PROCEDURES FOR MENTAL HEALTH SERVICES … · BHSVC 610341 10000 350591 00000 2015 NIA Send Response...

A RESOLUTION AUTHORIZING THE WAIVER OF THE COUNTY'S PURCHASING PROCEDURES FOR MENTAL HEALTH SERVICES FOR THE COUNTY OF ALAMEDA

RESOLUTION NUMBER R-2014=25 0

WHEREAS, the County of Alameda has approved a contract with Crestwood Behavioral Health Inc., on July 29, 2014; and

WHEREAS, the County wishes to retain the services of Crestwood Behavioral Health Inc., to provide residential mental health rehabilitation services; and

WHEREAS, Alameda County Administrative Code sections 4.12.010, 4.12.020, and 4.12.070 require for expenditures exceeding $100,000, the solicitation of bids except in unusual cases where the Board of Supervisors ("Board") has, by resolution, found and determined the public interest would not be served by complying with the bid solicitation process; and

WHEREAS, the Board has determined that Crestwood Behavioral Health Inc., has the necessary professional qualifications and demonstrated competence in providing mental health services through mental health rehabilitation facilities ; and

WHEREAS, the Board has determined that Crestwood Behavioral Health Inc. , has expertise and enjoys a unique position within the community to serve the targeted population , and the Board has determined that the public interest would not be served by requiring a bid solicitation process in this situation;

NOW, THEREFORE, BE IT RESOLVED as follows:

1. The findings stated in the recitals to this Resolution are restated in full and adopted by reference.

2. The requirements in Administrative Code Sections 4.12.010 to 4.12.020 for the solicitation of bids are hereby waived for the selection of Crestwood Behavioral Health Inc.

Adopted by the Board of Supervisors of the County of Alameda, State of California, on July 29, 2014, by the following called vote:

AYES: Supervisors Haggerry, Miley, Valle & Pres i dent Carson - 4 NOES: None EXCUSED: Supervisor Chan - 1

ATTEST: APPROVED AS TO FORM: Clerk of the Board of Supervisors, Donna Ziegler, County Counsel C ameda

By:~ ~£yd;/~ Farand Kan ZI Deputy County Counsel

form 110-9 Kev '6/ 13 REQUEST TO ENCUMBER, ADD, LIQUIDATE FUNDS OR PAY CONTRACTOR

PART I: REQUEST FROM CONTRACTING DEPARTMENT

Contractor' s Name: Crestwood Behavioral Health, Inc.

If Pay Contract-Remittance Address: PO Box 980966, West Sacramento. CA 95798

Contractor' s Tax ID: 68-0399495

Description of Contract: Out-of-County Services-as-Needed

Master Contract #: 000001

Procurement Contract Begin Date: 07/01 /2014

Elation Project Info: D Sub-Contractor Compliance

Contractor' s Vendor ID: 0000024452

Procurement Contract #: 10689

Expire Date: 06/30/2015

D Labor Compliance

B d W ·ver #: GSA Waiver #: Federal Fund Waiver #:

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QC/) crcr ~o o~ co> o<l er

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-------- ----------CUMBER FUNDS IN A NEW PURCHASE ORDER

e of Board Minute Order: 07/29/2014 Item/Contract Number: 15 .1 /000001

Total Amount Authorized By Board: Services-As-Needed Amount to be Encumbered: $110,000

Justification if partial encumbrance requested: Master ContraGt 000001 used for multiple out-of-county services-as-needed procurement contracts

B. ADD FUNDS TO AN EXISTING PURCHASE ORDER PO Number: ________ ___ ___ _

Date of Board Minute Order: File/Item/Contract Number:

Total Amount Authorized By Board: ________ _ Amount to be Encumbered: ---- -

Justification if partial encumbrance requested: ___________________________ _

C. LIQUIDATE FUNDS FROM A PURCHASE ORDER

Purchase Order Number: ----------- Amount to be Liquidated: _ _ __________ _

Liquidation Justification:---------------------------------

D. PAY CONTRACTOR -ATTACH INVOICE PO#: ------- PO Type: ___ ____ _

Business Unit: Voucher #: ------------ - - ------

Invoice #: Amount Due $: Service Period: --------- ------------Payment Handling: D US Mail D Return to Department D CBAP Payment

Pay Comments: ---------------------------------------

Dept Claims Processor: _____________ Dept. Claims Approver: ___ __________ _

Authorized signatory below certifies that contractor has provided goods/services as invoiced and verifies the mathematical accuracy of the invoice; that all financial provisions of the contract have been met (including the rates charged); that all invoiced items are specifically authorized by the contract and no contract limits have been exceeded (in total, by month or by expense category.

ACCOUNTING INFORMATION Business Unit Account Fund Dept Pro2ram BY Subclass

BHSVC 610341 10000 350591 00000 2015 NIA

Send Response to: Margaret Tolbert QIC: 28007

Authorized Signatur~. t~Department: BHCS - Network Office

Print Name of Authorized Signatory: R~ -

PART II: RESPONSE FROM AUDITOR-CONTROLLER

D The Auditor-Controller encumbered in a new PO. The PO Number is

Proj/Grant NIA

Total

Phone: 510-383-1743

Date: <6/nj I±

-------

0 The Auditor-Controller added to PO Number ---------------0 The Auditor-Controller liquidated from PO Number -------- ---

Amount 110,000

110,000

0 Contractor payment Approved D Contractor payment Denied-Reason: ___________________ _

D This form is being returned to you due to insufficient funds in the appropriation account.

D The following information is needed before this request can be processed.

Signature of Contract Processor/Claims Approver _________________ Date: _________ _

r . . ..

[Master Contract No.000001_. Procurement Contract No. 10689 .-

SERVICES-AS-NEEDED CONTRACT

THIS CONTRACT, made and entered into by and between the COUNTY OF ALAMEDA, a body corporate and politic of the State of California, hereinafter referred to as "County", and Crestwood Behavioral Health, Inc. , a For-Profit Corporation, doing business at 520 Capitol Mall, Suite 800, Sacramento, CA 95814, hereinafter referred to as "Contractor".

WITNESS ETH:

WHEREAS, County is desirous of contracting with Contractor for the provision of certain services, a description of which is presented in Exhibit A(s) , attached hereto; and

WHEREAS, Contractor is receiving funds pursuant to the funding terms indicated in Exhibit B(s); and

WHEREAS, Contractor is willing to provide proof of insurance as specified in Exhibit C; and

WHEREAS, Contractor willingly agrees to participate in audits required by the County as defined in Exhibit D; and

WHEREAS, Contractor agrees to comply with applicable federal suspension and .-1 c.; h"1 rr .. .,r,; 1·i-;g l il :.irion;:, a ...: p<;cifierl in l- h"bi; r: ~nd

WHEREAS, Contractor is willing and able to perform duties and render services which are determined by the Board of Supervisors to be necessary or appropriate for the welfare of residents of County; and

WHEREAS, County desires that such duties and services be provided by Contractor, and Contractor agrees to perform such duties and render such services, as more particularly set forth below:

NOW, THEREFORE, IT IS HEREBY MUTUALLY AGREED as follows:

1. Term of Agreement

The Term of this Agreement begins on the 1st day of July 2014 and ends on the 30th day of June 2015.

Contractor understands and agrees that there is no representation , implication, or understanding that the services provided by Contractor under this Agreement will be purchased by County from Contractor under a new Agreement following expiration or termination of this Agreement. Contractor waives all rights or claims to notice or hearing respecting any failure by County to continue to purchase all or any such service from Contractor following the expiration or termination of this Agreement.

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Contractor: Crestwood Behavioral Health, Inc.

Contract Period: July 1, 2014 - Ju ne 30, 2015

2. Program Description and Performance Requirements - Exhibit A(s)

This Agreement shall be accompanied by, marked Exhibit A(s) , and by this reference made a part hereof, a description of the duties and services to be performed for County by Contractor, and Contractor agrees to comply with all provisions, to perform all work, and to provide all such duties and services set forth in Exhibit A(s) in a professional and diligent manner.

3. Terms and Conditions of Payment - Exhibit B(s)

County has agreed to provide funds as described in this Agreement. Unless an amendment to this Agreement otherwise provides, no funds other than those for services described in this Agreement will be used for payment, and County shall under no circumstances be required to pay in excess of that amount. Payment shall be made pursuant to the terms and conditions set forth in Exhibit B(s), attached hereto and by this reference made a part hereof.

Unless it is otherwise provided in Exhibit B(s) to this Agreement, Contractor shall submit invoices no later than 35 calendar days after the last day of the service month. All claims submitted after forty-five (45) days following the ending date of the Agreement will not be subject to reimbursement by the County. Any "obligations incurred" included in claims for reimbursements and paid by the County which remain unpaid by the Contractor after forty-five (45) days following the ending date of the agreement will be disallowed under audit by the County.

Contractor agrees to comply with all requirements which are now, or may hernafter be, ·mposed by the funding goverrirnent with respect to the receipt and disbursement of the lu 1 s referred to in Exhibit B(s), as we ll as such requirements as may be imposed by County. Without limiting the generality of the foregoing , Contractor agrees that it will not use funds received pursuant to this Agreement, either directly or indirectly, as a contribution in order to obtain any Federal funds under any Federal programs without prior written approval of County.

4. Insurance - Exhibit C

Contractor shall maintain in force , at all times during the term of this Agreement, those insurance and bonding documentation described in Exhibit C attached hereto and made a part of this Agreement, and shall comply with all other requirements set forth in that Exhibit. Contractor shall provide Worker's Compensation insurance at Contractor's own cost and expense, and neither Contractor nor its carrier shall be entitled to recover from the County any costs , settlements, or expenses of Worker's Compensation claims arising out of this Agreement.

5. Additional Fiscal Provisions

Contractor shall not claim reimbursement from County for (or apply sums received from County with respect to) that portion of its obligations which has been paid by another source of revenue. Sums received as a result of applications for funds from public or private organizations shall be considered such revenue insofar as such sums are or can be applied to the work to be performed by Contractor pursuant to this Agreement.

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Contract Period: July 1, 2014 · June 30, 2015

Unrestricted or undesignated private charitable donations and contributions shall not be considered revenue applicable to this Agreement; Contractor has total freedom in planning for the usage of such resources in expanding and enriching programs, or in providing for such other operating contingencies as it may desire. Nothing herein shall be deemed to prohibit Contractor from contracting with more than one entity to perform additional work similar to or the same as that herein contracted for.

6. Business Associate

Contractor will be performing or assisting County in the performance of certain health care administrative duties that involve the use and/or disclosure of Protected Health Information as defined at 45 CFR. Part 164. As a result , Contractor is a Business Associate of County and shall comply with the provisions set forth in Exhibit E to this Agreement.

7. Records

(1) Contractor shall maintain on a current basis complete financial records including, but not necessarily limited to, books of original entry, source documents in support of accounting transactions, a general ledger, personnel and payroll records , cancelled checks, and related documents in accordance with generally accepted accounting principles and any specific requirements of the applicable funding source.

(2) Contractor shall maintain on a current basis complete records pertaining to the provision of services and eligibility, including, but not limited to , medical records, client files , participant records, patient logs or other service related documentation in accordance with instructions orovided by County.

(3) Contractor shall maintain on a current basis complete records pertaining tq Contractor's organizational structure and activities, including, but not limited to, bylaws, articles of incorporation, documentation of tax exempt status, Board of Directors roster, minutes of meetings of the Board of Directors and committees, administrative program policies and procedures and any other documents required by County or the State or federal government or the applicable funding source.

Contractor will cooperate with County in the preparation of, and will furnish any and all information required for, reports to be prepared by County and/or Contractor as may be required by the rules , regulations, or requirements of County of any other governmental entity or applicable funding source. County shall specify in detail the cooperation required .

Records shall be retained by Contractor, and shall be made available for auditing and inspection, for no less than seven (7) years following the provision of any services pursuant to this Agreement, or for a longer period as required by the applicable funding source. If Contractor enters into any County-approved agreement with any related organization to provide services such agreement shall contain a clause to the effect that the related records of that organization shall be retained, and shall be made available for auditing and inspection, for no less than seven (7) years following its provision of services pursuant to the subcontract, or for a longer period as required by the applicable funding source.

County reserves the right to issue further instructions regarding the extent of records required to be kept, the format to be used, and record retention and access requirements as is necessary to perform audits and to otherwise comply with requirements set forth by applicable funding sources.

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Contract Peri od: July 1, 2014 - June 30, 2015

8. Audits

Contractor's records, as defined in this Agreement, shall be accessible to County for audit and inspection to assure proper accounting of funds , and to certify the nature of, and evaluate Contractor's performance of its obligations as set forth in this Agreement. County shall be entitled to access onto Contractor's premises to observe operations, inspect records or otherwise evaluate performance at all reasonable times and without advance notice. County shall conduct inspections and manage information in a manner consistent with applicable laws relating to confidentiality of records and in a manner that will minimize disruption of Contractor's work.

Separate and apart from the audit and inspection provisions set forth immediately above, Contractor's records will be subject to audits as required by Federal and/or State agencies and/or other funding sources. These audits include those performed pursuant to applicable OMB Circulars, as described more fully in Exhibit D of this Agreement , or audits otherwise authorized by Federal or State law.

9. Indemnification

A Contractor shall defend, indemnify, and hold harmless County, its Board of Supervisors, officers, directors, agents, employees and volunteers from and against all demands, claims, actions, liabilities, losses, damages, and costs, including payment of reasonable attorneys' fees , arising out of or resulting from the performance of the Agreement, caused in part by the negligent or intentional acts or omissions of Contractor's officers, d·rectors, agents. employees or subcontractors.

B. County shall defend, indemnify, and hold harmless Contractor, its officers, directors, agents, employees, and subcontractors from and against all demands, claims, actions, liabilities, losses, damages and costs , including reasonable attorneys' fees, arising out of or resulting from the performance of the Agreement, caused in part by the negligent or intentional actors or omissions of County's Board of Supervisors, officers, directors, agents, employees, or volunteers.

C. It is the intention of County and Contractor that the provisions of this paragraph be interpreted to impose on each party responsibility to the other for the acts and omissions of their respective officers, directors, agents, employees, volunteers, County's board of Supervisors, and Contractor's subcontractors. It is also the intention of County and Contractor that, where comparative fault is determined to have been contributory, principles of comparative fault will be followed and each party shall bear the proportionate cost of any damage attributable to the fault of that party, its officers, directors, agents, employees, volunteers, County's Board of Supervisors and Contractor's subcontractors.

10. Subcontracting

None of the work to be performed by Contractor shall be subcontracted without the prior written consent of County. Contractor shall be as fully responsible to County for the acts and omissions of any subcontractors, and of persons either directly or indirectly employed by them, as Contractor is for the acts and omissions of persons directly employed by Contractor. Contractor shall not transfer any interest in this Agreement (whether by

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Cont ractor: Crestwood Behavioral Health, Inc.

Contract Period: July 1, 2014 - June 30, 2015

assignment or novation) without prior written approval of County. However, Contractor may assign its rights to receive compensation from the County for performance of the Agreement to financial institutions for the purpose of securing financial resources , provided that written consent from the supervising department shall have first been obtained. No party shall , on the basis of this Agreement, in any way contract on behalf of, or in the name of, the other party to the Agreement, and any attempted violation of the provisions of this sentence shall confer no rights, and shall be void .

11. Independent Contractor Status

Neither the Contractor nor any of its employees shall by virtue of this Agreement be an employee of County for any purpose whatsoever, nor shall it or they be entitled to any of the rights, privileges, or benefits of County employees. Contractor shall be deemed at all times an independent contractor and shall be wholly responsible for the manner in which it performs the services required of it by the terms of this Agreement. Contractor assumes exclusively the responsibility for the acts of its employees as they relate to the services to be provided during the course and scope of their employment.

12. Confidentiality

Contractor agrees to maintain the confidentiality of any information which may be obtained with this work. Contractor shall comply with whatever special requirements in this regard as are described or referred to in Exhibit A(s) to this Agreement. Confidential information is defined as all information disclosed to Contractor which relates to County's past, present and future activities, a well as activities under this Agreement. Contractor will hold all such information in -trust and confidence. Upon cancellation or expiration uf this Agreement, Contractor will return to County all written or descriptive matter which contains any such confidential information.

County shall respect the confidentiality of information furnished by Contractor to County as specified in Exhibit A(s) or as otherwise provided by law.

13. Termination Provisions

Termination for Cause - If County determines that Contractor has failed , or will fail, through any cause, to fulfill in a timely and proper manner its obligations under the Agreement, or if County determines that Contractor has violated or will violate any of the covenants, agreements, provisions, or stipulations of the Agreement, County shall thereupon have the right to terminate the Agreement by giving written notice to Contractor of such termination. Such termination shall be effective immediately upon receipt of notice, or on a later date as specified in its notice by County.

Without prejudice to the foregoing , Contractor agrees that if prior to or subsequent to the termination or expiration of the Agreement upon any final or interim audit by County, Contractor shall have failed in any way to comply with any requirements of this Agreement, then Contractor shall pay to County forthwith whatever sums are so disclosed to be due to County (or shall, at County's election, permit County to deduct such sums from whatever amounts remain undisbursed by County to Contractor pursuant to this Agreement or from whatever remains due Contractor by County from any other contract between Contractor and County) .

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Contractor: Crestwood Behavioral Health, Inc. Cont ract Pe riod: Ju ly 1, 2014 - June 30, 2015

Termination Without Cause - County and Contractor shall have the right to terminate this Agreement without cause at any time upon giving at least 60 days written notice prior to the effective date of such termination.

Termination By Mutual Agreement - County and Contractor may otherwise agree in writing to terminate this Agreement in a manner consistent with mutually agreed upon specific terms and conditions.

14. Compliance with Laws

Contractor shall observe and comply with all applicable laws, ordinances, codes and regulations of governmental agencies, including federal , state, municipal and local governing bodies, having jurisdiction over the scope of services or any part hereof, including Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794) , all provisions of the Occupational Safety and Health Act of 1979 and all amendments thereto, and all applicable federal , state, municipal and local safety regulations . All services performed by Contractor must be in accordance with these laws, ordinances, codes and regulations . Contractor shall indemnify and save County harmless from any and all liability, fines , penalties and consequences from any noncompliance or violations of such laws, ordinances, codes and regulations . A violation of such laws, ordinances, codes and regulations shall constitute a material breach of this Agreement and can lead to the termination of this Agreement and appropriate legal proceedings.

15. Accident Reporting

If a death, ~erious personal injury, or substantial property damage occurs in connection with the performance of this Agreement, Contractor shall immediately notify the Supervising Department by telephone. Contractor shall promptly submit a written report, in such form as may be required by Supervising Department, of all accidents which occur in connection with this Agreement. This report must include the following information: (1) name and address of the injured or deceased person(s) ; (2) name and address of Contractor's subcontractor, if any; (3) name and address of Contractor's liability insurance carrier; and (4) a detailed description of the circumstances surrounding the accident, whether any of County's equipment, tools , materials or staff were involved and the extent of damage to County and or other property; (5) determination of what effect, if any, accident will have upon Contractor's ability to perform services.

16. Personal Property

Unless otherwise provided in Exhibit B(s) to this Agreement, in the event that payment under this Agreement is other than by fee-for-service, title to all personal property having a unit purchase price of over $1 ,000 acquired by Contractor in connection with this Agreement or the services rendered pursuant thereto shall vest in County, and shall be returned to County at the expiration or termination of the Agreement.

17. Non-Discrimination

Contractor assures that he/she will comply with the Americans with Disabilities Act and Title VII of the Civil Rights Act of 1964. Contractor further agrees and that no person shall ,

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' . ' Contractor: Crestwood Behavioral Health, Inc.

Contract Period: July 1, 2014 - June 30, 2015

on the grounds of race, creed, color, disability, sex, sexual orientation or national origin, age, religion, Vietnam Era Veteran's status, political affiliation, or any other non-merit factors, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under this Agreement.

18. Governing Board Limitations: Conflict of Interest

Contractor shall observe and comply with all applicable laws, ordinances, codes and regulations of governmental agencies, including federal, state, municipal and local governing bodies regarding conflicts of interest.

If Contractor has entered into this Agreement as a not-for-profit organization as defined by state and federal law, and is in receipt of funds from County based on such status, Contractor shall at all times conduct its business in a manner consistent with that required of a not-for-profit organization by applicable laws.

Contractor, whether or not a not-for-profit organization, shall not permit any member of its governing board to perform for compensation any administrative or operational functions for the Contractor with respect to the performance of this contract, be it in the capacity as director, officer or employee, (including , but not by way of limitation, fiscal , accounting , or bookkeeping functions) without first obtaining the written consent of the County Agency Director/Chief Administrator.

No administrative employee, officer or director of Contractor may do any of the following without first having !=l iven advanced written notice to the County Agency Directo r/Chief Administrator:

• receive funds from County other than those funds provided pursuant to the Agreement;

• simultaneously serve as an employee, officer or director of another community based organization;

• simultaneously serve as a Director of another governing board or comm1ss1on which could have influence over the operations of Contractor.

Contractor shall not, without having given advanced written notice to County Agency Director/Chief Administrator of its intention, do any of the following :

• Employ any person who is related by blood or marriage to another employee, a manager, or a member of the governing board of the Contractor;

• Contract for the acquisition of goods or services for more consideration than would be paid for equivalent goods or services on the open market from any person who is related by blood or marriage to a manager or a member of the governing board of the Contractor; or

• Contract for the acquisition of goods or services for more consideration than would be paid for equivalent goods or services on the open market from any organization in which any person who is related by blood or marriage to a manager or member

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Contractor: Crestwood Behavioral Health, Inc. Contract Period : July 1, 2014 - June 30, 2015

of the governing board of the Contractor has a substantial personal financial interest.

Contractor shall not, during the term of this Agreement, permit any member of the governing board of the Contractor to have or acquire, directly or indirectly, any personal financial interest in the performance of the Agreement, as by providing goods or services for compensation , or otherwise, without having first disclosed the same to the board and the County Agency Director/Chief Administrator, and said member shall not participate in board discussion or action on such matter.

Should the County Agency Director/Chief Administrator object to such employment or contracting and a resolution cannot be achieved then the act of proceeding on such employment or contracting shall constitute grounds for Termination of this Agreement for Cause under the provisions of paragraph 12.

19. Drug-free Workplace

Contractor and Contractor's employees shall comply with the County's policy of maintaining a drug-free workplace. Neither Contractor nor Contractor's employees shall unlawfully manufacture, distribute, dispense, possess or use controlled substances, as defined in 21 U.S. Code Section 812, including marijuana, heroin, cocaine, and amphetamines, at any County facility or work site. If Contractor or any employee of Contractor is convicted or pleads nolo contendere to a criminal drug statute violation occurring at a County facility or work site, the Contractor, within five days thereafter, shall notify the Supervising Department of the County department/agencv for which the Ag reemenc services·are'0 performed. Violation of this_provision sr1all constitute a material breach of this Agreement.

20. . Modifications to Agreement

County shall assign a liaison to Contractor with respect to the performance of this Agreement. Unless otherwise provided in Exhibit A(s) and/or B(s) to this Agreement, any adjustments requested by the Contractor to line items of a budget or to the program description included as an Exhibit to this Agreement may only be made upon written approval of the supervising department. Such adjustments shall not alter (1) services or other performance to be provided under this Agreement, (2) the time of performance of any act hereunder, or (3) the total amount of money allocated hereunder.

This Agreement can be amended only by written agreement of the parties hereto.

21. Designation of Authorized Personnel

Contractor shall provide County with a list of Contractor's employees or members of Contractor's Board of Directors who have been authorized to act on behalf of Contractor in its dealings with County. An "act' on behalf of Contractor includes but is not necessarily limited to , execution of Agreement, Agreement amendments and exhibits, signing of claims, and authorization of payment on invoices. The list shall be updated as necessary to accurately reflect such authorizations.

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Contractor: Crestwood Behavioral Health, Inc. Contract Period: July 1, 2014 - June 30, 2015

22. Notice

All notices required hereunder will be in writing and served personally or by certified mail, return receipt requested , postage prepaid, at the addresses shown below:

CONTRACTOR Attn: Gary Zeyen, Executive Director Crestwood Behavioral Health, Inc. 520 Capitol Mall, Suite 800 Sacramento, CA 95814

COUNTY: County of Alameda Behavioral Health Care Services 1900 Embarcadero Cove, Suite 205 Oakland, CA 94606

IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date referenced below.

COUNTY OF ALAMEDA

I Date

Approved as to form:

Office of the County Counsel , Alameda County

By ----c:>~~----Deputy County Counsel

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CONTRACTOR

Crestwood Behavioral Health, Inc. Contractor

520 Capitol Mall, Suite 800 Street Address

Sacramento, CA 95814 City, State, Zip Code

68-0399495 Federal ID No.

Controller Title

EXHIBIT A

PROGRAM DESCRIPTION AND PERFORMANCE REQUIREMENTS

Contracting Department Alameda County Behavioral Health Care Services (BHCS) Contractor Name Crestwood Behavioral Health, Inc. Contract Period July 1, 2014-JW1e 30, 2015 Type of Contract Services As Needed Contract Number 000001

I. Program Name

Angwin: Crestwood Center Vallejo: Crestwood Recovery and Rehabilitation Center and Crestwood Manor

II. Contracted Services

Mental Health Rehabilitation Center (MHRC) Skilled Nursing Facility (SNF)/Skilled Treatment Program (STP)

III. Program Information and Requirements

A. Program Goals

Contractor shall provide services to accomplish the following goals: ., Increase Client recovery; • Increase Client's-·ability to maintain themselves in the commW1ity; • Reduce Client's placement in State hospitals; and • Reduce Client's symptoms.

B. Target Population

Contractor shall provide services to the following populations:

1. Service Groups

Contractor shall provide services to Alameda CoW1ty adults with severe and persistent mental illness (SPMI) who require treatment in a 24-hour residential setting, for generally more than six months.

2. Referral Process to Program

Contractor shall only accept referrals approved by BHCS' System Utilization Team Chair or her delegate or contract monitor.

3. Program Eligibility

Contractor shall serve individuals age 18 and over who meet the following criteria:

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Contractor: Crestwoord Behavioral Health, Inc Contract Period: July I, 2014-June 30, 2015

Exhibit A Page 2 of 5

• Have been assigned and authorized based on BHCS System Utilization Team meeting assessment, prioritization and referral.

Contractor shall primarily serve individuals aged 18 to 56 years. BHCS shall review individuals age 57 and older on a case-by-case basis to ensure appropriateness of level of care and setting.

Contractor shall only provide beds to Alameda County residents, as specified by the BHCS System Utilization Team Chair, unless otherwise authorized by designated BHCS staff

4. Limitations of Service

Contractor shall not accept individuals who meet any of the following criteria: • Have a primary diagnosis of organic mental disorders those referred with only

Axis II diagnosis and no record of Axis I, substance abuse • A secondary diagnosis of organic or neurological disorders makes them

unreceptive or unresponsive to treatment; • Have primary presenting problems resulting from drug and/or alcohol abuse

or who require drug or alcohol detoxification; clients with said problems will be i·eferred to appropriate dual diagnosis programs when available

• Have life-threatening medical problems, co1runw1icable diseases or any health h m, which requires more than an · lpati nt level of medi care;

• Wh _are persi tent Ii e- ett r ; • Individuals dangerous to others with active Tarasoff Warnings, who are in

close proximity to the identified victim.

Contractor shall work with BHCS monitor, or delegate to assess the admission of any individual who meets the legal definition for any of the following categories: Individuals with 1370.01 Status, Individuals with Murphy Conservatorship or Imminently Dangerous Persons.

C. Program Description

Contractor shall maintain programmatic services at the following minimum levels:

1. Program Design

Contractor shall provide inpatient, long-term, non-acute mental health rehabilitation, SNF/STP services. Contractor shall provide Clients with a therapeutic milieu, a structured group setting, which shall include rehabilitative therapy. Clients may receive individual and/or group therapy, art therapy, family support and medication, as needed.

Preparation Date: 07/09/14 Revision Date: 08/14/14

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Contractor: Crestwoord Behavioral Health, Inc Contract Period: July l , 2014 - June 30, 2015

2. Consumer/Client Flow

Contractor shall provide services as follows: Milestone Activity Timing Intake/ Assessment Upon Referral to Program Plan Development* Upon completion of Intake/ Assessment Intervention Between Plan Development and Discharge Reassessment Periodically Update of Plan and Following Reassessment Intervention

Exhibit A Page 3 of5

* Plan Development shall be strength-based, conducted in partnership with the client and family · whenever possible, and include clear and measurable goals, obj ectives and criteria for

graduation/voluntmy discharge from the program.

3. Discharge Criteria and Process

Contractor shall discharge Clients when they have met their treatment plan goals. Contractor shall coordinate discharge planning with the designated BHCS staff. Discharge planning shall include placement services, advocacy for appropriate social services and referrals. Contractor shall provide discharge plans in writing and include as pait of the Client's record. Upon discharge notes and documents shall reflect language of Wellness and Recovery model, diagnosis and term such as Anti Social sh2.ll not e used freely without confirmation, accurate hi ·tory and detailed review/agreement with county monitor or appropriate delegate.

4. Hours of Operation

Contractor shall maintain the following minimum hours of operation:

Service Hours 24 hours per day, seven days per week.

Intake Monday through Friday 9:00 am to 5:00 pm.

Visiting Hours Seven days per week 10:00 am to 8:30 pm.

5. Service Delivery Sites

Crestwood Behavioral Health Center 295 Pine Breeze Dr. Angwin, CA 94508

Crestwood Recovery and Rehabilitation Center

Preparation Date: 07/09/1 4 Revision Date: 08/14/14

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Contractor: Crestwoord Behavioral Health, Inc Contract Period: July 1, 2014-June 30, 2015

115 Oddstad Drive Vallejo, CA 94589

Crestwood Manor 115 Oddstad Drive Vallejo, CA 94589


Contractor shall obtain approval from BHCS through the BHCS Program Contract Manager prior to implementing any changes in service delivery sites.

D. Minimum Staffing Qualifications

Contractor shall have and maintain CUITent job descriptions on file with BHCS for all personnel whose salaries, wages, and benefits are reimbursable in whole or in part under this agreement. Job descriptions shall specify the minimum qualifications for employment and duties to be performed. Contractor shall submit revised job descriptions prior to implementing any changes or employing or contracting with persons who do not meet the minimum qualifications on file with BHCS. Contractor shall notify the BHCS Program Contract Manager of any change in administrative, supervisory and/or other personnel that may occur during the term of this contract.

IV. Contract Deliverables and Requirements

A. Process Measures

Contractor shall provide up to two resident beds at any given time on a service as needed over the contract period.

B. Outcome Measures Not applicable for FY 13/14.

V. Reporting and Evaluation Requirements

A. Reporting Requirements

Contractor shall routinely check in with Alameda County Monitor or Delegate to report on and provide feedback about relevant incident reports, clinical team meetings and key clinical information as requested; contractor will also submit any special reports requested by County financial or program monitors. Contractor shall comply with the reporting requirements of County, State, and Federal agencies as a condition of funding.

Contractor shall submit Crestwood Clinical Utilization Review and relevant annual reports, based on the prior year's work, which describes effectiveness, efficiency, access and client satisfaction data, which shall include program specific data September 30th each year.


. .. Contractor: Crestwoord Behavioral Health, Inc Contract Period: July 1, 2014-June 30, 2015


Contractor shall complete reports that may be required for conservators, or forensic court reporting that do not require specific credentialing reporting license or expertise.

B. Evaluation Requirements

Contractor shall submit periodic and annual reviews of program delivery and fiscal reporting as required by County, State, and Federal funding sources.

VI. Additional Requirements

A. Certification/Licensure

Contractor shall have and maintain cunent licensure: • California Department of Mental Health MHRC #02054010 (Angwin); #02060027

(Vallejo) • California Department of Public Health SNF #110000044 (Vallejo)

B. Other Requirements Not applicable.

VII. Entirety of Agreement

Contra to shall abide by·-all requirements contained in the Master Contract General Tenns and Conditions, all Exhibits and all Attachments that are associated with and included in this contract.

Contractor agrees to the following supplemental tern1s and conditions attached to this Exhibit A:

• Exhibit A-1: Additional Terms and Conditions of Program and Perfonnance. • Exhibit A-2: Addendum for Quality Assurance. • Exhibit A-3: Clarification Of Individuals With 1370.01 Status, Imminently Dangerous

Persons, Patients With Murphy Conservatorship


EXHIBIT A-1

ADDITIONAL TERMS AND CONDITIONS OF PROGRAM AND PERFORMANCE

Contracting Department: Behavioral Health Care Services

Contractor Name: Crestwood Behavioral Health 1 Inc.

Contract Period: 7/1/2014 to 6/30/2015

1. Confidentiality. Contractor shall comply with all applicable federal and state laws and regulations pertaining to the confidentiality of individually identifiable health information including, but not limited to, the Health Insurance Portability and Accountability Act (HIPAA) and Welfare and Institutions Code requirements regarding confidentiality of patient information, and records, commencing with Section 5328. Contractor shall inform and train its officers, employees and agents of the provisions for confidentiality of all information and records as set forth in those laws.

Contractor shall follow California state and federal guidelines pertaining to breaches of confidentiality. Contractor agrees to hold BHCS harmless for any breaches or violations arising from the actions/inactions of Contractor, their staff and subcontractors.

Contractor shall provide necessary client information to any other service provider within the Alameda County Behavioral Health Care Services (BHCS) System of County-operation and County-contracted providers for treatment activities (including the need to make timely referrals among programs for purposes of providing integrated services within this system of care) and/or for payment activities of said providers, and/or for health care operations of said provider· if each of the entities has or had a relationship with the client. Contractor shall

··obtair clients' informed consent whenever possible, however the absence of such consent will not preclude the exchange of information with other BHCS service providers. Contractor shall obtain client consent, in a form mandated by applicable state or federal law, before releasing information to those who are outside the BHCS system of services except as otherwise provided by law. In accordance with the law, Contractor shall disclose to appropriate treatment providers information concerning clients served pursuant to this Agreement for purposes of securing treatment, and to the extent minimally necessary to accomplish the purpose of coordinating or managing health care and to perform the functions specified in the California Welfare and Institutions Code.

2. Maintenance of Records. The maintenance, access, disposal and transfer of records shall be in accordance with professional standards and applicable County, State, and Federal laws and regulations including, if applicable, the specified regulations of the Substance Abuse and Crime Prevention Act of 2000.

Records shall contain sufficient detail to make it possible for contracted services to be evaluated. Contractor shall permit authorized BHCS personnel to make periodic inspections of the records. Contractor shall furnish information and patient records such as these personnel may require for monitoring , reviewing and evaluating fiscal and clinical effectiveness, appropriateness, and timeliness of the services being rendered under this contract.

3. Patients' Rights. Patients' rights shall be assured in compliance with Welfare and Institutions Code, Division 5, Section 5325; and California Code of Regulations, Title 9, Article 6. Patient records must comply with all appropriate state and federal requirements.

Page 1of3

. ·.

Contractor: Crestwood Behavioral Health, Inc. Contract Period : July 1, 2014 - June 30, 2015

E X HIB IT A-1

4. General Supervision. Services shall be under the general superv1s1on of the Director of BHCS, as specified in Section 521 of the California Code of Regulations. Further, said Section allows the aforementioned Director to supervise and specify as to the kind, quality, and amount of the services provided and the criteria used for determining patient eligibility.

5. Enrollment. All Contractors that bill third parties for provisions of services (e.g., Medi-Cal , Medicare, HealthPAC) shall check each client 's insurance status upon client's first entry into their program (admission/case opening/episode opening) and monthly thereafter. Contractor shall inform uninsured clients about options for health care coverage , including but not limited to federal and local programs, such as Medi-Cal , Medicare, HealthPAC, or other sources of payment, such as private insurance. Contractor is responsible for the verification of benefits. Contractor shall provide or arrange for, through referrals or otherwise, assistance with benefits enrollment and/or re-enrollment where benefits do not exist or coverage has lapsed.

6. Housing/Living Situation and Co-Occurring Informed Practice. Contractor shall operationalize at least one activity to promote improved housing/living situation from the list available on the BHCS website , at http://www.acbhcs.org/providers/network/docs/Contractor housing involve options.pdf. Contractor shall operationalize at least one activity to promote co-occurring informed practice from the list available online on the BHCS website , at http://www.acbhcs.org/providers/Ql/docs/CoOccurring/COC Contract Expectations FY 1-12.pdf.

7. BHCS Tobacco Control, Education arid Prevention Guidelines. Contractnr must_ adhere to the Tobacco Control, Education, and Prevention Guidelines that becarne 8ffective January 1, 2003 and are available on the BHCS website, at http://www. acbhcs. org/providers/Documentation/T obacco. pdf.

8. Materials and Presentations: Contractor shall give/publish credit in all media transmissions , published materials, or presentations to the community or other interested groups, supported in part or entirely by this contract, to County of Alameda Health Care Services Agency, Department of Behavioral Health Care Services.

9. Organizational Chart. Contractor shall have and maintain an organizational chart reflecting the current operating structure on file with BHCS. Contractor shall provide BHCS with an updated version of this document in the event of any change to the operational structure.

10. Administrative and Program Standards: Contractor shall comply with all administrative standards and program requirements as specified by specific State and Federal guidelines. Contractor shall comply with the Alameda County Ethical Code as posted on the Alameda County General Services Agency website, at http://www.acgov.org/auditor/sleb/documents/ethics .pdf, and by the Ethical Code of Conduct of all professional organizations that applies to their licensure.

11 . Licenses, Permits and Certificates: Contractor shall obtain and maintain during the term of this Contract, all appropriate licenses, permits and certificates required by all applicable Federal , State, County and/or municipal laws, regulations, guidelines and/or directives as

Page 2 of 3

Contracto r: Crestwood Behavioral Health, Inc. Contract Period : July 1, 2014 - June 30, 2015

EXHIBIT A-1

may be amended from time to time for the operation of its facility and/or for the provision of services hereunder.

12. Quality Assurance (QA): Contractor shall comply with the following QA prov1s1ons. Contractor shall comply with BHCS' Consumer Grievance and Appeal Policy and Procedures, as set forth in the BHCS QA Manual and such amendments as posted on the BHCS website, at http://www.acbhcs.org/providers/QA/QA.htm. Contractor shall comply with procedures, postings and adherence guidelines pertaining to the posting and distribution of BHCS' Informing Materials pertaining to Consumer Rights . Contractor shall submit reports of client deaths and sentinel events to the BHCS QA Office within 14 days of the knowledge of a beneficiaries' death , or other sentinel event. Contractor shall comply with the formalized case review policies as set forth in the BHCS QA Manual.

13. Continuity of Services. Contractor shall have a plan for the continuity of services to clients, including the maintenance and security of records . The continuity plan must provide for the transition of services and records in the event that a direct service staff dies or becomes unable to continue providing services.

14. Program Modification: Contractor shall secure the prior written approval of the Director of BHCS, or their Designee, in the event contracted services and activities require modification during the contract year. The request for modification shall be submitted to BHCS in writing .

15. Compliance with Contract Provisions. Contractors not in compliance with contract provisions, State or Federal law and/or regulation shall be immediately re ponsible for remedy and/or. a plan_ gf corcection subject to BHCS approval. The cost of the plan of correction shall be borne by the Contractor/Provider.

16. Medi-Cal Administrative Activities (MAA). Contractors reporting Medi-Cal Administrative Activities (MAA) will comply with the policies and procedures required by the MAA contract between Alameda County and the State of California.

17. Day Treatment Guidelines. Day treatment service providers shall adhere to the day treatment guidelines as contained in the DMH Information Notice 02-06, the BHCS QA Manual and the DMH Site Certification Protocol. All services shall be individualized to client need and shall be provided based on medical necessity.

Page 3 of 3

' . Contractor: Crestwood Behavioral Health, Inc. Contract Period: Ju ly 1, 2014 - June 30, 2015

EXHIBIT A-2

COMMUNITY BASED ORGANIZATION MASTER CONTRACT

Quality Assurance Addendum

Contractor shall be responsible for knowing and implementing the policies contained in Alameda County Behavioral Health Care Services' (BHCS') Quality Assurance (QA) Manual as may be updated from time to time by BHCS. The manual and updates shall be available on the BHCS website , at http://www.acbhcs.org/providers/QNQA.htm. Email communications may be made to notify providers of periodic updates and changes made to the QA Manual. Contractor shall have and maintain a QA Plan that meets the requirements of the BHCS Office of QA. This plan shall be available on-site for review by BHCS.

• UPDATES: Contractor shall be responsible for informing the QA Office of any changes to Contractor's primary email address.

• CREDENTIALING: Contractor shall be responsible for verifying the credentials and licensing of their staff and employees as contained in BHCS, state and federal requirements. Contractor shall ensure that staff providing services under this Agreement is in good standing with Centers for Medicare and Medicaid Standards (CMS) and not on any list of providers who are excluded from participation in federal health care programs.

• ~ DOCUMENTATION STANDARDS: Contractors shall comply with Documentation Standards, -Pol icy and Procedures as set fo rth in the QA Manual and as may be amended by notice on the BHCS Provider website.

• QA AUDITS: Contractor shall cooperate with BHCS in any review and/or audit initiated by BHCS.

• UTILIZATION MANAGEMENT: Contractor shall comply with policies related to the Utilization Management Program of BHCS as set forth in the QA Manual and the Clinical Quality Review Team (CORT) Manual as may be updated from time to time by BHCS.

• OTHER APPLICABLE POLICIES: All Contractors/Providers shall comply with all other applicable policies as set forth in the QA Manual and such amendments as posted on the BHCS Provider website.

Page 1 of 1 Last revised: 06/13/13

' .. EXHIBIT A-3

CLARIFICATION OF INDIVIDUALS WITH 1370.01 STATUS, IMMINENTLY DANGEROUS PERSONS, PATIENTS WITH MURPHY CONSERV ATORSHIP

I. PURPOSE OF EXHIBIT A-3

Exhibit A-3 is intended to provide clarification of individuals with 1370.01 Status, Imminently Dangerous Persons, and Patients with Murphy Conservatorship. Exhibit A-3 includes the following sections, which describe: • Definitions of Legal Categories; • Exhibits Between Parties (BHCS ' County' and Contractor) • Criteria for acceptance into specific contracted programs; • Contractor roles and responsibilities; • BHCS roles and responsibilities.

II. DEFINITIONS OF LEGAL CATEGORIES

• Individuals with 1370.01 Status: Defined as individuals charged with misdemeanors found to be mentally incompetent to stand trial by the Court. It is the responsibility of the local mental health director to recommend placement in a treatment facility or program. As such, these individuals are to be placed into appropriate treatment and out of jail.

• Imminently Dangerous Persons: Defined as individuals pursuant to Welfare and Institutions Code Section 5300 regarding placement of those persons requiring further treatment following a fourteen (14) day period of intensive treatment as a result of attempts to inflict, threats to inflict, or episodes of inflicting serious physical harm upon the person of another.

• Patients Murphy Conservatorship: Defined as a special type of conservatorship for those persons who have been indicted on dangerou. felonies, pla ed in State ho ·pital for competency restorati n as Penal Code (PC) 1370 and ho have not been -restored to competence to stand rial within the three-year period allowed by the PC 13 70 statute.

III. EXHIBIT BETWEEN PARTIES (BHCS AND CONTRACTOR)

A. General

In the event that a disagreement arises between Parties regarding Contractor's acceptance of a particular individual into treatment and/or any element in this Exhibit, Parties agree that a BHCS designee, approved by BHCS Director and Contractor's Vice President of Operations, or his/her designee, shall promptly meet to discuss the matter and to exert their best efforts to arrive at a mutually acceptable resolution.

B. Patient Admission Process

Contractor shall consider BHCS referrals on a case-by-case basis. The Parties agree that the ultimate decision of whether to accept any individuals with 1370.01 Status, Imminently Dangerous Persons and Patients with Murphy Conservatorship rests within the discretion of Contractor. Contractor shall use specified criteria and shall make good faith efforts. Such discretion rests with Contractor due to obligations and liability related to licensure and certification.

C. Patient Care Upon Admission

The Parties agree that any patients accepted for treatment pursuant to this Exhibit shall be provided the same nature and level of services as other individuals suffering from serious mental illness (SMI), unless otherwise stated herein or in the Court's Order. The Parties further agree that Contractor has the authority to formulate a treatment regimen for the patient with the goal of restoring that patient to their highest level of functioning, and will collaborate with BHCS' Criminal Justice Mental Health division as is necessary related to patients' legal status issues.

Contractor: Crestwood Behavioral Health, Inc. Exh ibit A-3 Page 2 of 4

No patient placed in Contractor facility pursuant to the terms of this Exhibit shall be eligible for supervised or unsupervised passes from the facility absent the express written approval of BHCS and by Court Order, if said Order is necessary because of patient status. If such written approval and Court Order is obtained, the patient shall participate in passes under the same criteria applied to other patients in the facility, subject to specific provisions regarding notifications to potential victims or next of kin to the victim as specified in Contractor' s policies and procedures.

Transportation of all patients placed in Contractor facilities pursuant to the terms of this Exhibit shall be provided under terms and conditions mutually agreed to by Contractor and BHCS. However, the parties agree that Contractor shall not bear the cost of any transportation services provided by BHCS or a third party or entity. In the event the patient requires routine medical treatment, or in the case of a medical emergency, including, but not limited to, psychiatric emergency, which requires that the patient receive immediate acute care, the patient may be transported by ambulance to Psychiatric Emergency Service at John George Psychiatric Pavilion, or to Highland Hospital, or to another facility mutually agreed to by the Parties. Contractor shall immediately notify BHCS ' Director or approved designee in the event of such transport.

The Parties recognize and acknowledge that patients who possess the requisite mental capacity to give informed consent for treatment may refuse or decline such treatment. The Parties further recognize that Contractor cannot compel such patients to submit to treatment of any kind over the patient's express objection and, further, may not achieve the established treatment goals if the patient declines treatment. Accordingly, BHCS agrees that it will promptly take all steps necessary to remove such patients from Contractor facility and/or, if appropriate, to obtain a Court Order permitting the administration of medication or work with Contractor to seek appointment of a surrogate decision-maker, depending on legal status.

Tl e Parties acknowledge and agree that patient · treated by Contractor pursuant to this Exhibit may be appropr· ate for dischar-ge from Contractor facil · y pr ior to the restoration of mental competence .. or prior to the expiration of the commitment period. Upon notice from Contractor, BHCS shall be responsible for discharge planning in coordination with Contractor facility's treatment staff. The parties agree that no discharges shall occur without a signed Court Order authorizing the discharge.

D. Patient Conservatorship

BHCS and Contractor agree to exercise best efforts and to cooperate with each other to secure a Lanterman-Petris Short (LPS) Conservatorship, when necessary, such as at termination of any individuals with 1370.01 statuses or Murphy Conservatorship, or to gain Court approval of urgent medical care for which an individual is not competent to consent. LPS Conservatorship is not a requirement for placement in Contractor facility for individuals currently on 1370.01 Status, Imminently Dangerous Persons and Patients with Murphy Conservatorship.

IV. CONTRACTOR'S ROLES AND RESPONSIBILITIES

A. Admission of Patients with Murphy Conservatorship In the case of Murphy Conservatorship, Contractor' s doctors may be called to testify about the patient' s mental condition.

B. Admission of Individuals on 1370.01 Status Contractor shall accept the PC 1370.01 Court Order as authorization for treatment, and shall not, require the appointment of an LPS Conservator for placement acceptance. Criteria for evaluating the placement of any individuals with 1370.01 status referrals shall include a careful review of past behaviors and allegations that may have involved incidents of physically assaultive behaviors and the patient's treatment history.

Date Updated: 07/09/14

J ' ·

Contractor: Crestwood Behavioral Health, fnc.

V. BHCS ROLES AND RESPONSIBILITIES

ExhibitA-3 Page 3 of 4

BHCS shall provide Contractor with, and fully cooperate in, Contractor's efforts to obtain, all past and present clinical information, including, but not limited to medical records and professional reports, on each patient referred for placement pursuant to the terms of this Exhibit.

BHCS shall actively monitor all pending criminal proceedings, immediately advise Contractor of the dismissal of any criminal charges pending against patients placed in Contractor facilities pursuant to the terms of this Exhibit, and to provide Contractor with a copy of the Order of Dismissal. Contractor shall notify the County designee of the placement in Contractor facilities of any criminal defendants pursuant to this Exhibit.

BHCS shall ensure that a signed Court Order is obtained for the placement of each patient prior to transfer of the patient to Contractor. Said Court Order shall accompany the patient to Contractor site. BHCS shall consult with Contractor on the exact terms of each order for placement. In all cases, the Court Order shall specify patient's competency to give consent and informed consent for treatment or the withholding of treatment, both routine medical treatment and treatment related to the underlying mental disorder, including the administration of psychotropic medications.

In all cases where the patient lacks mental capacity to give consent, the Court Order shall specify authority to provide treatment.

A. Admission of Patients with Murphy Conservatorship

BHCS shall refer Murphy Conservatees in accordance with Contractor's established referral procedures.

· In the case of Patients with Murphy Conservatorship, BHCS hall provide outside evaluators to do the assessments for competence.

It shall be the sole responsibility of BHCS, through the designated and authorized Criminal Justice Mental Health division (CJMH) staff, to make recommendations to the court regarding the patient's competency to stand trial or return to court for further proceedings (e.g., extension of the commitment beyond the maximum term) and to present evidence to the court on that issue.

BHCS shall provide Contractor with the following documents, when available, including, but not limited to the following documents listed: 1. Letters of Conservatorship. 2. All available information regarding the circumstances of the criminal offense and the

individual's prior criminal history; 3. Any court-ordered psychiatric examination or evaluation reports; 4. The County Mental Health Director's placement recommendation report (only applicable if

individual is awaiting original PC 1370 placement); 5. Any existing comprehensive report(s) of the conservatorship investigation conducted pursuant

to Welfare and Institutions Code Sections 5352 and 5354 for the preceding five (5) years.

B. Admission of Imminently Dangerous Persons

BHCS shall provide Contractor with the following documents, when available, including, but not limited to the following documents listed: 1. With respect to individuals referred for post-certification treatment pursuant to Welfare and

Institutions Code Section 5300, BHCS shall provide Contractor with copies of the petition and all supporting affidavits filed with the court in support of the request for a court order for postcertification treatment, and a copy of the court order for post-certification treatment.

2. For individuals on outpatient status pursuant to Welfare and Institutions Code Section 5305 and for whom BHCS seeks to have outpatient status revoked pursuant to Welfare and Institutions Code Sections 5306 and 5307 and placed with Contractor, BHCS shall provide


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Contractor: Crestwood Behavioral Health, Inc. Exhibit A-3 Page 4 of 4

Contractor with a copy of the documents filed in support of the request for an order revoking outpatient status, a copy of the Court Order permitting inpatient placement pending the outcome of the request for revocation of outpatient status, and a copy of the final Court Order revoking outpatient status.

3. BHCS shall provide Contractor with all available information related to the determination of dangerousness, including any criminal justice history to the extent said information exists and is available to the County.

4. BHCS shall cooperate with Contractor in evaluating those Welfare and Institutions Code Section 5300 patients, i.e., patients who may be appropriate for release prior to the expiration of the commitment period, in accordance with the provisions of Welfare and Institutions Code Section 5309, and to approve, in writing, all plans for unconditional release prior to the individual's release.

C. Admission of Individuals With 1370.01 Status

In the case of individuals with 1370.01 statuses, Contractor shall provide a written report by the facility Medical Director or their Designee, within 90 days of placement and as required thereafter. This report to the court and the County Mental Health Director or Designee, shall address the individual (defendant's) progress towards recovery of mental competence.

It shall be BHCS' sole responsibility, through the Criminal Justice Mental Health division or other BHCS entity, to make recommendations to the court regarding the patient's competency to stand trial or return to court for further proceedings (e.g., extension of the commitment beyond the maximum term) and to present evidence to the cowt on that issue.

BHCS shall provide Contractor with the following documents, when available, including, but not l"mited to the following docum nts listed: l .·. Individual's Commitment Ord~ ·, including a specificati n of c arges. 2. A computation or statement setting forth the maximwn term of commitment. 3. A computation setting forth the amount of credit for time served, if any, to be deducted from

the maximum term of commitment. 4. The State Summary Criminal History information. 5. Any arrest reports prepared by the police department or other law enforcement agency. 6. All available information regarding the circwnstances of the criminal offense and the person's

prior criminal history. 7. Any court-ordered psychiatric examination or evaluation reports. 8. The County Mental Health Director's placement recommendation report.


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Contractor: Crestwood Behavioral Health, Inc. Con tract Period: July 2014 - June 30, 2015

EXHIBIT B

TERMS AND CONDITIONS OF PAYMENT

(Short-Doyle Realignment)

In return for the aforementioned services as set forth in Exhibit A of this agreement, the County agrees to reimburse the Contractor on the following basis:

1. Total Remuneration

Remuneration to the Contractor under this agreement shall be known as net reimbursable cost.

2. Basis for Reimbursement During Contract Period

Contractor shall be reimbursed on the basis of negotiated rate(s) specified in the Exhibit B Attachment: Method and Rate of Reimbursement. County shall determine Contractor's final net reimbursable cost by: (a) multiplying the negotiated rate by the applicable units of service provided; (b) subtracting deductible revenues as defined in State DHCS Letter 84-10 and the State DHCS Cost Reporting/Data Collection Manual; and (c) paying the resultant net amount.

3. Final Cost Report Requirements

Contractor acknowledges that it i not possible ·for ·eounty to determine actual units ot service and net reimbursable cost until the end of the contract period and/or until an audit of Contractor's books for the contract period covered herein has been completed by both the State and County auditors, or their designees, and also by Federal auditors, or their designees, should any portion of this agreement be provided with Federal funds. To facilitate this final accounting, Contractor shall certify, in a format designated by the County, the units of service and deductible revenues as defined in Paragraph 2 above, and the amount of reimbursement received from County pursuant to this agreement.

4. Submittal Deadline for Claims & Client Data

Contractor shall submit monthly claim data to the County by the tenth (10th) calendar day of the month following the month of service. If Contractor provides direct treatment service, Contractor shall submit with the monthly invoice, client data for all Alameda County-funded patients .

Should Contractor fail to meet the above-indicated deadlines, Contractor shall be considered in non-compliance with the contract provisions and County shall withhold payment of Contractor's outstanding claims until such time that County is assured of Contractor's future compliance.

5. Short-Doyle/Medi-Cal Funding Provisions

Contractors receiving Short-Doyle/Medi-Cal funds are referred to Exhibit D-1, for further provisions regarding terms and conditions relating to Short-Doyle/Medi-Cal fund .

Page 1 of 1

Reporting Unit

Pending

Pending

Pending

EXHIBIT B ATTACHMENT: METHOD AND RATE OF REIMBURSEMENT

SERVICES-AS-NEEDED RATE SHEET

FY 14/15


Service I Program Reimbursement Method

Vallejo - Mental Health Rehab Center Negotiated Rate

Level 1

Level2

Level3

Level4

Vallejo - Skilled Nursing Facility (SNF) Negotiated Rate

Level 1

Level2

Level3

Level4

Angwin - Mental Health Rehab Center Negotiated Rate

Level 1

Level2

Level3

Revised 06/27 /14

Rate

$292.00 per patient day











I I

A

B

c

D

E

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Contractor: Crestwood Behavioral Health, Inc. Contract Pe riod: July 1, 2014 - June 30, 2015

EXHIBIT C COUNTY OF ALAMEDA MINIMUM INSURANCE REQUIREMENTS

Without limiting any other obligation or liability under this Agreement, the Contractor, at its sole cost and expense, shall secure and keep in force during the entire term of the Agreement or longer, as may be specified below, the following insurance coverage, limits and endorsements:

. . .,. - -{.~. TYPE OF INSURANCE COVERAGES '; .' ,".,!·l j.\'; MINIMUM LIMITS

Commercial General Liability $1,000,000 per occurrence (CSL) Premises Liability; Products and Completed Operations; Contractual Liability; Personal Bodily Injury and Property Damage Injury and Advertising Liability; Abuse, Molestation, Sexual Actions, and Assault and Battery

Commercial or Business Automobile Liability $1,000,000 per occurrence (CSL) All owned vehicles, hired or leased vehicles, non-owned, borrowed and permissive uses. Any Auto Personal Automobile Liability is acceptable for individual contractors with no Bodily Injury and Property Damage transportation or haulinq related activities

Workers' Compensation (WC) and Employers Liability (EL) WC: Statutory Limits Required for all contractors with employees EL: $100,000 per accident for bodily iniurv or disease

Professional Liability/Errors & Omissions $1,000,000 per occurrence Includes endorsements of contractual liability and defense and indemnification of the $2,000,000 project aggregate County

Endorsements and Conditions:

-

1. ADDITIONAL INSURED: All insurance required above with the exception of Professional Liability, Personal Automobile Liability, Workers' Compensation and Employers Liability, shal l be endorsed to name as additional insured: County of Alameda, its Board of Supervi sors, the individual members thereof, and all County officers, agents, employees and representatives.

2. DURATION OF COVERAGE: All required insurance shall be maintained during the entire term of the Agreement with the following exception: Insurance policies and coverage(s) written on a claims-made basis shall be maintained during the entire term of the Agreement and unti l 3 years following termination and acceptance of all work provided un er the Agreement, with U1e relroacti vs d::ite oi ~aid in. urance (as may be arplicablP.) concu rr~ 11 t with the commencement or aciivitie.; pursuant to this Agreement. --

3. REDUCTION OR LiMIT OF OBLIGATION: All insurance policies shall be primary insurance to any insurance available to the Indemnified Parties and Additional lnsured(s). Pursuant to the provisions of this Agreement, insurance effected or procured by the Contractor shall not reduce or limit Contractor's contractual obl igation to indemnify and defend the Indemnified Parties.

4. INSURER FINANCIAL RATING: Insurance shall be maintained through an insurer with a minimum A.M. Best Rating of A- or better, with deductible amounts acceptable to the County. Acceptance of Contractor's insurance by County shall not relieve or decrease the liability of Contractor hereunder. Any deductible or self-insured retention amount or other similar obligation under the policies shall be the sole responsibility of the Contractor. Any deductible or self-insured retention amount or other similar obligation under the policies shall be the sole responsibi lity of the Contractor.

5. SUBCONTRACTORS: Contractor shall include all subcontractors as an insured (covered party) under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the requirements stated herein.

6. JOINT VENTURES: If Contractor is an association, partnership or other joint business venture, required insurance shall be provided by any one of the following methods:

Separate insurance policies issued for each individual entity, with each entity included as a 'Named Insured (covered party), or at minimum named as an 'Additional Insured' on the other's policies. Joint insurance program with the association, partnership or other joint business venture included as a 'Named Insured.

7. CANCELLATION OF INSURANCE: All required insurance shall be endorsed to provide thirty (30) days advance written notice to the County of cancellation.

8. CERTIFICATE OF INSURANCE: Before commencing operations under this Agreement, Contractor shall provide Certificate(s) of Insurance and applicable insurance endorsements, in form and satisfactory to County, evidencing that all required insurance coverage is in effect. The County reserves the rights to require the Contractor to provide complete, certified copies of all required insurance policies. The required certificate(s) and endorsements must be sent to:

- Alameda County- BHCS, Insurance Coordinator, 1900 Embarcadero, Suite 205, Oakland, CA 94606 - With a copy to Risk Management Unit (125 -12th Street, 3rd Floor, Oakland, CA 94607)

Certificate C-2C (BHCS) For-Profit (Rev 4/06)

Last revised: 5/12

Page 1of1

Page 1of1

Form 2001-1

!

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CERTIFICATE OF INSURANCE

This Certificate is issued as a matter of iqformation only and confers no rights upon the Certificate Holder. This Certificate is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein.

CERTIFICATE HOLDER: County of Alameda, a California County, 2000 Embarcadero Cove, #3 02, Oakland, CA 94606

INSURED: Crestwood Behavioral Health Inc (all locations), 520 Capitol Mall #800, Sacramento, CA 95814

COVERAGES: This is to certify that the policies of insurance listed below have been issued to the Insured named above for the policy period indicated notwithstanding any requirement, tenn or condition of any contract or other document with respect to which this certificate may be issued or may pertain. The insurance afforded by the policies described herein is subject to the terms and conditions, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims.

WORKERS COMPENSATION CARRIER: National Union Fire Insurance Co., Policy 038238324; 1/1/2014-1/1/2015 Statutory WC; Employers Liability $1 ,000,000 claim/aggregate/employee

GENERAL & PROFESSIONAL LIAJ.HLITY CARRIER: Chartis Specialty Lines In -u:rance Co., Policy 1929732; "1/1/2014-1/1/201 5 $1/6,000,000 Each & Aggregate Cl_aims; OccmTence Manusc1ipt form both parts; Products/Completed Operations $6,000,000; Personal/ Advertising $1,000,000

DESCRIPTION OF OPERATIONS: Psychiatric & Skilled Nursing Facility

CANCELLATION: Should any of the above described policies be cancelled prior to expiration, the issuing company will endeavor to mail 30 days ·written notice to the certificate holder but failure to mail such notice will impose no obligation or liability of any kind upon the company, its agents, brokers or representatives.

Certificate holder is an Additional Insured for general liability coverage . Subrogation is waived for workers compensation coverage.

Robert M. Hunt, Authorized Representative RM Hunt & Associates, Inc. 625 Second St. Suite #206 Petaluma CA 94952 Tel: 707 769 2970

1/6/2014

I ( I ~ • •

ENDORSEMENT

This endorsement, effective 12:01 AM: 01 /01 /2014

Forms a part of policy no: GL 1929732

Issued to: CRESTWOOD BEHAVIORAL HEALTH INC

By: AfG SPECIALTY INSURANCE COMPANY

THIS ENDORSEMENT CHANGES iHE POLICY, PLEASE READ IT CAREFULLY.

ADDJTJONAL INSUREDS ENDORSEMEr.JT

The HEALTHCARE GENERAL LIABILITY OCCURRENCE COVERAGE PART is amended as follows:

Schedule

ANY CALIFORNIA COUNTY

!n Section H. WHO IS AN INSURED is amended to include as an additional insured the personfs} or organization(s) shown in the Schedule, but only with respect to liability for bodily Injury, property damage or personal and advertising injury caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. Jn the performance of your ongoing operations; or 2. In connection with )'\)Ur premises owned by or ret1ted to you

The insurance provided to ths scheduled person or organization wif[ not exceed the coverage and/or limits of this Policy.

Manuscript

All other terms, conditions and exclusions of the policy remain unchanged.

Authorized Representative Or Countersignature [in states where applicable)

. '· ~ . .

EXHIBIT D

AUDIT R EQUI REMENTS

The County contracts with various organizations to carry out programs mandated by the Federal and State governments or sponsored by the Board of Supervisors. Under the Single Audit Act Amendments of 1996 and Board policy, the County has the responsibility to determine whether organizations receiving funds through the County have spent them in accordance with applicable laws, regulations , contract terms, and grant agreements. To this end , the following are required .

I. AUDIT REQUIREMENTS

A. Funds from Federal Sources:

1. Nonfederal entities wh ich are determined to be sub-recipients by the supervis ing department according to§_ .210 of OMB Circular No. A-133 and which expend annual Federal awards in the amount specified in §_.200 (b) of OMB Circular No. A-133 are required to have a single audit performed in accordance with §_. 500 of OMB Circular No. A-133.

2. When a nonfederal entity expends annual Federal awards in the amount :3pesif1ed 1n §_ .200 (a) of OMB Circular No. A-133 under only one FAderal program (excluding R&D) and the Federal program's laws, regulations, or gra nt agreements do not require a financial statement audit, the nonfederal entity may elect to have a program-specific audit conducted in accordance with §_ .235 of OMB Circular No. A-133.

3. Nonfederal entities which expend annual Federal awards in the amount specified in §_.200 (d) of OMB Circular No. A-133 are exempt from the single audit requirement except that the County may require a limited-scope audit in accordance with §_.230 (b) (2) of OMB Circular No. A-133.

B. Funds from All Sources:

Nonfederal entities which expend annual funds from any source (Federal , State, County, etc.) through the County in an amount of:

1. $100,000 or more must have a financial audit in accordance with the U.S. Comptroller General's Government Auditing Standards covering all County programs.

2. Less than $100,000 are exempt from these audit requirements except as otherwise noted in the contract.

Nonfederal entities that are required to have or choose to do a single audit in accordance with OMB Circular No. A-133 are not required to have a financial audit in the

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Contract Period : July 1, 2014 - June 30, 2015

EXHIBIT 0

same year. However, nonfederal entities that are required to have a financial audit may · also be required to have a limited-scope audit in the same year.

C. General Requirements for All Audits:

1. All audits must be conducted in accordance with Generally Accepted Government Auditing Standards (GAGAS) issued by the Comptroller General of the United States which are applicable to financial audits.

2. All audits must be conducted annually, except where specifically allowed otherwise by laws, regulations , or County policy.

3. Audit reports must contain a separate schedule that identifies all funds passed through/from the County that is covered by the audit. County programs must be identified by contract number, contract amount, contract period , and amount expended during the fiscal year by funding source. An exhibit number must be included when applicable .

4. If a funding source has more stringent and specific audit requirements , these requirements must prevail over those described above.

11. AUDIT REPORTS

At ieast two copies of the audit report packag_e, including all attachments and any management letter with its corresponding response, should be sent to the County supervising department within six months after the end of the audit period , or other time frame specified by the department. The County supervising department is responsible for forwarding a copy to the County Auditor within one week of receipt.

111. AUDIT RESOLUTION

Within 30 days of issuance of the audit report, the entity must submit to its County supervising department a corrective action plan to address the findings contained in the audit report. Questioned costs and disallowed costs must be resolved according to procedures established by the County in the Contract Administration Manual. The County supervising department will follow up on the implementation of the corrective action plan as it pertains to County programs.

IV. ADDITIONAL AUDIT WORK

The County, the State, or Federal agencies may conduct additional audits or reviews to carry out their regulatory responsibilities. To the extent possible, these audits and reviews will rely on the audit work already performed under the audit requirements listed above.

Last revised: 5/12 Page 2 of 2

. ., Contractor: Crestwood Behavioral Health, Inc. Contract Period : July 1, 2014 - June 30, 2015

EXHIBIT F

COUNTY OF ALAMEDA

DEBARMENT AND SUSPENSION CERTIFICATION

(Applicable to all agreements funded in part or whole with federal funds and contracts over $25,000).

The contractor, under penalty of perjury, certifies that , except as noted below, the contractor, its principals, and any named and unnamed subcontractor:

• Is not currently under suspension , debarment, voluntary exclusion , or determination of

ineligibility by any federal agency;

• Has not been suspended, debarred, voluntarily excluded or determined ineligible by any

federal agency within the past three years ;

• Does not have a proposed debarment pending ; and

• Has not been indicted, convicted , or had a civil judgment rendered against it by a court

of competent jurisdiction in any matter involving fraud or official misconduct within the

past three years.

If there are any exceptions to this certification, insert the exceptions in the following space or attach an additional page.

Exceptions will not necessarily result in denial of award , but will be considered in determining contractor responsibility. For any exception noted above, indicate below to whom it applies, initiating agency, and dates of action.

Notes: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the contracting process.

By signing this contract and Exhibit F, Debarment and Suspension Certification , the Contractor/Grantee agrees to comply with applicable federal suspension and debarment regulations. including but not limited to 7 Code of Federal Regulations (CFR) 3016.35, 28 CFR 66.35, 29 CFR 97.35, 34 CFR 80.35, 45 CFR 92.35 and Executive Order 12549.

CONTRACTOR: Crestwood Behavioral Health, Inc.

PRINCIPAL: Gary Zeyen T TLE: Controller

Last revised: 8/ 19/14 Page 1 of 1

PROCEDURES FOR MENTAL HEALTH SERVICES … · BHSVC 610341 10000 350591 00000 2015 NIA Send Response...

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