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HomeMy WebLinkAboutMINUTES - 11071995 - C72 5�I . TO: BOARD OF SUPERVISORS ` FROM: Mark Finucane, Health Services Director Contra Costa DATE: October 25, 1995 County SUBJECT: Approval of Novation Contract #24-373-11 with . .`, Crestwood Hospitals, Inc. SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION I. RECOMMENDED ACTION: Approve and authorize the Health Services Director, or his designee (Lorna Bastian) , to execute on behalf of the County, Novation Contract #24-373-11 with Crestwood Hospitals, Inc. , for the period from July 1, 1995 through June 30, 1996, with a payment limit of $2 , 035, 000, for admission of, and treatment for, mentally disturbed persons in need of subacute skilled nursing care in a facility known as an Institution for the Mentally Diseased (IMD) . This Contract includes a six-month automatic extension from July 1, 1996 through December 31, 1996 with an extension period payment limit of $1,017,500. II. FINANCIAL IMPACT: This Contract is included in the Health Services Department's Fiscal Year 1995-96 Budget, and the funding source is County/Realignment 100%. III. REASONS FOR RECOMMENDATIONS/BACKGROUND: Effective July 1, 1992 , State Mental Health Realignment Legislation shifted responsibility for payment to providers from the State to the Counties and required Counties to assume direct responsibility for contracting with sub-acute skilled nursing facilities known as Institutions for the Mentally Diseased (IMDs) . On October 11, 1994, the Board of Supervisors approved Novation, Contract #24-373-10 with Crestwood Hospitals, Inc. , for admission and intensive day treatment of County-referred mentally disturbed persons who are in need of sub-acute skilled nursing care in an IMD. Novation Contract #24-373-11 replaces the automatic six-month extension under the prior contract. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S) ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS �L UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. Contact: Lorna Bastian (313-6411) CC: Health Services (Contracts) ATTESTED rn.-r^^ x¢ti Cl 9-5 Risk Management Phil BBaaWelor,WA of the 803 d Auditor—Controller Supervisors and County Administrator Contractor M382/7-83 BY ` DEPUTY Contra Costa County Number 24-373-11 Standard Form 1/87 STANDARD CONTRACT Fund/Org # 5984 (Purchase of Services) Account # 2320 NOVATION Other # 1. Contract Identification. Department: Health Services - Mental Health Division Subject: Admission of, and treatment for, mentally disturbed persons in need of subacute skilled nursing care in a facility hereinafter known as an Institution for the Mentally Diseased (IMD) . 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: CRESTWOOD HOSPITALS, INC. Capacity: California corporationO Taxpayer ID # 94-1718703 Address: 4635 Georgetown Place, Stockton, Californle 3. Term. The effective date of this Contract is July 11 9p and it terminates June 30, 1996 unless sooner terminated as provided herein. 4. Payment Limit. County's total payments to Contractor under this Contract shall not exceed X2,035,000. 5. 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. Project. This Contract implements in whole or in part the following described Project, the application and approval documents of which are incorporated herein by reference: Not applicable 9. Legal Authority. This Contract is entered into under and subject to the following legal authorities: Welfare and Institutions Code §5600 et seq. (The Bronzan- McCorquodale Act) ; C4v2ornia Code of Regulations, Title 22, §72445; and California Government Code §§ 2 d 31000. 10. Signatures. These signatup st 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 corporations (profit and nonprofit), the contract must be signed by two 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 acknowledged as set forth on page two. Contra Costa County Standard Form(Rev. 1/95) APPRO V ALS/ACKNOWLEDGMENT Number 24-373-11 APPROVALS RECOMMENDED BY DEPARTMENT FORM APPROVED GQU��y COUNSEL By By Designee Deputy APPROVED: COUNTY ADMINISTRATOR By: Designee ACKNOWLEDGMENT STATE OF CALIFORNIA ) ss. COUNTY OF CONTRA COSTA ) On , before me, (insert name and title of the officer), personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS MY HAND AND OFFICIAL SEAL. (Seal) Signature ACKNOWLEDGMENT(by Coryontion,Patmuahip,or Individual) (Civil Code it 189) Contra Costa County PAYMENT PROVISIONS Standard Form 6/90 (Fee Basis Contracts) Number 24-373-11 1. Payment Amounts. Subject to the Payment Limit of this Contract and subject to the following Payment Provisions, County will pay Contractor the following fee as full compensation for all services, work, expenses or costs provided or incurred by Contractor: [Check one alternative only. ] [ ] a. $ monthly, or [ ] b. $ per unit, as defined in the Service Plan, or [ ] c. $ after completion of all obligations and conditions herein. [X] d. A fee rate as set forth in Service Plan Paragraph XI. (Fee Rates) . 2. 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 1. (Payment Amounts) above. 3. Penalty for Late Submission. When Contractor fails to submit to County a timely demand for payment as specified in Paragraph 2. (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. 4. 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. 5. Audit Exceptions. 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. Initials: Contractor County Dept. SERVICE PLAN Number 24-373-11 I. Scope of Services. In accordance with directions issued by the State Department of Mental Health, the purpose of this Contract between County and Contractor is to provide intensive day treatment services for County-referred mentally disturbed persons who are in need of sub-acute skilled nursing care in Contractor's facility which shall be known as an Institution for the Mentally Diseased (IMD) . The goals of the IMD Program are as follows: A. To assist Contra Costa County in efficiently and effectively managing limited resources by providing an alternative to utilization of State hospital days and acute hospital administrative days; B. To increase the client's motivation and skills toward self-restoration; C. To prevent or decrease the rate of decompensation, thus decreasing placements at higher, more costly levels of care; and D. To provide the intensive staffing required to supervise and treat behavioral and medical conditions. II. Licensing Requirements. Contractor's program shall be conducted in a facility which is at all times in compliance with all licensing regulations for an IMD including but not limited to, Title 22 of the California Code of Regulations, Section 72445, which includes life skill training, money management, training on accessing community services, transitional programs, and discharge planning with County staff. Contractor further agrees that its basic services include reasonable access to required medical treatment and up-to-date psychopharmacology, bilingual/bicultural programming and transportation to needed off-site services. Contractor warrants that it and all its employees have all 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, and agrees to maintain these licenses and/or permits in effect for the duration of this Contract. Failure to maintain these licenses and/or permits shall constitute grounds for the termination of this Contract by County. Contractor warrants that its facilities are wheelchair accessible. III. Admission and Continued Stay Criteria. Contractor shall admit to its IMD, patients with a DSM IV-R diagnosis, subject to the availability of a bed and in accordance with the Admission Policies set forth below, and with the following criteria: A. Admission for contracted services shall occur only upon the order of a licensed Physician, with approval of County representative(s) . B. Admission shall be available only to individuals in need of 24-hour skilled nursing services, treatment and observation of mental illness, or other related disorders. Individuals with exclusively physical illnesses shall not be admitted. C. Clients must exhibit behavioral symptoms which prohibit them from being admitted into a lower level of care. Such symptoms may include suicidality, combativeness, . elopement risk, and verbal abusiveness. Initials: Contractor County Dept. 1 SERVICE PLAN Number 24-373-11 D. Clients exceeding the capabilities of the facility shall not be admitted. In the event of unusual circumstances, Contractor shall cooperate with County's liaison in the formal review of a denied admission. In the case of an admission denial, at the request of County and within three (3) working days of County's receipt of Contractor's written notification (which may be sent via Fax) that it has denied admission to a client, County will notify Contractor of its desire to appeal the denial. A meeting of representatives of County and Contractor will be arranged as soon as practicable to review and discuss the denial and to seek resolution of the issues so that, upon mutual agreement of the parties, Contractor may admit the client to its facility. E. Contractor reserves the right to conduct a pre-admission interview. Contractor shall designate specific individuals responsible for admission intake, acceptance of cases, and admission arrangements. Contractor shall conduct an interview with County- referred clients, make a decision regarding admission of the client, and notify County of its decision within three (3) working days of County's referral. Contractor shall notify County in writing of a denied admission and shall include Contractor's reasons for the denial. F. Services, benefits and facilities shall be provided to clients without regard to race, creed, national origin, sex, age or physical or mental handicap. Contractor agrees that it will not categorically deny admission of wheelchair-bound patients. G. With prior written authorization of County and in accordance with Paragraph IV. (Prior Authorization) below, transfers of clients among facilities within a contracted corporation shall be arranged by mutual consent, and with notification to, and appropriate input from, the client's conservator, significant family members, County liaison, and specified individuals involved with client's treatment and support. IV. Prior Authorization for Admission. Contractor shall obtain prior authorization from County before admitting any Contra Costa County patient to its treatment program. County shall appoint a County IMD Liaison who shall provide Contractor with a completed authorization form prior to each patient admission. A patient may be admitted without a completed authorization form on the basis of verbal authorization from County's IMD Liaison by mutual consent of County and Contractor provided County supplies Contractor with a completed form within three (3) days from the date of admission. V. Service Specifications. A. Basic Title 22 Skilled Nursing Facility/Special Treatment Program (SNF/STP) Services. Contractor's basic SNF/STP treatment services shall include an individualized program which shall be based on the specific needs of each patient. Individual patient needs shall be identified through patient assessments and a structured training regimen with individualized therapy to assist clients in the development of new skills and in modifying behaviors that exclude them from living in a lower level of care facility. Contractor's services hereunder shall include, but may not be limited to: 1. Special Treatment Program. Contractor shall provide the following special rehabilitation program services: Initials: Contractor County Dept. 2 SERVICE PLAN Number 24-373-11 a. Self-Help Skills Training. Contractor shall provide self-help skills training which shall include, but not be limited to, the following subjects: (1) Re-education of clients in Activities of Daily Living; (2) Supervision of medications and education regarding medications; (3) Money management; (4) Use of public transportation; (5) Use of community resources; (6) Behavior control and impulse control; (7) Frustration tolerance/stress management; (8) Mental health/substance abuse education; (9) Physical education; and (10) Health education, e.g. , AIDS, smoking, etc. b. Behavioral Intervention Training. Contractor shall provide behavioral intervention training which shall include but not be limited to the following subjects: (1) Behavior modification modalities; (2) Remotivation therapy; (3) Patient government activities; (4) Group counseling; and (5) Individual counseling. C. Interpersonal Relationships. Contractor shall provide opportunities for interpersonal relationships which shall include, but not be limited to: (1) Social counseling; (2) Educational and recreational therapy; and (3) Social activities such as outings and dances. d. Pre-vocational Preparation Services. Contractor shall provide pre-vocational preparation services which shall include, but not be limited to, the following activities: (1) Homemaking; (2) Work activity; and (3) Vocational counseling. e. Pre-release Planning. Contractor shall provide the following pre-release planning services: (1) Preparation for alternative (out-of-home) living; (2) Linkage to medical services in the community, as needed; (3) Medications needed at time of discharge; and (4) Linkage to County Case Management services. B. "Patch" Intensive Treatment Program (ITP) . Contractor shall provide Intensive Day Treatment Programs (ITPs) at its facilities for the care of seriously mentally Initials: Contractor County Dept. 3 SERVICE PLAN Number 24-373-11 ill clients who, because of the severity of their mental illness may have a concurrent medical problem(s) , who require additional services, and at times, more intense supervision and specialized treatment plans. Contractor's ITP services provide an alternative to, and diversion from, State hospital placement of those clients who, without the ITP, would require State hospitalization. Contractor's ITP program services shall include, but may not be limited to, the following: 1. ITP Program Services. Contractor's ITP program services shall include, but may not be limited to, the following: a. Specialized medical treatment for specified medical conditions that prevent placement at a lower level of care, including, but not limited to: (1) Pregnancy, up to the seventh month; and (2) Chronic medical problems that are exacerbated by unstable mental status, such as brittle diabetes. b. Treatment regimen for Clozapine patients. C. Focused intervention for SMI clients with severe substance abuse problems. d. Treatment for SMI clients who are HIV-infected. e. Adequate supervision for sexually vulnerable clients who lack judgment and insight and/or whose poor impulse control due to the severity of their mental illness, results in their being sexually vulnerable. f. Treatment for those clients who, because of known and identified behaviors, have "burned their bridges" and would not be treated without the benefit of the ITP. g. Treatment for those clients who have previously been assaultive, but who have not been assaultive for two (2) weeks. h. Linguistically and culturally relevant services for non- English-speaking, monolingual clients. Contractor shall arrange for translator services for said clients. 2. General Staffing. a. With the initial and continuing approval of County, Contractor shall assign to its ITP program appropriately trained and experienced staff who shall work exclusively for the ITP program, and who will act as Contractor's Treatment Team. Contractor's personnel records shall document the skills and experience of each staff member it assigns to the ITP program and shall identify ITP staff in each facility's organization chart. Initials: Contractor County Dept. 4 SERVICE PLAN Number 24-373-11 b. Contractor shall also hire a psychiatrist to provide Special Psychiatric Services as part of the fee rate set forth in the Payment Provisions of this Contract. Said Special Psychiatric Services shall be utilized for activities which are not eligible for payment under the Medi-Cal program, and shall include such activities as Treatment Team planning meetings, consultation with program staff and with County's IMD Liaison, family counseling, meetings with facility and County staff with regard to program development, and activities related to the legal status of clients, as set forth below. In addition, Contractor shall arrange for non-salaried physicians to provide psychiatric and medical services on a Medi-Cal fee-for-service basis, payable by the Medi-Cal program and at no cost to the County under this Contract. C. Contractor shall provide new ITP staff with at least twenty (20) hours of orientation and training, and shall provide all ITP staff with ongoing training at the minimum rate of one (1) hour per week, prorated for part-time staff. As requested by County's Mental Health Director or his/her designee, Contractor's ITP staff shall attend outside training activities. d. Contractor shall provide for its staff regularly scheduled clinical supervision groups which shall be conducted by mutually agreed upon professionals. e. Contractor shall obtain written approval from County's Mental Health Director or his/her designee prior to making any changes in its ITP staffing. 3. Program Management. Subject to written approval by County, Contractor shall provide a qualified Program Manager with mental health experience and training, who shall: a. Act as Contractor's primary contact person for County's IMD Liaison; b. Coordinate the various services provided by Contractor; C. Assist other Contractor staff in developing and implementing contract services. 4. Treatment Team. The activities of the Contractor's Treatment Team shall include, but may not be limited to, the following: a. Clinical Information. (1) Contacting and/or receiving calls from previous or current service providers (case manager, conservator, therapist, etc.) during a patient's course of treatment at Contractor's facility. (2) Relaying pertinent clinical information upon discharge to the next service provider (Board and Care operator, day treatment program, etc. ) Initials: Contractor County Dept. 5 SERVICE PLAN Number 24-373-11 (3) Relaying, as soon as possible, clinical information to an acute psychiatric service to which a patient may be. transferred. b. Assessment. Diagnosis. and Individual Treatment Plan. Contractor's Treatment Team shall meet at least weekly to review the progress of clients included in the Intensive Day Treatment Program. The Team shall develop an Intensive Treatment Plan (ITP) for each client within State- and Federally-mandated time frames. The ITP shall include a plan that identifies appropriate referrals for neurological, psychological and medical assessment for conditions which may be a factor in the client's functioning or which may need treatment follow-up. Each ITP shall be revised by Contractor at least quarterly, and more often if appropriate. County's IMD Liaison will participate in the Treatment Team's weekly meetings. C. Individual Treatment. Contractor shall provide individual counseling to appropriate clients by staff who are licensed or supervised-license-eligible. d. Treatment and Education Directed Toward Family and Significant Others. Contractor shall provide a Family Therapy Specialist who is a Licensed Marriage, Family and Child Counselor and who shall have regularly scheduled evening and weekend hours. The Family Therapy Specialist shall provide intervention, counseling and education for clients and their families and/or significant others for those clients in need of examining and restructuring relationships with significant others. The Therapist shall place emphasis on soliciting input from family members and significant others when collecting data for treatment plan development and on educating family/significant others about how they can support the treatment process. The Therapist shall conduct monthly group activities for clients, and shall invite family members and significant others. Said monthly group activities shall be held at least two times a year at a location within Contra Costa County. e. Substance Abuse Treatment. Contractor shall provide a Master's Degree level staff member trained in substance abuse treatment who will provide a program of counseling and education for clients and families. This staff person shall have regularly scheduled evening and weekend hours. f. Certified Nursing Assistants. Contractor shall provide, at all applicable facilities, Certified Nursing Assistants whose duties shall include, but not be limited to, the following: (1) Observe and assist patients with personal hygiene and grooming; (2) Encourage patients to participate in activities of daily living and program activities; and (3) Other activities as assigned by program/nursing staff. g. Activity Specialists. Contractor shall provide, at all applicable facilities, Bachelor's degree level staff trained in the provision of occupational and/or recreational therapy programs. The Activity Specialists shall provide a variety of Initials: Contractor County Dept. 6 SERVICE PLAN Number 24-373-11 educational, problem solving, "hands on" re-entry groups. The focus of these activities shall be to promote socialization and improve self-help skills for clients in order to. increase the likelihood of successful community reintegration when the client is discharged (i.e,. , re-enters the community) . h. Medication Group Sessions. Contractor shall conduct a weekly medication group session for clients. Contractor shall attempt to increase client empowerment and to improve informed consent in the area of medication, so that by the time clients are ready for discharge to the community, the level of medication will be within a range which is appropriate for clients living in the community. i. Case Monitoring. The Treatment Team and the designated County IMD Liaison shall review all ITP clients on a scheduled, regular basis by facility staff and designated County IMD Liaison. j . Psychological Testing. Contractor shall provide psychological testing that is not covered by Medi-Cal if the Treatment Team determines that such testing is necessary. k. Use of ITP Staff. In the event that any of the ITP staff described above has time available during which he/she is not involved in an activity related to his/her assigned specialized activity, he/she shall use that time to work directly with individual patients as part of Contractor's treatment milieu. The hours during which specialized staff perform non-specialized duties may be a regularly scheduled part of the employee's work week. 5. Client Participation Motivation. Whenever possible, Contractor's program shall include passes, rewards, and other incentives and approaches to maximize client participation in the program. 6. ITP Program Schedule. A daily program schedule (24-hour schedule) shall be submitted by Contractor for County's approval. This schedule may be modified upon the mutual consent of Contractor and County. C. Discharge Criteria and Planning. 1. Routine Discharges. Contractor shall initiate discharge planning at the time of admission and the planning shall continue throughout the client's stay. The treatment team, under the coordination of the IMD Program Director, shall assist in establishing an effective support network and outpatient services as available. The IMD Program Director shall coordinate his/her work with the client's physician, responsible party, County IMD Liaison, and appropriate social service agencies in planning and effecting transfers or discharges. Records concerning discharges shall include, but may not be limited to, the following: a. Discharge plans and goals shall be documented in the client's record at admission and shall be updated quarterly. b. Continuing re-evaluation of each client's discharge potential shall be noted as specified in the Medi-Cal and Medicare regulations. Initials: Contractor County Dept. 7 SERVICE PLAN Number 24-373-11 C. Contractor shall provide discharge summaries to County's designated liaison within thirty (30) days of clients discharge from the IMD. d. Contractor shall notify County of every regular discharge within 24 hours of discharge. 2. Unanticiyated Discharges. In the event of unanticipated discharge, Contractor shall notify the client's physician and County's representative within 24 hours of client's discharge. In the event that such discharge occurs after normal business hours, Contractor may contact County's Psychiatric Emergency Service at Merrithew Memorial Hospital: a. Contractor shall make its best efforts to assist County and client's physician with an orderly transfer and shall provide County with advance notice of client's impending discharge, if possible. b. Contractor's nursing notes shall provide the documentation supporting the rationale for discharge and details of the disposition. A completed transfer form shall accompany the client to the receiving facility. C. In the event that a client becomes Absent Without Leave (AWOL) , Contractor shall notify the County Crisis Unit, the attending physician, and the IMD Liaison no later than twelve (12) hours after a client becomes AWOL. 3. Other Discharge Criteria. a. In no case shall Contractor discharge clients for exhibiting symptoms ordinarily attributed to mental disease, e.g. , lack of motivation. Clients who are uncontrollably and persistently violent or who set fires may be considered for discharge after discussion and coordination with County's Mental Health Medical Director or his/her designee. b. Clients shall be discharged from the IMD only upon the written order of the attending physician or the IMD Medical Director. C. If a client has been voluntarily admitted to the IMD and wishes to leave the facility without the order of his/her physician, the client must sign a statement acknowledging departure from the IMD without a written physician order. d. In the case of an untoward incident, e.g. , injury or death of a client, the attending physician, and the IMD Liaison shall be notified immediately. Contractor shall provide a written report of the incident to the County IMD Liaison and the attending physician within forty-eight (48) hours of the incident. e. Upon discharge or death of the client: (1) Contractor shall refund: (a) any unused funds received by the facility for the client's bill to the payor source within 30 days. Initials: Contractor County Dept. 8 SERVICE PLAN Number 24-373-11 (b) any entrusted funds held in an account for the client to the client within three normal banking days. (2) Any money or valuables which were entrusted by the client to the care of the IMD and stored at the IMD shall be returned to the client upon demand in exchange for a signed receipt. D. Case Management. 1. Contractor shall provide ongoing assessment of need for case management. Each client shall be reviewed by the treatment team upon admission and at least quarterly to assure that all client needs are met. 2. The IMD Program Director or his/her designee shall contact the County-designated Case Management staff/liaison or Conservator when services are required. Support staff shall hold regularly-scheduled meetings. 3. Subject to appropriate approvals for release of information, client records shall be available to County's IMD Liaison and County's Utilization Review Staff, as needed. E. Medical Care of IND Clients. 1. Emergency Care. In the event of a medical emergency, the Contractor shall arrange for the client to be treated at the nearest medical facility which can provide definitive treatment of the client's problem. When the client is stabilized, Contractor shall notify the client's Conservator and County's IMD Liaison. 2. Non-emergency Care. In the event that a client requires medical care of a non-emergent nature, and the cost of such service may exceed $2,000, Contractor must notify the client's Conservator and the Mental Health Medical Director prior to authorizing such care. F. Bilingual/Bicultural Programming. Contractor shall be responsible for using available staff resources to provide Bilingual/Bicultural programming which shall include, but may not be limited to: providing services to non-English-speaking clients in their own languages and providing services that incorporate the cultural background of the client, taking into consideration the language, family structure, religion, nutritional habits, belief system, or other cultural needs of the client. VI. Reporting of Services. Contractor shall report daily and/or monthly to County via electronic transmission (Modem or FAX) in a format specified by County. Reports shall include, but may not be limited to, the following: A. Daily census detail including admissions, discharges and transfers within facilities; and Initials: Contractor County Dept. 9 SERVICE PLAN Number 24-373-11 B. Monthly summary statistics on diagnoses, average length of stay, and medication utilization. VII. Quality Assurance .and Utilization Review Requirements. Contractor shall comply with requirements and procedures established by the State, County, and Federal governments for quality assurance and utilization review, including, but not limited to, submission of periodic quality assurance reports to County; staff assignments for utilization review and coordination of duties; use of standardized case record and treatment planning forms; peer review; and medication monitoring. In addition, Contractor shall allow County-designated employees access to Contractor's medical records for its IMD clients. VIII. Psychopharmacology. Contractor shall, through its Medical Director, maintain appropriate medication regimens for its IMD clients. Contractor's Medical Director, or designated Psychiatrist, shall be well-versed in the clinical indications for, and use of, effective medications including Clozapine and/or other innovative treatments of mental disease. IX. Conservatorship Hearings. Contractor shall make its best efforts to ensure that client's attending physician, or his/her designee, attend conservatorship hearings. X. Service Unit Definition. A unit of service for payment and reporting purposes shall be known as one "client-day" which is defined as one calendar day during which Contractor provides program services to a client under this Contract, except that the day of a client's discharge from the program shall not be considered a "client-day" , and Contractor shall not charge County for that calendar day. XI. Fee Rates. A. During the period from July 1, 1994 through June 30, 1995, subject to the Contract Payment Limit, County shall pay Contractor at the following fee rates for County- authorized clients who are admitted to, and receive care and treatment in, Contractor's IMD: 1. Crestwood Manor-San Jose (Provider #0044) : a. $98.03 per client per unit of service for clients who are enrolled in and who receive the Basic Title 22 SNF/STP care and treatment authorized by County; and b. $17.00 per client per unit of service for clients who are enrolled in and who receive "Patch" Intensive Treatment Program (ITP) services which are over-and-above Contractor's Basic Title 22 SNF/STP services. 2. Crestwood Manor-Valleio (Provider #0046) : a. $86.60 per client per unit of service for clients who are enrolled in and who receive the Basic Title 22 SNF/STP care and treatment authorized by County; Initials: Contractor County Dept. 10 SERVICE PLAN Number 24-373-11 b. $17.00 per client per unit of service for clients who are enrolled in and who receive "Patch" Intensive Treatment Program (ITP) services which are over-and-above Contractor's Basic Title 22 SNF/STP services; and C. $80.00 per client per unit of service for clients who are enrolled in and who receive enhanced "Patch" ITP services which are over-and-above Contractor's Basic Title 22 SNF/STP services. 3. Crestwood Manor-Stockton (Provider #0045) : a. $86.60 per client per unit of service for clients who are enrolled in and who receive the Basic Title 22 SNF/STP care and treatment authorized by County; b. $14.00 per client per unit of service for clients who are enrolled in and who receive "Patch" Intensive Treatment Program (ITP) services which are over-and-above Contractor's Basic Title 22 SNF/STP services; C. $20.00 per client per unit of service for clients who score between 21 and 49 on the admission assessment tool; and d. $50.00 per client per unit of service for clients who score at 50 or above on the admission assessment tool. 4. Crestwood Manor-Modesto (Provider #0041) : a. $86.60 per client per unit of service for clients who are enrolled in and who receive the Basic Title 22 SNF/STP care and treatment authorized by County; and b. $14.00 per client per unit of service for clients who are enrolled in and who receive "Patch" Intensive Treatment Program (ITP) services which are over-and-above Contractor's Basic Title 22 SNF/STP services; 5. Crestwood Manor-Fremont (Provider #0040) : a. $98.03 per client per unit of service for clients who are enrolled in and who receive the Basic Title 22 SNF/STP care and treatment authorized by County; b. $17.00 per client per unit of service for clients who are enrolled in and who receive "Patch" Intensive Treatment Program (ITP) services which are over-and-above Contractor's Basic Title 22 SNF/STP services; and C. $20.00 per client Der unit of service for clients who score between 21 and 49 on the admission assessment tool. B. Prior Authorization. County shall pay Contractor the above specified fee rates for Basic Title 22 SNF/STP Services for all clients who are referred to Contractor and are authorized by County's Mental Health Director or his/her designee prior to admission to Initials: Contractor County Dept. 11 SERVICE PLAN Number 24-373-11 Contractor's facilities for care and treatment under this Contract in Contractor's Basic Title 22 SNF/STP Service Program as described in Service Plan Paragraph V. In addition, County shall also pay Contractor the above specified "Patch" Treatment Program fee rates for certain clients whom County referred to Contractor and whom County's Mental Health Director or his/her designee authorized in advance to receive additional treatment services under this Contract in a "Patch" Treatment Program in one of Contractor's specified facilities. C. Unoccupied Beds. County shall reimburse Contractor at the Medi-Cal bed hold rate (Title 22 of the California Code of Regulations, Section 51535.1) for beds which are unoccupied as a result of approved temporary client absences, as determined by Contractor and County to be appropriate. Initials: Contractor County Dept. 12 SPECIAL CONDITIONS Number 24-373-11 1. Financial Statement. Contractor shall prepare a financial statement verifying the total number of service units actually provided and covering the costs that are actually incurred in the provision of services under this Contract ending June 30, 1996. Contractor shall have said financial statement reviewed and verified by an independent Certified Public Accountant and shall submit said financial statement, together with the Certified Public Accountant's verification, to County not later than August 31st of each fiscal year under this Contract, or 60 days following the termination of this Contract, whichever comes first, in lieu of Contractor filing a cost report. The financial statement is required for information only and shall not be used by County to adjust payments made to Contractor during the term of this Contract. 2. Third-Party Payment Liability. Contractor shall be solely responsible for any payments due from Contractor to third parties or for any liabilities, obligations, or commitments of Contractor arising from Contractor's performance of this Contract, including, but not limited to, any payments that Contractor may owe to contractors or other suppliers for goods and services received by Contractor in the operating, equipping, altering, remodeling, renovating, or repairing of Contractor's program and facilities established under this Contract. In no event shall County be responsible for any payments due from Contractor to third parties or for any liabilities, obligations, or commitments of Contractor arising from Contractor's performance of this Contract. 3. Insurance Requirements. Paragraph 19. (Insurance) of the General Conditions is hereby modified by the addition of a subparagraph e. to read as follows: "e. Professional Liability Insurance. Contractor shall provide and keep in effect a policy or policies of professional liability insurance including coverage against errors and omissions (malpractice) with a minimum coverage limit of $1,000,000 per occurrence/$3,000,000 annual aggregate for all damages resulting from professional services provided by Contractor. Not later than the effective date of this Contract, Contractor shall provide County with a certificate(s) of insurance if there is any change in coverage. ,, 4. Adjustments for Erroneous Demands and Payments. a. If any payments are demanded by Contractor in violation of the terms of this Contract (including all applicable statutes, regulations, guidelines, bulletins, and circulars) , or if County determines that any payment amounts received by Contractor are erroneous or otherwise invalid,. County may deduct the amount of such erroneous payments from payments otherwise payable to Contractor in order to recover any such amount erroneously paid in the current or preceding fiscal years. No such action taken by County shall entitle Contractor to reduce program operations or salaries, wages, fringe benefits, or services for any program participant, or client, including Contractor's staff. Any such reduction in services may be deemed sufficient cause for termination of this Contract. Within thirty (30) days of request by County, Contractor shall reimburse County for any such erroneous payments which are in violation of this Contract. b. Contractor shall indemnify County fully and completely for any repayment of funds made by the County to the State or Federal governments after it has been determined Initials: Contractor County Dept. 1 SPECIAL CONDITIONS Number 24-373-11 that such repayment is required from the County due to erroneous, unauthorized or illegal payment demands by Contractor. The State or Federal government's determination as to the necessity for any such repayment shall be conclusive as between County and Contractor. 5. Endorsements. Contractor shall not in its capacity as a contractor with Contra Costa County publicly endorse or oppose the use of any particular brand name or commercial product without the prior approval of the Board of Supervisors. In its County contractor capacity, Contractor shall not publicly attribute qualities or lack of qualities to a particular brand name or commercial product in the absence of a well-established and widely- accepted scientific basis for such claims or without the prior approval of the Board of Supervisors. In its County contractor capacity, Contractor shall not participate or appear in any commercially-produced advertisements designed to promote a particular brand name or commercial product, even if Contractor is not publicly endorsing a product, as long as the Contractor's presence in the advertisement can reasonably be interpreted as an endorsement of the product by or on behalf of Contra Costa County. Notwithstanding the foregoing, Contractor may express its views on products to other contractors, the Board of Supervisors, County officers, or others who may be authorized by the Board of Supervisors or by law to receive such views. 6. Automatic Contract Extension. . Notwithstanding Paragraph 3. (Term) of this Contract, unless this Contract is terminated by either party pursuant to General Conditions Paragraph 5. (Termination) prior to June 30, 1996, the term of this Contract shall be automatically extended from June 30, 1996 through December 31, 1996. During its extended term, this Contract is nevertheless subject to all the terms and conditions applicable during its initial term, including but not limited to General Conditions Paragraph 5. (Termination) , except as to payment for services rendered during the extended term. The purpose of this automatic six-month extension is to allow for continuation of services as specified in this Contract, to avoid interruption of payment to Contractor, and to allow County time in which to complete a novation or renewal contract for Contractor and County Board of Supervisors approval. As to any such six-month extension: a. The Contract Payment Limit, specified in Paragraph 4. (Payment Limit) of this Contract, is increased by $1,017,500 (the six-month Payment Limit) and County's total payments to Contractor for the six-month period from June 30, 1996 through December 31, 1996 shall not exceed this six-month Payment Limit, subject, nevertheless, to the aforesaid novation or renewal contract. b. County shall continue to pay Contractor in accordance with Payment Provisions Paragraph 1. (Payment Amounts) at the rates set forth in Service Plan Paragraph XI. (Fee Rates) . C. Contractor shall continue to provide services as set forth in the Service Plan, subject to any amendments thereto; d. This six-month contract extension shall be subject to any further agreement (novation) which Contractor and County may enter into covering the provision of services during the contract period immediately following the contract period specified in Contract Paragraph 3. (Term) . Initials: Contractor County Dept. 2 Contra Costa County Standard Form V87 GENERAL CONDITIONS (Purchase of Services) 1. Compliance with Law. Contractor shall be subject to and comply with all Federal, State and local laws and regulations applicable with respect to its performance under this Contract, including but not limited to, licensing, employment and purchasing practices; and wages, hours and conditions of employment, including nondiscrimination. 2. Inspection. Contractor's performance, place of business and records pertaining to this Contract are subject to monitoring, inspection, review and audit by authorized representatives of the County, the State of California, and the United States Government. 3. Records. Contractor shall keep and make available for inspection and copying by authorized representatives of the County, the State of California, and the United States Government, the Contractor's regular business records and such additional records pertaining to this Contract as may be required by the County. a. Retention of Records. The Contractor shall retain all documents pertaining to this Contract for five years from the date of submission of Contractor's final payment demand or final Cost Report; for any further period that is required by law; and until all Federal/State audits are complete and exceptions resolved for this contract's funding period. Upon request, Contractor shall make these records available to authorized representatives of the County, the State of California, and the United States Government. b. Access to Books and Records of Contractor, Subcontractor. Pursuant to Section 1861(v)(1) of the Social Security Act, and any regulations promulgated thereunder, Contractor shall, upon written request and until the expiration of four years after the furnishing of services pursuant to this Contract, make available to the Secretary of Health and Human Services or to the Comptroller General, or any of their duly authorized representatives, this Contract and books, documents, and records of Contractor that are necessary to certify the nature and extent of all costs and charges hereunder. Further, if Contractor carries out any of the duties of this Contract through a subcontract with a value or cost of $10,000 or more over a twelve-month period, such subcontract shall contain a clause to the effect that upon written request and until the expiration of four years after the furnishing of services pursuant to such subcontract, the subcontractor shall make available, to the County, to the Secretary or to the Comptroller General, or any of their duly authorized representatives, the subcontract and books, documents, and records of the subcontractor that are necessary to verify the nature and extent of all costs and charges thereunder. This special condition is in addition to any and all other terms regarding the maintenance or retention of records under this Contract and is binding on the heirs, successors, assigns and representatives of Contractor. 4. Reporting Requirements. Pursuant to Government Code Section 7550, Contractor shall include in all documents or written reports completed and submitted to County in accordance with this Contract, a separate section listing the numbers and dollar amounts of all contracts and subcontracts relating to the preparation of each such document or written report. This section shall apply only if the payment limit under this Contract exceeds $5,000. 1 Contra Costa County Standard Form 1/87 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 cancelled 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 but not 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 concerning 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. 2 Contra Costa County Standard Form 1/87 GENERAL CONDITIONS (Purchase of Services) 10. Choice of Law and Personal Jurisdiction. 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. Confidentiality. 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. 3 Contra Costa County Standard Form 1/87 GENERAL CONDITIONS (Purchase of Services) 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. 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 indemnification, 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 unless otherwise expressed in the Special Conditions: a. Liability Insurance. The Contractor shall provide comprehensive liability insurance, including coverage for owned and non-owned automobiles, with a minimum combined single limit coverage of$500,000 for all damages, including consequential damages, due to bodily injury, sickness or disease, or death to any person or damage to or destruction of property, including the loss of use thereof, arising from each occurrence. Such iifsurance shall be endorsed to include the County and its officers and employees as additional insureds as to all services performed by Contractor under this agreement. Said policies shall constitute primary insurance as to the County, the State and Federal Governments, and their officers, agents, and employees, so that other insurance policies held by them or their self- insurance program(s) shall not be required to contribute to any loss covered under the Contractor's insurance policy or policies. b. Workers' Compensation. The Contractor shall provide workers' compensation insurance coverage for its employees. C. Certificate of Insurance. The Contractor shall provide the County with (a) certificate(s) of insurance evidencing liability and worker's compensation insurance 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 (a) current certificate(s) of insurance. 4 Contra Costa County Standard Form 1/87 GENERAL CONDITIONS (Purchase of Services) d. Additional Insurance Provisions. The insurance policies provided by the Contractor shall include a provision for thirty (30) days written notice to County before cancellation or material changes of the above specified coverage. 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. Notices 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 tar, 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