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HomeMy WebLinkAboutMINUTES - 02231993 - 2.3 �. p, 3 'Cr BOARD OF SUPERVISORS ---- FROM: Mark Finucane, Health Services Director '1F ';. Contra Costa DATE: February 12, 1993 ^ uK W� County SUBJECT: State Hospital Alternative RFP SPECIFIC REQUEST(S)OR RECOMMENDATION(S) &BACKGROUND AND JUSTIFICATION RECOMMENDATION: • Approve the Request for Proposal (RFP) for alternative treatment services for Contra Costa County residents in State hospitals. • Authorize distribution by the Health Services Director to all Contra Costa County hospitals, Skilled Nursing Facilities, Mental Health Division Contractors, and other interested providers of services to this population. • Direct the Health Services Director to return to the Board of Supervisors with recommendations by June 30, 1993. FISCAL IMPACT: The potential savings associated with the proposal is significant. The County may save as much as $2 million from its fiscal 1993-94 forecasted expenditures through this effort. BACKGROUND: This RFP seeks proposals from Contra Costa County or regional hospitals, Skilled Nursing Facilities and/or other qualified providers of services to 67 clients now residing at Napa State Hospital. The RFP establishes a review process to recommend selection of a provider to the Board of Supervisors. The RFP and selection process is similar to procedures established by the Board in other RFPs. Selection will include consideration of specific programs through which the potential provider will care for this population. Specific programs and capabilities, in which the provider is currently engaged or proposes to undertake if granted a contract, will be thoroughly examined. For many years, Contra Costa County has utilized beds at State hospitals for mentally ill residents who could not be placed in local less costly facilities. The cost of providing these services has steadily increased and is expected to be approximately $7.9 million in fiscal 1992-93. This is a growing burden on the County's dwindling budget. In September, 1992, the Board of Supervisors directed the Health Services Department, Mental Health Division, to explore alternatives to State hospital utilization in order to provide a comparable level and quality of care at a cost less than State hospitals. The Contra Costa County Contractors Alliance expressed a desire to offer needed services to this population. However, on detailed examination of the clients by the Alliance, it was felt that the clients were too severely ill to be cared for via existing programs. CONTINUED ON ATTACHMENT: YES SIGNATURE RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDAT ON OF BOARD COMMITTEE APPROVE _OTHER SIGNATURE (S): ACTION OF BOARD ON --? APPROVED AS RECOMMENDED -<, OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. Contact Person: Lorna Bastian CC: County Administrator ATTESTED �iLG Health Services Director PHIL BATCHELOR, CLER F THE BOARD OF Mental Health Director SUPERVISORS AND COUNTY ADMINISTRATOR BY ����DEPUTY 2 Following this sequence of events, the Board of Supervisors directed the Health Services Department, Mental Health Division, to prepare a Request For Proposal to formally seek applicants willing and able to render care to the subject population via existing or newly created programs or services. This directive has been fulfilled and, at this time, the recommendation for an RFP process is to formally seek contractors to submit proposals to render care to the client population. It will be necessary for the County to maintain a service capability in State hospitals for Penal Code patients as well as patients that are too severely ill for alternative treatments. The Department has developed the following forecast of estimated costs: Service Per Diem Cost Annual Est. Cost Subacute $ 160.98 $ 2,174,065 Special Treatment $ 220.18 1,205,464 SNF $ 249.55 1,366,310 Total $ 4,745,839 CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT MENTAL HEALTH DIVISION REQUEST FOR PROPOSALS SUBACUTE TREATMENT/SNF ALTERNATIVES TO STATE HOSPITALIZATION SERVICES t' t TABLE OF CONTENTS Overview I. Introduction and Purpose of Program II. Program Description A. Required Program Components B. Program Method and Staffing C. Target Population D. Eligibility/Gatekeeping E. Family/Significant Others Involvement in Patients Social Network F. Cultural Competency G. Program Reporting Requirements, Contract Monitoring and Program Evaluation III. Budget Preparation IV. General Guidelines and Requirements for Proposal Preparation A. Evaluation of Proposals B. Rejection of Proposals C. Cost of Proposals D. Truth and Accuracy of Representations E. Contract Award F. Disclosure of Contents of Proposals G. Contact with County Employees H. Determination of Capacity/Responsibility I. Taxes J. Compliance with Applicable Law K. Staff, Services and Supplies L. Equipment and Other Personal Property V. Instructions for Submitting Proposals VI. Proposal Format and Content VII. Selection Process and Evaluation Criteria Attachments Exhibit A - Contra Costa County Mental Health Division overview and Philosophy Exhibit B - State Hospital Alternative Matrix Exhibit C - Performance Bond - Health Services Exhibit D - Standard Contract (Purchase of Services) Exhibit E - Bidders Conference Inquiries r r r CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT MENTAL HEALTH DIVISION SUBACUTE TREATMENT/SNF ALTERNATIVES TO STATE HOSPITALIZATION SERVICES The attached Request for Proposal (RFP) invites bids for comprehensive adult treatment programs to be located in the Greater Bay Area in Northern California. The Bronzan-McCorquodale Act, legislation enacted in 1991, transferred State Hospital funding and responsibility from the State Department of Mental Health to individual counties. Transfer of State Hospital funds created a unique opportunity for counties to develop small to medium size programs to serve the specialized needs of the mental health population. As an outgrowth of this initiative, the Mental Health Division of the Contra Costa County Health Services Department has been involved in an active planning effort for the treatment and needs of the seriously and persistently mentally ill adult residents of the County. (See Exhibit A. ) Contra Costa County sees the development of a community-based treatment program as an important component of a service continuum, which includes specialized subacute treatment in and/or near the County. The County is seeking providers willing to participate in developing this enhanced continuum of care and specifically interested in developing treatment settings capable of meeting the therapeutic/rehabilitation needs of this seriously disabled population. The development of appropriate alternatives to state hospitalization will assist the County in identifying resources for its locally based continuum of care. Appropriate treatment planning, enhanced programming with ensured quality care, improved linkage with local providers, and easier access for families and significant others are a few of the positive aspects that are anticipated with the development of subacute treatment alternatives in the Bay Area. Treatment plans which incorporate interventions that are linked to community-based resources/services will provide for a smoother transition to lower levels of care in the community while retaining an overall goal of community placement (and increased community tenure) where this is at all possible. The involvement of family and the recognition of the client's social supports are important aspects which may enhance the client's overall capacity for functioning in the community. Family members and others can participate more readily in the treatment 1 I � Y process where realistic role expectations and the struggles for independence can be addressed within the context of the client's social system. These factors will result in. better treatment outcomes for Contra Costa clients and their families. Contra Costa County encourages direct service applications from providers with a proven history of success and experience in the provision of comparable services to: a) SPMI adults in need of subacute treatment, and b) skilled nursing levels of care. Applications will be considered which conform to the requirements stipulated in the enclosed RFP. Priority will be given to proposals that: (1) Best meet the basic requirements of the RFP at the lowest cost benefit per client; (2) Serve the greatest number of eligible adults; (3) Provide programs which create a shared sense of community among clients; (4) Provide an organizational structure which facilitates effective communication between program components; (5) Have the ability to provide well planned, efficient and effective resources; (6) Have an identified mechanism(s) for establishing collaborative linkages with programs that provide lower levels of care within the community; and (7) Can provide services that are culturally and linguis- tically competent. Providers are offered an option of bidding on the three client cohorts as described in the RFP (Pages 4 to 7) , or any one of the three distinct groups. Proposal responses must, at a minimum, address the needs of one distinct client group. For further information regarding the enclosed RFP, please contact Essie Henderson, Residential Services Coordinator, at (510) 313-6406 or Remia Adams at (510) 313-6401. 2 1' REQUEST FOR PROPOSAL I. INTRODUCTION AND PURPOSE OF PROGRAM: Contra Costa County has a number of clients that are unable to be clinically or behaviorally managed in an unlocked setting due to violence, destructive behavior, multiple placement failures or elopement potential (as evidenced by history) . The only alternative when this occurs has been an extended stay at one of the State Hospitals. From a budget perspective, extended stays at state hospitals are costly. They also remove clients from the community and known supports, often requiring difficult and prolonged transitions prior to discharge and community reintegra- tion. The state hospital as a treatment resource consumes a disproportionate share of mental health dollars, resulting in an imbalance between hospital-based care and community-based lower levels of care. Contra Costa Mental Health has identified as one of its highest priorities, the need for a well-managed, regional skilled nursing and subacute program for the seriously and persistently mentally ill (SPMI) adults who would have in the past been considered for State hospitalization. There is a need for continuous programming at these varied levels of care for a total of 67 clients. Providers are offered an option of bidding on the three client cohorts, as described in the RFP (Pages 4 to 7) , or any one of the three distinct groups. Proposal responses must, at a minimum, address the needs of one distinct client group. (See Exhibit B. ) 1 II. PROGRAM DESCRIPTION A. Required Program Components: This program will be designed as an alternative to State hospitalization. The program goal is to provide the SPMI adult population ages 18-65 with skilled nursing and subacute levels of 24 hour mental health care that will allow continuous, secure treatment in a structured milieu. Organizational and program objectives should include but not be limited to the following: (1) Organizational Objectives: (a) Development of a facility which at all times is in total compliance with licensing regulations for Institutions of Mental Diseases (IMD) , including but not limited to Title 22, Article 3, Sections 72301-72389 of the California Code of Regulations, which includes Physician Services, Nursing Services, Administration of Medications and Treatments, Patient Care, Restraints and Postural Supports, Dietetic Services, Pharmaceutical Service and Activity Program. (b) Basic services will also include Title 22, Article 4 , Sections 72401-72441, which includes reasonable access to required routine and emergency medical treatment, bilingual/bicultural programming and transportation to needed off-site services, Physical Therapy Service, Occupational Therapy Service, Speech Pathology and/or Audiology Service, Social Work Service, and Special Treatment Program Service Sections 72443-72471. (c) Employees of the facility must have all of the necessary licenses and/or permits required by the laws of the United States, the State of California, Contra Costa County and all other appropriate government agencies. (d) A description of how the proposed program will network/coordinate with Contra Costa County Mental Health System and other related resources and services currently available to meet the needs of the target population and families to be served. (2) Program Objectives: (a) To assist Contra Costa County in effectively and efficiently managing limited resources by providing 2 an alternative to utilization of state hospital days. (b) Stabilize/maintain clients at the subacute/SNF level of care. (c) To increase the client's motivation and skills toward maximum self-sufficiency. (d) To prevent or decrease the rate of decompensation, thus decreasing placements at higher, more costly levels of care. (e) To provide the intensive staffing required to supervise and treat behavioral and medical conditions. B. Program Method and Staffing: The mental health program must provide a comprehensive treatment system to include the following: (1) A 24 hour secured, locked capability. (2) Five day a week admission and evaluation. (3) Comprehensive assessment; history and physical completed within 24 hours of admission. (4) Individual, group, and family therapy. (5) Adjunctive therapies/group programming such as occupational therapy, drama, art, movement, vocational, etc. , which are designed to address the identified problem behaviors including, but not limited to, remotivation, current events, social interaction, community orientation, problem solving and skill development such as self-care. (6)- Specific approaches to improve problem behaviors including, but not limited to, orientation, bowel and bladder management and self-care, and modify annoying or anti-social behavior. (7) Formal one-to-one supervision as needed. (8) Suicide precautions/other observation as needed to ensure safety. (9) Provision of redirection to client for specific behaviors. 3 (10) Administration of medication plan for up-to-date medications (consultation, evaluation, treatment and monitoring by psychiatrist with Clozaril treatment capabilities) . Continued Medi-Cal TAR process as needed. Administration of medication to resistant clients, including IM medication. (11) Administration of PRN medications. (12) Restraint and seclusion as ordered. Restraints as needed to ensure safety. (13) Geriatric chair for behavior control when less restrictive interventions are ineffective. Staffing for all parts of the program must meet appropriate requirements of California Code of Regulations Title 9 and Title 22 and/or Short-Doyle/Medi-Cal. Staffing should provide bilingual capability and a level of cultural competence appropriate to the target population being served. Additional staffing requirements may be requested to meet specific programmatic needs, i. e. , a licensed RN for evening coverage. C. Target Population: The target population of adult clients will have a Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised (DSM III-R) principal diagnosis, without or with a substance abuse diagnosis (including schizophrenia, major affective disorder, severe borderline disorder, organic brain syndrome with behavioral and/or psychotic symptoms) . The population consists of three distinct categories of adults, who would ordinarily have been considered appropriate for State hospitalization. The categories are Skilled Nursing, Specialized Treatment and Rehabilitation, and Subacute. Category TApproximate Number of Clients Skilled Nursing 15, Specialized Treatment and 15, Rehabilitation Subacut 1 37 These groups are described below along with their general characteristics: 4 (1) Skilled Nursing Level - Total Nursing Care, bed bound with No Rehabilitation Potential, e.g. brain damaged, advanced Huntington's Chorea, deep vegetative states. This level may include but not be limited to the following characteristics: - Nasogastric (Ng) Nutritional Support - Bladder-bowel incontinence - Total Nursing Care/bed bound - Non-progressive neurological conditions, e.g. disabilities (motor, cognitive, speech, behavioral) ; may be from mild to moderately severe. - Chronic medical diagnoses superimposed over a long history of mental illness, e.g. cardio- vascular disease; dementia, Alzheimer's, seizures/diabetes (controlled) . Huntington's Chorea clients generally have Chronic Obstructive Pulmonary Disease (COPD) , with periodic oxygen use, prone to pneumonia, aspiration. Skilled Nursing Treatment Goals: - To provide Internal Medicine and medical nursing services. - To prevent further progression of the illness. - To provide clients with the optimum quality of life. - To maximize client's potential within his/her physical and mental limitations. Skilled Nursing Program Needs: - Internal Medicine Physician. - 24 hour Nursing Staff with a varied skill level matrix (RN, LVN, CNA) and skills and work values compatible with the community standards of practice. - Laboratory, Portable X-Ray, Dental, Pharmacy. - Occupational/physical therapy services. - Exercise activities. - Recreational therapy. - Individual/group therapy. - Social interaction groups. (2) Specialized Treatment and Rehabilitation clients are usually unable to be maintained in an unlocked setting due to violence, self-destructive behavior, destruction of property, and a history of failed placements. They may also be characterized by the following conditions: 5 - Chronic and severe mental disorders accompanied by poor adaptive functioning, e.g. , social interaction skills, activities of daily living, symptom management. - Non-progressive neurological conditions, e.g. , disabilities (motor, cognitive, speech, behavioral) ; may range from mild to moderately severe. - Serious medical problems (e.g. , diabetes, hypertension, pica, polydypsia, caffeine abuse, hypothyroidism) . - Dual diagnosis of mild to moderate mental retardation and mental disorders. These clients may be susceptible to abuse from higher functioning clients. - Periodic need for seclusion and restraint. Specialized Treatment Goals: - To provide an individualized treatment program within a structured milieu designed to meet both the physical, medical, and psychological needs of the client. Assist the client in keeping psychiatric symptomatology under control. - To encourage the development of new skills or to regain lost skills and abilities. - To reduce disabling behaviors which are barriers to placement in a less restrictive environment. Specialized Treatment Program Needs: - Behavior management and reduced opportunity for elopement. - Medication management. - Therapeutic community. - Activities of daily living. - Social and leisure skill training. - Prevocational preparation training. (3) The Subacute category consists of chronic, severe mental disorders coupled with maladaptive behaviors such as: 6 1 - Poor social skills (1-ow to moderate functioning when in remission) ; - Inability to care for self (poor activities of daily living, intermittent bowel/bladder incontinence) ; - Violence to self/others; - Sexually aggressive/inappropriate behavior; - AWOL risks; - Serious medical problems (e.g. , diabetes, hypertension, pica, polydypsia, caffeine abuse, hypothyroidism) ; and - Periodic need for seclusion and restraint. Subacute Treatment Goals: - To maintain the client at the highest level of functioning. - To medically supervise the medical and psychiatric needs of the clients. - To reduce the need for a higher level of care. - To reduce disabling behaviors which are barriers to placement in the least restrictive environ- ment. - To teach new or restore adaptive life skills. Subacute Program needs: - Activities of Daily Living. - Social Interaction Training. - Behavior Management. - Substance Abuse Groups and Education. - Medication Education and Management. - occupational/Recreational/Vocational Therapies. - Individual/Group Therapy. - Intensive Day Treatment Program. D. Eligibility/Gatekeeping: All referrals to the program will come from the Contra Costa County Mental Health System. Clients may be admitted from an acute care setting or a lower level of care if authorized by the Contra Costa County Mental Health Division. All clients should be stabilized and have LPS conservatorship status. All referrals will receive prior authorization for admission by Contra Costa County Mental Health IMD/State Hospital Liaison or another designated staff member. E. Family/Significant Others Involvement in Clients Social Network: Program will encourage the regular participation and involvement of family members whenever possible. Where clients have developed 7 social supports ouside of the traditional family, the program will make every effort to identify relevant individuals and involve them in plans for the client's transition to the community. F. Cultural Competency: Culture, language and ethnicity are acknowledged as predominant factors in shaping behaviors, values and decision making. Contra Costa County requires that the provider of the service contract to be awarded through this RFP provide evidence of cultural and language competency in their proposals. A culturally competent program of care acknowledges and incorporates at all levels of the organization the importance of culture and language, the assessment of cross cultural relations, vigilance towards the dynamics that are a result. of cross cultural differences, the expansion of cultural knowledge, and the adaptation of services to meet culturally and linguistically unique needs. G. Program Reporting Requirements, Contract Monitoring and Program Evaluation (1) Program Reporting Requirements: The selected contractor will be required to participate in all Contra Costa County mental health system reporting requirements, these include but are not limited to policy and procedures in the following areas: (a) Peer Review; (b) Medication Monitoring; (c) Quality Assurance, including all Incident/ Accident/and Untoward Event Reporting; (d) Utilization Review; (e) All documents deemed relevant and appropriate for billing, program evaluation or research and management information, including participation in the Contra Costa County PSP system; and (f) Client Data System reporting. (2) Performance Bond Requirement: The selected contractor will be required to furnish a performance bond in the amount of one hundred percent (100%) of the contract amount. This bond is to be secured from a surety company authorized to do business in the State of California. The bond shall be issued on the form set forth in Exhibit C. 8 (3) Contract Monitoring: The selected contractor will report directly to the Contra Costa County Mental Health Director who will monitor or designate a contract monitor for the selected contract. The Contra Costa County Mental Health System will monitor programs according to the Department's contract monitoring policies and procedures. The County shall use applicable Federal, State and County guidelines to ensure compliance with all legal and professional requirements. The County shall have access to all of the Contractor's records relating to clinical care. This shall include, but not limited to, the Quality Assurance (QA) system, minutes of QA Committee meetings, clinical records, medication monitoring, peer review, utilization review, client complaints, incident reports and all management and evaluation information. (4) Program Evaluation: The selected contractor shall have, approved by Contra Costa County Mental Health and in place at the time of the opening of the program, specific measurable goals and objectives and a plan for their annual evaluation in the following core areas: (a) Organizational objectives to include at least the following: - Communication between management, professional departments and treatment teams; - Supervision of treatment and non-treatment staff; - System/program integration between Contractor and appropriate departments, agencies and personnel in Contra Costa County, including community support providers; - Frequency of participation by clients in all aspects of treatment; - A method for analyzing patterns of discharge, community tenure, and length of stay; and - Fiscal practices (budgeting and billing) . (b) Treatment objectives to include at least the following: 9 - Degree of attainment of clinical/behavioral objectives for all program participants and a method for reporting; - Involvement of Case Managers in treatment and discharge planning and methods of reporting; - Expected length of stay and a cost of treatment for each participant and a method of reporting; and - Staff, consumer, family and placement resource satisfaction and a method for reporting. (c) Other performance outcome studies/reviews as needed. 10 ti• r III. BUDGET PREPARATION Each proposal must include a budget which details program expendi- tures. The submitted budget should reflect planned capacity of the program. Funding for the Adult Residential Treatment program will be provided by County realignment funding, which will be made available by the diversion of State Hospital clients. The County will assume responsibility for billing and revenue collection. Contra Costa County has developed the following per diem rate requirements for the three target populations described in this Request for Proposal. Annual Service Per Diem Cost Estimated Cost Subacute $160. 98 $2, 174, 065 Specialized Treatment $220. 18 $1, 205,464 SNF $249 . 55 $1, 366, 310 Total $4,745,839 • If the program is designed to exist within a current agency structure, the expenditure budget must show the program's relation to the total organization. Distribution of administrative costs between existing programs and the proposed service must also be detailed. • A review of the completeness and internal consistency of the budget will comprise a critical component of the proposal review process. The proposal budget should include the following sections: 1. Personnel Budget 2 . Operating Expenses 3 . -- Administrative Costs 4 . Summary Each section should be completed in sufficient detail to present a complete budgetary picture of the proposal. Personnel Budget • Salaries Personnel information is for Program personnel only and must be shown by classification title. Show the number of positions, the number of Full Time Equivalents (FTEs) and the total annual cost 11 r for each classification. FTE and annual cost information should be shown be program component and for the total program. Attach supporting workpapers which document the allocation basis for positions which are allocated to more than one program component. Data for existing agency programs should be summarized under "Other Agency Programs" . The amount shown under total agency will be the sum of existing expenditures and the proposed program. • Benefits Employee benefits do not need to be detailed by benefit type. Benefits as a percentage of salary should correspond to historical ratios of the organization preparing the bid. • Contracts and Professional Fees This section will contain personnel or professional expenses incurred outside of the normal employer/employee! relationship. As ' with salaried employees, show the number of positions. FTE's and costs are to be shown by program, existing agency services and totaled. Operating Expenses Operating expenses should be classified and subtotaled by the following categories: A. Services and Supplies Detail by type (e.g. , occupancy costs, dues, educational and program supplies, insurance, taxes, vehicle costs, etc. ) . B. Equipment Detail by type (e.g. , purchased equipment, leased equip- ment and maintenance costs) . C. Other Detail by type any costs not otherwise included. Provide a separate attachment detailing the allocation basis and methodology for any operating expense allocated to more than one program component. 12 ' r Administrative Costs Agency administrative costs should be detailed by the same categories as the proposed program. Show annual expenditures for agency administrative personnel and operating expenses. Please note any additional administrative staff which will be hired to oversee the proposed program. Indicate the methodology for allocating these administrative costs among the organization's programs. Show the allocated amounts in the appropriate program columns. The total of the administrative cost allocated to the proposed and existing programs should equal the annual expenditures for agency administrative personnel and operating expenses. 13 IV. GENERAL GUIDELINES AND REQUIREMENTS FOR PROPOSAL PREPARATION A. Evaluation of Proposals: Contra Costa County Mental Health Services (CCCMHS) reserves the sole right to evaluate the contents of proposals submitted and to select a successful Contractor, if any. To be accepted and eligible for evaluation, a proposal must be prepared in accordance with the proposal format and instructions provided in Section V (Instructions for Submitting Proposals) and VI (Proposal Format and Content) . B. Rejection of Proposals: CCCMHS may, in its sole discretion, reject ani► or all proposals submitted in response to this RFP. C. Cost of Proposals: CCCMHS shall not in any way be liable or responsible for any costs incurred in connection with the preparation or presentation of any proposal submitted in response to this RFP. D. Truth and Accuracy of Representations: False, incomplete, or unresponsive statements in connection with a proposal may be cause for its rejection. The evaluation and deter- mination of the fulfillment of the above requirement will be CCCMHS' sole judgment and its judgment shall be final. E. Contract Award: Acceptance or recommendation of a proposal does not constitute formation of a contract. A contract with the County of Contra Costa can be created only by formal approval by the Board of Supervisors and execution according to law. A sample contract used by the County is attached as Exhibit D. Respondents should review the sample to become familiar with all contract terms and/or conditions, including, but not limited to, those which may result in operational and/or administrative costs to be: borne by the Con- tractor (e.g. performance bond, insurance, etc. ) . Failure to do so will be at the sole risk of the Contractor. F. Disclosure of Contents of Proposals: All proposals in response to the RFP shall become the exclusive property of CCCMHS. At such time as the Director of Mental Health Services recommends a Contractor to the Board of Supervisors, and such recommendation with any recommended contract appears on the Board agenda, all proposals submitted shall become a matter of public record and shall be regarded as public records, with the exception of those elements in each proposal which are defined by 14 the Contractor as business' or trade secrets and plainly marked as "Trade Secret" , "Confidential", or "Proprietary" . CCCMHS shall not in any way be liable or responsible for the disclosure of any such records or any part thereof if disclosure is required or permitted under the California Public Records Act or otherwise by law. G. Contact with Employees of Contra Costa Counties: As of the issuance date of this RFP and continuing until the final date for submission of proposals, all County personnel are specifically directed not to hold meetings, conferences or technical discussions with any respondent which relate to the RFP. The BIDDERS CONFERENCE will be the sole meeting held to respond to inquiries, concerns, and questions in response to the RFP. H. Determination of Capacity/Responsibility: An inquiry to determine the operational and financial capacity and responsibility of a respondent may be conducted by the County. The failure of a respondent to promptly supply information in connection with such an inquiry, including, but not limited to, information regarding past performance, may be grounds for a deter- mination of non-responsibility with respect to such respondent and may eliminate that respondent's proposal from future consideration. I. Taxes: The County shall not be liable nor responsible for any taxes, including, but not limited to, sales and income taxes, which may be imposed in connection with the Contractor's performance of any re- sultant contract. J. Compliance with Applicable Law: Any contract which may be entered into by the County as a result of this RFP shall be performed in compliance to all applicable Federal, State, County and local laws, ordinances, regulations, rules and directives. R. Staff, Services and Supplies: The selected Contractor shall furnish all staff, supplies, materials, support equipment, vehicles, and other items required to perform the services identified in this RFP. L. Equipment, and Other Personal Property: (1) All equipment or other personal property which is to be acquired by purchase or lease for the performance of any resultant contract and which will be paid for by the County, shall be acquired only with the written consent of the County based upon vendor cost comparisons 15 1 , submitted to the County for review and approval. This provision does not apply to purchase of office supplies and other consumable items. Any new equipment purchased and installed by the Contractor, which will be amortized by the Contractor, shall become County property at the time a contract is terminated, at no additional cost to the County. (2) Contractor shall maintain, repair and provide regular preventive maintenance for any and all County owned or paid for equipment; used for the performance of the contracted services. If the Contractor is found by the County to have been at fault in the use, care and/or control of any such County equipment, all costs then incurred by the County, less normal depreciation, shall be a charge to the Contractor. (3) The Contractor shall not assign, transfer, sublease or relinquish possession of, nor create or suffer to exist any lien, mortgage, security interest or encumbrance upon County owned or paid for equipment or other personal property without the prior written consent of the County. 16 • 1 V 1 V. INSTRUCTIONS FOR SUBMITTING PROPOSALS A. Responses to RFP Responses to this RFP shall be in accordance with the instructions in this section and Section VI (Proposal Format and Content) both for content and form. The proposal shall be used to determine capability of rendering the services to be provided. The proposal must be specific and complete in every detail. The failure of a respondent to fully comply with the instructions in such Sections may eliminate the proposal from further evaluation, as determined at the sole discretion of the County. B. Acceptance of Terms and Conditions Respondents understand and agree that submission of a proposal constitutes acknowledgement, acceptance of, and a willingness to comply with, all terms and conditions contained in this RFP. C. Addenda to RFP The County, at its sole discretion, may interpret or change any provision of this RFP at any time prior to the proposal submission deadline. Any such change shall be in the form of written addendum to this RFP, and may become part of any resultant contract. Such addendum shall be made available to each person or organization which County records indicate has received this RFP. D. Mandatory Bidders Conference As a condition for submitting a proposal, all respondents submitting proposals must participate in a Bidders Conference. This conference will beheld from 9: 30 a.m. - 12 : 30 p.m. on FEBRUARY _, 1993 , at CONTRA COSTA COUNTY MENTAL HEALTH ADMINISTRATION 595 CENTER AVENUE, SUITE 200 CONFERENCE ROOM B MARTINEZ, CALIFORNIA 94553 Respondents are encouraged to submit questions about the RFP prior to the Bidders Conference. (See Exhibit E. ) These questions should be submitted in writing to: Remia Adams, LCSW Contra Costa County Mental Health Administration 595 Center Avenue, Suite 200 Martinez, California 94553 17 Contra Costa County Mental Health Services shall respond to all written questions during the Bidders Conference. The County is responsible only for what is expressly stated in this RFP and any authorized written addenda thereto. The County is not responsible for and shall not be bound by any representations otherwise made by any individual acting or purporting to act on its behalf. E. Submission of Proposals It is the sole responsibility of each respondent to assure that the proposal is received at the following address by 3 : 00 p.m. , , 1993: REMIA ADAMS,__.LCSW CONTRA COSTA COUNTY MENTAL HEALTH ADMINISTRATION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CALIFORNIA 94553 The respondent must deliver the original and ten (10) copies of the bid/proposal. The proposal shall be securely bound and enclosed in front and back covers. The proposal must be delivered in a sealed package, plainly marked in the upper left corner with the name and address of the respondent. The respondent shall bear all risks associated with the use of mail or other delivery services. Any proposal received after the submission deadline shall be returned, unopened, to the sender and shall not be evaluated. The proposal must be identified by the RFP Title, typewritten, double-spaced and not more than twenty (20) pagers in length. Each page shall be numbered. The budget and other attachments need not be numbered and shall not count as part of the twenty narrative pages. F. Firm Offer All proposals shall be firm and final offers and shall not be withdrawn for a period of at least one hundred: and eighty (180) days following the proposal submittal date. G. Conditions or Limitations Any proposal which contains any conditions or limitations set forth by the respondent may be deemed irregular and naay be rejected by the County. 18 V •l BIDDERS INSTRUCTIONS TIME SCHEDULE All bidders are hereby advised of the following schedule and will be expected to adhere to the specified performance requirements. Date (1) Bid package mailed to prospective bidders. (2) Mandatory Bidders Conference held. (3) Bid proposals received by 3: 00 p.m. on designated bidding date. (4) Technical review of proposals. (5) Program Review Committee proposal review. (6) Notification of successful applicant. (7) Notification of unsuccessful applicants. (8) Appeals period begins. (9) Appeals period ends. (10) Contract development. (11) Program Development. (12) Program Opening. SUBMISSION OF BIDS (1) Bids and modifications or corrections thereof received after the closing time specified will not be considered. (2) The bid must be typewritten. No erasures are permitted. Errors may be crossed out and corrections printed in ink or typewritten adjacent to the error. The correction must be initialed in ink by the person signing the bid. (3) A bid/proposal may be rejected if conditional or incomplete or if it contains any alterations of form or other irregularities of sufficient magnitude or quantity to warrant finding of being substantially non-compliant. 19 V (4) Contra Costa County Mental Health may accept or reject any or all bids and may waive any immaterial defect in a bid. Contra Costa Mental Health's waiver of an immaterial defect shall in no way modify the bid/proposal requirements or excuse the bidder from full compliance with the objective if awarded the contract. (5) All bidders shall submit a detailed budget. . The budget information will become a part of the contract document. Following bid opening, Contra Costa Mental Health reserves the right to negotiate with the successful bidders any redistribution of cost within the budget deemed necessary by Contra Costa Mental Health in order to better achieve program goals. An unwillingness to negotiate shall be considered grounds for rejection of the proposal. (6) The original and ten (10) copies of the bid./proposal shall be securely bound and enclosed in front and back covers. The proposal must be identified by the RFP Title, typewritten, double-spaced and not more than twenty (20) pages in length. Each page shall be numbered. The budget and other attach- ments need not be numbered and shall not count as part of the twenty narrative pages. REJECTION/DISOUALIFICATION The following shall cause the immediate rejection or disqualification of a bid/proposal: (1) Any bid/proposal not received at the time and place specified in the RFP. (2) Any bid/proposal not plainly marked with the name and address of the submitting organization(s) . (3) Substantial non-compliance with the RFP requirements. (4) Substantial non-responsiveness to programmatic requirements. CONTRACT AND AWARD PROCESS All proposals will be reviewed by the Technical Preview Committee to determine which proposals meet the format., technical and programmatic requirements stipulated in the RFP. All proposals meeting the aforementioned requirements shall then be submitted to the Program Review Committee designated by the Contra Costa County Mental Health Director and the! Health Services Director. 20 The Program Review Committee shall evaluate and score the proposals using the criteria specified in the RFP. In scoring the proposal, each individual component will be weighed in the context of its contribution to the end product. All proposals and all evaluation and scoring sheets shall be available for public inspection at the conclusion of the Program Review Committee scoring process and notification of the successful and unsuccessful applicants. THE PROPOSAL GIVEN THE HIGHEST SCORE BY THE PROGRAM REVIEW COMMITTEE WILL BE REFERRED TO THE CONTRA COSTA COUNTY MENTAL HEALTH DIRECTOR AND THE HEALTH SERVICES DIRECTOR, WHO HAVE FINAL AUTHORITY AND RESPONSIBILITY FOR RECOMMENDING THE SELECTED PROGRAM AND VENDOR TO THE CONTRA COSTA COUNTY BOARD OF SUPERVISORS. The successful applicant will be notified within seven days of the final selection by the Contra Costa County Mental Health Director. All other unsuccessful applicants will be notified within three to five days subsequent to the notification of the successful applicant. APPEALS PROCESS (1) Within fifteen (15) days after an unsuccessful respondent receives a certified, registered letter from the Mental Health Director informing the respondent that its proposal has not been selected, the unsuccessful respondent may appeal the decision to the Mental Health Director. Appeals must be limited to the following grounds: (a) The County failed to follow RFP procedures which affected the proposal's scoring; and/or (b) The RFP evaluation criteria were not appropriately applied to the proposal. (2) The Mental Health Director will respond to the appeal within fifteen (15) days. The decision of the Mental Health Director shall be final and not subject to further review. 21 VI. PROPOSAL FORMAT and CONTENT Proposals must be submitted using the following organization/ outline. A. A one page Cover Letter citing the nature and purpose of the proposal. B. A Program Abstract which should not exceed twenty (20) double- spaced, typewritten pages. The abstract should be succinct and well organized, and must contain all information necessary for reviewers to understand the project. Appendices may be attached for technical or specialized materials but may not be used merely to extend the abstract. The Program Abstract :should include the following: (1) A description of the respondent's experience in providing the program outlined in the RFP. (2) A description of the respondent's experience working in mental health systems that emphasize the importance of inter-program and system collaboration and shared responsibility for clients at all levels of care. (3) A description of respondent's experience working with seriously mentally ill adults with significant functional/physical health disabilities. (4) A description of the local target population to be served by the project and a description of the mental health and any other social welfare needs of the target population and their families. (5) A description of how the proposed program will network/ coordinate with Contra Costa County Mental Health System, justice system, social welfare, and other related resources/services currently available to meet the interorganizational needs of the target populations and their families. (6) A discussion on the inability of existing resources and services to respond to the service needs of the target population and their families and how -these deficiencies will be addressed/improved through the proposed program. (7) A comprehensive program description. (8) A management plan and timetable, including procedures and deadlines for the procurement of resources, hiring of staff and consultants, and initiation of program activities and services, for each component of the program with indirect cost broken out for each year. 22 als The mode of treatment, method of treatment, expected al, length of treatment and time frame in which treatment its will be developed for each service component. .ion the A description of any special equipment (e.g. and telecommunication devices) which will be utilized in .meeting the communication needs of the target population. IEW A description of how the program will be coordinated with LTH the local mental health planning activities, including ITY I how the program will interact with the Mental Health 'DOR System, and the Contra Costa Mental Health Board (formerly Mental Health Advisory Board) . the A description of how interest groups (i.e. , consumers, or. families, other service providers) might be involved in evaluating the program, or making recommendations for : to change. ful A description of how issues of quality care are evaluated and related to program change through a Quality Assurance or Total Quality Management program. ent An evaluation plan which relates to organizational and lth programmatic goals and objectives. not the A detailed budget. be r ted ely hin for i I I 23 VII. SELECTION PROCESS AND EVALUATION CRITERIA. FOR PROPOSALS A. Selection Process The County reserves the right to evaluate the contents of proposals in the evaluation and selection process. The selection process will be governed by the following rules: (1) To be evaluated, a proposal must fully comply with the format for proposal development. (2) The initial review of each proposal will be completed by the Technical Review Committee designated by the Mental Health Director. The Technical Review Committee does not issue points; rather it provides a well-justif ied list of points to be deducted for "technical reasons" from the final score given by the Program Review Committee. The Technical Review Committee shall use the following criteria and deduct the appropriate points from each proposal. (a) Omission of a section 10 points (b) Incompatibility with RFP instructions 10 points (3) Evaluation of the proposals will be completed by a Program Review Committee designated by the Mental Health Director and the Health Services Director. The Program Review Committee will evaluate proposals and qualifications of the respondents submitting proposals. Evaluation criteria which the Program Review Committee will utilize shall include the following: (a) Evidence of understanding the needs of the target population. The extent to which the respondent describes a clear understanding of the scope and the range of service needs among the target population. (b) The clarity, adequacy, comprehensiveness, and feasibility of the proposal plan of action, such as: - The extent to which the respondent addresses all components of services outlined in the RFP and provides for a continuum of service for the target population in the County. - The adequacy and appropriateness of the proposed services for the identified needs of the target population and the probability that the proposed 24 services :will have "a significant impact upon program participants. - The adequacy and availability of facilities, equipment, supplies, staffing and other resources needed to carry out the program. - The clarity of the description of the organization/staffing structure of the proposed program and of the responsibilities of all personnel and appropriateness of the proposed staffing plan. - The adequacy of the proposed line item budget and the probability that program goals can be met under the proposed budget. - The extent to which the program will substantially expand and/or improve service delivery to the target population. - The adequacy of the proposed strategy for management and coordination of a comprehensive, community-based system to meet the needs of the target population. - The extent to which proposed management and program staff have qualifications, expertise, and prior experience in working with the target population in the context of the approach identified in the proposal. - The extent to which the proposed program uses volunteers and client groups in program activities. The extent to which the respondent has anticipated and identified potential barriers to implementing the program, and has proposed adequate solutions. The extent to which interest groups (e.g. families, consumers, community representatives, service providers, etc. ) are adequately involved in planning, implementing and evaluating the program. - The cultural and linguistic competency of proposed services for racial and ethnic minority persons among the target population. - The ability to provide, report, and evaluate all services indicated. The respondent must deliver all services identified in the RFP in a manner 25 which will insure all services; provided can be reported, coordinated, evaluated and the results measured. - The evidence of professional business management and administrative skills. The respondent must demonstrate competency to manage key organizational functions such as fiscal management and procedures, personnel management and adherence to business/ audit and program standards. The presentation and organization of the proposal itself will be considered a partial reflection of the respondent's ability in these areas. - The cost effectiveness being proposed, i.e. , respondent's ability to provide the level of services in the RFP at competitive rates. The rate should reflect the effective and efficient utilization of respondent's resources, all revenues, client's SSI benefits, etc. , in order to provide quality mental health services. - The ability to implement services by July 1, 1993 . (Contra Costa County is seeking a Contractor with the ability to initiate all contracted services on or before the stated date. ) (4) All respondents shall submit their proposals to Contra Costa County with the understanding that the selection by the Mental Health Director and the: Health Services Director is final, except as provided for in the Appeals Process. 26 SUBACUTE RESIDENTIAL TREATMENT/SNP ALTERNATIVES TO STATE HOSPITALIZATION SERVICES PROPOSAL EVALUATION RATING CRITERIA REVIEW CRITERIA MAXIMUM POINTS 1. Characteristics of Applicant 20 2. Program Services 20 3 . Program Staffing and Responsibilities 15 4 . Program Evaluation 10 5. Cultural and Language Competency 20 6. Budget 15 7. Adherence to the Intent and Format of RFP 10 TOTAL MAXIMUM POINTS 100 27 TECHNICAL REVIEW COMMITTEE CHECKLIST PROPOSAL SUBMITTED BY: Please review each proposal for the following contents (as per Pages 24-27 of the RFP) . The initial review of each proposal does not issue points--rather it provides a well-justified list of points to be deducted for "Technical Reasons" from the final score given by the Review Committee. The Review Committee shall use the following criteria and deduct the appropriate points from each proposal. A. Omission of a Section 10 Points B. Incompatibility with RFP Instructions 10 Points 1. A one-page cover letter citing the nature and purpose of the proposal. PRESENT ABSENT 2 . A Program Abstract which does not exceed twenty (20) double- spaced typewritten pages. The abstract should be succinct and well organized, and must contain all information necessary for reviewers to understand the project. After reading the full abstract, does it Exceed 20 pages YES NO Is the abstract Succinct/well organized YES NO 3 . The program abstract should be reviewed to determine if it contains the following: A. A description of the respondent's experience in providing the program outlined in the RFP. PRESENT ABSENT B. A description of the respondent's experience in working in mental health systems that emphasize the importance of inter-program and system collaboration and shared responsibility for clients at all levels of care. PRESENT ABSENT I Page 2 C. A description of the local target population to be served by the project and a description of the mental health, health, educational, housing , legal and any other social welfare needs of the population and their families. PRESENT ABSENT D. A description of how the proposed program will network/ coordinate with Contra Costa County's mental health system, social welfare and other related resources and services currently available to meet the inter- organizational needs of the target population and families to be served. PRESENT ABSENT E. A discussion of the inability of existing resources and services to respond to the service needs of the target population and their families and how these deficiencies will be addressed/improved through the proposed program. PRESENT ABSENT 4 . A comprehensive program description to include the following: A. A management plan and timetable including procedures and deadlines for the procurement of resources, hiring of staff and consultants, and initiation of program activities and services, for each component of the program with indirect cost broken out for each year. PRESENT ABSENT B. The mode of treatment, method of treatment, expected length of treatment and time frame in which treatment will be developed for each service component. PRESENT ABSENT C. A description of any special equipment (e.g. , tele- communication devices) which will be utilized in meeting the communication needs of the target population. PRESENT ABSENT Page 3 D. A description of how the program will be coordinated with local mental health planning activities, including how the program will interact with the Mental Health system, and the Contra Costa Mental Health Board (formerly the Mental Health Advisory Board) . PRESENT ABSENT E. A description of how issues of quality care are evaluated and related to program change through a Quality Assurance or Total Quality Management program. PRESENT ABSENT F. A description of how interest groups (e.g. , consumers, families, citizens, service providers, etc. ) may be involved in planning, implementing and evaluating the program. PRESENT ABSENT G. An evaluation plan which relates to organizational and programmatic goals and objectives. PRESENT ABSENT H. A detailed budget. PRESENT ABSENT EVALUATION CRITERIA FOR THE SUBACUTE RESIDENTIAL TREATMENT/SNF ALTERNATIVES TO STATE HOSPITALIZATION SERVICES REVIEWER'S PACKET OF INSTRUCTIONS Page 1 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. The extent to which the proposal addresses all 20 components of services outlined in the RFP and provides for a continuum of services to the target population either through contract or demonstrable relationships with other agencies. REVIEW CRITERIA #1 2. The adequacy and availability of facilities, equipment, supplies, and other resources necessary to CHARACTERISTICS OF carry out the program. APPLICANT .3. The clarity of the description of the organizational structure of the proposed program and of the responsibilities of all personnel and the appropriateness of the proposed staffing pattern. 4. The adequacy of the proposed strategy for management and coordination of a comprehensive community-based system to meet the needs of the target population. S. The extent to which proposed management and program staff have qualifications, expertise, and prior experience in working with the population in the context of the approach outlined in the proposal. 6. The cultural and linguistic competency of the program as it affects minority persons to be served. Z The ability to provide, report and evaluate a.11 services indicated. & The evidence of professional business management and administrative skills. ACTUAL POINTS GIVEN: Page 2 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. The adequacy and appropriateness of the proposed 20 services for the identified needs of the target population and the probability that the proposed services will have a significant impact upon program participants. 2. The adequacy and availability of facilities, REVIEW CRITERIA 112 equipment, supplies, staffing and other resources needed to carry out the program. PROGRAM SERVICES 3. The clarity of the description of the organization/ staffing structure of the proposed program and of the responsibilities of all personnel and the appropriateness of the proposed staffing plan. 4. The adequacy of the proposed strategy for management and coordination of a comprehensive community-based system to meet the needs of the target population. 5. The adequacy of the proposed strategy for coordinating program activities with County/private mental health services and planning activities in the local area. 6. The extent to which the program uses volunteers and client groups in program activities. 7. The extent to which interest groups are adequately involved in evaluating the program and in providing input to the program. & The cultural and linguistic competency of proposed services. ACTUAL POINTS GIVEN: Page 3 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. The clarity of the description of the organization/ 15 staffing`ing structure of the proposed program and of the responsibilities of all personnel and the appropriateness of the proposed staffing plan. 2. The adequacy of the proposed strategy for REVIEW CRITERIA #3 management and coordination of a comprehensive community-based system to meet the needs of the target PROGRAM STAFFING population. AND RESPONSIBILITIES 3. The adequacy of the proposed strategy for coordinating program activities with County/private mental health services and planning activities in the local jurisdictions. 4. The extent to which proposed management and program staff have qualifications, expertise, anti'prior experience in working with the target population in the context of the approach identified in the proposal. S. The extent to which the proposed program uses volunteers and client groups in program activities. 6. The cultural and linguistic competency of proposed services for racial and ethnic minority persons among the target population from each jurisdiction. ACTUAL POINTS GIVEN: y Page 4 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. The extent to which the proposal addresses all 10 components of services outlined in the RFP and provides for a continuum of services for the target population in the local jurisdictions, either through contract agency or through established demonstrable relationships with other agencies in the local jurisdictions. REVIEW CRITERIA #4 2. The adequacy and appropriateness of the proposed PROGRAM services for the identified needs of the target population EVALUATION and the probability that the proposed services will have a significant impact upon program participants. 3. The adequacy and availability of facilities, equipment, supplies, staffing and other resources needed to carry out the program. 4. The ability to provide, report and evaluate all services indicated. The proposal must deliver all services identified in the RFP in a manner which will insure all services provided can be reported, coordinated, evaluated and the results measured. S. The evidence of professional business management and administrative skills. ?he proposal must demonstrate competency to manage key organizational functions such as fiscal management and procedures, personnel management and adherence to business/audit and program standards. The presentation and organization of the proposal itself should be considered a partial reflection of the respondent's ability in these areas. ACTUAL POINTS GIVEN: i Page 5 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. The adequacy and appropriateness of the proposed 10 services for the identified needs of the target population and the probability that the proposed services will have a significant impact upon program participants. 2. The clarity of the description of the organization/ REVIEW CRITERIA #5 staffing structure of the proposed program and of the responsibilities of all personnel and the appropriateness CULTURAL/ of the proposed staffing plan. LANGUAGE COMPETENCY 3. The extent to which proposed management and program staff have qualifications, expertise, and prior experience in working with the target population in the context of the approach identified in the proposal. 4. The extent to which the proposal has anticipated and identified potential barriers to implementing the program, and has proposed adequate solutions. 5. The cultural and linguistic competency of proposed services for racial aqui ethnic minority persons among the target population from each jurisdiction. ACTUAL POINTS GIVEN: Page 6 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. The cost effectiveness being proposed, i.e., the 10 respondent's ability to provide the level of services in the RFP at competitive rates. 2. The evidence of professional business management and administrative skills. The respondent must REVIEW CRITERIA #6 demonstrate competency to manage key organizational functions such as fiscal management and procedures, BUDGET personnel management and adherence to business/audit and program standards. The presentation and organiza- tion of the proposal itself will be considered a partial reflection of the respondent's ability in these areas. 3. The ability to provide, report, and evaluate all services indicated. The respondent must deliver all services identified in the RFP in a manner which will insure all services provided can be reported, coordinated, evaluated and the results measured. 4. The adequacy of the proposed line item budget and the probability that program goals can be met cost effectively under the proposed budget. 5. The clarity of the description of the organization/ staffing structure of the proposed program and of the responsibilities of all personnel and the appropriateness of the proposed staffing plan. 6. The extent to which the proposal addresses all components of services outlined in the RFP and provides for a continuum of services for the target population in the local jurisdictions, either through the contract agency or through established demonstrable relationships with other agencies in the local jurisdictions. ACTUAL POINTS GIVEN: Page 7 PROPOSAL SUBMITTED BY: REVIEWER NAME CRITERIA TO BE CONSIDERED TOTAL (from RFP PP. ) POINTS POSSIBLE _ 1. Does the proposal follow the format outlined in the 10 RFP? 2. Is it comprehensive? What, if anything, would have made this proposal stronger? REVIEW CRITERIA #7 3. Have each of the evaluable criteria been given sufficient attention? ADHERENCE TO THE INTENT AND FORMAT 4. Is there adequate explanation of each of the program OF THE RFP areas? If not, what is missing? Is further explanation necessary for you to adequately evaluate this proposal? 5. How do the following compare: (a) Cost? (b) Staffing patterns for each mode of service? (c) Staff to client ratio-by-shift in each mode of service? 6. Is there a real commitment to cultural competency? 7. Are proposed resumes, organizational relationships and staff supervision, and staff development and training given the necessary attention for the development and implementation phases of such a complex program? ACTUAL POINTS GIVEN: EXHIBIT A CONTRA COSTA COUNTY MENTAL HEALTH DIVISION OVERVIEW AND PHILOSOPHY TARGET POPULATION: Contra Costa County Mental Health will provide services to targeted populations in accordance with Public Law 99-660, State Comprehensive Mental Health Services Plan of 1986, the AB 904 California Mental Health Master Plan and AB 1288 Mental Health Realignment Legislation. The targeted populations are described in the following three groups: •Seriously emotionally disturbed children and adolescents under age 18, with active consideration given to the needs of families of the target populations; •Seriously and persistently mentally ill (SPMI) adults who are functionally disabled; •Older adults, 60 years and over, who require specialized services due to functional impairment or significant changes in behavior related to a serious, persistent mental illness or a dementia. PHILOSOPHY AND VALUES: Services will strive to meet the needs of clients. Mental health workers will assist clients in identifying and using the spectrum of mental health and community services. Clients will also be assisted in "developing the skills and acquiring the supports and resources they need to succeed where they choose to live, learn, and/or work; to maintain responsibility, to the greatest extent possible, for setting their own goals, directing their own lives, and acting responsibly as members of the community" (CA Mental Health Master Plan) . Programs will focus on strengthening skills, and developing environmental supports to sustain clients in the community. The system of care will acknowledge and incorporate the importance of culture and language, the value of cultural diversity, and the adaptation of services to meet culturally unique needs. CLIENT-DIRECTED SERVICES: Based on client strengths and functional and/or organic disabilities, realistic goals will be set by the client and mental health worker, in consultation with family and/or significant others. Family and community supports will be ` identified to assist in meeting goals. Service decisions will be made by the client in consultation with the mental health worker who will assist the client in making choices about living environments, social relationships, leisure activities and housing. CONTRA COSTA COUNTY MENTAL HEALTH DIVISION OVERVIEW AND PHILOSOPHY March, 1992 Page 2 For children, realistic goals will be set by mental health staff , in concert with the child, his/her family, and in collaboration with other child-serving agencies; e.g. , the schools, probation, social services, etc. The Mental Health Division will design servicer that enhance the quality of life, promote client empowerment, encourage clients' achievement of potentials, and respond to clients of varied ethnic and cultural origin. MENTAL HEALTH GOALS: For adult clients, the Mental Health Division will strive to measurably reduce use of hospitals, IMD facilities, jail and crisis services; increase length of community tenure; increase paid and unpaid employment; increase stability in housing; increase use of nationally recognized intervention methods; increase symptom management and medication education (pseudo- educational interventions) ; develop additional service system components; e.g. , respite for care givers, supported housing and supported employment; and strive to respond to, and meet, the culturally unique needs of the ethnically and culturally diverse client population. For children and adolescents, the Mental Health Division will provide high quality family-focused clinical services to an ethnically and culturally diverse population of children, adolescents and families throughout the county. Staff will consult with, collaborate with, and participate in interagency services and planning with the County departments legally responsible for the education, care, and custody of children (including care-giving county facilities) as well as with community agencies serving targeted population groups. Children's services will strive to design programs and provide treatment and case management services which: (1) maintain children in the least-restrictive environment; (2) build on family strengths to prevent acute hospitalization and/or reduce the length of hospital stay; (3) divert youngsters from residential treatment, juvenile hall, and crisis services; and (4) aim to increase the child and family's ability to function within the home and in the community. �! avaodphi a a N 44 m to au H q �If -41 it o tr tp a tj U tp" a >, P `°"4 a �Jt; as14 • 0 v p a m 'qQv vr- K:a `Auyt4 0 0 ld U, 0W � >•41 p••.1 � tr a 0 o tr ' li.0.aMti ! to qa a u [ o a>il o�► a uw aH Katy a d N >1 .i• •.i a�4P0Ha tr Ei o.-� M °��� R ��p dM y,m�ia�a� qv V[ 0 p1 (+�arM0y•t HNa NiA1NQ� gpb r " 0V� Q-4-4 4-14,q� U aEL.'- �ry0"." ." 4+i a >a lLU ' 1 10d4O ( NU9t VU 'A ar. 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OonE.1 �p goa8 � -4vA u a n 14 n y " 0a ; . aA !tr. 0:0H4.,o� l r e .a 'io y•+ o b+o U p 1 N .) ° � --g -41 Qi A 1144 q V a fl .ta U IU O -V 1 04 UAiH ..ill 9> G A•, °arH Wb • ONn 0U 1•i Ftp U A 11 o0 ,f p O IcaFxtlo O .W 0 AHto v * t> Of A:A A.tit tn i N 't7 O p H'U 0 fA E-1 H to Ln iJ4 H za z 0 E0 H z H HH W0 aWf.4 N � w � Ha Z E-4 C4 EXHIBIT C PERFORMANCE BOND - HEALTH SERVICES Bond No. Premium Any claim under this Bond should be sent to the following address: KNOW ALL MEN BY THE PRESENT: That we, , as Principal, and a corporation organized and existing under the laws of the State of and authorized to transact surety business in the State of California, as Surety, are held and firmly bound unto CONTRA COSTA COUNTY. as obligee,in the sum of Dollars($) lawful money of the United States of America, for the payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors and assigns,jointly and severally, firmly by these presents. THE CONDITION of the above obligation is such that,whereas the Principal has entered into a contract dated, _, 19_, with the obligee to render the following services, to-wit: as is more specifically set forth in the contract documents, reference to which is hereby made. NOW, THEREFORE, if the Principal shall well and truly perform all the requirements of said contract documents required to be performed on its part, at the times and in the same manner specified therein, then this obligation shall be null and void, otherwise it shall remain in full force and effect. PROVIDED, that the principal fails to perform according to the provisions of said contract documents,any and all costs required in rendering services or furnishing supplies or fulfilling any other provisions of said contract documents, shall be the responsibility of the Principal and the Surety thereunder. PROVIDED, that if any action is commenced on this bond by the Obligee, in addition to the sum specified above, the Principal and the Surety, their heirs, executors, administrators, successors and assigns,jointly and severally, shall be obligated to pay the Obligee all costs, attorney's fees and other litigation expenses incurred by the Obligee in collecting monies due under the terms of this bond. SIGNED AND SEALED, this day of ' 19 (SEAL) (SEAL) (Principal) (Surety) By: (Signature) (Signature) (SEAL AND ACKNOWLEDGEMENT OF NOTARY) tLMJJ3l'1' U Contra Costa County Number Standard Form 1/87 STANDARD CONTRACT Fund/Org # (Purchase of Services) Account # 1. Contract Identification. Department: Health Services - Subject: 2. Parties. The County of Contra Costa, California (County) , for its Department named above, and the following named Contractor mutually agree and promise as follows: Contractor: Capacity: Taxpayer ID if Address: 3. Term. The effective date of this Contract is and it terminates unless sooner terminated as provided herein. 4. Payment Limit. County's total payments to Contractor under this Contract shall not exceed S S. County's Obligations. County shall make to the Contractor those payments described in the Payment Provisions attached hereto which are incorporated herein by reference, subject to. all the terms and conditions contained or incorporated herein. 6. Contractor's Obligations. Contractor shall provide those services and carry out that work described in the Service Plan attached hereto which is incorporated herein by reference, subject to all the terms and conditions contained or incorporated herein. 7. General and Special Conditions. This Contract is subject to the General Conditions and Special Conditions (if any) attached hereto, which are incorporated herein by reference. 8. Proiect. This Contract implements in whole or in part the following described Project, the application and approval documents of which are incorporated herein by reference: 9. Legal Authority. This Contract is entered into under and subject to the following legal authorities: 10. Signatures. These signatures attest the parties' agreement hereto: COUNTY OF CONTRA COSTA, CALIFORNIA ATTEST: Phil Batchelor, Clerk of the Board BOARD OF SUPERVISORS of Supervisors and County Administrator By By Chairman/Designee Deputy CONTRACTOR By By (Designate business capacity A) (Designate business capacity B) Note to Contractor: For corporation (profit or nonprofit), the contract must be signed by tow officers. Signature A must be that of the president or vice-president and Signature B must be that of the secretary or assistant secretary (Civil Code Section 1190 and Corporations Code Section 313). All signatures must be acknowledge as set forth on page two. Contra Costa County Standard ,For!p 6/90 PAYMENT PROVISIONS (Cost Basis Contracts) Number 1. Payment Basis. Subject to the Payment Limit, payments to the Contractor for all services provided for County under this Contract shall only be for costs that are allowable costs that are actually incurred in the performance of Contractor's obligations under this Contract. 2. Payment Amounts. Subject to later adjustments in total payments as provided below and subject to the Payment Limit of this Contract, County will pay Contractor as full compensation for all services, work, expenses or costs provided or incurred by Contractor: [Check one alternative only] [ ) a. $ monthly, or [ j b. $ per unit, as defined in the Service Plan, or [ j c. An amount equal to Contractor's allowable costs that are actually incurred each month, but subject to the "Budget of Estimated Program Expenditures" included in the Service Plan. [ ] d. As set forth in Paragraph 1. of the Service Plan. 3: Allowable Costs. Contractor's allowable costs are only those which are determined in accordance with: [Check applicable alternative] [ ] a. Department of Health and Human Services Administration of Grants Federal Regulations Title 45 Part 74 including any amendments thereto and the applicable Subpart listed hereunder; and other documents specified in the Service Plan regarding principles for determining and allocating the allowable costs of providing the services; and any standards set forth in the Service Plan for determining the allowability of selected items of costs of providing the services. [ ] Federal Management Circular A-87, including any amendments to the circular published in the Federal Register by OMB is to be used for determining allowable costs of activities conducted by state and local governmental agencies. [ ] OMB Circular A-122, including any amendments to the Circular published in the Federal Register by .OMB is to be used for determining allowable costs of activities conducted by nonprofit organizations (other than government agencies, educational institutions, and hospitals) . [ ] 41 CFR Subpart 1-15.2 shall be used for profit organizations other than hospitals. [ ] OMB Circular No. A-21, including any amendments to the Circular published in the Federal Register by OMB shall be the principles to be used for determining allowable Costs by educational institutions (other than for-profit institutions) . Initials: Contractor County Dept. 1 ,Contra Costa County Standard Form 6/90 PAYMENT PROVISIONS , (Cost Basis Contracts) Number [ ] Appendix E Subpart Q Section 74.173 shall be used for determining costs of research, development work, and other activities for determining allowable costs. [ ] b. Such State regulations and documents as are set forth in the Service Plan regarding accounting guidelines, including standards for determining allowable or non-allowable costs. [ ] C. Part IV Department of Labor, Employment and Training administration, 20 CFR Part 674, Section 674.402 and any amendments thereto; and California Department of Aging Title V Operations Handbook, 1987, Section 505.4 and any amendments thereto. 4. Payment Demands. Contractor shall submit written demands. Said demands shall be made on County Demand Form D-15 and in the manner and form prescribed by County. Contractor shall submit said demands for payment no later than 30 days from the end of the month in which the contract services upon which such demand is based were actually rendered. Upon approval of said payment demands by the head of the County Department for which this Contract is made, or his designee, County will make payments as specified in Paragraph 2. (Payment Amounts) above. 5. Penalty for Late Submission. When Contractor fails to submit to County a timely demand for payment as specificed in Paragraph 4. (Payment Demands) above, and as a result of Contractor's late submission the County is unable to obtain reimbursement from the State of California or otherwise; to the extent the County's recovery of funding is prejudiced, County shall not pay Contractor for such services, even though such services were fully provided. 6. Right to Withhold. County has the right to withhold payment to the Contractor when, in the opinion of the County expressed in writing to the Contractor, (a) the Contractor's performance, in whole or in part, either has not been carried out or is insufficiently documented, (b) the Contractor has neglected, failed or refused to furnish information or to cooperate with any inspection, review or audit of its program, work or records, or (c) Contractor has failed to sufficiently itemize or document its demand(s) for payment. 7. Cost Report and Settlement. No later than forty-five (45) days following the termination of this Contract, Contractor shall submit to County a cost report in the form required by County, showing the allowable costs that have actually been incurred by Contractor under this Contract. If said cost report shows that the allowable costs that have actually been incurred by Contractor under this Contract exceed the payments made by County, subject nevertheless to the payment limit of this Contract, County will remit any such excess amount to Contractor, provided that the payments made, together with any such excess amount, may not exceed the contract payment limit. If said cost Initials: Contractor County Dept. 2 Contra Costa County Standard Form .6/90 PAYMENT PROVISIONS (Cost Basis Contracts) "' - Number report shows that the payments made by County exceed the allowable costs that have actually been incurred by Contractor under this Contract, Contractor shall remit any such excess amount to County. S. Audits. The records of the Contractor may be audited by the County, state, or United .. States government, in addition to any certified cost report or audit required by the Service Plan. Any certified cost report or audit required by the Service Plan shall be submitted to County by Contractor within such period of time as may be expressed by applicable State or Federal regulations, policies or contracts, but in no event later than 18 months from the termination date of this Contract. If such audit(s) show that the payments made by County exceed the allowable costs that have actually been incurred by Contractor under this Contract, including any adjustments made pursuant to Paragraph 6. (Cost Report and Settlement) , then Contractor shall pay to County within 30 days of demand by County any such excess amount. If such audit(s) show that the allowable costs that have actually been incurred by Contractor under this Contract exceed the payments made by County, including any adjustments made pursuant to Paragraph 6. (Cost Report and Settlement) , then County agrees to pay to Contractor any such excess amount, provided that the payments made, together with any such excess payment, may not exceed the contract payment limit. 9. Audit Exceptions. In addition to its obligations under Paragraph 7. (Audits) above, Contractor agrees to accept responsibility for receiving, replying to, and/or complying with any audit exceptions by appropriate County, State or Federal audit agencies occurring as a result of its performance of this Contract:. Contractor also agrees to pay to the County within 30 days of demand by County the full amount of the County's obligation, if any, to the State and/or Federal government resulting from any audit exceptions, to the extent such are attributable to the Contractor's failure to perform properly any of its obligations under this Contract. 10. Rewired Audit. If Contractor is funded by $25,000 or more in federal grant funds in any fiscal year from any source, Contractor shall provide to County at Contractor's expense an audit conforming to the requirements set forth in the most current version of Office of Management and Budget Circular A-133. If Contractor is funded by $25,000 to $100,000 in federal grant funds in any fiscal year from any source, Contractor shall arrange for conduct of the federally-required audit biennially and shall submit the audit to County in the time, form, and manner required by the most current version of Office of Management and Budget Circular A-133 and by County. If Contractor is funded by $100,000 or more in federal grant funds in any fiscal year from any source, Contractor shall arrange for the audit to County in the time, form, and manner required by the most current version of Office of Management and Budget Circular A-133 and by County. Contractor is solely responsible for arranging for the conduct of the audit, and for its cost, and County may withhold the estimated cost of the audit or 10 percent of the contract amount, whichever is larger, or the final payment, from Contractor until County receives the audit from Contractor. Initials: Contractor County Dept. 3 Contra Costa County Standard Form X1/87 GENERAL CONDITIONS ' (Purchase of Services) 5. Termination. a. Written Notice. This Contract may be terminated by either party, at their sole discretion, upon thirty-day advance written notice thereof to the other, and may be canceled immediately by written mutual consent. b. Failure to Perform. The County, upon written notice to Contractor, may immediately terminate this Contract should the Contractor fail to perform properly any of its obligations hereunder. In the event of such termination, the County may proceed with the work in any reasonable manner it chooses. The cost to the County of completing Contractor's performance shall be deducted from any sum due the Contractor under this Contract, without prejudice to the County's rights otherwise to recover its damages. C. Cessation of Funding. Notwithstanding Paragraph 5.a. above, in the event that Federal, State, or other non-County funding for this Contract ceases, this Contract is terminated without notice. 6. Entire Agreement. •This Contract contains all the terms and conditions agreed upon by the parties. Except as expressly provided herein, no other understanding, oral or otherwise, regarding the subject matter of this Contract shall be deemed to exist or to bind any of the parties hereto. 7. Further Specifications for Operating Procedures. Detailed specifications of operating procedures and budgets required by this Contract, including butnot limited to, monitoring, evaluating, auditing, billing, or regulatory changes, may be developed and set forth in a written Informal Agreement between the Contractor and the County. Such Informal Agreements shall be.designated as such and shall not be amendments to this Contract except to the extent that they further detail or clarify that which is already required hereunder. Such Informal Agreements may not enlarge in any manner the scope of this Contract, including any sums of money to be paid the Contractor as provided herein. Informal Agreements may be approved and signed by the head of the County Department for which this Contract is made or his designee. 8. Modifications and Amendments. a. General Amendments. This Contract may be modified or amended by a written document executed by the Contractor and the Contra Costa County Board of Supervisors or, after Board approval, by its designee, subject to any required State or Federal approval. b. Administrative Amendments. Subject to the Payment Limit, the Payment Provisions and the Service Plan may be amended by a written administrative amendment executed by the Contractor and the County Administrator or his designee, subject to any required State or Federal approval, provided that such administrative amendments may not materially change the Payment Provisions or the Service Plan. 9. Disputes. Disagreements between the County and Contractor conderning the meaning, requirements, or performance of this Contract shall be subject to final determination in writing by the head of the County Department for which this Contract is made or his designee or in accordance with the applicable procedures (if any) required by the State or Federal Government. 10. Choice of Law and Personal Jurisdiction. 2 Fop► ra Costa County Standard Form 1/87 GENERAL CONDITIONS (Purchase of Services) a. This Contract is made in Contra Costa County and shall be governed and construed in accordance with the laws of the State of California. b. Any action relating to this Contract shall be instituted and prosecuted in the courts of Contra Costa County, State of California. 11. Conformance with Federal and State Regulations and Laws. Should Federal or State regulations or laws touching upon the subject of this Contract be adopted or revised during the term hereof, this Contract shall be deemed amended to assure conformance with such Federal or State requirements. 12. No Waiver by County. Subject to Paragraph 9. (Disputes) of these General Conditions, inspections or approvals, or statements by any officer, agent or employee of the County indicating the Contractor's performance or any part thereof complies with the requirements of this Contract, or acceptance of the whole or any part of said performance, or payments therefor, or any combination of these acts, shall not relieve the Contractor's obligation to fulfill this Contract as prescribed; nor shall the County be thereby estopped from bringing any action for damages or enforcement arising from any failure to comply with any of the terms and conditions of this Contract. 13. Subcontract and Assignment. This Contract binds the heirs, successors, assigns and representatives of Contractor. The Contractor shall not enter into subcontracts for any work contemplated under this Contract and shall not assign this Contract or monies due or to become due, without the prior written consent of the County Administrator or his designee, subject to any required State or Federal approval. 14. Independent Contractor Status. This Contract is by and between two independent contractors and is not intended to and shall not be construed to create the relationship between the parties of agent, servant, employee, partnership, joint venture or association. 15. Conflicts of Interest. Contractor, its officers, partners, associates, agents, and employees, shall not make, participate in making, or in any way attempt to use the position afforded them by this Contract to influence any governmental decision in which he or she knows or has reason to know that he or she has a financial interest under California Government Code Sections 87100, et seq. , or otherwise. 16. Confidentialitv. Contractor agrees to comply and to require its officers, partners, associates, agents and employees to comply with all applicable State or Federal statutes or regulations respecting confidentiality, including but not limited to, the identity of persons served under this Contract, their records, or services provided them, and assures that: a. All applications and records concerning any individual made or kept by Contractor or any public officer or agency in connection with the administration of or relating to services provided under this Contract will be confidential, and will not be open to examination for any purpose not directly connected with the administration of such service. b. No person will publish or disclose or permit or cause to be published or disclosed, any list of persons receiving services, except as may be required in the administration of such service. Contractor agrees to inform all employees, agents and partners of the above provisions, and that any person knowingly and intentionally disclosing such information other than as authorized by law may be guilty of a misdemeanor. 3 Contra Costa County Standard Fora► ,:L/87. GENERAL CONDITIONS (Purchase of Services) 17. Nondiscriminatory Services. Contractor agrees that all goods and services under this Contract shall be available to all qualified persons regardless of age, sex, race, religion, color, national origin, or ethnic background, or handicap, and that none shall be used, in whole or in part, for religious worship or instruction. 18. Indemnification. The Contractor shall defend, indemnify, save, and hold harmless the County and its officers and employees from any and all claims, costs and liability for any damages, sickness, death, or injury to person(s) or property, :including without limitation all consequential damages, from any cause whatsoever arising directly or indirectly from or connected with the operations or services of the Contractor or its agents, servants, employees or subcontractors hereunder, save and except claims or litigation arising through the sole negligence or sole willful misconduct of the County or its officers or employees. Contractor will reimburse the County for any expenditures, including reasonable attorneys' fees, the County may make by reason of the matters that are the subject of this indemnifica- tion, and if requested by the County will defend any claims -or litigation to which this indemnification provision applies at the sole cost and expense of the Contractor. 19. Insurance. During the entire term of this Contract and any extension or modification thereof, the Contractor shall keep in effect insurance policies meeting the following insurance requirements: a. Comprehensive or commercial general liability insurance, including bodily injury and death, and property damage which provides limits of not less than $1 million combined single limit per occurrence for comprehensive general liability or limits of not less than $1 million with a $2 million aggregate for commercial general liability insurance. The above insurance shall include premises and operations, contractual liability, personal injury liability with an additional insured endorsement naming the County, its officers, employees and volunteers as respects all services performed by the contractor under this agreement. b. Automobile liability including owned and non-owned automobiles with a limit of not less than $1 million combined single limit per occurrence. C. Professional malpractice or errors or omissions liability insurance in an amount of not less than $1 million per occurrence, $3 million aggregate. d. Worker's compensation and employers' liability insurance for a statutory California workers.' compensation coverage, employers' liability coverage for not less than $1 million per occurrence for all employees engaged in services or operations under this agreement. e. Director's and officers' liability insurance in the amount of no less than $500,000. f. Certificate of insurance. Contractor shall provide the County with a certificates) of insurance evidencing liability and workers' compensation insurance coverage as required herein no later than the effective date of this contract. If the contractor should renew the insurance policy(ies) or acquire either a new insurance policy(ies) or amend the coverage afforded through an endorsement to the policy at any time during the term of this contract, then contractor shall provide current certificate(s) of insurance. g. Contractors insurance policies shall include provision for 30 days' notice to the County before cancellation or material change of the above specified coverage. 4 4Cgntr,,a Costa County Standard Form 1/87 GENERAL CONDITIONS (Purchase of Services) h. Contractor's insurance policy(ies) shall constitute primary insurance as to the County, the State and Federal Governments and their officers, agents and employees so that no other insurance policies held by them or their self-insurance programs shall not be required to contribute to any loss covered under the contractor's insurance policy or policies. 20. Notices. All notices provided for by this Contract shall be in writing and may be delivered by deposit in the United States mail, postage prepaid. Notices to the County shall be addressed to the head of the County Department for which this Contract is made. N±iMB to the Contractor shall be addressed to the Contractor's address designated herein. The effective date of notice shall be the date of deposit in the mails or of other delivery, except that the effective date of notice to the County shall be the date of receipt by the head of the County Department for which this Contract is made. 21. Primacy of General Conditions. Except for Special Conditions which expressly supersede General Conditions, the Special Conditions (if any) and Service Plan do not limit any term of the General Conditions. 22. Nonrenewal. Contractor understands and agrees that there is no representation, implication, or understanding that the services provided by Contractor under this Contract will be purchased by County under a new contract following expiration of termination of this Contract, and waives all rights or claims to notice or hearing respecting any failure to continue purchase of all or any such services from Contractor. 23. Possessory Interest. If this Contract results in the Contractor having possession of, claim to or right to the possession of land or improvements, but does not vest ownership of the land or improvements in the same person, or if this Contract results in the placement of taxable improvements on tax exempt land (Revenue & Taxation Code Section 107) , such interest or improvements may represent a possessory interest subject to property tax, and Contractor may be subject to the payment of property taxes levied on such interest. Contractor agrees that this provision complies with the notice requirements of Revenue & Taxation Code Section 107.6, and waives all rights to further notice or to damages under that or any comparable statute. 24. No Third-Party Beneficiaries. Notwithstanding mutual recognition that services under this Contract may provide some aid or assistance to members of the County's population, it is not the intention of either the County or Contractor that such individuals occupy the position of intended third-party beneficiaries of the obligations assumed by either party to this Contract. 25. Copyrights and Rights in Data. Contractor shall not publish or transfer any materials produced or resulting from activities supported by this agreement without the express written consent of the County Administrator. If any material is subject to copyright, the County reserves the right to copyright such and the Contractor agrees not to copyright such material. If the material is copyrighted, the County reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish, and use such materials, in whole or in part, and to authorize others to do so. 5 EXHIBIT E BIDDERS CONFERENCE TITLE: SUBACUTE TREATMENT/SNF ALTERNATIVES TO STATE HOSPITALIZATION SERVICES INQUIRIES, CONCERNS AND QUESTIONS: SUBMITTED BY: TELEPHONE NUMBER FAX AGENCY: