HomeMy WebLinkAboutMINUTES - 03231993 - 1.49 TO: BOARD OF SUPERVISORS
FROM:Mark Finucane, Health Services Director Contra
By: Elizabeth A. Spooner, Contracts Administrator Costa
DATE: March 11, 1993 County
SUBJECT: Approval of Standard Agreement #29-309 with the State Department
of Health Services for reimbursement of certain non-medical
services provided to the Department's Medi-Cal eligible clients
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) 8c BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Health Services Director to execute on
behalf of the County, the required Certification Regarding
Lobbying and Standard Agreement #29-309 (State #92-16112) with the
State Department of Health Services, for the period from July 1,
1992 through June 30, 1994, with a total funding amount not to
exceed $2, 000, 000 to reimburse the County for certain non-medical
administrative and case management services which the Department
provides to its Medi-Cal eligible clients.
II. FINANCIAL IMPACT:
The State Department of Health Services will reimburse the County
quarterly for a portion of the actual expenses incurred by the
County in performing services under this agreement, but not to
exceed a total funding amount of $1, 000, 000 for each fiscal year
period hereunder. No County funding is required.
III. REASONS FOR RECOMMENDATION/BACKGROUND:
As a result of recent legislation, the Department may claim
reimbursement from the State Department of Health Services for
specified administrative and case management activities related to
non-medical services for the Medi-Cal eligible clients who receive
services from the County's Health Services Department.
This Agreement implements a cooperative effort between the State
and the County to ensure more efficient administration of the
State Medi-Cal Plan and to assure the availability, accessibility,
coordination, and appropriate utilization of required health care
resources to the Health Services Department's Medi-Cal eligible
clients. Activities which can be reimbursed under the new
regulations include many of the staff activities leading up to,
and following after, direct health services, such as identifying
and assessing the health care needs of Medi-Cal eligible clients,
and planning, coordinating, and monitoring the delivery of
preventive and treatment services to meet those needs.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEI!ATIIDNOF BOARD eOMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON APPROVED AS RECOMMENDED -><, OTHER
VOTE OF SUPERVISORS
_ UNANIMOUS (ABSENT _ ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
Contact: Patrick Godley (370-5007)
OF SUPERVISORS!//,ON THE DATE SHOWN.
?
CC: Health Services (Contracts & Grants) ATTESTED a,/,? a 3
Auditor-Controller (Claims)
State Department of Health Services Phil Batchelor, Clerk of the Board of
3UPe1ViW13 aW Gounty AftnL,&ator
M382/7-e3 BY `i �� DEPUTY
TATE nF CALIFORNIA
APPROVED BY THE
STANDARD AGREEMENT Al-1ORNEY GENERAL -49 �NTRACTNUMBER A�t.NG
70.2(REV.8-89) 92-16112
CONTRACTOR'S FEDERAL LD.
-MS AGREEMENT,made and entered into this 1St day of J u 1 y - - 19-2Z—, 94-6000 5 0 9
n the State of California,by and between State of California,through its duly elected or appointed,qualified
Ind acting - 29 - 309
ITLE OF OFFICER ACTING FOR STATE AGENCY
Chief, Program Support Branch Department of Health Services
hereafter called the State and
Contra Costa County Health Services Department
.hereafter called the ConC(ator.
NITNESSETH: That the Contractor for and in consideration of the covenants.conditions,agreements,and stipulations of the State heszinaftrr expensed,
ices hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor,
irne for performance or completion,and attach plans and specifications,if any.)
WHEREAS, The Department of Health Services (DHS) , hereinafter known as the
State, is the single state agency responsible for administering the California
Medi-Cal Assistance Program (hereinafter referred to as Medi-Cal) which is
authorized by Title 42 , United States Code, Section 1396 et seq. and Welfare
and Institutions Code, Section 1400 et seq. ;
WHEREAS , Section 1902 (a) ( 11 ) (A) of the federal Social Security Act
mandates cooperative arrangements between the single state agency and State
agencies responsible for administering health services; and
WHEREAS, the California Welfare and Institutions Code, Section 14113 , requires
the State to enter into cooperative arrangements with other state agencies or
departments responsible for health services to ensure the appropriate
utilization of such services;
WHEREAS, the Contractor consists of the agency/department and its employees:-as
well as affiliated agencies operating under contract or memorandum of
understanding with it;
NOW THEREFORE, the State and the Contractor enter into the following agreement:
:ONTINUED ON SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER.
The provisions on the reverse side hereof constitute a part of this agreement.
N WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date fust above written.
STATE OF CALIFORNIA CONTRACTOR
kGENCY CONTRACTOR it ofb•rm uW b •
Department of Health Services Contra Lit eaTtti erv1 ec�`sp .
3Y(AUTHORIZED SIGNATURE) BY(AUTHORI SIGMA E)
> D
2RINT9D NAME OF PERSON SIGNING PRI TED NAME AND TITLE OF P f(SON SIGNING
Edward E. Stahlberg Mark Finucane, Director
ITLE ADDRESS
Chief, Program Support Branch 651 Pim- Street, Martinez, CA 94553
\MOUNT ENCUMBERED BY THIS PROGRAMfCATEGORY(CO0E AND TITLE) FUND TITLE Department of OWOM Serv(pi
)OQCUMENT W&I Sec. 14157, Local Asst.l HCDF Use Onty
J 1,000,000 (OPTIONAL USE)
)RIOR AMOUNT ENCUMBERED FOR Fed. Cat. No. 93778 4260-101-890
'HIS DOCUMENT
$ 0 ITEM CHAPTER STA 75
Ff YEA
4260-603-912 1 587 1912 992-�3
'OTAL AMOUNT ENCUMBERED TO
)ATE OBJECT OF EXPENDITURE(CODE AND TITLE)
$ 1,000,000
I hereby certify upon my own personal knowledge that budgeted funds T.B.A.NO. B.R.NO.
are available for the period and purpose of the expenditure stated above.
;IGNATURE OF ACCOUNTING OFFICER I DATE
CONTRACTOR 17 STATE AGENCY DEPT.OF GEN.SER. 11 CONTROLLER F-1 89 54245
'a'E a
STANDARD AGREEMENT i
-fico C .n :lora a=rtes to Indomnifv,dcIcnc anti save t:armIess the Staic.:ts officers.accnts and emplovees from
anv ar:d all ci::ims anti losses accruing or resulting to :tny Lind all contractors, subcontractors, materialmen,
laborc-,and anv other person,firm or corporation furnishing or supplying work services.materials or supplies
in connedion.-lin the performance of this contract,and froth any and till claims and losses accruine orresulting
w any Person,firm or corporation who may be injtued or damaged by the Contractor in the performance of this. :
comract -rqa,eft ZZCL;
The Ccnuactor.=d the agents anti crnplovecs of Contractor, in the performance of the agreement.shall act in
an indcccrdent capacity and not as oiticcrs or employees or agents of State of California.
The St:::_may terminate this agrcemcmand he reiievcti of thepaymentofam'consideration to Contractor should
Conmaztor fail to per toren the covenants,herein conmincd at the time and in the manner herein provided. In the
went�t such t-rmination the State may proceed with the work in any manner deemed proper by the State. The
cost to t^.c Statc shall be cicductzd froin anv sum dile the Contractor under this a;rcemertt. and the balance,if
any. _:.aii be raid the Contractor upon demand.
�`:iihc c; rase .L rl,,cn consent of the S talc,this agreement is not assignable by Contractor c:;lter in whole or in part.
Tilnc :� ^f the essence In this aLrecincnl.
h. No aiu-coon c;variation of the terms of this contract shall be valid unless made in writing and signed by the
Carrie iucrcto,and no oral undcrsu indimz or agrecinent not incorporated herein.shall be binding on any of the
parties h"reto.
The consideration to be paid Contactor, as, provided herein. shall he in compensation for all of Contractor's
expenses incurred in the performance i;crcof. including: travel and per diem, unless othervise expressly so
provided.
AO e3mt r::
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. �4 1Lt 61G�1�41P
Contra Costa County Health Services Department Contract No: 92-16112
I. PURPOSE OF AGREEl�i�1T
A. This Agreement is entered into by the State and the Contractor to
implement the provisions of Section 14132 . 44 of the Welfare and
Institutions Code (SB 910, Chapter 1179, Statutes of 1991) .
B. The purpose of this Agreement is to ensure the more efficient
administration of the State Medi-Cal Plan. The provision of Medi-
cal Administration by the Contractor has been determined to be an
effective method of assuring the availability, accessibility,
coordination, and appropriate utilization of required health care
resources to Medi-Cal eligible individuals served by the
Contractor. These individuals may be served through specialized
programs of the Contractor, including, but not limited to the
Adolescent Family Life Program, Black Infant Health Program and
public guardians.
C. The State recognizes the unique relationship that the Contractor
has with its Medi-Cal eligible clients. It further recognizes the
expertise of the Contractor in identifying and assessing the
health care needs of Medi-Cal eligible clients it serves and in
planning, coordinating, and monitoring the delivery of preventive
and treatment services to meet their needs. The State, in order
to take advantage of this expertise and relationship, enters into
this Agreement with the Contractor.
D. The State and the Contractor enter into this Agreement with full
recognition of all other existing agreements which the State may
have developed for services to Title XIX eligible clients living
in county and which are currently included in the Title XIX State
Plan.
II. MUTUAL OBJECTIVES
Both parties to the Agreesent desire:
A. To assure that all Title XIX eligible clients served by the
Contractor and their families, where appropriate, are informed of
the Medi-Cal program and how to access it.
B. To assure that assistance is provided to eligible individuals in
determining their eligibility for participation in California's
Medi-Cal plan.
C. To assure the availability of early and appropriate interventions
so that diagnosis and treatment occur in a timely manner.
D. To assure that eligible individuals are aware of and understand,
in culturally competent and language specific terms, the benefits
of preventive and remedial health care.
2
Contra Costa County Health Services Department Contract No: 92-16112
E. To assure that health-related services provided to clients served
by the Contractor are of sufficient amount, duration, and scope
to correct or ameliorate the condition for which they were
determined to be medically necessary.
F. To comply with the requirements of the federal Office of
Management and Budget (OMB) Circular A-87.
III. RESPECTIVE RESPONSIBILITIES
The State agrees to•
A. Reimburse the Contractor the Title XIX federal share of actual
and reasonable costs for Medi-Cal administration provided by
staff based upon a time-accounting system which is in accordance
with the provisions of OMB Circular A87 and 45 Code of Federal
Regulations Part 74 and 95 , the expense and equipment costs
necessary to collect data, disseminate information, and carry out
the staff functions outlined in this Agreement. Reimbursement
shall be made subsequent to the quarter in which a claim for
Medi-Cal administration is made.
1. Guidelines on claiming overhead costs are included in Exhibit
A (Claiming Overhead Costs) , which is hereafter incorporated
into and made part of this Agreement.
2. The rate of reimbursement for allowable administrative
activities performed by personnel other than Skilled
Professional Medical Personnel shall be 50 percent of such
costs. The rate of reimbursement for activities qualifying
under regulations applying to Skilled Professional Medical
Personnel (SPMP) and their direct supporting clerical staff
shall be 75 percent of such costs for activities identified
as "enhanced" or 50 percent of such costs for activities
identified as "non-enhanced" . Categories of cost eligible for
75 percent reimbursement include the following items only:
compensation and applicable fringe benefits , travel and
training of SPMP and their direct supporting clerical staff.
3. Changes in any federal regulation affecting the matching
percentage , and/or costs eligible for enhanced or
administrative match, which become effective subsequent to
the execution of the Agreement will be applied herein as
provided in such changes to the regulations. As the State
becomes aware of changes in applicable federal regulations,
it will forward such information to the Contractor.
Conditions for reimbursement of eligible costs applying to
Skilled Professional Medical Personnel and their direct
supporting staff shall be in accordance with federal
guidelines, which are included in Exhibit B (FFP Guidelines
for Securing Federal Match for the Activities of Skilled
Professional Medical Personnel) of this Agreement and
hereafter made part of it.
3
Contra Costa County Health Services Department Contract No: 92-16112
B. Prepare and submit to the State Department of Finance a Budget
Revision included as part of the Department of Health Services'
November 1992 Medi-Cal Estimate.
C. Provide the Contractor with a standardized invoice format which
identifies the claim categories to which expenditure data must
adhere for insertion into the federal claim. The format for this
invoice, which shall be submitted on the Contractor's letterhead,
is included as Exhibit C and, hereafter, made part of this
Agreement.
D. Include the Contractor's expenditures for Medi-Cal administration
in the Title XIX claim for federal participation.
E. Designate a State employee to act as liaison with the Contractor
for issues concerning this Agreement.
The Contractor agrees to:
A. Perform Medi-Cal Administrative activities as an agent for the
State Department of Health Services to improve the availability,
accessibility, coordination, and appropriate utilization of
preventive and remedial health care resources to Medi-Cal
eligible individuals, and their families (where appropriate)
served by the Contractor. Activities to be included are described
in detail in the time study referred to in Exhibit B, to be used
by the Contractor. These activities encompass the following
general categories.
1. Medi-Cal Eligibility Determination
2 . Outreach Activities
3 . Coordination of Health Screenings, Assessments, Examinations
and Evaluations
4 . Immunization Coordination and Follow Up
5. Case Planning and Coordination
6. Intensive Informing and Anticipatory Guidance
7. Interagency Liaison and Coordination
8. Patient Assistance
9. Utilization Review
10. Training
4
Contra Costa County Health Services Department Contract No: 92-16112
B. Account for the activities of staff providing Medi-Cal
administration in accordance with the provisions of OMB Circular
A 87 and 45 CFR Part 74 and 95.
C. Provide the State the expenditure information to include in the
Title XIX claim approximately sixty-five (65) days after the end
of each quarter, but no later than twelve (12) months after the
end of the quarter in which a time study was completed. This
information shall be included in a standardized invoice format
specified in Exhibit C.
D. Certify the non-federal match for Title XIX funds claimed for
Medi-Cal administrative activities performed by the Contractor.
The certification will be made on each quarterly invoice
submitted to the state for payment and will contain the
certification statement as shown at the bottom of Exhibit C
(Invoice) .
E. Ensure that the appropriate audit trail exists by retaining all
appropriate records and documents for three years after the claim
revision; or if an audit is in process, three years after the
completion of the audit.
F. Designate an employee to act as liaison with the State for issues
concerning this Agreement.
IV. JOINT RESPONSIBILITIES
A. The State and the Contractor hereby agree to comply with all
applicable laws governing the confidentiality of client
information, for clients served by the Contractor under this
Agreement. Applicable laws include, but are not limited to,
Welfare and Institutions Code, Section 14100. 2 and 42 Code of
Federal Regulations, Section 431.300 et seq.
B. Both parties accept and hereinafter make part of this Agreement
the attached Exhibit D, State of California Department of Health
Services Additional Provisions (for Federally Funded Subvention
Aid/Local Assistance Cost Reimbursement Contracts/Grants) .
V. TERK OF CONTRACT
A. The term of this Agreement shall be from July 1, 1992 , through
June 30, 1994 .
B. This Agreement may be amended at any time by mutual written
agreement of the two parties to this Agreement. Either party may
also terminate this Agreement without cause by delivering written
notice of termination to the other party at least thirty (30)
days prior to the effective date of termination.
5
Contra Costa County Health Services Department Contract No: 92-16112
VI. FISCAL PROVISIONS
A. Payment provisions under this Agreement shall be made in the
following manner:
1. Upon the Contractor's compliance with its responsibilities
pursuant to Section Article III of this Agreement in a
satisfactory manner and upon the submission of a quarterly
invoice, the State agrees to pay the Contractor an amount
equal to the federal share of cost, not to exceed $1, 000, 000
annually. Payment is conditioned on the Contractor supplying
the foregoing information to the State. Payment shall not be
withheld pending the submission of similar claims by other
jurisdictions who have entered into similar Agreements to
provide Medi-Cal administration as part of the implementation
of Section 14132 . 44 of the Welfare and Institutions Code
(SB 910) .
2 . In the event that the Contractor' s claim for Medi-Cal
administration exceeds the amount identified in Item VI (A) (1)
above, the Contractor shall provide sixty (60) days' written
notice to the State of its proposal to amend this contract in
order to increase the amount set forth herein for the federal
share of cost. Within 60 days of receiving this notice, the
State shall notify the Contractor whether the proposal is
acceptable as stated or for a modified lesser amount, pending
approval by the Department of General Services , or is
rejected . If the proposal is accepted as stated or as
modified, the parties will execute an amendment to this
Agreement.
3. Invoices shall be submitted quarterly, in triplicate,
addressed to:
Department of Health Services
Accounting Section
714 P Street, Room 1140
Sacramento, CA 95814
Invoices shall reference this Agreement number and the time
period covered.
4. The attached Exhibit E, entitled "Federal Contract Funds", is
incorporated herein and made a part hereof by this reference
in recognition by both the State and the Contractor that the
validity and enforceability of this Agreement are contingent
upon the availability of funds appropriated by the U. S .
Congress.
5. In addition, this Agreement is valid and enforceable only if
the Contractor certifies that sufficient matching funds are
available for the purpose of this program. The agreement is
also subject to any additional restrictions, limitations or
conditions enacted by the appropriate governing body which
may affect the provisions, term or funding of this Agreement
in any manner.
6
Contra Costa County Health Services Department Contract No: 92-16112
6. This Agreement will terminate without penalty at the end of
any fiscal year in the event funds are not appropriated by
U.S. Congress for the next succeeding fiscal year. If funds
are appropriated for a portion of the fiscal year, this
Agreement will terminate, without penalty, at the end of the
term for which funds are appropriated.
7. Transfer of funds is contingent upon the availability of
Federal Financial Participation.
8. Both parties to this Agreement shall receive and reply to any
audit exceptions by State and Federal audit agencies that
directly relate to the services to be performed under this
Agreement.
The State will be held harmless from any federal disallowance
resulting from payments made to the Contractor. The
Contractor that has received payments shall be liable for any
federal disallowance made with respect to those payments. The
State shall recoup from the Contractor the amount of any
federal disallowance in the manner authorized by applicable
laws and regulations.
Both parties to this Agreement recognize that the Contractor
is liable only for its own audit exception and has no
liability for any other entity which may enter into a similar
Agreement with the State for Medi-Cal administration.
B. Both parties to this Agreement recognize that the Department of
Health Services will incur additional administrative
responsibilities and costs to support the claims made by the
Contractor for Medi-Cal administration . To meet these
responsibilities, both parties agree to the following provisions:
1. The Department of Health Services will hire three staff to
process the claims and perform other necessary administrative
duties generated as a result of this Agreement and similar
Agreements negotiated with other jurisdictions in accordance
with the provisions of Section 14.132 . 44 of the Welfare and
Institutions Code (SB 910) . An Accountant I and an Associate
Administrative Analyst - Accounting Systems shall be located
in DHS' Accounting Section in Sacramento and an Associate
Governmental Program Analyst shall be located in DHS '
Medi-Cal Benefits Branch, also in Sacramento.
2 . The Department of Health Services shall submit a request for
reimbursement of the actual costs of these staff on a
quarterly basis to a host county so designated by the SB 910
Steering Committee and affirmed in a contract between the
State and the host county to this effect. The amount of the
non-federal share of these costs shall not exceed $125, 000
annually.
7
Contra Costa County Health Services Department Contract No: 92-16112
3 . The host county shall be responsible for paying the State or
for obtaining appropriate payment for the State from each
participating entity.
VII. T TATION OF STATE LIABILITY
A. The maximum amount payable without Amendment for the 1992-93
Fiscal Year ending June 30, 1993 , shall not exceed $1, 000, 000.
Any requirement of performance by the State and the Contractor
for the period of the contract subsequent to June 30, 1993, will
be dependent upon the availability of future appropriations by
the U. S. Congress for Title XIX of the Social Security Act.
B. If funds become available for purposes of this Agreement from
future appropriations by the U.S. Congress, the maximum amount
payable without Amendment under this Agreement in the 1993-94
Fiscal Year ending June 30, 1994 shall not exceed $1,000, 000.
C. The maximum amount payable under this Agreement without Amendment
shall not exceed $2, 000, 000.
VIII. GENERAL PROVISIONS
A. This Agreement constitutes the entire contract between the
parties. No condition, provision, agreement or understanding not
stated in this Agreement shall affect any rights , duties or
privileges in connection with this Agreement.
B. Each party or its designees shall have access to and the right to
examine, monitor and audit all records, documents, conditions and
activities related to the program funded by this Agreement.
C. Should any disagreement arise between the State and the
Contractor on any provisions of this Agreement, the parties agree
that the same shall be the subject of discussion between their
two Directors in a good faith effort to achieve resolution.
D. None of the provisions of this Agreement are or shall be
construed as for the benefit of or enforceable by any person not
a Party to this Agreement.
XI. NON-DISCRIIEMATION CLAUSE COMPLIANCE
The Contractor shall comply with the provisions of the Non-
Discrimination Clause which is incorporated herein and made part of
herein by this reference as Exhibit D, entitled Non-Discrimination
Clause, consisting of one page.
8
Contra Costa County Health Services Department Contract No: 92-16112
EXHIBIT A
CIA ORING OVERHEAD COSTS
If one of the components of cost to be claimed as part of Medi-Cal
administration is county or city overhead costs , then there are
certain federal requirements that must be met. In order to claim
county or city administrative overhead (County or City Central
Services) costs , also referred to as "External Administrative
Overhead" costs, these entities must have an approved county wide or
city wide administrative overhead cost allocation plan for the
applicable period and these costs must be claimed in accordance with
the plan. A county' s plan is submitted to the California State
Controller's Office, who was delegated authority from the Federal
Government to approve it.
Internal (departmental) administrative overhead costs are allowable
for FFP only if there is a departmental overhead indirect cost
allocation plan prepared and on file for audit purposes for the
applicable period and costs are claimed in accordance with it.
NOTE: Both External and Internal administrative cost allocation plans
must comply with provisions of the Federal Office of Budget and
Management (OMB) Circular A-87, entitled "Cost Principles for
State and Local Governments" and Federal Publication OASC-10,
entitled "A Guide for State and Local Governments/Cost
Principles and Procedures for Establishing Cost Allocation
Plans and Indirect Cost Rates for Grants and Contracts with the
Federal Government. "
Contra Costa County Health Services Department Contract No: 92-16112
EX�BIT B
FFP GUIDELINES FOR SECURING FEDERAL MATCH FOR THE
ACTIVITIES OF SKILLED PROFESSIONAL MEDICAL PERSONNEL
Seventy-five percent (Enhanced) federal matching can be claimed for
salaries , benefits, travel and training of skilled professional
medical personnel , and clerical staff directly supporting those
personnel . Fifty percent (Non-Enhanced) federal matching can be
claimed for skilled professional medical personnel and directly
supporting clerical staff performing related services that are non-
enhanced.
The following classifications are eligible for Enhanced funding:
1. Physicians
2 . Registered Nurses
3 . Physicians Assistants
4. Dentists
5. Dental Hygienists
6. Nutritionists - with a Bachelor of Science (B. S . ) degree in
Nutrition or Dietetics and eligible to be registered with the
Commission of Dietetics Registration (R.D. ) .
7. Medical Social Workers - with a Master degree in Social Work
(MSW) with a specialty in a medical setting.
8. Health Educators - with a Master degree in Public or Community
Health Education and graduated from an institution accredited by
the American Public Health Association or the Council on
Education for Public Health.
9. Licensed Vocational Nurses - who have . graduated from a two-year
program.
10. Clerical Staff - who are in direct support of and supervised by
skilled professional medical personnel.
The civil service job specification must require clerical skills.
The program duty statement must reflect clerical functions in
support of a skilled medical professional.
The civil service job specification must stipulate that the incumbent
be from one of the above classification and the program duty statement
must reflect Enhanced and non-Enhanced activities.
Contra Costa County Health Services Department Contract No: 92-16112
"Skilled professional medical personnel" does not include non-medical
health professionals, such as public administrators, medical budget
directors or analysts, lobbyists, or senior managers of public
assistance or Medicaid programs. "Skilled professional medical
personnel" includes only professionals in the field of medical care.
"Directly supporting staff" includes only those clerical job
responsibilities that directly support skilled professional medical
personnel (Part 423 .2, 42 CFR) .
Expenditures for the actual administering of medical services by
skilled professional medical personnel do not qualify in California
for Federal matching at 75 percent but do so at the 50 percent level.
Professional Education and Training
Skilled professional medical personnel are required to have education
and training at a professional level in the field of medical care or
appropriate medical practice before FFP can be claimed at 75 percent.
"Education and training at professional level" means the completion of
a two year or longer program leading to an academic degree or
certificate in a medically related profession. Completion of a program
may be demonstrated by possession of a medical license or certificate
issued by a recognized national or staff medical licenser or
certifying organization or a degree in a medical field issued by a
college or university certified by a professional medical
organization. Experience in the administration, direction, or
implementation of the Medicaid program will not be considered the
equivalent of professional training in a field of medical care.
Seventy-five percent FFP is available for those positions that require
professional medical knowledge and skills, as evidenced by position
descriptions, job announcements, or job classifications and when
qualified functions are performed such as:
Liaison on medical aspects of the program with providers of
services and other agencies that provide medical care,
Furnishing expert medical opinions,
Reviewing complex physicians' billings,
Participating in medical review, or
Assessing, through case management activities, the necessity for
and adequacy of medical care and services.
The directly supporting staff must provide clerical services that are
directly necessary for carrying out the professional medical
responsibilities and functions of the skilled professional medical
personnel . The skilled professional medical personnel must be
immediately responsible for the work performed by the clerical staff
and must directly supervise (immediate first-level supervision) the
supporting staff and the performance of the supporting staff's work.
Contra Costa County Health Services Department Contract No: 92-16112
Direct Support Staff are defined as clerical staff and
Interpreted to mean secretarial, stenographic, copy personnel,
and file clerks that provide direct support to the Skilled
Professional Medical Personnel.
Must provide clerical services directly necessary for carrying
out the professional medical responsibilities and functions of
the Skilled Professional Medical Personnel.
Documentation must exist that the services provided for the
Skilled Professional medical Personnel are directly related and
necessary to the execution of the Skilled Professional Medical
Personnel responsibilities.
Costs for the professional medical personnel and directly supporting
staff whose time is split among functions which are eligible for
Enhanced or Non-Enhanced funding, must be allocated to each function
accordingly.
TIME DOCUMENTATION:
All persons who perform both Enhanced and Non-Enhanced functions must
complete a detailed time study with a degree of frequency that meets
requirements of the Health Care Financing Administration.
The time study must:
Clearly differentiate between activities eligible for Enhanced
and Non-Enhanced Funding.
Provide a means of indicating how much time may be claimable to
medical administration.
Be completed either at the same time each quarter or completed in
accordance with a pre-calculated random selection of days in each
quarter.
Account for all time for each working day being studied and
include time spent on unallowable activities (such as billable
Medi-Cal services) .
Time does not need to be broken down in smaller than fifteen minute
intervals.
The Contractor should have on file the civil service job specification
and the duty statement for each position. The duty statement should
have a breakdown of the estimated time spent on each activity for
audit purposes.
Contra Costa County Health Services Department Contract No: 92-16112
ACTIVITIES IN MEDI—CAL ADMINISTRATION
(Refer to Time Study Codes for more detailed explanations. )
A. Activities Eligible for Enhanced Funding in the Time Study (75
percent reimbursement.
1. Coordination of health screenings, assessments, examinations
and evaluations.
2 . Assistance provided to eligible persons to assure that
appropriate immunizations are provided.
3. Case planning and coordination.
4. Intensive informing and anticipatory guidance.
5. Interagency liaison and coordination.
6. Utilization review.
7. Training.
B. Activities Eligible for Non-Enhanced Funding in the Time Study
(50 percent reimbursement)
1. General administration
2 . Medi-Cal eligibility determination
3 . Outreach
4. Patient assistance, including the provision of transportation
and the services of a translator.
C. Activities Not Eligible for Reimbursement through Medi-Cal
Administration
1. Patient care, treatment and counseling.
2. Any other health-related services not included in the above
codes.
Contra- Costa County Health Services Department Contract No: 92-16112
EXHIBIT C
Period of Service: to
Contract Number: Invoice Number:
QUARTERLY INVOICE*
Medi-Cal Administration in Local Health and Human Service Agencies
COST CATEGORIES(**) FORMULAS FOR COST POOL #1 FORMULAS FOR COST POOL #2
COST POOL#1 SPMP I COST POOL #2 Non-SPMP
(A) Salary Costs I $ I $
(B) Benefits Costs $ $
(C) Training Costs $ I $
(D) Travel Costs $ $
(E) Other Costs(***) I $ I $
(F) Total Costs A+B+C+D+E $ ! A+B+C+D+E $
I
TIME STUDY RESULT I
PERCENTAGES
(G) %U.R. Enhanced Time I (Code 13) %` (Code 13) %1/
(H) %Enhanced Time I (Codes 3,4,5,7,8,9) %I (Codes 3,4,5,7,8,9) %1/
(I) %Eligibility Time (Code 1) %1 (Code 1) %
(J) %Other Claimable Time (Codes 2,6) % (Codes 2,6) %
(K) %Non-Claimable Time (Codes 10,11) %+ (Codes 10,11) %
(L) %General Admin. Time I (Code 12) %� (Code 12) %
(M) %Total Time I (G+H+I+J+K+L) 100 % 100 %
I
CLAIMING PERCENTAGES
(N) % of MediCaL Recipients) (
in Service Population) %I %
(0) Enhanced Svc.2/ I G+(HxN) %I
(P) Mon-Enhanced Svc. I+(JxN) %I %
(Q) General Admin. I (O+P)xL %I %
(R) Non-Enhanced Claim P+Q %I %
CLAIM CALCULATION
(S) Enhanced Claim Basis I (A+B+C+D)XO $ I XXXXXXXXXX
(T) Non-Enhan Claim Basis $ $
I (FxR)+(ExO) I Fx(O+R)
(U) Federal Enhanced Share I (Sx75%) $ XXXXXXXXXX
(V) Non-Fed Enhanced Share I (Sx25%) S XXXXXXXXXX
(W) Fed. Non-Enhan. Share (Tx50%) $ $
(X) Non-Fed Non-Enhan Share (Tx50%) S ' S
(Y) Total Federal Share $ $
u+W W
(Z) Total Non-Fed ShareI $ I $
V+X X
I certify that the funds/contributions necessary to match federal expenditures for
administrative activities which have been provided pursuant to Section 14132.44 of the Welfare
and Institutions Code (SB 910) meet the requirements of 42 CFR 433.45.
Name and Title Date
See Footnotes on next page.
Contra Costa County Health Services Department Contract No: 92-16112
EXHIBIT C
Footnotes:
Non-enhanced staff.
J Allowable at 75 percent when performed by SPMPs and at 50 percent for all other staff.
* The invoice must be submitted on the Local jurisdiction's letterhead.
** Each individual employee should be in EITHER Cost Pool 1 OR Cost Pool 2. All Skilled
Professional Medical Personnel as well as clerical staff directly supporting SPMP's
should be included in Cost Pool #1. Each individual's share of the agency indirect and
overhead costs should be included in item E "Other Costs" within the Cost Pool in
which the individual is located.
*** Each individual's share of the direct (non-clinical), agency indirect and overhead
costs would be included under item E "Other Costs". These expenditures include such
items as liability insurance, communications, office expense, books and subscriptions,
printing expense, etc. Malpractice insurance should not be included in this cost pool.
Contra Costa County Health Services Department Contract No: 92-16112
EXHIBIT C (Continued)
Period of Service: _ to
Contract Number: Invoice Number:
SUMMARY QUARTERLY INVOICE*
Medi-Cal Administration in Local Health and Human Service Agencies
COST CATEGORIES(**) FORMULAS FOR COST POOL #1 FORMULAS FOR COST POOL #
COST PO0L#1 SPMP COST POOL #2 Non-SPMP
(A) Total Federal Enhanced Add Line U totals $ XXXXXXXXXXXXXXXXXXX XXXXXXXX
Share Costs from each separate
invoice
(B) Total Non-Federal Add line V totals $ XXXXXXXXXXXXXXXXXXX XXXKXXXX
Enhanced Share Costs from each separate
invoice
(C) Total Federal Non- Add line W totals $ Add line W totals $
Enhanced Share Costs from each separate from each separate
invoice for Cost invoice for Cost
Pool #1 Pool #2
(D) Total Non-Federal Non- Add line X totals $ Add line X totals $
Enhanced Share Costs from each separate from each separate
invoice for Cost invoice for Cost
Pool #1 Pool #2
(E) Total Federal Share A + C $ C $
(F) Total Non-Federal Shared B + D $ D $
I certify that the funds/contributions necessary to match federal expenditures for
administrative activities which have been provided to pursuant to Section 14132.44 of the
Welfare and Institutions Code (SB910) meet the requirements of 42 CFR 433.45.
Name and Title Date
* The invoice must be submitted on the local jurisdiction's letterhead.
** Each individual employee should be in EITHER Cost Pool 1 OR Cost Pool 2. All Skilled
Professional Medical Personnel as well as clerical staff directly supporting SPMP's
should be included in Cost Pool #1. Each individual's share of the agency indirect and
overhead costs should be included in item E "Other Costs" within the Cost Pool in which
the individual is located.
Exhibit D
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
ADDITIONAL PROVISIONS
(FOR FEDERALLY FUNDED SUBVENTION AID/LOCAL ASSISTANCE
COST REIMBURSEMENT CONTRACTS/GRANTS)
1. Equal Qpportunity Clause
a. The Contractor will not discriminate against any employee or applicant for
employment because of race, color, religion, sex, national origin, physical or mental
handicap, or age. The Contractor will take affirmative action to ensure that qualified
applicants are employed, and that employees are treated during employment
without regard to their race, color religion, sex, national origin, physical or mental
handicap, or age. Such action shall include, but not be limited to, the following:
employment, upgrading, demotion or transfer; recruitment or recruitment advertising;
layoff or termination; rates of pay or other forms of compensation; and career
development opportunities and selection for training, including apprenticeship. The
Contractor agrees to post in conspicuous places, available to employees and
applicants for employment, notices to be provided by the Federal Government or the
State, setting forth the provisions of the Equal Opportunity clause and the
Rehabilitation Act of 1973. Such notices shall state the Contractor's obligation under
the law to take affirmative action to employ and advance in employment qualified
applicants without discrimination based on their race, color, religion, sex, national
origin, physical or mental handicap, or age,.and the rights of applicants and
employees.
b. The Contractor will, in all solicitations or advertisements for employees placed by or on
behalf of the Contractor, state that all qualified applicants will receive consideration
for employment without regard to race, color, religion, sex, national origin, physical or
mental handicap,or age.
c. The Contractor will send to each labor union or representative of workers with which
he or she has a collective bargaining agreement or other contract or understanding a
notice, to be provided by the Federal Government or the State, advising the labor
union or worker's representative of the Contractor's commitments under this Equal
Opportunity clause and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
d. The Contractor will comply with all provisions of the Rehabilitation Act of 1973 and of
the Federal Executive Order No. 11246 as amended,and of the rules, regulations, and
relevant orders of the Secretary of Labor.
e. The Contractor will furnish all information and reports required by Federal Executive
Order No. 11246 as amended and the Rehabilitation Act of 1973, and by the rules,
regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit
access to his books, records, and accounts by the contracting agency and the
Secretary of Labor for purposes of investigation to ascertain compliance with such
rules,regulations and orders.
CMS honicbonci&delln No.02(11/91)
f. In the event of the Contractor's noncompliance with the requirements of this Equal
Opportunity clause or with any federal rules, regulations, or orders which are
referenced in this clause, this contract may be canceled, terminated, or suspended in
whole or in part and the Contractor may be declared ineligible for further federal or
state contracts in accordance with procedures authorized in Federal Executive Order
No. 11246 as amended and such other sanctions may be imposed and remedies
invoked as provided in Federal Executive Order No. 1124.6 as amended, or by rule,
regulation, or order of the Secretary of Labor, or as otherwise provided by law.
g. The Contractor will include the provisions of paragraphs [a] through [g] in every
subcontract or purchase order unless exempted by rules, regulations, or orders of the
Secretary of Labor issued pursuant to Federal Executive Order No. 11246 as amended,
or Section 503 of the rehabilitation Act of 1973, so that such provisions will be binding
upon each subcontractor or vendor. The Contractor will take such action with
respect to any subcontract or purchase order as the.Director of the Office of Federal
Contract Compliance Programs or the State may direct as a means of enforcing such
provisions including sanctions for noncompliance-provided, however, that in the event
the Contractor becomes involved in, or is threatened with, litigation with a
subcontractor or vendor as a result of such direction by the State, the Contractor may
request in writing to the State, who, in turn, may request the United States to enter into
such litigation to protect the interests of the State and of the United States.
2. Travel and Per Diem
Any reimbursement for necessary traveling and per diem shall be at rates not to exceed
those amounts paid to the State's represented employees under collective bargaining
agreements currently in effect. No travel outside the State of California shall be reimbursed
unless prior written authorization is obtained from the State.
3. Procurement Requirement
a. Prior authorization in writing by the State will be required before the Contractor will be
reimbursed for any purchase order or subcontract exceeding $2,500 for any articles,
supplies, equipment, or services or for any fee, or other payment, for consultation of
three hundred fifty dollars ($350) or more per day. The Contractor must provide in its
request for authorization all particulars necessary for evaluation of the necessity or
desirability of incurring such cost, and as to the reasonableness of the price or cost.
For purchases of any said articles, supplies, equipment, services, or for consultant fees
exceeding such minimum amount, three competitive quotations must be submitted
with the request, or the absence of bidding must be adequately justified.
b. If other than the lowest bidder or a sole-source provider is selected, all documents
used in contractor selection must be presented in writing to the State for prior
approval before awarding any contract, and maintained for possible future audit as
specified in paragraph 7 below.
c. The terms "purchase order" and "subcontract" as used in the above paragraph 3a
only, excludes: (a) purchase orders not exceeding $2,500, and (b) subcontracts or
purchase orders for public utility services at rates established for uniform applicability
to the general public.
-2-
Exhibit D
4. Standards of Work
The Contractor agrees that the performance of work and services pursuant to the
requirements of this contract shall confirm to high professional standards.
5. Furnishing of Property by the State or Purchase of Property with State or Federal Funds
a. (1) All equipment, material, supplies, or property of any kind purchased from funds
advanced or reimbursed or furnished by the State under the terms of this
contract and not fully consumed in the performance of the contract shall be the
property of the State and shall be subject to the provisions of this paragraph (a),
as well as paragraphs(b),(c),and(d)below.
If the Equipment Line item in the budget or in any other paragraph of this
contract,exceeds$10,000 or more,the provisions of subparagraph b shall apply.
(2) Inventory and Disposition
(a) Contractor shall, at the request of the State, submit an inventory of
equipment furnished or purchased under the terms of this contract. Such
inventory will be required not more frequently than annually.
(b) At the termination of this contract, the Contractor shall provide a final
inventory to the State and shall at that time query the State as to the State's
requirements, including the manner and method, in returning said
equipment to the State. Final disposition of such equipment shall be at state
expense in accordance with instructions from the State to be issued
immediately after receipt of the final inventory.
(3) Motor Vehicles
(a) If, under the provisions of paragraph (2) above, any part of such property is
motor vehicles, the State Office of Procurement shall purchase said motor
vehicles for and on behalf of the Contractor. The provisions of clause (5b)
below are applicable to this paragraph concerning motor vehicles.
(b) If, under the provisions of paragraphs (2) or (3) above, any part of such
property is motor vehicles, the State authorizes the Contractor to use said
motor vehicles under the terms and conditions of this contract for purposes
of this contract only, and in accordance with the provisions of
subparagraphs (c) through (f) below.
(C) It is mutually understood that the State of California shall be the legal owner
of said vehicles and the Contractor shall be the registered owner.
(d) Upon return of such motor vehicles to the State, Contractor shall deliver to
State all necessary documents of title to enable proper transfer of
marketable title to the State.
(e) Contractor agrees that all operators of motor vehicles listed in said
agreement shall hold a valid State of California driver's license. In the event
12 or more passengers are to be carried in any one vehicle listed in said
agreement,a Class 2 driver's license will also be required.
(f) Contractor shall furnish to the State a certificate of insurance stating that
there is liability insurance presently in effect for the Contractor of not less
than $500,000 per occurrence for bodily injury and property damage liability
combined.
-3-
The certificate of insurance must include provisions (i) and (ii),stating that:
01 The insurer will not cancel the insured's coverage without 30 days prior
written notice to the State.
(i) The State of California,its officers, agents, employees,and servants are
included as additional insureds, but only insofar as the operations
under this contract are concerned.
Contractor agrees that the bodily injury liability insurance herein provided
for shall be in effect at all times during the term of this contract. In the event
said insurance coverage expires at any time or times during the term of this
contract, Contractor agrees to provide at least thirty (30) days prior to said
expiration date a new certificate of Insurance evidencing insurance
coverage as provided for herein for not less than the remainder of the term
of the contract, or for a period of not less than one (1) year. New
certificates of insurance are subject to the approval of said Department of
General Services, and Contractor agrees that no work or services shall be
performed prior to the giving of such approval. In the event Contractor fails
to keep in effect at all times insurance coverage as herein provided. State
may, in addition to any other remedies it may have,terminate this contract
upon the occurrence of such event.
b. If the Equipment line item budget in this contract is $10,000 or more, the State shall
purchase said equipment through its Office of Procurement. The cost of the
procurement of equipment will be deducted from the contract amount. Contractor
shall submit to the State a separate Inst of the equipment specifications. State will pay
vendor directly for equipment purchases and title to the equipment will remain with
the State. The equipment will be delivered either to the Contractor's address as
stated in the contract unless notified by the Contractor in writing.
c. (1) Title to state property shall not be affected by the incorporation or attachment
thereof to any property not owned by the State, nor shall such state property, or
any part thereof, be or become a fixture or.lose its identity as personality by
reason of affixation to any realty.
(2) Unless otherwise provided herein, the State shall not be under any duty or
obligation to restore or rehabilitate, or to pay the cost of the restoration or
rehabilitation of the Contractor's facility or any portion thereof which is affected
by removal of any state property.
(3) The Contractor shall maintain and administer,in accordance with sound business
practice, a program for the utilization, maintenance, repair, protection, and
preservation of state property so to assure its full availability and usefulness for the
performance of this contract. The Contractor shall take all reasonable steps to
comply with all appropriate directions and instructions which the State may
prescribe as reasonably necessary for the protection of state property.
d. For equipment only. Before equipment purchases made by the Contractor are
reimbursed by the State, the Contractor must submit paid vendor receipts identifying
the purchase price, description of the item, serial number, model number, and
location where equipment will be used during the term of this agreement. Said paid
receipts will be attached to Contractor's invoices submitted to the State.
-4-
Exhibit D
6. Income Restrictions
The Contractor agrees that any refunds, rebates, credits, or other amounts (including any
interest thereon) accruing to or received by the Contractor under this contract shall be
paid by the Contractor to the State, to the extent that they are properly allocable to costs
for which the Contractor has been reimbursed by the State under this contract.
.7. E amination of Accounts. Audit. Records_ and Subcontract Language
a. The Contractor shall maintain books, records, documents, and other evidence,
accounting procedures, and practices, sufficient to reflect properly all direct and
indirect costs of whatever nature claimed to have been incurred in the performance
of this contract, including any matching costs and expenses. The foregoing
constitutes"records'for the purpose of this clause.
b. The Contractor's facility or office or such part thereof as may be engaged in the
performance of this contract and his records shall be subject at all reasonable times
to inspection, audit, and reproduction by the State or any of its duly authorized
representatives, including the Comptroller General of the United States.
c. The Contractor shall preserve and make available his records (i) for a period of three
years from the date of final payment under this contract, and (ii) for such longer
period, if any, as is required by applicable statute, by any other clause of this contract,
or by subparagraphs (1) or (2) below.
(1) If this contract is completely or partially terminated, the records relating to the
work terminated shall be preserved and made available for a period of three
years from the date of any resulting final settlement.
(2) If any litigation, claim, negotiation, audit, or other action involving the records
has been started before the expiration of the three-year period, the records shall
be retained until completion of the action and resolution of all issues which arise
from It, or until the end of the regular three-year period, whichever is later.
d. The Contractor further agrees to include in all his subcontracts hereunder a written
agreement with said subcontractor or vendor, the following clause:
"(Name of Vendor or Subcontractor) agrees to maintain and preserve, until three
years after termination of (Contractor's name) agreement or contract with the State
of California, and to permit the State or any of its duly authorized representatives,
including the Comptroller General of the United States, to have access to and
examine and audit any pertinent books, documents, papers, and records of(name of
subcontractor or vendor) related to this(purchase order or subcontract)."
8. Covenant Against Contingent Fees
The Contractor warrants that no person or selling agency has been employed or retained
to solicit or secure this contract upon an agreement or understanding for a commission,
percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide
established commercial or selling agencies maintained by the Contractor for the purpose
of securing business. For breach or violation of this warranty, the State shall have the right
to annul this contract without liability or in its discretion to deduct from the contract price or
consideration, or otherwise recover, the full amount of such commission, percentage,
brokerage, or contingent fee.
-5-
9. Inspection
The State, through any authorized representatives, has the right at all reasonable times to
Inspect or otherwise evaluate the work performed or being performed hereunder including
subcontract supported activities and the premises in which it is being performed. If any
Inspection or evaluation is made by the State of the_premises of the Contractor or a
subcontractor, the Contractor shall provide and shall require his subcontractors to provide
all reasonable facilities and assistance for the safety and convenience of the state
representatives in the performance of their duties. All inspections and evaluations shall be
performed in such a manner as will not unduly delay the work.
10. Nondiscrimination In Services_ Benefits. and Facilities
a. The Contractor will not discriminate in the provision of services because of race, color,
creed, national origin, sex, age, or physical or mental handicap as provided by state
and federal law.
b. For the purpose of this contract, distinctions on the grounds of race, color, creed,
national origin, sex, age, or physical or mental handicap include, but are not limited
to, the following: denying a participant any service or providing a benefit to a
participant which Is different, or is provided in a different manner or at a different time
from that provided to other participants under this contract; subjecting a participant
to segregation or separate treatment in any matter related to his receipt of any
service; restricting a participant in any way in the enjoyment of any advantage or
privilege enjoyed by others receiving any service or benefit; treating a participant
differently from others in determining whether he satisfied any admission, enrollment
quota, eligibility, membership, or other requirement or condition which Individuals must
meet in order to be provided any service or benefit; the assignment of times or places
for the provision of services on the basis of the race, color, creed, or national origin of
the participants to be served.
c. The Contractor will take affirmative action to ensure that intended beneficiaries are
provided services without regard to race, color, creed, national origin, sex, age, or
physical or mental handicap.
d. The Contractor agrees that complaints alleging discrimination in the delivery of
services by the Contractor or his or her subcontractor because.of race, color, national
origin, creed, sex, age, or physical or mental handicap will be resolved by the State
through the Department of Health Services' Affirmative Action/Discrimination
Compliant Process.
e. The Contractor shall, subject to the approval of the Department of Health Services,
establish procedures under which service participants are informed of their rights to file
a complaint alleging discrimination or a violation of their civil rights with the
Department of Health Services.
f. The Contractor shall operate the program or activity in such a manner that it Is readily
accessible to and usable by mentally or physically handicapped persons pursuant to
45 Code of Federal Regulations, Parts 84,Sections 84.21 and 84.22.
g. The Contractor shall keep records, submit required compliance reports, and permit
state access to records In order that the State can determine compliance with the
nondiscrimination requirements pursuant to 45 Code of Federal regulations, Parts 80,
84, and 90, Sections 80.6, 84.61, and 90.42.
-6-
Exhibit D
1 1. Final Invoice—Final Report—Retention of Funds
If a final report is required by this contract, 10 percent of the face amount of the contract
or 50 percent of the final invoice, whichever is the larger amount, but not to exceed $3,000,
shall be withheld until after receipt by the State of a report satisfactory to the State.
12. Officials Not to Benefit
No member of or delegate to Congress or the State legislature shall be admitted to any
share or part of this contract, or to any benefit that may arise therefrom; but this provision
shall not be construed to extend to this contract if made with a corporation for its general
benefit.
13. Rights in Data
a. Subject Data. As used in this clause, the term "Subject Data" means writings, sound
recordings, pictorial reproductions, drawings, designs.or graphic representations,
procedural manuals, forms, diagrams, work flow charts, equipment descriptions, data
files and data processing or computer programs, and works of any similar nature
(whether or not copyrighted or copyrightable) which are first produced or developed
under this contract. The term does not include financial reports, cost analyses, and
similar information incidental to contract administration.
b. Federal Government and State Rights. Subject only to the provisions of °c° below, the
Federal Government and State may use, duplicate, or disclose in any manner and for
any purpose whatsoever, and have or permit others to do so, all Subject Data
delivered under this contract.
c. License to Copyrighted Data. In addition to the Federal Government and State rights
as provided In (bj above, with respect to any subject data which may be
copyrighted, the Contractor agrees to and does hereby grant to the Federal
Government and State a royalty-free, nonexclusive and irrevocable license
throughout the world to use, duplicate, or dispose of such data in any manner for
State or Federal Government purposes and to have or permit others to do so.
Provided, however, that such license shall be only to the extent that Contractor now
has, or prior to completion or final settlement of this contract may acquire, the right to
grant such license without becoming liable to pay compensation to others solely
because of such grant.
d. Relation to Patents. The State reserves a license on patent rights In any contract
Involving research or developmental, experimental, or demonstration work with
respect to any discovery or invention which arises under this contract.
e. Marking and Identification. The Contractor shall mark all Subject Data with the
number of this contract and the name and address of the contractor or
subcontractor who generated the data. The Contractor shall not affix any restrictive
markings upon any Subject Data, and If such markings are affixed, the Federal
Government or State shall have the right at any time to modify, remove, obliterate, or
ignore any such markings.
f. Subcontractor Data. Whenever any Subject Data is to be obtained from a
subcontractor under this contract, the Contractor shall use this same clause in
subcontract without alteration, and no other clause shall be used to enlarge or
diminish the Federal Government's or State's rights In the subcontractor Subject Data.
-7-
g. Deferred Ordering and Delivery of Data. The Federal Government or State shall have
the right to order, at any time during the performance of this contract, or within two
years from either acceptance of all items (other than data) to be delivered under this
contract or termination of this contract, whichever is later, any Subject Data and any
data not called for in the schedule of this contract but generated in performance of
the contract, and the Contractor shall promptly prepare and deliver such data as Is
ordered. If the principal investigator is no longer associated with the Contractor, the
Contractor shall exercise its best efforts to prepare and deliver such data as is ordered.
The Federal Government's or State's right to use data delivered pursuant to this
paragraph (g) shall be the same as the rights in Subject Data as provided in "b"
above. The Contractor shall be relieved of obligation to furnish data pertaining to an
Item obtained from a subcontractor upon the expiration of two years from the date
he accepts such items. When data, other than Subject Data, is delivered pursuant to
this paragraph (g), payment shall be made, by equitable adjustment or otherwise, for
converting the data into the prescribed form, reproducing it or preparing It for
delivery. The terms of such payment shall be agreed upon in writing by the
Contractor and the State and/or Federal Government, whichever ordered the
production of the data.
14. Disabled Veterans and Veterans of the Vietnam Era
a. The Contractor will not discriminate against any employee or applicant for
employment because he or she is a disabled veteran or veteran of the Vietnam era In
regard to any position for which the employee or applicant for employment Is
qualified. The Contractor agrees to take affirmative action to employ, advance In
employment, and otherwise treat qualified disabled veterans and veterans of the
Vietnam era without discrimination based upon their disability or veterans status In all
employment practices such as the following: employment upgrading, demotion or
transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of
compensation, and selection for training, including apprenticeship.
b. The Contractor agrees that all suitable employment openings of the Contractor which
exist at the time of the execution of this contract and those which occur during the
performance of this contract, Including those not generated by this contract and
Including those occurring at an establishment of the Contractor other than the one
wherein the contract Is being performed but excluding those of independently
operated corporate affiliates, shall be listed at an appropriate local office of the state
employment service system wherein the opening occurs. The Contractor further
agrees to provide such reports to such local office regarding employment openings
and hires as may be required.
State and local government agencies holding federal contracts of $10,000 or more
shall also list all their suitable openings with the appropriate office of the state
employment service, but are not required to provide those reports set forth In
paragraphs"d" and "e'.
c. Listing of employment openings with the employment service system pursuant to this
clause shall be made at least concurrently with the use of any other recruitment
source or effort and shall Involve the normal obligations which attach to the placing
of bona fide job order, Including the acceptance of referrals of veterans and
nonveterans. The listing of employment openings does riot require the hiring of any
particular job applicant or from any particular group of job applicants, and nothing
herein is Intended to relieve the Contractor from any requirements in Executive Orders
or regulations regarding nondiscrimination in employment.
-8-
Exhibit D
d. The reports required by paragraph "b" of this clause shall include, but not be limited to,
periodic reports which shall be filed at least quarterly with the appropriate local office
or, where the Contractor has more than one hiring location in a State, with the central
office of that state employment service. Such reports shall indicate for each hiring
location (1) the number of individuals hired during the reporting period, (2) the
number of nondisabled veterans of the Vietnam era hired, (3) the number of disabled
veterans of the Vietnam era hired, and (4) the total number of disabled veterans
hired. The reports should include covered veterans hired for the on-the-job training
under 39 U.S.C. 1787. The Contractor shall submit a report within 30 days after the end
of each reporting period wherein any performance is made on this contract
identifying data for each hiring location. The Contractor shall maintain at each hiring
location copies of the reports submitted until the expiration of one year after final
payment under the contract, during which time these reports and related
documentation shall be made available, upon request, for examination by any
authorized representatives of the Federal Contracting Officer, the State, or the
Secretary of Labor. Documentation would include personnel records respecting job
openings, recruitment, and placement.
e. Whenever the Contractor becomes contractually bound to the listing provisions of this
clause, it shall advise the employment service system in each state where it has
establishments of the name and location of each hiring location in the state. As long
as the Contractor is contractually bound to these provisions and has so advised the
state system, there is no need to advise the state system of subsequent contracts. The
Contractor may advise the state system when it is no longer bound by this contract
clause.
f. This clause does not apply to the listing of employment openings which occur and are
filled outside the 50 states, the District of Columbia, Puerto Rico, Guam, and the
Virgin Islands.
g. The provisions of paragraphs "b", "c", "d", and "e" of this clause do not apply to
openings which the Contractor proposes to fill from within his own organization or to fill
pursuant to a customary and traditional employer-union hiring arrangement. This
exclusion does not apply to a particular opening once an employer decides to
consider applicants outside of his own organization or employer-union arrangement
for that opening.
h. As used In this clause:
(1) "All suitable employment openings" Includes, but is not limited to, openings which
occur in the following job categories: production and nonproduction: plant and
office; laborers and mechanics: supervisory and nonsupervisory; technical and
executive, administrative, and professional openings that are compensated on a
salary basis of less than $25,000 per year. This term includes full-time employment,
temporary employment of more than three days' duration, and part-time
employment. It does not include openings which the Contractor proposes to fill
from within his own organization or to fill pursuant to a customary and traditional
employer-union hiring arrangement nor openings in an educational institution
which are restricted to students of that institution. Under the most compelling
circumstances, an employment opening may not be suitable for listing, including
such situations where the needs of the Federal Government cannot reasonably
be otherwise supplied, where listing would be contrary to national security, or
where the requirement of listing would otherwise not be for the best interest of
the Federal Government.
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(2) "Appropriate office of the state employment service system" means the local
office of the federal/state national system of public employment offices with
assigned responsibility for serving the area where the employment opening is to
be filled, including the District of Columbia, Guam, Puerto Rico, and the
Virgin Islands.
(3) "Openings which the Contractor proposes to fill from within his own organization"
means employment openings for which no consideration will be given to persons
outside the Contractor's organization (including any affiliates, subsidiaries, and
the parent companies) and Includes any openings which the Contractor
proposes to fill from regularly established "recall" lists.
(4) "Openings which the Contractor proposes to fill pursuant to a customary and
traditional employer-union hiring arrangement" means employment openings
which the contractor proposes to fill from union halls which is part of the
customary and traditional hiring relationship which exists between the Contractor
and representatives of his employees.
1. The Contractor agrees to comply with the rules, regulations, and relevant orders of the
Federal Secretary of Labor issued pursuant to the Act.
J, In the event of the Contractor's noncompliance with the requirements of this clause,
actions for noncompliance may be taken in accordance with the rules, regulations,
and relevant orders of the Federal Secretary of Labor issued pursuant to the Act.
k. The Contractor agrees to post In conspicuous places available to employees and
applicants for employment notices in a form to be prescribed by the Director of the
Office of Federal Contract Compliance Programs, provided by or through the
contracting Officers or State. Such notices shall state the Contractor's obligation
under the law to take affirmative action to employ and advance in employment
qualified disabled veterans and veterans of the Vietnam era for employment, and the
rights of applicants and employees.
1. The Contractor will notify each labor union or representative of workers with which it
has a collective bargaining agreement or other contract understanding that the
Contractor Is bound by terms of the Vietnam Era Veteran's Readjustment Assistance
Act and Is committed to take affirmative action to employ and advance In
employment qualified disabled veterans and veterans of the Vietnam era.
m. The Contractor will Include the provisions of this clause in every subcontract or
purchase order of $10,000 or more unless exempted by rules, regulations, or orders of
the Federal Secretary of Labor Issued pursuant to the Act, so that such provisions will
be binding upon each subcontractor or vendor. The Contractor will take such action
with respect to any subcontract or purchase order as the,Director of the Office of
Federal Contract Compliance Programs may direct to enforce such provisions,
including action for noncompliance.
15. Clean Air and Watel
a. (Applicable only If the contract is not with a sole source vendor of products or
services, or if it exceeds $5,000.)
The Contractor agrees under penalty of perjury (it,he,she) is not in violation of any
order or resolution which is not subject to review promulgated by the State Air
Resources Board or an air pollution district.
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Exhibit D
The Contractor agrees under penalty or perjury (it, he, she) is not subject to cease and
desist order which is not subject to review issued pursuant to Section 13301 of the
Water Code for violation of waste discharge requirements or discharge prohibitions, or
is not finally determined to be in violation of provisions of federal law relating to air or
water pollution.
b. (Applicable only if the contract or subcontract exceeds $100,000 or the contract is not
otherwise exempt under 40 CFR 15.5.)
The Contractor agrees as follows:
(1) To comply with all the requirements of Section 114 of the Clean Air act as
amended (42 U.S.C. 7401 et seq., as amended by Public Law 95-95), and section
308 of the Federal Water Pollution Control Act (33 U.S.C. 1251 et seq., as
amended by Public Law 92-500),respectively, relating to inspection, monitoring,
entry, reports, and information, as well as all other requirements specified in
Section 114 and Section 308 of the Air Act and the Water Act, respectively, and
all regulations and guidelines issued to implement those Acts before the award of
this contract.
(2) That no portion of the work required by this contract will be performed in a facility
listed on the Environmental Protection Agency List of Violating Facilities on the
date when this contract was awarded unless and until the Environmental
Protection Agency eliminates the name of such facility or facilities from such
listing.
(3) To use his best efforts to comply with clean air standards and clean water
standards at the facility in which the contract is being performed. The terms used
in this paragraph have the following meanings:
(a) The term "clean air standards" means any enforceable rules, regulations,
guidelines standards, limitations, orders, controls, or prohibitions or other
requirements which are contained in, issued under, or adopted pursuant to
the Clean Air Act.
(b) The term "clean water standards" means any enforceable limitation, control,
condition, prohibition, standard, or another requirement which Is
promulgated pursuant to the Clean Water Act or contained in a permit
Issued to a discharger by EPA or by the State under an approved program
as authorized by Section 402 of the Clean Water Act (33 U.S.C. 1342), or by
a local government to ensure compliance with pretreatment regulations as
required by Section 307 of the Clean Water Act (33 U.S.C. 1317), and
regulations issued pursuant thereto.
(c) In addition to compliance with clean air and water standards, the term
compliance shall also mean compliance with a schedule or plan ordered or
approved by a court of competent jurisdiction, the Environmental Protection
Agency, or an air or water pollution control agency in accordance with the
requirements of the Clean Air Act and the Federal Water Pollution Control
Act.
(4) As a condition for the award of a contract the applicant or contractor shall notify
the State of the receipt of any communication from the Assistant Administrator
for Enforcement, U.S. EPA indicating that a facility to be utilized for the contract Is
under consideration to be listed on the EPA List of Violating Facilities. Prompt
notification shall be required prior to contract award.
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(5) To report violations to the State and to the Assistant Administrator for
Enforcement.
(6) To insert the substance of the provisions of paragraph [b] Into any nonexempt
subcontract, Including this paragraph [b6], and to take such action as the
Federal Government may direct as a means of enforcing such provisions.
16. Utilization of Small Business and Minority and Women Owned Business Enterprise
a. It is a federal policy to award a fair share of contracts to small, minority, and women
owned business firms. The State Legislature has declared that a fair proportion of the
total purchases and contracts or subcontracts for property and services for the State
be placed with small minority and women owned business enterprises.
b. A firm shall qualify as a small business If It meets the requirements specified in
Government Code Section 14837.
c. The Contractor hereby agrees to carry out this policy in the awarding of subcontracts
to the fullest extent consistent with efficient contract performance. As used In this
contract, the term "minority business enterprise" means a business concern (1) which Is
at least 51 percent owned by one or more minority group members or women, or in
the case of publicly owned business, at least 51 percent of the stock of which Is
owned by one or more minority group members or women; and (2) whose
management and daily business operations are controlled by one or more such
individuals. A minority group member is a person who is Black, Asian, Hispanic, Filipino,
Polynesian, American Indian, or Alaskan Native. °Control," cis used in this clause, means
exercising the power to make policy decisions.
d. Contractors acting In good faith may rely on written representations by their
subcontractors regarding their status as minority business enterprises in lieu of an
independent Investigation.
17. Pdnflnq
If Printing or other reproduction work of more than an incidental and minor dollar amount Is
a reimbursable item in this contract, it shall be printed or produced by the State Printer. The
State Printer may, at his sole option, elect to forego said work and delegate the work to the
private sector. If the State Printer prints or produces said work, or the State obtains the
printing or other work through the Office of State Procurement, the cost will be deducted
from said contract amount. This requirement does not apply to normal In-house copying
necessary for routine business matters of the Contractor.
18. Prior Aonroval of Training Seminars_Works_hons. or Conferences
Contractor shall obtain prior state approval over the location, costs, dates, agenda, instructors,
instructional materials, and attendees at any reimbursable training seminar, workshop or conference,
and over any reimbursable publicity or educational materials to be made available for distribution.
The Contractor shall acknowledge the support of the State whenever publicizing the work under the
contract In any media. This paragraph does not apply to necessary staff meetings to conduct routine
business matters.
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Exhibit D
19.
a. The Contractor and his or her employees agents, or subcontractors shall protect from
unauthorized disclosure names and other identifying information concerning persons
either receiving services pursuant to this contract or persons whose names or
identifying information become available or are disclosed to the Contractor, his/her
employees, agents, or subcontractors as a result of services performed under this
contract, except for statistical information not identifying any such person.
b. The Contractor, his/her employees, agents, or subcontractors shall not use such
identifying information for any purpose other than carrying out the Contractor's
obligations under this contract.
c. The Contractor, his/her employees, agents, or subcontractors shall promptly transmit
to the State all requests for disclosure of such identifying information not emanating
from the client or person.
d. The Contractor shall not disclose, except as otherwise specifically permitted by this
contract or authorized by the client, any such identifying information to anyone other
than the State without prior written authorization from the State.
e. For purposes of this paragraph, identity shall Include, but not be limited to, name,
identifying number, symbol, or other identifying particular assigned to the Individual,
such as finger or voice print or a photograph.
20. Ngtional Labor Relations Hoard Certification
(not applicable if Contractor is a public entity.)
Contractor, by signing this agreement, does swear under penalty of perjury that no more
than one final unappealable finding of contempt of court by a federal court has been
issued against Contractor within the immediately preceding two-year period because of
the Contractor's failure to comply with an order of a federal court which orders the
Contractor to comply with an order of the National Labor Relations Board.
21. Documents and Written Reports
Any document or written report prepared as a requirement of this agreement shall contain,
in a separate section preceding the main body of the document, the number and dollar
amounts of all contracts and subcontracts relating to the preparation of such document or
report, if the total cost for work by nonemployees of the State exceeds $5.,000.
22. Resolution of Direct Service Contract Disputes
a. If the Contractor believes there is a dispute or grievance between the Contractor and
the State, the procedures set forth In Chapter 2.1, Sections 20201 through 20205, of
Title 22, of the California Code of Regulations, shall be followed.
b. If the Contractor wishes to appeal the decision of the Deputy Director for Public
Health or his/her designee, the Contractor shall follow the procedures set forth in
Division 25.1 (commencing with Section 38050) of the Health and Safety Code and
the regulations adopted thereunder. (Title 1, Subchapter 2.5 commencing with
Section 251, California Code of Regulations.)
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c. Disputes arising out of an audit or examination of a contract not covered by subdivision
(a) of Section 20204, of Chapter 2.1,Title 22, of the California Code of Regulations, and
for which no procedures for appeal are provided in statute, regulation or the contract
shall be handled in accordance with the procedures identified in Sections 51016
through 51047,Title 22,California Code of Regulations.
23.' Financial and Comollance Audit of Nonprofit Entities
(Applicable only if Contractor Is a private, nonprofit entity)
a. Definitions within this paragraph are defined in Section 38040 of the Health and Safety
Code,which,by this reference,is made a part hereof.
b. Contractor agrees to obtain an annual single, organization wide, financial and
compliance audit. The audit shall be conducted in accordance with the requirements
specified in the Federal Office of Management and the Budget (OMB) Circular A-133,
'Audits of Institutions of Higher Education and Other Nonprofit Organizations.'
c. References to "Federal' in OMB Circular A-1 33 shall be considered to man 'Federal
and/or State" in contracts where State funds are present either alone or in conjunction
with Federal funds.
d. The audit shall be completed by the 15th day of the fifth month following the end of the
Contractor's fiscal year. Two copies of the audit report shall be delivered to the State
program funding this contract. The report shall be due within 30 days after the
completion of the audit.
e. If the contractor receives less than $25,000 per year from the State, the audit shall be
conducted biennially, unless there is evidence of fraud or other violation of state law in
connection with this contract. This requirement takes precedence over the OMB A-133
section which exempts from Federal audit requirements any nonprofit institution
receiving less than $25,000 per year.
f. The cost of such audit may be included in the funding for this contract up to the
proportionate amount this contract represents of the Contractor's total revenue.
g. The State, or its authorized designee including the Auditor-General, is responsible for
conducting contract performance audits which are not financial and compliance
audits.
h. Nothing in this contract limits the State's responsibility or authority to enforce State law or
regulations, procedures, or reporting requirements arising pursuant thereto.
I. Nothing in this paragraph limits the authority of the State to make audits of this contract,
provided however, that if independent audits arranged for by Contractor meet
generally accepted governmental auditing standards, the State shall rely on those
audits and any additional audit work shall build upon the work already done.
j. The State may, at its option, direct its own auditors to perform the single audit described
in OMB Circular A-133. The State's auditors shall meet the independence standards
specified in Government Auditing Standards. The audit shall be conducted in
accordance with OMB Circular A-133 so as to satisfy all State and Federal requirements
for a single organization wide audit.
24. Contract Amendments
a. This contract may be amended by mutual agreement between the parties and, if
required by Government Code, Section 11010.5, or Public Contract Code, Section
10355,the amendment shall be subject to the approval of the Department of General
Services,unless otherwise exempted.
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Exhibit D
b. If any amendment to this contract has the effect of increasing the monetary amount
of the contract or an agreement by the State to indemnify or save harmless the
Contractor, his agents or employees, the amendment shall be approved by the
Department of General Services, unless otherwise exempted.
25, Fyaluafi6n of Controctgrs (Applicable only to Consulting Services Contracts in excess
of $5,000)
The Contractor's performance under this contract shall be evaluated at the conclusion of
the term of this contract. The evaluation shall Include, but not be limited to:
a. Whether the contracted work or services were completed as specified in the contract
and reasons for and amount of any cost overruns.
b. Whether the contracted work or services met the quality standards specified In the
contract.
c. Whether the Contractor fulfilled all requirements of the contract.
d. Factors outside the control of the Contractor which caused difficulties In Contractor
performance. The evaluation of the Contractor shall not be a public record.
26. Conflict of Interest—Current and Former State Ems-ygas
a. Current State Officers and Employees
(1) Contractor shall not utilize in the performance of this contract any state officer or
employee In the state civil service or other appointed state official unless the
employment, activity, or enterprise is required as a condition of the officer or
employee's regular state employment. Employee in the state civil service is
defined to be any person legally holding a permanent or intermittent position in
the state civil service.
(2) If any state officer or employee Is utilized or employed In the performance of this
contract, Contractor shall first obtain written verification from the State that the
employment, activity, or enterprise is required as a condition of the officer's,
employee's, or official's regular state employment and shall keep said verification
on file for three years after the termination of this contract.
(3) Contractor may not accept occasional work from any currently employed state
officer, employee, or official.
(4) If Contractor accepts volunteer work from any currently employed State officer,
employee, or official, Contractor may not reimburse, or otherwise pay or
compensate, such person for expenses incurred, Including, without limitation,
travel expenses, per diem, or the like, in connection with volunteer work on
behalf of contractor.
(5) Contractor shall not employ any state officers, employees, or officials who are on
paid or unpaid leave of absence from their regular state employment.
(6) Contractor or anyone having a financial interest in this contract may not
become a state officer, employee, or official during the term of this contract.
Contractor shall notify each of its employees, and any other person having a
financial interest In this contract that it is unlawful under Public Contract Code,
Section 10410 for such person to become a state officer, employee, or official
during the term of this contract unless any relationship with the Contractor giving
rise to a financial Interest, as an employee or otherwise, is first terminated.
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(7) Occasional or one-time reimbursement of a state employee's travel expenses is
not acceptable.
(Citation: Public Contract Code, Section 10410)
b. Former State Officers and Employees
(1) Contractor shall not utilize in the performance of this contract any formerly
employed person of any state agency or department that was employed under
the state civil service, or otherwise appointed to serve in the State Government, if
that person was engaged in any negotiations, transactions, planning,
arrangement, or any part of the decision-making process relevant to the
contract while employed in any capacity by any state agency or department.
This prohibition shall apply for a two-year period beginning on the date the
person left state employment.
(2) Contractor shall not utilize within 12 months from the date of separation of
services, a former employee of the contracting state agency or department if
that former employee was employed in a policy making position in the same
general subject area as the proposed contract within the 12-month period prior
to the employee leaving state service.
(Citation: Public Contract Code, Section 10411)
c. Failure to Comply with Subparts"a"or"b"
(1) If Contractor violates any provision of Subparts "a" or "b" above, such action by
Contractor shall render this contract void, Unless_the violation is technical or
nonstibstontive_
(Citation: Public Contract Code, Section 10420)
27. single Audit Act of 1984 (applicable only if Contractor is a governmental entity)
In accordance with Public Law 98-502 and OMB Circular A-128, it is stipulated between the
parties hereto that:
a. The cost of the single audit will be charged to the federal assistance program
providing funds for this agreement on a "Fair Share" basis. The amount chargeable to
federal assistance programs for the cost of the single audit is calculated based on the
ratio of federal expenditures to total expenditures of the Contractor. The State's share
of the single audit cost under this contract is based upon the ratio of federal funds
received under this agreement to total federal funds received by the Contractor
each fiscal year.
b. The Contractor shall include a clause in any contract the Contractor enters into with
the audit firm doing the single audit to provide access by the State or Federal
Government to the working papers of the independent auditor who prepares the
single audit for the Contractor.
c. Federal or State auditors shall have "expanded scope auditing" authority to conduct
specific program audits during the same period in which a single audit is being
performed, but the audit report has not been issued. The federal or state auditors
shall review and have access to the current audit work being conducted and will not
apply any testing or review procedures which have not been satisfied by previous
audit work that has been completed.
-16.
Exhibit D
The term 'expanded scope auditing' is applied and defined in the U.S. General
Accounting Office (GAO) issued Standords for Audit of Governmental Organizations,
Programs,Activities and Functions,better known as the 'yellow book.'
28. Contractor Name Change
Contractor shall provide written notice to the State at least 30 days prior to any changes to
the Contractor's current legal name.
29. NoycrHon
If the Contractor proposes any novation agreement,the State shall act upon the proposal
within 60 days after receipt of the written proposal. The State may review and consider the
proposal,consult and negotiate with the Contractor,and accept or reject all or part of the
proposal. Acceptance or rejection may be made orally within the 60 day period, and
confirmed in writing within five days.
30. Drug-Free Workplace
Contractor certifies to the State that it will provide a drug-free workplace by doing all of
the following:
a. Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensation, possession, or use of a controlled substance is prohibited in
the person's or organization's workplace and specifying the actions that will be taken
against employees for violations of the prohibition.
b. Establishing a drug-free awareness program to inform employees about all of the
following:
(1) The dangers of drug abuse in the workplace.
(2) The person's or organization's policy of maintaining a drug-free workplace.
(3) Any available drug counseling, rehabilitation, and employee assistance
programs.
(4) The penalties that may be imposed upon employees for drug abuse violations.
c. Requiring that each employee engaged in the performance of the contract or grant
be given a copy of the statement required by subdivision(a) and that,as a condition
of employment on the contract or grant,the employee agrees to abide by the terms
of the statement.
d. Contractor agrees this contract may be subject to suspension of payments or
termination of this contract,or both,and the contractor may be subject to debarment,
in accordance with the requirements of the Government Code Section 8350,et seq., if
the Department determines that any of the following has occurred:
(1) The contractor or grantee has made a false certification.
(2) The contractor violates the certification by failing to carry out the requirements of
subdivisions(a)through(c)above.
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31. Debarment and Suspension Requirements
Contractor agrees to comply with the debarment and suspension requirements as found in
7 Code of Federal Regulations, Part 3017,or as amended.
32. LIMITATIONS ON PAYMENTS TO INFLUEN=
CERTAIN FEDERAL ACTIONS AND RELATED DISCLOSURES
(a) Definitions. As used in this Exhibit,
'Agency," as defined in 5 U.S.C. 552(f), includes Federal executive departments and
agencies as well as independent regulatory commissions and Government
corporations,as defined in 31 U.S.C.9101(1).
'Covered Federal action' means any of the following Federal actions:
(1) The awarding of any Federal contract;
(2) The making of any Federal grant;
(3) The making of any Federal loan;
(4) The entering into of any cooperative agreement; and
(5) The extension, continuation, renewal, amendment, or modification of any
Federal contract,grant,loan,or cooperative agreement.
Covered Federal action does not include receiving from an agency a commitment
providing for the United States to insure of guarantee a loan.
'Indian tribe' and 'tribal organization' have the meaning provided in section 4 of the
Indian Self-Determination and Education Assistance Act (25 U.S.C. 450B). Alaskan
Natives are included under the definitions of Indian tribes in the Act.
'Influencing or attempting to influence' means making, with the intent to influence,
any communication to or appearance before an officer or employee of any agency,
a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress,in connection with any covered Federal action.
'Local government' means a unit of government in a State and, if chartered,
established, or otherwise recognized by a State for the performance of a government
duty, including a local public authority, a special district, an intrastate district, a
council of governments, a sponsor group representative organization, and any other
instrumentality of a local government.
'Officer or employee of an agency' includes the following individuals who are
employed by an agency:
(1) An individual who is appointed to a position in the Government under title 5,
U. S. Code, including a position under a temporary appointment;
(2) A member of the uniformed services as defined in section 101(3), title 37,
U. S. Code;
(3) A special government employee as defined in section 202, title 18, U. S. Code;
and
(4) An individual who is a member of a Federal advisory committee, as defined by
the Federal Advisory Committee Act,title 5,U. S. Code,Appendix 2.
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'Person" means an individual, corporation, company, association, authority, firm,
partnership, society, State, and local government, regardless of whether such entity is
operated for profit or not for profit. This term excludes an Indian tribe, tribal
organization, or any other Indian organization with respect to expenditures specifically
permitted by other Federal law.
'Reasonable compensation' means, with respect to a regularly employeed officer or
employee of any person, compensation that is consistent with the normal
compensation for such officer or employee for work that is not furnished to, not
funded by,or not furnished in cooperation with the Federal Government.
'Reasonable payment' means, with respect to professional and other technical
services,a payment in an amount that is consistent with the amount normally paid for
such services in the private sector.
'Recipient' includes the Contractor or Grantee, and all subcontractors or subgrantees
at any tier in connection with a Federal contract, grant, or other Federally funded
activity. The term excludes an Indian tribe, tribal organization, or any other Indian
organization with respect to expenditures specifically permitted by other Federal law.
'Regularly employed' means, with respect to an officer or employee of a person
requesting or receiving a Federal contract, an officer or employee who is employed
by such person for at least 130 working days within 1 year immediately preceding the
date of the submission that initiates agency consideration of such person for receipt of
such contract. An officer or employee who is employed by such person for less than
130 working days within 1 year immediately preceding the date of the submission that
initiates agency consideration of such person shall be considered to be regularly
employed as soon as he or she is employed by such person for 130 working days.
'State" means a State of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, a territory or possession of the United States, an
agency or instrumentality of a State, and a multi-State, regional, or interstate entity
having governmental duties and powers.
b Prohibition.
(1) Section 1352 of title 31, U. S. Code provides in part that no appropriated funds
may be expended by the recipient of a Federal contract, grant, loan, or
cooperative agreement to pay any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in
connection with any of the following covered Federal actions: The awarding of
any Federal contract, the making of any Federal grant, the making of any
Federal loan, entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal contract,
grant,loan,or cooperative agreement.
(2) The prohibition does not apply as follows:
(i) Agency and legislative liaison by Own Employees.
(A) The prohibition on the use of appropriated funds, in paragraph (b)(1),
does not apply in the case of a payment of reasonable compensation
made to an officer or employee of a person requesting or receiving a
Federal contract if the payment is for agency and legislative liaison
activities not directly related to a covered Federal action.
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(B) For purposes of paragraph (b)(2)(i)(A), providing any information
specifically requested by an agency or Congress is allowable at any
time.
(C) For purposes of paragraph (b)(2)(i)(A) of this section, the following
agency and legislative liaison activities are allowable at any time only
where they are not related to a specific solicitation for any covered
Federal action:
W Discussing with any agency (including individual demonstrations)
the qualities and characteristics of the person's products or
services,conditions or terms of sale,and service capabilities; and,
(iD Technical discussions and other activities regarding the
application or adaptation of the person's products or services for
an agency's use.
(D) For purposes of paragraph (b)(2)(0(A) of this section, the following
agency and legislative liaison activities are allowable only where they
are prior to formal solicitation of any covered Federal action:
01 Providing any information not specifically requested but necessary
for an agency to make on informed decision about initiation of a
covered Federal action;
(ii) Technical discussions regarding the preparation of an unsolicited
proposal prior to its official submission; arid,
(iii) Capability presentations by persons seeking awards from an
agency pursuant to the provisions of the Small Business Act, as
amended by Public Law 95-507 and other subsequent
amendments.
M Only those activities expressly authorized by paragraph (b)(2)(i) are
allowable under paragraph(b)(2)().
(i) Professional and technical services by Own Employees.
(A) The prohibition on the use of appropriated funds, in paragraph (b)(1),
does not apply in the case of any reasonable payment of reasonable
compensation made to an officer or employee of a person requesting
or receiving a Federal contract or an extension, continuation, renewal,
amendment, or modification of a Federal contract if payment is for
professional or technical services rendered directly in the preparation,
submission or negotiation of any bid, proposal, or application for that
Federal contract or for meeting requirements imposed by or pursuant
to law as a condition for receiving that Federal contract.
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(B) For purposes of paragraph (b)(2)(ii)(A), 'professional and technical
services' shall be limited to advice an analysis directly applying any
professional or technical discipline. For example, drafting of a legal
document accompanying a bid or proposal by a lawyer is allowable.
Similarly, technical advice provided by an engineer on the
performance or operational capability of a piece of equipment
rendered directly in the negotiation of a contract is allowable.
However, communications with the intent to influence made by a
professional (such as a licensed lawyer) or a technical person (such as
a licensed accountant)are not allowable under this section unless they
provide advice and analysis directly applying their professional or
technical expertise and unless the advice or analysis is rendered
directly and solely in the preparation, submission or negotiation of a
covered Federal action. thus, for example, communications with the
intent to influence made by a lawyer that do not provide legal advice
and analysis directly and solely related to the legal aspects of his or her
client's proposal, but generally advocate one proposal over another
are not allowable under this section because the lawyer is not
providing professional legal services. Similarly,communications with the
intent to influence made by an engineer providing an engineering
analysis prior to the preparation or submission of a bid or proposal are
not allowable under this section since the engineer is providing
technical services but not directly in the preparation, submission or
negotiation of a covered Federal action.
(C) Requirements imposed by or pursuant to law as a condition for
receiving a covered Federal award include those required by law or
regulation,or reasonably expected to be required by law or regulation,
and any other requirements in the actual award documents.
(D) Only those services expressly authorized by paragraph (b)(2)(ii) are
allowable under paragraph(b)(2)(ii).
(iii) Reporting for Own Employees.
No reporting is required with respect to payments of reasonable
compensation made to regularly employed officers or employees of a
person.
(iv) Professional and technical services by Other than Own Employees.
(A) The prohibition on the use of appropriated funds, in paragraph (b)(1),
does not apply in the case of any reasonable payment to a person,
other than an officer or employee of a person requesting or receiving a
covered Federal action, if the payment is for professional or technical
services rendered directly in the preparation,submission,or negotiation
of any bid, proposal, or application for that Federal contract or for
meeting requirements imposed by or pursuant to law as a condition for
receiving that Federal contract.
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(B) For purposes of paragraph (b)(2)(Iv)(A), "professional and technical
services' shall be limited to advice and analysis directly applying any
professional or technical discipline. For example, drafting of a legal
document accompanying a bid or proposal by a lawyer is allowable.
Similarly, technical advice provided by an engineer on the
performance or operational capability, of a piece of equipment
rendered directly in the negotiation of a contract is allowable.
However, communications with the intent to influence made by a
professional (such as a licensed lawyer) or a technical person (such as
a licensed accountant) are not allowable under this section unless they
provide advice and analysis directly applying their professional or
technical expertise and unless the advice or analysis is rendered
directly and solely in the preparation, submission or negotiation of a
covered Federal action. Thus, for example, communications with the
intent to influence made by a lawyer that do not provide legal advice
or analysis directly and solely related to the legal aspects of his or her
client's proposal, but generally advocate one proposal over another
are not allowable under this section.because the lawyer is not
providing professional legal services. Similarly,communications with the
intent to influence made by an engineer providing an engineering
analysis prior to the preparation or submission of a bid or proposal are
not allowable under this section since the engineer is providing
technical services but not directly in the preparation, submission or
negatiation of a covered Federal action.
(C) Requirements imposed by or pursuant to law as a condition for
receiving a covered Federal award Include those required by law or
regulation,or reasonably expected to be required by law or regulation,
and any other requirements in the actual award documents.
(D) Persons other than officers or employees of a person requesting or
receiving a covered Federal action include consultants and trade
associations.
(E) Only those services expressly authorized by paragraph (b)(2)(Iv) of this
section are allowable under paragraph(b)(2)(W.
(v) The prohibition on use of Federal appropriated funds does not apply to
influencing activities not in connection with a specific covered Federal
action. These activities include those related to legislation and regulations
for a program versus a specific covered Federal action.
(55 Fed. Reg. 24542 (June 15, 1990).)
(c) Certification and Disclosure.
(1) Each person (or recipient) who requests or receives a contract, subcontract,
grant,or subgrant,which is subject to section 1352 of title 31, United States Code,
and which exceeds S100A00 at any tier, shall file a certification (in the form set
forth in Attachment 1, consisting of one page; entitled "Certification Regarding
Lobbing") that the recipient has not made, and will not make, any payment
prohibited by paragraph (b) of this Exhibit.
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(2) Each recipient shall file a disclosure (in the form set forth in Attachment 2
consisting of three pages, entitled "Standard Form-LLL-"Disclosure of Lobbying
Activities') if such recipient has made or has agreed to make any payment using
nonappropriated funds (to include profits from any covered Federal action) in
connection with a contract or grant or any extension or amendment of that
contract or grant,which would be prohibited under paragraph (b) of this Exhibit
if paid for with appropriated funds.
(3) Each recipient shall file a disclosure form at the end of each calendar quarter in
which there occurs any event that requires disclosure or that materially affects
the accuracy of the information contained in any disclosure form previously filed
by such person under paragraph (c)(2). An event that materially affects the
accuracy of the information reported includes:
() A cumulative increase of $25,000 or more in the amount paid or expected
to be paid for influencing or attempting to Influence a covered Federal
action;or
(i) A change in the person(s) or Individual(s) influencing or attempting to
influence a covered Federal action; or,
(iii) A change in the officer(s), employee(s), or Member(s) contacted for the
purpose of influencing or attempting to influence a covered Federal action.
(4) Each person (or recipient) who requests or receives from a person referred to in
paragraph (c)(1) of this section a contract, subcontract, grant, or subgrant
exceeding $100= at any tier under a contract or grant shall file a certification,
and a disclosure form,if required,to the next tier above.
(5) All disclosure forms (but not certifications) shall be forwarded from tier to tier until
received by the person referred to in paragraph (1) of this section. That person
shall forward all disclosure forms to the State agency.
(d) Agreement. In accepting any contract,grant,subcontract or subgrant subject to this
Exhibit,the recipient(and any person submitting an offer for such a contract or grant)
agrees not to make any payment prohibited by law or this Exhibit.
(e) Penalties.
(1) Any person who makes an expenditure prohibited under paragraph (b) of this
Exhibit shall be subject to a civil penalty of not less than $10A00 and not more
than $100,000 for each such expenditure.
(2) Any person who fails to file or amend the disclosure form to be filed or amended
if required by this Exhibit,shall be subject to a civil penalty of not less than $10A00
and not more than $100,000 for each such failure.
(3) Recipients may rely without liability on the representations made by their
subcontractors or subgrantees in the certification and disclosure form.
(f) Cost allowability. Nothing in this Exhibit is to be interpreted to make allowable or
reasonable any costs which would be unallowable or unreasonable in accordance
with Part 31 of the Federal Acquisition Regulation. Conversely,costs made specifically
unallowable by the requirements in this Exhibit will not be made allowable under any
of the provisions of Part 31 of the Federal Acquisition Regulation.
-23-
Attachment 1
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
The undersigned certifies,to the best of his or her knowledge and belief,that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned,to any person for Influencing or attempting to Influence an officer or employee of an agency
of the United States Government, a Member of Congress. an officer or employee of Congress, or an
employee of a Member of Congress in connection with the making, awarding or entering Into of this
Federal contract, Federal grant, or cooperative agreement, and the extension, continuation, renewal,
amendment,or modification of this Federal contract,grant,or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person
for influencing or attempting to Influence an officer or employee of any agency of the United States
Government,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with this Federal contract,grant,or cooperative agreement,the undersigned shall
complete and submit Standard Form LLL, 'Disclosure of Lobbying Activities' In accordance with Its
Instructions.
(3) The undersigned shall require that the language of this certification be Included in the award
documents for all subawards at all tiers (including subcontractors,subgrants, and contracts under grants
and cooperative agreements) of S100.000 or more, and that all subreciplents shall certify and disclose
accordingly.
This certification Is a material representation of fact upon which reliance was placed when this transaction
was made or entered Into. Submission of this certification Is a prerequisite for making or entering Into this
transaction Imposed by Section 1352, Title 31, U. S. Code. any person who falls to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each
such failure.
Name of Cordrocfor Printed Mane of Peron So-w p for Contractor
Contract/C4cr#Number Skrx*m of Peron Sigr*V for cormodor
Date True
After execution by or on Behalf of Contractor,please return to:
Department of Health Services
(Name of the DHS program providing the funds)
P.O.Box 942732
714 P Street
Sacramento,CA 94234-7320
CMS tsstnicrionct&retro Na 13(10/91) -24-
Attachment 2
DISCLOSURE OF LOBBYING ACTIVITIES Appoea�
aa
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
(See reverse for public burden disclosure)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
❑ a. contract ❑ a. bid/offer/application
❑ a. initial filing
b. grant b. Initial award b. material change
c. cooperative agreement c. post-award For Material Change Only:
d. loan
e. loan guarantee Year quarter
f. loan Insurance date of last report
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No.4 Is Subawardee,Enter Name
and Address of Pri
❑ Prime ❑ Subawardee
Tier ,If known:
Congressional District,if known: Con ressional District,If known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number.if applicable:
8. Federal Action Number,if known: 9. Award Amount,If known:
10. a. Name and Address of Lobbying Entity b. Nome and Address of Lobbying Entity
(if Individual,last name.first name.Mi): (If Individual,last name,first name,MI):
(attach Continuation Sheet(s)SF-LLL-A,if necessary)
11. Amount of Payment(check all that apply): 13. Type of Payment(check all that apply):
$ ❑ actual ❑ planned ❑ a. retainer
12. Form of Payment(check all that apply): ❑ b. one-time fee
❑ c. commission
❑ a. cash
❑ b. in-kind.specify: Nature ❑ d contingent fee
❑ e. deferred
Value ❑ f. other,specify:
14. Brief Description of Services Performed or to be Performed and Date(s)of Service,Including Officer(s).Employee(s),
or Member(s)Contacted,for Payment Indicated In Item 11:
(Attach Continuation Sheet(s)SF-LLL-A,if necessary)
15. Continuation Sheet(s)SF-LLL-A Attached: ❑ Yes ❑ No
16. Information requested through this form is authorized by Title 31,
U.S.C., Section 1352. This disclosure of lobbying activities Is a SgrxO re
material representation of fact upon which reliance was
placed by the tier above when this transaction was made or
entered into. This disclosure Ls required pursuant to Title 31, Rhf N=e:
U.S.C.,Section 1352. This information will be reported to the
Congress semiannually and will be available for public :
inspection. Any person who fails to file the required disclosure
shall be subject to a civil penalty of not less than$10,000 and
not more than S 100,000 for each such failure. Telephone No.: Oate:
f:�i:Y: :tr:o •v%.
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CMS hsfnictior d&Wath Na 14(10/91) -25-
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the
initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to Title 31, U.S.C.,
Section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for
influencing or attempting to Influence an officer or employee of any agency, a Member of congress, an officer or
employee of congress,or an employee of a Member of Congress in connection with a covered Federal action. Use the
SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that
apply for both the initial filing and material change report. Refer to the Implementing guidance published by the Office of
Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to Influence the
outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identity the appropriate classification of this report. if this Is a follow up report caused by a material change to the
Information previously reported,enter the year and quarter In wtdch the change occurred. Enter the date of the last
previously submitted report by this reporting entity for this covered Federal Action.
4. .Enter the full name,address,city,state and zip code of the reporting entity. Include Congressional District,if known.
Check the appropriate classification of the reporting entity that designates if It is, or expects to be, a prime or
subaward recipient. Identity the tier of the subowardee, e.g., the first subawardee of the prime is the 1st tier.
Subawards include but are not limited to subcontracts,subgrants and contract awards under grants.
5. If the organization filing the report In Item 4 checks'Subawardee;then enter the full name,address,city,state and zip
code of the prime Federal recipient. Include Congressional District,If known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational
level below agency name,if known. For example,Department of Transportation,United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the full
Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan
commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action Identified in Item 1
(e.g., Request for Proposal (RFP) number; Invitation for Bid(IFB)number; grant announcement number; the contract,
grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include
prefixes,e.g.'RFP-DE-90-001.'
9. For a covered Federal action where there has been an award or loan commitment lay the Federal agency.enter the
Federal amount of the award/loan commitment for the prime entity Identified In Item 4 or 5.
10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reproting entity
Identified in Item 4 to influence the covered Federal action.
(b) Enter the full names of the Individual(s)performing services,and Include full address if different from 10.(a). Enter
last name.first name,and middle Initial(MI).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (ttem 4)to the
lobbying entity(Item 10). INdiccte whether the payment has been made(actual)or will be made(planned). Check
all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to
be made.
12. Check the appropriate box(es). Check all boxes that apply. If payment is:made through an in-kind contribution,
specify the nature and value of the in-kind payment.
13. Check the appropriate box(es). Check all box(es)that apply. If other.specify nature.
14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to
perform,and the date(s) of any services rendered. Include all preparatory and related activity,not just time spent in
actual contact with Federal officials. Identity the Federal official(s) or employee(s) contacted or the officer(s),
employee(s),or Member(s)of Congress that were contacted.
15. Check wether or not a SFLLL-A continuation Sheet(s)is attached.
16. The certifying official shall sign and date the form,print his/her name,title.and telephone number.
Public reporting burden for this collection of Information is estimated to average 30 minutes per response,
including time for reviewing instructions,searching existing data sources,;gathering and maintaining the
data needed,and completing and reviewing the collection of informatlon. Send comments regarding
the burden es timate or any other aspect of this collection of information. Including suggestions for
reducing this burden. to the Office of Management and Budget. Papenvork Reduction Project
(0348-0046).Washington,D.C..20503.
-26-
DISCLOSURE OF LOBBYING ACTIVITIES
CONTINUATION SHEET
Approved by OMB
-348-0046
Reporting Entity: Page of
CMS hshuc#onal k"th N0.14(10/91) Aufhoraed for ta-Locd wd Foff uctlon
'2�' StarxlQd Farm-LLL-A
Contra Zostq County Health Services Department Contract No: 92-16112
E�LHIBIT E
FEDERAL CONTRACT FUNDS
1. It is mutually understood between the parties that this contract
may have been written before ascertaining the availability of
Congressional appropriation of funds, for the mutual benefit of
both parties in order to avoid program and fiscal delays which
would occur if the contract were executed after the
determination was made.
2. This contract is valid and enforceable only if sufficient funds
are made available to the state by the United States Government
for the purposes of this program. In addition, this contract is
subject to any additional restrictions , limitations or
conditions enacted by the Congress or any statute enacted by the
Congress which may affect the provisions, terms, or funding of
this contract in any manner.
3 . It is mutually agreed that if the Congress does not appropriate
sufficient funds for the program, this contract shall be amended
to reflect any reduction in funds.
4 . Each party has the option to void the Contract under the 30-day
cancellation clause or to amend the Contract to reflect any
reduction of funds.