EXHIBIT "A-111
COMPLIANCE/AUDIT REQUIREMENTS
i. 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 #: 95-75005
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
Branch, within 10 days of the meeting, appealing the intended
action of the State. If the Chief, Forensic Services Branch,
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 Branch, deems it appropriate to resume NNA payments.
Contract 95-75005
Contractor: Contra Costa County
Health Services Department
EXHIBIT "B11
Specific Provisions
1. The term of this contract shall be from 07/01/95 through
06/30/96.
2. The State has designated Grant Ute, LCSW, to be its Manager,
CONREP Operations. Except as otherwise provided herein all
communication concerning this contract shall be with the
Manager, CONREP Operations.
3. The total amount payable by the State to the Contractor
under this contract shall not exceed $745,841. Of this
amount, total payments for Negotiated Net Amount (NNA)
Services shall not exceed $598,496. The total payments for
Negotiated Rate (.NR) Services - Conditional Release Program
shall not exceed $147,345. The Contractor may, with the
written approval of the Manager, CONREP Operations, shift
funds between the contract categories of CONREP NNA and
CONREP NR.
4. In consideration of .the services, as specified in EXHIBIT
"All 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 "B-111 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 $548,621.
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 "B-111.
Contract #: 95-75005
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 Manager, CONREP Operations at: '
Grant Ute, LCSW
Manager, CONREP Operations
Department of Mental Health
Forensic Services
World Trade Center, Suite 231
San Francisco, CA 94111
5. This agreement shall become effective on 07/01/95, 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. 95-75005 _X_Contract Budget Submission: 06/22/95
Fiscal Year Ending: June 30, 1996 _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 7 8 4 4 12 35
B.Mode and Service Function
Forensic Weekly Weekly Weekly 3 Times Once
Individual 4/Month 4/Month 4/Month /Month Monthly
Contact
15-80 336 384 192 144 144 1,200
Group Weekly Weekly Weekly Twice Once
Contact 4/Month 4/Month 4/Month Monthly Monthly
15-50 336 384 192 96 144 1,152
Home Once Once Once Every Once
Visits Monthly Monthly Monthly 6 Weeks Quarterly
50-40 84 1 96 48 36 48 312
Comm.Care Fac.Aug (Annual Projection 6 Beds X 365 Days X 90%)
10-50 1,971
Collateral 6 Per Year 6 Per Year 6 Per Year 6 Per Year 6 Per Year
15- 10 42 48 24 24 72 210
Lab Once Twice Twice Once Once
Screenings Weekly , Monthly Monthly Monthly Quarterly
15-21 364 192 96 48 48 748
Assessments 1 Per Year 1 Per Year 1 Per Year 1 Per Year 1 Per Year
15-30 7 8 4 4 12 35
Total Units 1,169 1,112 556 352 468 5,628
Total Amount
Item 2. Total Negotiated Net Amount Services(NNA): $598,496
Item 3. Total Negotiated Rate Services Amount(NR): 147,345
Item 4. Total Contract Amount: $745,841
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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. 95- 75005 _�Contract Budget Submission: 06/22/95
Fiscal Year Ending: June 30, 1996 _Year End Cost Report Amendment:
UNE ITEMS Subtotal- Total
1.Personnel Costs $442,131
2.Operating Expenses $140,543
a.Office Services&Supplies $6,000
b.Communications 10,000
c.Travel(Including Training) 11,000
d.Facility 60,152
e.Medical procedures,Supplies, Pharmacy 1,000
I.Consulting Fees 1,000
g. Emergency Life Support 1,000
h. Life Support-Residential Care(05/90 500 units @$24.60) 12,300
i. Life Support-Independent Living(05/85 700 units @$22.04) 15,428
J. Other: Money Management(via MOU with HSD Conservatorship Unit) 3,000
k. Other:50/50(2500 units @$6.00) 15,000
i. Other:Assessment Quality Control-FHC,Inc.) 1,843
m.Other: STEP Program(Office supplies$720;Recreation$1,000;Mileage&Maint.$600; 2,820
Insurance$500)
3. Equipment Over$300 Per Unit $0
4.Administrative Services&Overhead (15%of Personnel Cost-less On-Call) $64,520
5.Total Cost of the CONREP Unit $647,194
6. Equipment Offset 0
7.Subtotal $647,194
8 Revenues (Sum of items a through g) $1.0..,227
a.Patient Fees $0
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 5,227
g.Other(Specify) 0
9.Net Cost 1 $636,967
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CONTRACT NO. : 95-75005
CONTRACTOR : Contra Costa Co.
Hlth. Services
EXHIBIT "C"
General Provisions
1 . Contractor shall submit any Code, Section 12900 et. seq. ) and the
subcontracts . to the State designated applicable regulations promulgated
Project Manager for approval . Upon thereunder (California Administrative
termination of any subcontract, the State Code, Title 2, Section 7285 et. seq.) . The
shall be notified immediately. applicable regulations of the Fair
Employment and Housing Commission
2. By signing this contract, Contractor implementing Government Code Section
swears under penalty of perjury that no 12990, set forth in Chapter 5 of Division
more than one final unappealable finding 4 of Title 2 of the California
of contempt of court by a Federal court Administrative Code are incorporated into
has been issued against this Contractor this contract by reference and made a part
within the immediately preceding two-year hereof as if set forth in full..
period because of the Contractor's failure Contractor and its subcontractors shall
to comply with an order of a Federal court give written notice of their obligations
which orders the Contractor to comply with under this clause to labor organizations
an order of the National Labor Relations with which they have a collective
Board. (Public Contract Code Section bargaining or other agreement.
10296)
Contractor shall include the
3. This contract may be canceled at any nondiscrimination and compliance
time by either party, by giving 30 days provisions of this clause in all
written notice. to the other party,. and may subcontracts to perform work under the
be amended upon mutual consent. contract. (SAM 1204.5)
4. Contractor understands that no Federal 7. The State reserves the right to use and
or State income tax will be withheld from reproduce all reports and data produced
the payments under this contract. and delivered pursuant to this agreement,
However, the State is required to report and reserves the right to authorize others
all payments to the Internal Revenue to use or reproduce such materials.
Service for tax purposes. No distinction
of fee, travel or per diem will be made. 8. Should a dispute arise under this
No wage and tax statement (W-2) will be contract, Contractor may, in addition to
issued for the services performed under any other remedies which may be available,
this agreement. provide written notice of the particulars
of such dispute to the -Deputy Director,
5. Contractor is advised and understands Division of Administration, Department of
that its performance under this contract Mental Health, 1600 Ninth Street,
will be evaluated in accordance with the Sacramento, CA. 95814. Such written
provisions of Public Contract Code Section notice must contain the Contract Number.
10367. Within ten days of receipt of such notice,
the Deputy Director, Division of
6. During the performance of this Administration shall advise Contractor of
contract, Contractor and its his findings and a recommended means of
subcontractors shall not unlawfully resolving the dispute. (Public Contract
discriminate against any employee or Code, Section 10381)
applicant for employment because of race,
religion, color natural origin, ancestry, 9. Contractor is hereby notified that
physical handicap, medical condition, Public Contract Code Section 10381
marital status, age (over 40) , or sex. provides that Contractors have certain
Contractors and subcontractors shall specific rights , duties, and obligations
comply with the provisions of the Fair when entering into consultant services
Employment and Housing Act (Government contracts with the state.
�• • CONTRACT NO. : 95-75005
CONTRACTOR : Contra Costa Co.
Hlth. Services
EXHIBIT "C"
General Provisions
identifying information concerning persons
10. Travel and per diem if, authorized receiving services pursuant to this
under this agreement shall be paid in contract, except for statistical
accordance with the State Administrative information not identifying any client.
Manual Section 1243 and the Department of Client is defined as "those persons
Personnel Administration Rules and receiving services pursuant to a
Regulations and as amended from time to Department of Mental Health funded
time. No travel outside the State of program" .
California shall be reimbursed unless
expressly authorized herein or unless Contractor shall not use such identifying
prior written authorization is obtained information for any purpose other than
from the State. (SAM 1242) carrying out the Contractor' s obligations
under this contract.
11 . Contractor agrees to maintain books,
records, documents, and other evidence 15. Contractor shall promptly transmit to
necessary to support contractor' s claims the State all requests for disclosure of
for reimbursement under this contract. such identifying information not emanating
(SAM 1272) from the client.
12. Contractor agrees that the State 16. Contractor shall not disclose, except
reserves title to any property purchased as otherwise specifically permitted by
or financed from the proceeds of this this contract or authorized by the client,
contract if such property is not fully any such identifying information to anyone
consumed in the performance of this other than the State without prior written
contract. This provision shall be authorization from the State.
operational even though such property may
have been purchased in whole or in part 17. For purposes of this paragraph,
by Federal funds and absent a Federal identity shall include but not be limited
requirement for transfer of title. (SAM to name, identifying number, symbol , or
1269 & 8602) other identifying particular assigned to
the individual , such as finger or voice
13. Contractor agrees to place in each of print; or a photograph.
its subcontracts, which are in excess of
$10,000 and utilize State funds, a 18. In accordance with the provisions of
provision that: The contracting parties Section 1618 of the Penal Code, "The
shall be subject to the examination and administrators and the supervision and
audit of the Auditor General for a period treatment staff of the conditional release
of three years after final payment under program shall not be held criminally or
contract (GOVERNMENT CODE SECTION 10532) " . civilly liable for any criminal acts
The Contractor shall also be subject to committed by the persons on parole or
the examination judicial commitment status who receive
and audit of the . Auditor General for a supervision or treatment. This waiver of
period of three years after final payment liability shall apply to employees of the
under contract (GOVERNMENT CODE SECTION State Department of Mental Health and the
10532) " . agencies or persons under contract to this
department to provide supervision or
14. Contractor shall protect from treatment to mentally ill parolees or
unauthorized disclosure, names and other persons under judicial commitment."