request for letters of interest (rfi) sober living

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COUNTY OF MARIN

DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF BEHAVIORAL HEALTH AND RECOVERY SERVICES

________________________________________

REQUEST FOR LETTERS OF INTEREST (RFI)

Sober Living Environment

RFI-HHS-2018-13 ________________________________________

DATE ISSUED: August 17, 2018 DEADLINE FOR SUBMISSIONS: September 7, 2018

The County of Marin Health and Human Services Department does not discriminate on the basis of sex, race, color, religion, age, sexual orientation, disability, marital status, or national original in employment or in its educational programs and activities. Auxiliary aids and services are available upon request to individuals with disabilities. Alternative formats will be made available upon request.

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I. Background AB109 is a bill that was signed into law by Governor Edmund Brown and became effective October 2011. This bill is referred to as “Public Safety Realignment.” It is designed to correct the problems caused by the overcrowded population in California state prisons. The legislation redistributes the responsibility of non-serious, non-violent, non-sex offenders to local county jurisdictions. Counties now have the responsibility for monitoring, tracking and incarcerating lower-level offenders who were previously slated for state prison. As a result, sentencing and post-incarceration supervision is affected by this bill for the newly statutorily classified (AB 109) offenders. Additionally, community alternatives have been designated to assist these offenders with community reintegration and stabilization. On average, Marin County Probation and the Marin County Department of Health and Human Services have approximately eighty (80) medium to high-risk eligible probationers per year. Approximately one third of these individuals have been identified as lacking transitional/permanent housing as they seek to reintegrate back into the community. Years of research have shown that without reasonable housing accommodations, ex-offenders will re-offend and potentially return to prison within three years. In its effort to provide comprehensive services to Marin’s AB 109 population, the purpose of this RFI is to seek Sober Living Environments (SLE’s) that meet, at a minimum, the requirements of the attached Marin County Guidelines for Sober Living Environments. Respondents to this RFI, who agree to and are evaluated as meeting these minimum guidelines, will form the basis of a list of safe, sober housing from which medium to high risk offenders may apply to for housing. II. Project Period The purpose of this RFI is to generate a list of Transitional Housing [Sober Living Environments (SLE’s)] that meet, at a minimum, the requirements of the attached Marin County Guidelines for Sober Living Environments (Attachment A). Respondents to this RFI, who agree to and are evaluated as meeting these minimum guidelines, will form the basis of a list of safe, sober housing from which medium to high risk offenders may apply to for housing. Note: This RFI is not intended as a competitive process but is intended as a vetting and monitoring process whereby those SLE’s that are providing housing services to more than 5 clients annually will be placed on contract with the County of Marin. Agencies that have already submitted a Letter of Interest for Transitional Housing/SLE under a previously issued RFI that was approved by the County do not need to re-apply under this RFI. The anticipated contract period is September 1, 2018, through June 30, 2019 contingent on contract approval, compliance and funding availability. III. Available Funding The County intends to create a list of SLE’s which provides sober living housing services for eligible individuals referred by Probation. Reimbursement for services are fully described under Section VIII. Applicant Instructions, C. Budget IV. Proposed Project/Scope of Work Target Population: Individuals who are on active Probation and who have been screened as medium to high risk probationers or eligible for AB 109 or SB 678-funded services.

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Eligible Grant Activities: The purpose of this RFI is to generate a list of Transitional Housing [Sober Living Environments (SLE’s)] that meet, at a minimum, the requirements of the attached Marin County Guidelines for Sober Living Environments (Attachment A). Respondents to this RFI, who agree to and are evaluated as meeting these minimum guidelines, will form the basis of a list of safe, sober housing from which medium to high risk offenders may apply to for housing. Eligible individuals will receive financial and a range of support services and be expected to comply fully with Probation orders and re-entry plans in order to attain full self-sufficiency within a designated period of time. The level and duration of financial assistance each eligible individual receives will be contingent upon their specific re-entry plans. V. Reporting and Performance Requirements The grantee will be required to meet mutually developed reporting requirements, including but not limited to entering client data, charting of engagement activities and billing in the Marin Web Infrastructure for Treatment Services (WITS), participating in a mid-year site visit, and completing an annual report. All program participants must be asked and agree to provide a release of information to, at a minimum, their Probation Officer.

VI. Eligible Bidders APPLICANT ELIGIBILITY: Any public and/or privately owned Transitional Housing/Sober Living Environment successfully operating in Marin County may apply. Currently SLE’s are not required, nor able to be licensed by the State of California. They are however subject to landlord/tenant laws in California, and zoning and other requirements of their local jurisdiction. Applicants must be able to provide the following written policies / procedures which comply with all federal, state and local statutes, laws, regulations, and ordinances:

a. Conflict of interest policy for staff and governing boards. b. Grievance procedure for customers / clients. c. Does not discriminate against nor deny employment or services to any person on

the grounds of race, color, religion, sex, national origin, age, disability, citizenship, political affiliation or belief.

d. Complies with the 1990 ADA. e. Complies with the County of Marin Living Wage Ordinance.

The following is a list of resources which provides guidance and information on successful operation of SLE’s:

• California Association of Addiction Recovery Resources 2129 Fulton Avenue, Sacramento, CA 95821 (916) 338-9460

• Sober Living Network P.O. Box 5235, Santa Monica, CA 90409 (310) 396-5270

• Oxford House Inc. P.O. Box 994, Great Falls, VA 22066-0994

• A Guide to Housing for Low Income People Recovering from Alcohol and Other Drug Problems. U.S. Department of Public Health Services, National Institute on Alcohol Abuse and Alcoholism, 5600 Fishers Lane, Rockville, MD 20857.

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VII. Requirements and Expectations for Grantees A. Summary of Contract Terms, Conditions and Requirements The grantee shall be required to comply with Public Law 102-321 (1992) which enacted the Alcohol, Drug Abuse, and Mental Health Reorganization Act, 42 CFR Part 96; Division 10.5, California Health and Safety Code; Title 9, California Code of Regulations; Americans With Disabilities Act of 1990; this Request for Proposal RFI-HHS-2018-13; and the terms and conditions required by the original funding source for the programs/services described by this RFI; and the terms and conditions of the County of Marin’s Standard Professional Services Contract. The County’s Standard Professional Services Contract, attached hereto as Attachment E, contains specific provisions including, but not limited to, nondiscrimination in hiring and in the provision of services, program evaluation, record keeping, payments, limitations and obligations, conflict of interest, indemnification and insurance, assignment, and HIPAA. By submitting a proposal, the applicant agrees to be bound by all terms and conditions of the County’s Standard Professional Services Contract, attached hereto as Attachment E, and execute the same, if selected. B. Insurance The County requires that all contractors carry $1,000,000 in liability insurance ($2,000,000 aggregate). The County must be named as additional insured, and specific language must be included on the signed endorsement to the policy. The required insurance coverage requirements includes automobile insurance and is described in the County of Marin’s Standard Professional Services Contract, attached hereto as Attachment B. It is strongly suggested that applying entities be certain of the ability to secure this insurance and verification prior to submitting an Application. C. Administrative Requirements

1. Contractors will be paid on a monthly basis, following the submission of an invoice through the Marin County WITS system to the Marin County Department of Health and Human Services for services performed to County’s satisfaction. Specific instructions on how to use the WITS system and appropriate access will be provided to grantees upon award of a contract. Services will be reimbursed according to a fee for service model for contracted services provided on the monthly invoices, not to exceed the total contract amount. It is the responsibility of the contractor to track expenditures and any services provided by contractor and/or subcontractors. Expenses that exceed the annual allocation will not be reimbursed.

2. This RFI and any resulting agreement, contract, and purchase order shall be governed by all applicable federal, state and local laws, codes, ordinances and regulations, including but not limited to, those promulgated by CAL-OSHA, FED-OSHA, EPA, EEOC, DFEH, the California State Department of Health Services, and the County of Marin. All matters and subsequent contract shall be governed by, and in accordance with, the substantive and procedural laws of the State of California. The applicant agrees that all disputes arising out of or in connection with the Professional Services Contract and the procurement process shall be construed in accordance with the laws of the State of California and that the venue shall be in Marin County, California.

3. Nuclear Free Zone: The County is a nuclear free zone, in which work on nuclear weapons or the storage or transportations of weapons-related components and nuclear material is prohibited or appropriately restricted. The County is prohibited or restricted from contracting for services or products with, or investing County funds in, any nuclear

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weapons contractor.

4. Non-Appropriations: The County's performance arising from this RFI process is contingent upon the availability of funds. Should funds not be appropriated or otherwise made available to the County, any contract entered into pursuant to this RFI will be terminated with respect to any payments for which such funds are not available.

5. Applicant must be legally authorized to conduct business in the State of California and have established administrative and program resources to provide services in Marin County. The applicant must also have appropriate federal, state and local permits or certifications necessary to perform the services that are the subject of this RFI. Documentation: Tax Identification Number and a description of the applicable administrative and program resources.

6. Prior to executing a contract, the applicant (and any subcontractors/partners) must be able to provide the following written policies and procedures that comply with and are otherwise acceptable to the federal, state and local statutes, laws, regulations, and ordinances:

a. Conflict of interest policy for staff and governing boards. Documentation: copy of the conflict of interest policy.

b. Grievance procedure for customers and clients. Documentation: copy of grievance procedure.

c. Does not discriminate against nor deny employment or services to any person on the grounds of race, color, religion, sex, national origin, age, disability, citizenship, political affiliation or belief. Documentation: copy of nondiscrimination policy and certification statement.

d. Complies with the 1990 ADA. Documentation: certification statement.

7. Applicants must have proven fiscal capacity including capacity for fund accounting.

8. Applicants must have access to non-County funds sufficient to cover any disallowed costs that may be identified through the audit process.

9. Applicants must agree that state, federal, and local monitors or auditors may review

provider facilities and relevant financial and performance records to ensure compliance with funding requirements. Documentation: certification statement.

10. Applicants must be eligible to receive Federal funds. Documentations: debarment certification statement.

11. Applicants must have the demonstrated ability to collect outcome data, which measure performance to plan.

12. If applicable, Contractor shall maintain medical records required by the California Code of Regulations. Notwithstanding the foregoing, Contractor shall maintain beneficiary medical and/or clinical records for a period of ten (10) years, except that the records of persons under age eighteen (18) at the time of treatment shall be maintained: a) until one (1) year beyond the person’s eighteenth (18th) birthday or b) for a period of ten (10) years beyond the date of discharge, whichever is later.

13. Contractor shall comply with applicable local, State and Federal statutes and regulations, and case law, including but not limited to the Federal Health Insurance Portability and Accountability Act (HIPAA), Title 42 of the Code of Federal Regulations, Title 9, California Administrative Code, hereinafter referred to as “Code”, as well as all

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future changes or amendments to each of the preceding, and the State of California, Department of Health Care Services, Cost Reporting/Data Collection System.

14. Contractor agrees to administer/utilize any and all survey instruments as directed by the County Department of Health and Human Services, including outcomes and satisfaction measurements. Contractors must also comply with all reporting requirements set forth by the Department of Health and Human Services and the State Department of Health Care Services, including, but not limited to, completion of cost reports, annual provider self-audits and site visits.

15. Cultural Competency: All program staff shall receive at least four hours of in-service training per year on some aspect of providing culturally and linguistically appropriate services. At least once per year and upon request, Contractor shall provide County with a schedule of in-service training(s) and a list of participants at each such training.

Applicants who do not meet these minimum requirements shall be deemed non-responsive and will not receive further consideration. Any application that is rejected as non-responsive will not be evaluated and no score will be assigned. D. Tentative Time Schedule All applicants are hereby advised of the following schedule and will be expected to adhere to the applicant- related deadlines below:

RFI Advertised August 17, 2018 RFI Released to Prospective Applicants August 17, 2018 Question/Answer Period Opens August 17, 2018 Question/Answer Period Closes August 30, 2018 RFI Answers Posted August 31, 2018 Letters of Interest Due September 7, 2018 Applicant Review & Interviews (if applicable) Mid – September 2018 Posting of Applicants Approved Mid – Late September 2018

VIII. Application Instructions In responding to the RFI, use the outline as it appears below and label your responses accordingly. If the total number of pages exceeds the parameters stated below, the additional pages will be discarded and will not be reviewed by the Proposal Review Committee. A non-response will result in disqualification of the proposal. A. Cover Page (Use Attachment B)

I. Using the Cover Page template, complete the document, including (1) Name of Individual and /or Organization Submitting LOI, (2) Address, (3) Telephone Number, (4) E-mail, (5) Date of Submission, and (6) Federal Tax ID. Signing of the cover page indicates agreement to the following terms: “The costs of the proposed project can be carried by the applicant for at least 90 days at any point during the term of the contract.” Note that actual documents will be required prior to approval of contract. Documents to demonstrate this should be current and may include: Balance Sheet; Income Statement; Cash Flow Statement; Debt Structure Statement; and Accounts Receivable Schedule.

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B. Applicant Capability (Use Attachment C)

I. Describe your experience in the operation of a Transitional Housing/Sober Living Environment in Marin County. Please include an overview of your housing services such as how long the house has been in operation, any history of providing such services to the target population, the level of on-site management and any existing contractual agreements with other governmental agencies.

II. Describe your knowledge of and experience collaborating and/or making/receiving

referrals with community-based service partners, such as community-based organizations, Health and Human Services’ Divisions, criminal justice systems and other relevant agencies/organizations. In your response, be sure to include typical population and gender served, admission criteria describing client suitability and the duration of experience and specific examples of working relationships that you will bring to the project target populations identified in the RFI.

III. Please provide a brief narrative describing your plan to adhere to the Marin County Guidelines for Sober Living Environments. In addition, please provide a copy of your Policies & Procedures Manual.

IV. Please provide a brief narrative describing your plan to adhere to Marin County’s Professional Service Contract Exhibit I: Substance Use Disorder Service Programs on Medication Assisted Treatment. Which states, “Contractors shall develop and implement policies and procedures that ensure non-discrimination in access to or the provision of services because of the prescribed use of or need for Medication Assisted Treatment for substance use disorders.”

C. Budget (Use Attachment D)

The Department projects that financial assistance to eligible individuals may range from 100% assistance initially to decreasing amounts of financial assistance as individuals become more self-sufficient in the community (obtain job, etc.) Projected costs are $600-$1,240/month per individual, dependent upon the level of services provided at the SLE site. Eligible individuals are expected to comply with their specific Probation orders related to additional services they must be involved in (i.e. work, vocational training, treatment, etc.). To provide consistency and reliability in services and funding for both clients and providers, the Probation Department will be using the following standardized funding schedule for all new clients who are determined to need financial support, unless specific individual agreements are made with the Probation Department: Daily Living Cost: • Months 1-4: County pays 100%, no client co-pay • Months 5-8: County pays 75%, client co-pay 25% • Months 9-12: County pays 50%, client co-pay 50% Billing: SLE’s should bill clients directly for their co-pay, billing the County only for the standardized amount, or agreed to exception where valid.

Provide an itemized budget for the project including items such as staffing costs, housing and transportation costs, supplies, etc. A sample blank budget sheet is provided as Attachment D. Provide a budget narrative explaining all costs contained in the proposed budget. Explain the expected program costs and a rationale for each line item in the budget. List and briefly explain

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each staff position, including number of hours worked weekly, number of hours worked yearly, and hourly rate. Provide your agency’s indirect rate and a detailed description of what is included in calculating the indirect rate. Indirect rates cannot exceed 15% of personnel and direct costs. If your agency has a federally-approved indirect rate, attach a copy of the documentation with your proposal.

IX. Application Submission Requirements A. General Policies

1. The County assumes no obligation for any of the costs associated with responding to this RFI including, but not limited to, development, preparation and submission of applications.

2. This RFI is in no way an agreement, obligation, or contract between County and any applicant.

3. The applications will become the property of the County upon submission and may be subject to the terms of the California Public Records Act (“PRA”), as required by law.

4. By submitting an application, applicants acknowledge and agree as follows: that the County is a public agency subject to the disclosure requirements of the PRA; that applicants must clearly identify all proprietary information that is contained in the application submitted to the County, if applicant claims that such information falls within one or more PRA exemptions; that applicants must mark said proprietary information as “CONFIDENTIAL AND PROPRIETARY” and must identify the specific lines containing the information; that the County will make reasonable efforts to provide notice to the applicants prior to such disclosure in the event of a PRA request; that applicants are required to obtain a protective order, injunctive relief, or other appropriate remedy from the Marin County Superior Court, before the County’s deadline for responding to the PRA request; that if an applicant fails to obtain such remedy within County’s deadline for responding to the PRA request, County may disclose the requested information without penalty or liability; and that applicants shall defend, indemnify, and hold County harmless against any claims, action, or litigation, including but not limited to all judgments, costs, fees, and attorneys fees that may result from denial by County of a PRA request for information arising from any representation or any action (or inaction), by the applicants.

5. After submission of the application and closing of the application period, no information other than what is outlined in this RFI will be released, until an award becomes final.

6. The County reserves the right to make an award without further discussion of the applications received. Therefore, it is important that the application be submitted initially on the most favorable terms from both a technical and cost standpoint.

7. While it is the intention to award the contract to one applicant, the County reserves the right to split the award in any manner deemed most advantageous to the County. The County also reserves the right to increase or decrease the award amount.

8. In an effort to reach a decision concerning the most qualified applicant, the County reserves the right to evaluate all factors it deems appropriate, whether or not such factors have been stated in the RFI.

9. The County reserves the sole right to interpret, change or terminate any provision of the RFI at any time prior to the submission date. Any such interpretation or change shall be in the form of a written addendum and shall become part of the RFI. The County also reserves the right to accept and reject any or all of the RFI, cancel the RFI in whole or in part, or terminate the process and elect to operate by other means.

10. An applicant may not be recommended for funding, regardless of the merits of the application submitted, if it has a history of contract non-compliance with the

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requirements of Marin County Department of Health and Human Services (“HHS”) or other funding source or poor past or current contract performance with any HHS or other funding source. The applicant may be given a provisions award with the stipulation that special terms and conditions regarding the areas of concern will be a part of the contract.

11. An application may be immediately rejected and disqualified for any of the following reasons:

a. The application is not received at the time and place specified in the RFI; b. The application does not adhere to the required material elements of format and

guidelines or substantive requirements set forth in this RFI; c. Evidence indicates that the applicant, applicant’s staff or consultants have in any

way attempted to influence the confidential nature of the review through contact with the Marin County BRHS staff or members of the selection review committee.

B. Submission Deadline and Format One (1) original application and three (3) additional copies of all documents must be received by 3:00pm on September 7, 2018. Submit applications to:

Cody Milner, Senior Program Coordinator Marin County Department of Health and Human Services

Behavioral Health and Recovery Services 20 North San Pedro Road, Suite 2021, San Rafael, CA 94903

1. Proposals may not be faxed or electronically transmitted. Proposals must be received by

the date and time recited above. POST MARKS or delivery service marks will not be accepted. Proposals and/or modifications and/or corrections thereof, received after the deadline specified will not be considered.

2. Only proposals submitted in the format described within this RFI will be considered. Proposals must be submitted on standard 8-1/2" x 11", plain white paper, typed, single- spaced, in no less than 12-point typeface, with one-inch (1”) margins and pages numbered consecutively. Designer or hard covers are not permitted and will be removed from proposals prior to their being shared with the review committee. Proposals shall be fastened in the top left-hand corner with a metal staple, clasp or other type of fastener.

3. A proposal may be rejected if incomplete and/or if it contains any alterations of form and/or other irregularities of sufficient magnitude or quantity to warrant a finding of being substantially non-compliant.

4. The County may in its discretion accept or reject in whole or in part any or all proposals, may cancel, amend or reissue the RFI at any time prior to contract approval and may waive any immaterial defect in a proposal. The County's waiver of an immaterial defect shall in no way modify the proposal requirements or excuse the applicant grantee from full compliance with the objective if awarded the contract.

C. Contact between Applicant and County

1. County staff contact: During the period from issuance of this RFI and the award of contracts to successful applicants, contact regarding the specific subject of this RFI between potential or actual applicant and County staff is restricted under the terms of this section. A documented instance of such contact by an actual or potential applicant shall be grounds for disqualification from the process. County staff is defined as any County employees, agents or contractors involved in or connected with this RFI process.

2. Questions regarding the RFI: To maintain a fair and impartial process, all questions

regarding this RFI must be submitted in writing via the County website and contain a

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contact name and address. The final date and time to submit questions in writing is 3:00 pm on August 30, 2018. All questions and responses will be available on the County website on or before August 31, 2018. No telephone consultation will be provided. Questions must be submitted via the County website at https://www.marinhhs.org/requests-proposals-or-statements-interest-rfp.

X. Application Review and Selection Process A. Application Review and Selection

Staff from BHRS will conduct an initial technical review to ensure that the format requirements outlined in this RFI have been fulfilled. If any of the material format or substantive requirements is missing or incorrect, the application may be disqualified. All applications that pass the initial technical review will be submitted to an Application review committee that shall evaluate and rank the applications. The committee may consist of persons experienced in mental health services, alcohol and other drug program services, representatives from other county departments, representatives from local advisory boards, and any other individuals that Health and Human Services deems capable and appropriate for the selection of potential providers. The committee shall not include potential contractors, and no committee member may apply or assist others in applying for this contract. The purpose of the evaluation is to determine which applicants demonstrate the skills, expertise and experience to successfully perform the tasks specified in the RFI. Each committee member will read and score each application using a standardized scoring instrument. The scoring instrument will reflect the requirements of the RFI. An applicant may not be recommended for funding, regardless of the merits of the application submitted, if it has a history of contract non-compliance with the requirements of Marin County Department of Health and Human Services (“HHS”) or other funding source or poor past or current contract performance with any HHS or other funding source. The applicant may be given a provisional award with the stipulation that special terms and conditions regarding the areas of concern will be a part of the contract. The committee will make an award recommendation to the Alcohol and Drug Administrator, who will make the final recommendation to the Marin County Board of Supervisors. Prior to making an award, the County may choose to conduct interviews with applicants. The purpose of the interviews would be to ask follow-up questions that may arise from the review committee and collect any additional information not gleaned from the Applications. The County may also request additional information necessary to determine the applicant’s financial stability, ability to perform on schedule or willingness to incorporate additional features in the application, and any other relevant information necessary to make the award. Once a decision is made, a Notice of Intent to Award will be mailed to all applicants evaluated by the committee.

B. Post Award

Once the Notice of Intent to Award has been issued, the provider selected will be contacted to execute the County’s Standard Professional Services Contract. At that time, the selected provider and the County may discuss adjustments to the budget and/or the scope of work. However, no other provisions of the County’s Standard Professional

https://www.marinhhs.org/requests-proposals-or-statements-interest-rfp

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Services Contract will be negotiated. Refer to Attachment E for a copy of the County’s Standard Professional Services Contract. The applicant grantee awarded a contract under this bid process will be required to adhere to the reporting requirements set forth by BHRS, as well as to provide any additional data needed to satisfy other local, state or federal reporting requirements. For the duration of the contract period, annual contract renewals are contingent upon the demonstration of progress in achieving measurable results to the County’s satisfaction and compliance with all contract requirements, as well as the continued availability of contract project funding. Award of a contract under this process does not preclude the County from conducting another RFI process for these services at a future date.

C. Appeal

Should an applicant not accept the decision in the Notice of Intent to Award, the following appeal process may be exercised. The appellant applicant must file a Notice of Intent to Appeal with the County Office that issued the RFI. No other method of delivery will be accepted. The Notice of Intent to Appeal must be received at the address stated below no later than ten (10) working days after the Notice of Intent to Award letter has been posted and mailed to all participating applicants.

Cody Milner, Senior Program Coordinator Marin County Department of Health and Human Services

Behavioral Health and Recovery Services 20 North San Pedro Road, Suite 2021, San Rafael, CA 94903

The Notice of Intent to appeal must include a full and complete written statement specifying the grounds for the appeal. Areas subject to appeal are: appeal from disqualification; appeal from rejection notice; appeal from award to another applicant; or appeal challenging the validity of the process. The appeal should identify the appealing party, be in writing, refer to the specific RFI sections and pertinent documents, and state the relief requested. The notice will be forwarded, through the appropriate administrative channels, to the Director of the Marin County Department of Health and Human Services, or designee. The Department Director or designee may review the original RFI Application(s), the public notice, the Request for Application document, and the scoring instruments of the Application review committee, and any other document deemed appropriate. The decision of the Department Director or designee shall be final.

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ATTACHMENT A

Purpose and Philosophy

It is the policy of the Marin County, Department of Health and Human Services to provide guidance and recommendations for the effective creation and operation of Sober Living Environments (“SLE”) in Marin County, California. The term SLE is generally used to describe a specific type of housing. SLE’s provide a housing alternative to individuals in recovery from alcohol and/or drug addiction. These facilities are not subject to licensing by any State agency and are not subject to certification or accreditation.1 Some other terms used to describe such housing are “recovery residences" “cooperative housing for recovering people", "resident-run housing", "sober cooperative living", "alcohol, drug free living centers", etc. These residences are intended for cooperative living for individuals recovering from alcoholism and/or drug addiction. Resident responsibility for the environment sets it apart from formal recovery programs. The SLE is a safe, clean, sober, residential environment that promotes individual recovery through positive peer group interactions among house members and staff. Sober living housing is affordable, alcohol and drug free and allows the house members or residents to continue to develop their individual recovery plans and to become self-supporting. In doing so, the SLE must co-exist in a respectful, lawful, non-threatening manner within residential communities in Marin County. These guidelines are a minimum standard to which Marin County Department of Health and Human Services will provide oversight and quality assurance through monthly reporting, semi-annual site visits and audits with contractual SLE services.

Marin County Department of Health & Human Services, Division of Community Health, Mental Health and Substance Use Services would like to thank the Marin Recovery Project (MRP) for the amount of time, research and dedication they provided in developing these Guidelines for Marin County. The MRP consists of a group of self-identified peer leaders in our community whose major goals include: (1) Changing public perceptions of recovery; (2) Promoting effective public policy, and; (3)Demonstrating that recovery is working for millions of Americans.

1 California Consortium of Addiction Programs and Professionals, Standards pg. 2

Marin County Health and Human Services Guidelines for Sober Living Environments

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Marin County Health and Human Services Guidelines for Sober Living Environments

Policies and Procedures

Each House shall have a current Policies and Procedures Manual that sets forth the rules, regulations, expectations, governance and grievance procedures of the house. Each house member shall be familiar with the policies and procedures contained in the Policy and Procedures Manual and will sign an agreement to abide by them while a member of the house. At a minimum, a House Policies and Procedures Manual shall contain the following sections:

A. Standards of Operation The SLE shall provide 24-hour safe housing, free from alcohol and other drugs which, at a minimum, shall include the following components:

1. Residents shall be required to attend regular house meetings with house managers, and/or operators. These meetings may be in a group setting with other residents of the SLE; SLE’s shall not require residents to attend programs or counseling sessions, however certain rules may be set as requirements for residency. House rules may include curfew, smoking, chores, payment of rent, and attendance at house meetings, and A.A. /N.A. meetings, and must include prohibition of any use of alcohol and or drugs.

2. Residents shall be provided with opportunities to engage in regular activities necessary (or optional) that define a residence such as cooking, laundry, housecleaning, yard work, etc;

3. Each SLE shall have a "common area" with adequate space for the proper number of residents to assemble for social and/or other group activities;

4. Each SLE shall have adequate personal space for each resident to be provided dignity, respect and appropriate privacy at all times, and the SLE will comply with applicable guidelines for the amount of square feet per resident and the number of residents per room; Attention should be given to the health and safety of all residents and therefore the home should meet minimum fire and health standards;

5. SLE operators and house managers shall take appropriate measures to ensure that the personal property of each resident is secure;

6. The SLE shall establish and maintain a culture and environment that is welcoming and understanding to those they serve;

7. All residents shall have access to the: kitchen, refrigerator, stove, dining room, laundry facilities, restrooms, and showers to ensure basic needs are met;

8. The following minimum health safety requirements shall be followed: a. There shall be adequate space for food storage; b. All food shall be stored in covered containers, or properly wrapped; c. Perishable items shall be refrigerated and adequate refrigeration in good repair

shall be available; d. All dishes and cooking implements shall be washed upon use; e. There shall be adequate hot water for dish washing; f. Bathroom space shall be adequate for number of residents;

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g. Bathrooms shall be kept clean on a daily basis; h. Bathrooms shall provide personal privacy; i. There is a policy for drug testing;

9. The SLE shall post a written description of the procedural processes regarding chores,

assignment of roommates, and primary house rules in a space that is accessible to all residents;

10. The SLE shall be a non-smoking residence. If the operator’s policy is to allow smoking on the property, a smoking area must be designated clearly in an outdoor space where smoke will not affect neighbors and is in compliance with any and all local smoking rules/ordinances. (A Good Neighbor Policy should also be established between the SLE operator and direct neighbors of the SLE) Any and all litter generated in a designated smoking area must be cleaned up daily;

11. Each SLE shall afford residents opportunities to engage in daily recreational, cultural, physical, and spiritual activities, either as an individual or with a group;

12. All SLE residents MUST be engaged in employment, treatment, education, volunteer work, active job search (for a defined period), or other approved daily activities conducive to the recovery process;

13. SLE proprietors are responsible for ensuring neighborhood parking is in compliance with town/city ordinances and is NOT intrusive to neighbors;

14. SLE proprietors shall establish and maintain a "Good Neighbor Policy." 15. The following minimum fire safety requirements shall be followed:

a. There shall be no smoking in residences (including porches, patios, and balconies);

b. Smoking is allowed outside only (20 feet from any door or operable window) and smoking materials shall be disposed of safely;

c. There shall be no accumulation of clothing, newspapers, or cartons in the living/sleeping areas;

d. Stoves and cooking areas shall be kept clean of grease accumulation; e. Furniture and drapes are treated with fire retardant materials f. Smoke detectors fire extinguishers, and CO2 detectors shall be installed

(according to Marin County Fire Code); g. Exit doors shall be clearly marked and readily available; h. Fire drills from sleeping areas should be encouraged; i. Buildings with 2nd floor shall have emergency fire ladders clearly marked;

B. Admission and Discharge

1. Each SLE shall have a written admission procedure; 2. Each SLE shall have a written policy for discharge, grounds for discharge and discharge

protocols that address the personal property of residents, referral to further services, monies paid, and information sharing ,if applicable;

3. Each prospective resident shall be interviewed and assessed by the House Manager to determine whether he or she is an appropriate fit for the SLE;

4. If the prospective resident is referred from another source, the interviewer may contact that source as a means of gathering information about the suitability of the prospective

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resident and Releases of Information (HIPAA, 42-CFR) may be requested for this purpose;

5. If the prospective resident is currently involved with the criminal justice system (probation/parole), releases of information (42-CFR) may also be requested by the interviewer;

6. Any/all prescription medications must be disclosed by the prospective resident and a 7-day minimum supply must be on hand prior to the resident moving into the SLE. (Prospective residents CANNOT be denied services based on prescribed medications);

7. Copies of all policies, procedures, house rules and expectations shall be presented to the prospective resident during the interview process, and specific questions or concerns of the resident at this time should be recorded as a means of documenting their understanding of the rules and expectations;

8. Admission and SLE residency documents shall be kept in a resident’s file at the premises at all times.

C. Eligibility for Continued Residency

Residency criteria must be clearly defined. Eligibility shall be determined through a formal interview process set forth by the proprietor/management of the SLE. At a minimum, prospective residents must be willing to comply with and meet the following criteria:

1. Residents must demonstrate being clean and sober by one or more of the following means:

a. Submit a negative urinalysis sample; b. Be actively enrolled in an alcohol and other drug treatment program; c. Regular attendance at self-help groups such as AA, NA, CA, etc.

2. SLE residents must demonstrate employment (paid or volunteer), ability to pay, or making a good faith effort to do so (determined by SLE operator or House Manager), be actively enrolled in a formal alcohol or other drug treatment program or be involved with community service work for a minimum of 20 hours per week as acceptable by the SLE operator and the resident’s supervising officer (if applicable).

3. Residents must possess a willingness and demonstrate the ability to comply with all SLE House rules, standards and procedures.

4. A signed residential agreement on file for each resident.

D. House Rules SLE rules must be clearly defined. Any optional rules the SLE proprietor chooses to implement must be for the needs of the residents, shall not be overly burdensome, and must be consistent across multiple residents. The following should be considered minimum mandatory standards for every SLE:

1. There shall be no consuming alcohol and/or other drugs by anyone on the property of the SLE;

2. Alcohol and items containing alcohol shall not be brought onto the property for any reason;

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3. Alcohol and other drug use may be grounds for dismissal from the SLE; Upon being notified of possible alcohol and/or other drug use by a resident, the House Manager shall first refer the resident for detoxification services for up to three days. Further, a resident has the right to file a grievance if dismissed from the residence without being referred to detoxification services. Note: The SLE operator or House Manager assumes NO fiscal responsibility for payment for detoxification for a resident of the SLE;

4. Regular attendance of house meetings shall be mandatory for all residents and it shall be the responsibility of SLE management to ensure proper participation;

5. Operators or House Managers in charge of an individual SLE facility must be accessible to residents daily. The operator and/or House Manager shall be clearly and easily identified and shall remain available at all times;

6. Each SLE shall have in its house rulebook a policy addressing visitation including hours, terms of contact, areas for visitation, visitor access, child visitation and monitoring, etc.

E. Confidentiality Policy The SLE shall protect the privacy of individuals being served and will not disclose confidential information without express written consent except as required or permitted by law. The House Manager will maintain release forms for house members to authorize the release of information. The SLE shall also affirmatively inform house members' of the privacy of information disclosed in house meetings or other SLE activities. SLE management shall remain knowledgeable of and obey all state and federal laws and regulations relating to confidentiality of records for the providers of services. Confidential information acquired during residency at the SLE shall be safeguarded from illegal or inappropriate use, access and disclosure, or from loss, unsecured maintenance of records or recording of an activity or presentation without appropriate releases. Forms will be provided to house members for the authorization to release information in compliance with Federal Law 42-CFR Part 2.

F. Sexual Harassment and Verbal Abuse Policy The SLE will not tolerate any behavior that is abusive, harassing or intimidating toward House Manager, volunteers, house members' or visitors.

G. Weapons, Alcohol, Illegal Drugs and Illegal Activity Policy The SLE strictly prohibits on its property the possession, and/or use of firearms, other weapons, illegal drugs, illegal activities and acts or threats of violence. Such acts shall be reported to the local law enforcement agencies immediately. Residents will be terminated from the house for such offenses. House Managers found to have violated the policy may face immediate termination. Each SLE shall have a written policy addressing weapons, alcohol and other drug use, relapse, and illegal activity by residents and staff.

H. Prescribed Medication Policy Each facility shall have a written policy regarding the use and storage of residents' prescribed medications. Medications must be properly secured. The policy concerning the storage of medications does not apply to those

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medications, such as an asthma inhaler, to which medical necessity requires the resident to have immediate access. The SLE shall not dispense medication but must ensure it is securely stored by the resident. I. Drug and Alcohol Testing Protocol

1. Each SLE shall have a written policy addressing the policies and procedures of specimen collection and shall maintain appropriate urinalysis equipment and/or access to an outside drug and alcohol testing service so that all residents may be tested at random to protect the safety and integrity of the house and its residents;

2. Parole, Probation or the Courts may impose and provide drug and alcohol testing to the residents referred by the Courts and/or Probation;

3. Positive drug tests of residents shall be reported immediately to the probation officer/parole agent or to the courts, as applicable.

J. Management

1. Managers Responsibility: The person in charge of the facility shall be clearly identified to all residents and on the premises (a). This should be person or designated person within the group. This individual shall be responsible for the maintenance and safety of the building. (b) If the person is designated, the lines of authority must be clearly defined. (c) The manager should be the keeper of the “good neighbor” policy and liability insurance and copies should be available and visible in the home.

2. Staff: An SLE may or may not elect to have paid staff. The role of staff members must be clearly for housing management and not for management of individuals. Staffing may or may not be necessary depending on the nature of the housing. At a minimum, someone must be responsible for the safety of the building, someone must be available to maintain records, to collect rent, and to register and check-out residents, and to maintain rules of the house. The resident group may choose to have other staff available such as cooks, grounds keepers, etc. Staff shall not provide any direction to the residents but shall be available for appropriate management of the physical plant.

K. Documentation/Record Keeping

1. Each SLE Manager shall keep a record of all residents as follows:

a. A resident’s date of birth, emergency contact information, pertinent emergency medical information, list of current medications and pharmacy where prescriptions are on file, employer or school contact information and any releases of information that are deemed necessary by the House Manager. Incidents of relapse should also be documented;

b. A resident sign in/out sheet should be placed near the main entrance/exit of the residence;

c. Each SLE shall keep clear records of rent/expenses paid and provide each resident with a receipt each and every month, or as appropriate, when rent/expenses are paid;

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d. The SLE shall have clear policies concerning curfew, prescribed medications, urinalysis monitoring, visitation, rent/expense payments, disposal of medications, relapse, resident/consumer conduct and expectations, and resident departures from those requirements shall be documented;

e. Each SLE shall have a specific policy addressing relapse and the actions taken by the house manager to address an incident of relapse.

L. Incident Report Policy The SLE House Manger will complete an internal incident report for all incidents involving house members. The incident report will be completed within 72 hours of the occurrence of an on-site incident or, in the case of an off-site incident when House Manager became aware of, or reasonably should have known of an incident that occurred. The incident report will provide:

1. A detailed description of the event including the date, time, location, individuals, name involved, and action taken.

2. The House Manager responsible for completing the report will sign it and record the date and time it was completed.

3. All incident reports will be stored in in a single, separate file.

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ATTACHMENT B

MARIN COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION OF BEHAVIORAL HEALTH AND RECOVERY SERVICES Sober Living Environment

RFI-HHS-2018-13

Date:

Certifications

The applicant certifies to the best of his/her knowledge and belief that the data in this application is true and correct and that filing of the application has been duly authorized by the governing body of the applicant and that applicant will comply with the assurances required of applicant if the application is approved and a contract is awarded. The applicant also attests that the costs of the project can be carried by the applicant for at least 90 days at any point during the term of the contract.

Signature: Date: Name: Title: For County Use Only Date Received: Time Received:

Marin County BHRS Staff Signature Acknowledging Receipt of Application:

Legal Applicant: Name Address Telephone Fax E-mail Federal Tax ID No.

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Attachment C

County of Marin

Department of Health and Human Services

APPLICATION HHS RFI: FRI-HHS-2018-13 ISSUED: August 17, 2018 I. Describe your experience in the operation of a Transitional Housing/Sober Living Environment in Marin County. Please include an overview of your housing services such as how long the house has been in operation, any history of providing such services to the target population, the level of on-site management and any existing contractual agreements with other governmental agencies.

II. Describe your knowledge of and experience collaborating and/or making/receiving referrals with community-based service partners, such as community-based organizations, Health and Human Services’ Divisions, criminal justice systems, and other relevant agencies/organizations. In your response, be sure to include typical population and gender served, admission criteria describing client suitability and the duration of experience and specific examples of working relationships that you will bring to the project target populations identified in the RFI.

III. Level of residential management (i.e. on-site or off-site manager)?

IV. History of providing services to probation population?

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V. Provide a brief narrative describing your plan to adhere to the Marin County Guidelines for Sober Living Environments. In addition, please provide a copy of your Policies & Procedures Manual.

VI. Provide a brief narrative describing your plan to adhere to Marin County’s Professional Service Contract Exhibit I: Substance Use Disorder Service Programs on Medication Assisted Treatment. Which states, “Contractors shall develop and implement policies and procedures that ensure non-discrimination in access to or the provision of services because of the prescribed use of or need for Medication Assisted Treatment for substance use disorders.”

VII. Any existing contractual agreements with other governmental agencies? VIII. Experience collaborating and/or making/receiving referrals with community-based service partners. IX. Please state whether you agree to adhere to the Marin County Guidelines for Sober Living Environments (Please review Attachment A). Yes ☐ No ☐ X. Please provide a copy of your Policies & Procedures Manual.

Local: Yes ☐ No ☐ If Yes, please list

State: Yes ☐ No ☐ If Yes, please list

Fed: Yes ☐ No ☐ If Yes, please list

a. Community-based organizations Yes ☐ No ☐ b. Health and Human Services’ Divisions Yes ☐ No ☐ c. Criminal justice systems agencies/organization Yes ☐ No ☐ d. Does facility have an admission criteria/suitability Yes ☐ No ☐ e. Gender served Male ☐ Female ☐ f. Typical population (Check all that apply):

Criminal Justice ☐ Recovery ☐ Women ☐ Children ☐ Co-ed ☐ Other ☐ If Other, please list:

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Attachment D BUDGET DETAIL

FY 2018/19 FY 2019/20 FY 2020/21 Total

Salaries, Wages & Benefits

$0

$0

$0

Sub-Total $0 $0 $0 $0

Employee Benefits $0

Total of Salaries & Benefits $0 $0 $0 $0

Services & Supplies

Office Supplies $0

Printing/Copying $0

Postage $0

Repairs & Maintenance $0

Rent $0

Utilities $0

Security $0

Communications $0

Advertising/Recruiting $0

Consultants - Acctg/Other $0

Educational Materials $0

Insurance $0

Vehicle Expense $0

Consultants – Medical $0

Lab Tests & Urinalysis $0

Medical Supplies $0

Training/Travel $0

$0

Total Services & Supplies $0.00 $0.00 $0.00 $0.00

Indirect Costs

Indirect Costs @ X % $0

TOTAL EXPENSES $0 $0 $0 $0

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Attachment E Professional Services Contract

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CAO Contract Log #___________ COUNTY OF MARIN Dept. Contract Log #BHRS-Various-18-19 PROFESSIONAL SERVICES CONTRACT

2012 - Edition 1

THIS CONTRACT is made and entered into this day of , 2018, by and between the COUNTY OF MARIN, hereinafter referred to as "County" and Various Providers, hereinafter referred to as "Contractor.”

RECITALS: WHEREAS, County desires to retain a person or firm to provide the following service: Sober Living Environment Services; and WHEREAS, Contractor warrants that it is qualified and competent to render the aforesaid services;

NOW, THEREFORE, for and in consideration of the Contract made, and the payments to be made by County, the parties agree to the following:

1. SCOPE OF SERVICES: Contractor agrees to provide all of the services described in Exhibit A attached hereto and by this reference made a part hereof. 2. FURNISHED SERVICES: The County agrees to:

A. Guarantee access to and make provisions for the Contractor to enter upon public and private lands as required to perform their work.

B. Make available all pertinent data and records for review. C. Provide general bid and Contract forms and special provisions format when needed.

3. FEES AND PAYMENT SCHEDULE: The fees and payment schedule for furnishing services under this Contract shall be based on the rate schedule which is attached hereto as Exhibit B and by this reference incorporated herein. Said fees shall remain in effect for the entire term of the Contract. Contractor shall provide County with his/her/its Federal Tax I.D. number prior to submitting the first invoice. 4. MAXIMUM COST TO COUNTY: In no event will the cost to County for the services to be provided herein exceed the maximum sum of $800,000.00 including direct non-salary expenses. As set forth in section 14 of this Contract, should the funding source for this Contract be reduced, Contractor agrees that this maximum cost to County may be amended by written notice from County to reflect that reduction. 5. TIME OF CONTRACT: This Contract shall commence on July 1, 2018, and shall terminate on June 30, 2019. Certificate(s) of Insurance must be current on day Contract commences and if scheduled to lapse prior to termination date, must be automatically updated before final payment may be made to Contractor. The final invoice must be submitted within 30 days of completion of the stated scope of services. 6. INSURANCE: Commercial General Liability: The Contractor shall maintain a commercial general liability insurance policy in the amount of $1,000,000 ($2,000,000 aggregate). The County shall be named as an additional insured on the commercial general liability policy. Commercial Automobile Liability: Where the services to be provided under this Contract involve or require the use of any type of vehicle by Contractor, Contractor shall provide comprehensive business or commercial automobile liability coverage, including non-owned and hired automobile liability, in the amount of $1,000,000.00.

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Workers’ Compensation: The Contractor acknowledges the State of California requires every employer to be insured against liability for workers’

compensation or to undertake self-insurance in accordance with the provisions of the Labor Code. If Contractor has employees, a copy of the certificate evidencing such insurance, a letter of self-insurance, or a copy of the Certificate of Consent to Self-Insure shall be provided to County prior to commencement of work. Errors and Omissions, Professional Liability or Malpractice Insurance. Contractor may be required to carry errors and omissions, professional liability or malpractice insurance. All policies shall remain in force through the life of this Contract and shall be payable on a "per occurrence" basis unless County specifically consents to a "claims made" basis. The insurer shall supply County adequate proof of insurance and/or a certificate of insurance evidencing coverages and limits prior to commencement of work. Should any of the required insurance policies in this Contract be cancelled or non-renewed, it is the Contractor’s duty to notify the County immediately upon receipt of the notice of cancellation or non-renewal. If Contractor does not carry a required insurance coverage and/or does not meet the required limits, the coverage limits and deductibles shall be set forth on a waiver, Exhibit C, attached hereto. Failure to provide and maintain the insurance required by this Contract will constitute a material breach of this Contract. In addition to any other available remedies, County may suspend payment to the Contractor for any services provided during any time that insurance was not in effect and until such time as the Contractor provides adequate evidence that Contractor has obtained the required coverage. 7. ANTI DISCRIMINATION AND ANTI HARASSMENT: Contractor and/or any subcontractor shall not unlawfully discriminate against or harass any individual including, but not limited to, any employee or volunteer of the County of Marin based on race, color, religion, nationality, sex, sexual orientation, age or condition of disability. Contractor and/or any subcontractor understands and agrees that Contractor and/or any subcontractor is bound by and will comply with the anti discrimination and anti harassment mandates of all Federal, State and local statutes, regulations and ordinances including, but not limited to, County of Marin Personnel Management Regulation (PMR) 21.

8. SUBCONTRACTING: The Contractor shall not subcontract nor assign any portion of the work required by this Contract without prior written approval of the County except for any subcontract work identified herein. If Contractor hires a subcontractor under this Contract, Contractor shall require subcontractor to provide and maintain insurance coverage(s) identical to what is required of Contractor under this Contract and shall require subcontractor to name Contractor and County of Marin as an additional insured under this Contract for general liability. It shall be Contractor’s responsibility to collect and maintain current

evidence of insurance provided by its subcontractors and shall forward to the County evidence of same. 9. ASSIGNMENT: The rights, responsibilities and duties under this Contract are personal to the Contractor and may not be transferred or assigned without the express prior written consent of the County.

10. LICENSING AND PERMITS: The Contractor shall maintain the appropriate licenses throughout the life of this Contract. Contractor shall also obtain any and all permits which might be required by the work to be performed herein. 11. BOOKS OF RECORD AND AUDIT PROVISION: Contractor shall maintain on a current basis complete books and records relating to this Contract. Such records shall include, but not be limited to, documents supporting all bids, all income and all expenditures. The books and records shall be original entry books with a general ledger itemizing all debits and credits for the work on this Contract. In addition, Contractor shall maintain detailed payroll records including all subsistence, travel and field expenses, and canceled checks, receipts and invoices for all items. These documents and records shall be retained for at least five years from the completion of this Contract. Contractor will permit County to audit all books, accounts or records relating to this Contract or all books, accounts or records of any business entities controlled by Contractor who participated in this Contract in any way. Any audit may be conducted on Contractor's premises or, at County's option, Contractor shall provide all books and records within a maximum of fifteen (15) days upon receipt of written notice from County. Contractor shall refund any monies erroneously charged.

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12. WORK PRODUCT/PRE-EXISTING WORK PRODUCT OF CONTRACTOR: Any and all work product resulting from this Contract is commissioned by the County of Marin as a work for hire. The County of Marin shall be considered, for all purposes, the author of the work product and shall have all rights of authorship to the work, including, but not limited to, the exclusive right to use, publish, reproduce, copy and make derivative use of, the work product or otherwise grant others limited rights to use the work product. To the extent Contractor incorporates into the work product any pre-existing work product owned by Contractor, Contractor hereby acknowledges and agrees that ownership of such work product shall be transferred to the County of Marin.

13. TERMINATION:

A. If the Contractor fails to provide in any manner the services required under this Contract or otherwise fails to comply with the terms of this Contract or violates any ordinance, regulation or other law which applies to its performance herein, the County may terminate this Contract by giving five (5) calendar days written notice to the party involved.

B. The Contractor shall be excused for failure to perform services herein if such services are prevented by acts of God, strikes, labor disputes or other forces over which the Contractor has no control.

C. Either party hereto may terminate this Contract for any reason by giving thirty (30) calendar days written notice

to the other parties. Notice of termination shall be by written notice to the other parties and be sent by registered mail.

D. In the event of termination not the fault of the Contractor, the Contractor shall be paid for services performed to

the date of termination in accordance with the terms of this Contract so long as proof of required insurance is provided for the periods covered in the Contract or Amendment(s).

14. APPROPRIATIONS: The County's performance and obligation to pay under this Contract is contingent upon an annual appropriation by the Marin County Board of Supervisors, the State of California or other third party. Should the funds not be appropriated County may terminate this Contract with respect to those payments for which such funds are not appropriated. County will give Contractor thirty (30) days’ written notice of such termination. All obligations of County to make payments after the termination date will cease. Where the funding source for this Contract is contingent upon an annual appropriation or grant from the Marin County Board of Supervisors, the State of California or other third party, County's performance and obligation to pay under this Contract is limited by the availability of those funds. Should the funding source for this Contract be eliminated or reduced, upon written notice to Contractor, County may reduce the Maximum Cost to County identified in section 4 to reflect that elimination or reduction. 15. RELATIONSHIP BETWEEN THE PARTIES: It is expressly understood that in the performance of the services herein, the Contractor, and the agents and employees thereof, shall act in an independent capacity and as an independent Contractor and not as officers, employees or agents of the County. Contractor shall be solely responsible to pay all required taxes, including but not limited to, all withholding social security, and workers’ compensation.

16. AMENDMENT: This Contract may be amended or modified only by written Contract of all parties. 17. ASSIGNMENT OF PERSONNEL: The Contractor shall not substitute any personnel for those specifically named in its proposal unless personnel with substantially equal or better qualifications and experience are provided, acceptable to County, as is evidenced in writing.

18. JURISDICTION AND VENUE: This Contract shall be construed in accordance with the laws of the State of California and the parties hereto agree that venue shall be in Marin County, California.

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19. INDEMNIFICATION: Contractor agrees to indemnify, defend, and hold County, its employees, officers, and agents, harmless from any and all liabilities including, but not limited to, litigation costs and attorney’s fees arising from any and all claims and losses to anyone who may be injured or damaged by reason of Contractor’s negligence, recklessness or willful misconduct in the performance of this Contract. 20. COMPLIANCE WITH APPLICABLE LAWS: The Contractor shall comply with any and all Federal, State and local laws and resolutions: including, but not limited to the County of Marin Nuclear Free Zone, Living Wage Ordinance, and Board of Supervisors Resolution #2005-97 prohibiting the off-shoring of professional services involving employee/retiree medical and financial data affecting services covered by this Contract. Copies of any of the above-referenced local laws and resolutions may be secured from the Contract Manager referenced in section 21. In addition, the following NOTICES may apply:

1. Pursuant to California Franchise Tax Board regulations, County will automatically withhold 7% from all payments made to vendors who are non-residents of California.

2. Contractor agrees to meet all applicable program access and physical accessibility requirements under State and Federal laws as may apply to services, programs or activities for the benefit of the public.

3. For Contracts involving any State or Federal grant funds, Exhibit D must be attached. Exhibit D shall

consist of the printout results obtained by search of the System for Award Management at www.sam.gov. Exhibit D - Debarment Certification By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below.

• The certification in this clause is a material representation of fact relied upon by County.

• The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its

certification was erroneous or has become erroneous by reason of changed circumstances.

• Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals:

• Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily

excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR

180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period;

• Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a);

• Have not had one or more public transactions (Federal, State, or Local) terminated within the

preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered

transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction.

• The Contractor to this Contract and any subcontractor will provide a debarment certification that includes the

debarment clause as noted in preceding bullets above, without modification.

http://www.sam.gov/

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21. NOTICES: This Contract shall be managed and administered on County’s behalf by the Department Contract Manager named below. All invoices shall be submitted and approved by this Department and all notices shall be given to County at the following location:

Contract Manager:

Various Contract Managers County of Marin

Dept./Location:

HHS - Division of Behavioral Health and Recovery Services 20 North San Pedro Road San Rafael, CA 94903

Telephone No.:

415.473.4074

Notices shall be given to Contractor at the following address(es):

Contractor: Various Providers Address:

Telephone No.:

Contractor: Address:

Telephone No.:

22. ACKNOWLEDGEMENT OF EXHIBITS: Check applicable Exhibits CONTRACTOR’S

INITIALS EXHIBIT A.

Scope of Services

EXHIBIT B.

Fees and Payment

EXHIBIT C.

Insurance Reduction/Waiver

EXHIBIT D.

Contractor’s Debarment Certification

EXHIBIT E.

Subcontractor’s Debarment Certification

OTHER REQUIRED EXHIBITS (HHS USE ONLY)

Exhibit M - Business Associate Agrmt Exhibit I - Substance Use Services

IN WITNESS WHEREOF, the parties have executed this Contract on the date first above written. CONTRACTOR: APPROVED BY COUNTY OF MARIN: By: _________________________________ _ Name: ___________________________ Title: ___________________________ By:__________________________________ President, Board of Supervisors

COUNTY COUNSEL REVIEW AND APPROVAL (required if template content has been modified) County Counsel: _______________________________________ Date: ____________________________________

EXHIBIT A - SCOPE OF SERVICES

SOBER LIVING ENVIRONMENT

JULY 1, 2018 – JUNE 30, 2019

Services Provided

A Sober Living Environment (SLE) is a safe, clean, sober, residential environment that promotes individual recovery through positive peer group interactions among house members and staff. Sober living housing is affordable, alcohol and drug free and allows the house members or residents to continue to develop their individual recovery plans and to become self-supporting. In doing so, the SLE must co-exist in a respectful, lawful, non-threatening manner within residential communities in Marin County. The Marin County Division of Behavioral Health and Recovery Services provides oversight and quality assurance through monthly reporting, semi-annual site visits and audits with contractual SLE services. Each resident will be authorized by the County for admission and length of stay. Residents will begin to seek employment upon admission and stabilization. Residents are expected to pay a portion of their rent which will increase in steps as a resident is able to gain financial stability. Program/house manager to meet with resident and complete necessary paperwork. Standards of Operation The SLE shall provide 24-hour safe housing, free from alcohol and other drugs which, at a minimum, shall include the following components:

1. Residents shall be required to attend regular house meetings with house managers, and/or operators. These meetings may be in a group setting with other residents of the SLE; SLE’s shall not require residents to attend programs or counseling sessions, however certain rules may be set as requirements for residency. House rules may include curfew, smoking, chores, payment of rent, and attendance at house meetings, and A.A. /N.A. meetings, and must include prohibition of any use of alcohol and or drugs.

2. Residents shall be provided with opportunities to engage in regular activities necessary (or optional) that define a residence such as cooking, laundry, housecleaning, yard work, etc.;

3. Each SLE shall have a "common area" with adequate space for the proper number of residents to assemble for social and/or other group activities;

4. Each SLE shall have adequate personal space for each resident to be provided dignity, respect and appropriate privacy at all times, and the SLE will comply with applicable guidelines for the amount of square feet per resident and the number of residents per room; Attention should be given to the health and safety of all residents and therefore the home should meet minimum fire and health standards;

5. SLE operators and house managers shall take appropriate measures to ensure that the personal property of each resident is secure;

6. The SLE shall establish and maintain a culture and environment that is welcoming and understanding to those they serve;

7. All residents shall have access to the: kitchen, refrigerator, stove, dining room, laundry facilities, restrooms, and showers to ensure basic needs are met;

8. The following minimum health safety requirements shall be followed: a. There shall be adequate space for food storage; b. All food shall be stored in covered containers, or properly wrapped; c. Perishable items shall be refrigerated and adequate refrigeration in

good repair shall be available; d. All dishes and cooking implements shall be washed upon use; e. There shall be adequate hot water for dish washing; f. Bathroom space shall be adequate for number of residents; g. Bathrooms shall be kept clean on a daily basis; h. Bathrooms shall provide personal privacy; i. There is a policy for drug testing;

9. The SLE shall post a written description of the procedural processes regarding chores, assignment of roommates, and primary house rules in a space that is accessible to all residents;

10. The SLE shall be a non-smoking residence. If the operator’s policy is to allow smoking on the property, a smoking area must be designated clearly in an outdoor space where smoke will not affect neighbors and is in compliance with any and all local smoking rules/ordinances. (A Good Neighbor Policy should also be established between the SLE operator and direct neighbors of the SLE) Any and all litter generated in a designated smoking area must be cleaned up daily;

11. Each SLE shall afford residents opportunities to engage in daily recreational, cultural, physical, and spiritual activities, either as an individual or with a group;

12. All SLE residents MUST be engaged in employment, treatment, education, volunteer work, active job search (for a defined period), recovery support services or other approved daily activities conducive to the recovery process;

13. SLE proprietors are responsible for ensuring neighborhood parking is in compliance with town/city ordinances and is NOT intrusive to neighbors;

14. SLE proprietors shall establish and maintain a "Good Neighbor Policy." 15. The following minimum fire safety requirements shall be followed:

a. There shall be no smoking in residences (including porches, patios, and balconies);

b. Smoking is allowed outside only (20 feet from any door or operable window) and smoking materials shall be disposed of safely;

c. There shall be no accumulation of clothing, newspapers, or cartons in the living/sleeping areas;

d. Stoves and cooking areas shall be kept clean of grease accumulation; e. Furniture and drapes are treated with fire retardant materials; f. Smoke detectors fire extinguishers, and CO2 detectors shall be

installed (according to Marin County Fire Code); g. Exit doors shall be clearly marked and readily available; h. Fire drills from sleeping areas should be encouraged; and

i. Buildings with 2nd floor shall have emergency fire ladders clearly marked.

House Rules SLE rules must be clearly defined. Any optional rules the SLE proprietor chooses to implement must be for the needs of the residents, shall not be overly burdensome, and must be consistent across multiple residents. The following should be considered minimum mandatory standards for every SLE:

1. There shall be no consuming alcohol and/or other drugs by anyone on the

property of the SLE;

2. Alcohol and items containing alcohol shall not be brought onto the property

for any reason;

3. Alcohol and other drug use may be grounds for dismissal from the SLE; Upon

being notified of possible alcohol and/or other drug use by a resident, the

House Manager shall first refer the resident for detoxification services for up

to three days. Further, a resident has the right to file a grievance if dismissed

from the residence without being referred to detoxification services. Note:

The SLE operator or House Manager assumes NO fiscal responsibility for

payment for detoxification for a resident of the SLE;

4. Regular attendance of house meetings shall be mandatory for all residents

and it shall be the responsibility of SLE management to ensure proper

participation;

5. Operators or House Managers in charge of an individual SLE facility must be

accessible to residents daily. The operator and/or House Manager shall be

clearly and easily identified and shall remain available at all times;

6. Each SLE shall have in its house rulebook a policy addressing visitation

including hours, terms of contact, areas for visitation, visitor access, child

visitation and monitoring, etc. The House Rulebook shall also contain

standards of operation and rules, regulations, expectations and governance

procedures of the House,

Required Policies

1. Admission and Discharge 2. Confidentiality 3. Sexual Harassment & Verbal Abuse 4. Weapons, Alcohol, Illegal Drugs and Illegal Activity 5. Prescribed Medication Policy 6. Drug and Alcohol Testing Protocol 7. Management and Staff Responsibilities 8. Documentation/Record Keeping/Financial Agreements 9. Incident Report Policy

10. Accessibility of Service Requirements

11. Cultural Competency

12. Nondiscrimination

Performance Standards

Compliance with Marin County Health and Human Services Guidelines for Sober Living Environments. (www.MarinHHS.org/BHRS) Utilize Marin WITS System for client profile information. Billing will be performed through the Marin WITS system. All residents must have a personal file that contains at a minimum the following items:

• Basic personal information such as name, DOB, emergency contact, etc.

• Recognition of client rights, house expectations, grievance and complaint procedures.

• Initial financial assessment done at entry and every month thereafter. Note: County is to be notified when residents’ financial status changes affects resident share of cost.

• Appropriate releases of information, as they apply.

• Current employment status, updated as needed, and proof of salary (i.e. a copy of check stub).

• Urinalysis results

• Any incident reports regarding resident

Outcomes Residents who are receiving County financial assistance toward rent are expected to pursue employment and will be responsible for full rent payment beyond 1 year (365 days) residency. At 90 days, 75% to 100% of clients will be:

• Gainfully employed (if employable) and contributing to their rent

• Obtaining & continuing to maintain sobriety

• Actively engaged in the recovery support activities

• Exhibiting no new criminal activity

• Engaged with all health services, as appropriate

Program Licensure, Certification and Standards

Contractor shall comply with any and all federal, state and local laws as residential member of Marin County. Contractor shall agree to comply with Marin County Health and Human Services Guidelines for Sober Living Environments (Attached and at www.MarinHHS.org/BHRS)

Contract Changes

If significant changes are expected, you must submit a request in writing to the contract manager. Changes include significant program or policy revisions, or proposing to re-distribute more than 20% between budget categories, proposing to increase or decrease FTE or proposing to increase the contract maximum. Contractor shall also report any other key changes per the timelines and processes outlined in Exhibit I and applicable Policies and Procedures (www.MarinHHS.org/policies-procedures), including, but not limited to: 1) Staff Updates; 2) Facility alterations/renovations; 3) Unusual occurrences or incidents; 4) Not accepting residents (facility at capacity).

DMC-ODS Participation

If applicable, contractors receiving funding to provide Recovery Residence services as part of the Drug/Medi-Cal Organized Delivery System are required to adhere to applicable regulations and policies, including the below Beneficiary Protections and Beneficiary Informing Materials.

http://www.marinhhs.org/BHRS

http://www.marinhhs.org/policies-procedures

Contractor shall make available at initial contact, and shall notify beneficiaries of their right to request and obtain at least once a year and thereafter upon request, the following materials: DMC-ODS Beneficiary Booklet and Provider Directory. Contractor shall also post notices explaining grievance, appeal and expedited appeal processes in all program sites, as well as make available forms and self-addressed envelopes to file grievances, appeals and expedited appeals without having to make a verbal or written request to anyone. The County will produce required beneficiary informing materials in English and Spanish. Contractor shall request materials from the County, as needed. Refer to 42 CFR 438.10(g)(2)(xi) for additional information about the grievance and appeal system.

EXHIBIT A - PROGRAM REPORTING

To document program activities and progress toward achieving the expected outcomes, Providers are required to collect and submit the following:

DOCUMENT TITLE DUE DATE WHERE SUBMITTED SUBMISSION

FORMAT PRIMARY

CONTACT Ongoing/ As Needed

Not Accepting New Beneficiaries

By 9am each day that the program is not accepting new beneficiaries

BHRS Office E-mail BHRS Access, Contract Manager

Marin WITS (CalOMS) - Client-specific data - DMC Billing - ASAM, Timely

Access Data, etc.

Client-specific data should occur within 7 days of event

MarinWITS: www.MarinWITS.org

Electronic Submission

Leigh Steffy

Adult Drug Court Weekly Progress Reports

By 12noon every Friday Jordan Hall [email protected] or 415.473.7008

Encrypted E-mail or Secure Fax

Jordan Hall

Any issue that would require a Notice of Adverse Benefit Determination (NOABD)

Within 24 hours of the event requiring a NOABD

BHRS Office Telephone or E-mail

Contract Manager

Staff Update Form Prior to or within 24 hours of the staff change [e.g. new staff, separating staff, change of roles]

Marin WITS Administrator [email protected]

E-mail Leigh Steffy

Monthly Submission

Monthly Provider Check and attestation

By the 10th of the month BHRS Office E-mail Cody Milner

All Billing Invoices and Supporting Documentation

By the 10th of the month Marin WITS and BHRS Office

Electronic Submission

Contract Manager

Drug and Alcohol Treatment Access Report (DATAR)

By the 10th of the month State DHCS Electronic Submission

State DHCS

Resubmission of Denied DMC Claims

By the 20th of the month following notice of denial

Marin WITS Electronic Submission

Leigh Steffy

Prevention Providers Only: PPSDS Data Template

By the 10th of the month BHRS Office E-mail Melissa Struzzo

Annual Submission

Provider Self Audit January 2019 BHRS Office Hard Copy (signatures) and Electronic Copy

Contract Manager

Annual Report July 31, 2019 BHRS Office E-mail or Hard Copy

Contract Manager

Provider Cost Reports Late August/ Early September 2019

BHRS Office TBD HHS Fiscal

http://marin.witsweb.org/wits/default.aspx

mailto:[email protected]


County of Marin Accessibility Requirements for Delegated Direct Services The Americans with Disabilities Act of 1990 requires that all of the County of Marin’s programs, services, and activities be accessible to and usable by individuals with disabilities. This law also stipulates that we may not delegate away our responsibility to ensure people with disabilities have equitable access. This means that not only must the programs and services administered by the County be accessible, but also those administered on behalf of the County by third party agencies. All entities receiving County funding which provide direct services to the public must also comply with the accessibility requirements set forth in the ADA, and other applicable laws and regulations. This guide has been created to assist agencies under contract with the County of Marin to ensure that they comply with accessibility requirements. Inquiries related to the content herein can be directed to:

County of Marin Disability Access Program

(415) 473-4381 (voice) (415) 473-3232 TTY

[email protected]

Programs and Services Every aspect of the service you provide is considered part of your program, and therefore it must be accessible to individuals with disabilities. This includes parking lots, service counters and spaces, transportation (shuttles, etc.), agendas, flyers, emails, online services, phone calls, meetings, celebrations, classes, recreational activities and more. The guidance in this document is primarily intended to help you provide accessible programs by providing you with the tools to:

▪ survey facilities and identify common architectural barriers for people with disabilities; ▪ identify common ADA compliance problems in your communications and activities; and ▪ remove barriers and fix common ADA compliance problems in these areas.

ADA Technical Assistance Materials ADA Update Your programs can be broken into three main categories, (Communications, Facilities, and Activities) which will be covered in more detail below. Communications All the communications within your program must be accessible. This means any documents you provide must be made available in alternative formats, upon request. Brochures, agendas, schedules, and lists all may be requested by a client to be provided in alternative formats. Alternative formats can include Braille, large font, or documents on a thumb drive. You do not need to have all formats on hand at all times, but you must have a plan in place to provide them in a reasonable amount of time. Some clients may require professional support from providers such as sign language interpreters. Requests for these accommodations must be addressed in a timely manner as well. The following is a list of resources and tools you may find helpful when ensuring the accessibility of your communications: ADA Requirements: Effective Communications General Effective Communication Requirements under Title II of the ADA US Access Board Guidelines and Standards: Communications


https://www.ada.gov/ta-pubs-pg2.htm

https://www.ada.gov/regs2010/titleII_2010/title_ii_primer.html

https://www.ada.gov/effective-comm.htm

https://www.ada.gov/pcatoolkit/chap3toolkit.htm

https://www.access-board.gov/guidelines-and-standards

Facilities If you are bringing clients into your facilities, or providing facilities for their use (recreation, program participation, housing, etc.) these facilities must meet accessibility requirements. In California, the best source of information on accessibility requirements for facilities is the California Building Code (CBC). The accessibility requirements contained in the CBC are compatible with the Federal requirements adopted by the United States Access Board. What is most important to remember about facilities is that your clients with disabilities need to be able to arrive, enter, conduct business, and interact with your program in the same way that clients without disabilities can. This generally means you must provide accessible parking, path of travel, meeting and workspaces, restrooms, and communal areas. All areas of your facility where clients will visit must be accessible. Please note there are different requirements for different types of facilities, so please review the requirements carefully. The best way to determine if your facility is accessible and to determine what remediation may be necessary to bring your facility into compliance is to conduct a survey. You can either do this yourself, with the help of the tools provided below, or you can hire a Certified Access Specialist (CASp) to perform a survey for you and compile the findings. A list of CASp certified individuals can be found on the California Department of General Services Website. This list includes both public and private specialist, many of whom are available to work with publically contracted service providers. The following is a list of resources and tools you may find helpful when trying to assess the accessibility of your facilities: US Access Board ADA Requirements US Access Board Guidelines and Standards: Buildings and Sites California Building Code, Chapter 11B – Accessibility ADA Checklist for Existing Facilities Overview of Title II ADA Requirements for Buildings and Facilities Activities Meetings, company outings, fundraising events, counseling sessions, classes and trainings are all examples of some activities your organization may provide. Any interaction between your agency and the client must be accessible to clients and/or employees with disabilities. Many accessibility issues surrounding activities will be remediated through ensuring your facilities and communications are accessible; however there are other areas you must consider. For example, course content may need to be modified for a client with a developmental disability, accessible transportation may need to be provided to an event site with no public transit access, etc. The following is a list of resources and tools you may find helpful when trying to assess the accessibility of your activities: A Planning Guide for Making Temporary Events Accessible to People with Disabilities Accessible Events: Planning and Preparation are Key Website Accessibility under Title II of the ADA ADA Guidelines for Recreational Facilities US Access Board Guidelines and Standards: Recreation Facilities, Streets and Sidewalks, Transportation, Health Care

https://www.apps2.dgs.ca.gov/dsa/casp/casp_certified_list.aspx

https://www.access-board.gov/guidelines-and-standards/buildings-and-sites/about-the-ada-standards/ada-standards


https://codes.iccsafe.org/public/chapter/content/1780/

https://www.adachecklist.org/doc/fullchecklist/ada-checklist.pdf

http://sfgov.org/mod/overview-title-ii-ada-requirements-buildings-and-facilities

https://adata.org/publication/temporary-events-guide

http://www.adainfo.org/content/access-events-article

https://www.ada.gov/pcatoolkit/ch5_toolkit.pdf

https://www.access-board.gov/guidelines-and-standards/buildings-and-sites/about-the-ada-standards/background/ada-accessibility-guidelines-for-recreation-facilities



Exhibit B – Unit Rates

Sober Living Environment Master Agreement Projected Unit Rate Range*

Unit of Service Description

Projected Reimbursement

Months 1-4: County pays 100%, no client co-pay $20.00 - $40.00/day*

1 unit = 1 Bed Day

Months 5-8: County pays 75%, client co-pay 25% Months 9-12: County pays 50%, client co-pay 50%

New Client Admission Fee $300.00/client

EXHIBIT B

TERMS AND CONDITIONS OF PAYMENT

TYPE OF CONTRACT: FEE FOR SERVICE

Claims Submission and Re-Submission

1. Invoices and applicable supporting documentation are due by the 10th of the month for services

delivered the preceding month.

2. Following claims submissions to the County by the 10th of the month for services delivered the

preceding month and a subsequent utilization review of Drug/Medi-Cal files, the County will

submit eligible Drug/Medi-Cal claims received by the Contractor to DHCS.

3. Any Drug/Medi-Cal denials shall be resubmitted, as appropriate, by the Contractor to the

County, by the 20th of the month following notification of the denial.

4. As claims for Physician Consultation services can only be billed by the eligible DMC provider

receiving Physician Consultation services, Contractor is responsible for submitting claims for any

Physician Consultation services provided by the County to the Contractor. The County will

retain all reimbursements for Physician Consultation services provided by the County to the

Contractor. The County can provide receipts to Contractor for the purposes of documentation.

5. Claims for final payment must be submitted within thirty (30) days of the expiration date of this

Agreement. Payment of claims due may be withheld pending receipt of documents required by

this contract.

Reimbursement

1. Contractor will be paid on a monthly basis, following the submission of an invoice (submitted

through Marin WITS, as applicable, and on a template provided and/or agreed to by the County)

for services delivered to the County’s satisfaction. Contractor will be reimbursed the negotiated

unit of service rate for all approved claims. Final settlement will be the total of approved claims

times the negotiated Fee for Service rate, up to the contract maximum.

2. Contractor will be reimbursed on a Net 30 basis, meaning generally, payments will be processed

within 30 days from the invoice date.

3. Unless otherwise noted in the contract, services provided and reimbursed under this contract

are only for Marin County Medi-Cal beneficiaries and low-income (< 138% FPL) uninsured Marin

residents.

Monitoring and Reporting

1. Contractor is subject to annual fiscal monitoring by the County or County’s qualified designee.

2. At mid-year, or as requested by the County, Contractor shall submit supporting documentation

(e.g. copy of General Ledger, report of expenses from financial system) for actual costs to the

Marin County Division of Behavioral Health and Recovery Services for management information

and planning purposes.

3. Annual Cost Reports and all supporting documentation must be submitted within sixty (60) days

of the expiration date of this Agreement. The Cost Report shall be based on actual costs.

Additional SAPT Block Grant Funding Requirements

1. Prior to expending SAPT Block Grant funding, every reasonable effort should be made to,

including the establishment of systems for eligibility determination, billing, and collection: (1)

Collect reimbursement of the costs of providing such services to persons who are entitled to

insurance benefits under the Social Security Act, including programs under Title XVIII and Title

XIX, any State compensation program, any other public assistance program for medical

expenses, any grant program, any private health insurance, or any other benefit program; and

(2) Secure from patient or clients payments for services in accordance with their ability to pay.

2. In accordance with Title 45 Code of Federal Regulations, Part 96, Section 96.137, SAPT Block

Grant funding is the “payment of last resort” for services for Pregnant and Parenting Women,

Tuberculosis, and HIV.

EXHIBIT I

Substance Use Disorder Service Programs

1. Services

Services and work provided by Contractor at the County’s request under this Agreement will be performed in a timely

manner, and in accordance with applicable federal and state statutes and regulations, including, but not limited to, sections 96.126, 96.127, 96.128, 96.131 and 96.132, and all references therefrom, of the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) Reauthorization Act, Public Law 106-310, the State of California Alcohol and/or Other Drug Program Certification Standards (2017 version), Title 21, CFR Part 1300, et seq., Title 42, CFR, Part 8; Drug Medi-Cal Certification Standards for Substance Abuse Clinics; Title 22, CCR, Sections 51341.1, 51490.1, and 51516.1; Title 9, CCR, Division 4, Chapter 4, Subchapter 1, Sections 10000, et seq.; Title 22, CCR, Division 3, Chapter 3, sections 51000 et. seq.; 42 CFR Part 438 Managed Care, and any and all guidelines promulgated by the State Department of Health Care Services’ (DHCS) Alcohol and Drug Programs and the Marin County Department of Health and Human Services to serve special populations and groups, as applicable; County laws, ordinances, regulations and resolutions; and in a manner in accordance with the standards and obligations of Contractor's profession. Contractor shall devote such time to the performance of services pursuant to this Agreement as may be reasonably necessary for the satisfactory performance of Contractor’s obligations. The County shall maintain copies of above-mentioned statutes, regulations, and guidelines for Contractor’s use. Copies of Substance Use Disorder Service Programs Policies and Procedures can be found on the Marin County Behavioral Health and Recovery Services (BHRS) website at: www.MarinHHS.org/policies-procedures. Contractor shall adhere to the applicable provisions of the Multi-Year State-County Contract referenced below in their entirety.

1.1 Counselor Certification: Any registered or certified counselor providing intake, assessment of need for services, treatment or recovery planning, individual or group counseling to participants, patients, or residents in a DHCS licensed or certified program is required to be certified as defined in Title 9, CCR, Division 4, Chapter 8. [State-County Contract, Exhibit A, Attachment I, Part I]

1.2 Re-Certification Events: Contractor shall notify DHCS and the County Alcohol and Drug Administrator 60 days prior to the desired effective date of the reduction of Medi-Cal covered services or relocation, , in addition to applicable federal, state and local regulations and policies of any triggering recertification events, such as change in ownership, change in scope of services, remodeling of facility, or change in location. [State-County Contract, Exhibit A, Attachment I; MHSUS-ADP-18]

1.3 Cultural and Linguistic Proficiency: To ensure access to quality care by diverse populations, each service provider receiving funds from the State-County Contract shall adopt the federal Office of Minority Health Culturally and Linguistically Appropriate Services (CLAS) national standards (2016 version). [State-County Contract, Exhibit A, Attachment I, Part I; MHSUS-ADP-05; 42 CFR 438.206(c)(2)]

1.4 Perinatal Services Network Guidelines: Perinatal programs shall comply with the Perinatal Services Network Guidelines FY 2016-17 until such time new Perinatal Services Network Guidelines are established and adopted. [State-County Contract, Exhibit A, Attachment I, Part IV; MHSUS-ADP-10]

1.5 Charitable Choice Requirements: Contractors shall not use funds provided through this contract for inherently religious activities, such as worship, religious instruction, or proselytization. Contractors that are religious organizations shall establish a referral process to a reasonably accessible program for clients who may object to the religious nature of the Contractor’s program and contractors shall be required to notify clients of their rights prohibiting

discrimination and to be referred to another program if they object to the religious nature of the program at intake. Referrals that were made due to the religious nature of the Contractor’s program shall be submitted annually to the

County Alcohol and Drug Administrator by June 30 for referrals made during the fiscal year. [State-County Contract, Exhibit A, Attachment I, Part III; MHSUS-ADP-03]

1.6 Trafficking Victims Protection Act of 2000: Contractor shall comply with Section 106(g) of the Trafficking Victims Protection Act of 2000 as amended (22 U.S.C. 7104). The County is authorized to terminate the

http://www.marinhhs.org/policies-procedures

contract, without penalty, if the Contractor: (a) Engages in severe forms of trafficking in persons during the period of time that the award is in effect; (b) Procures a commercial sex act during the period of time that the award is in effect; or (c) Uses forced labor in the performance of the award or subawards under the award. [State-County Contract, Exhibit A, Attachment I, Part I; MHSUS-ADP-19]

1.7 Access to Drug/Medi-Cal Services: When a request for non-urgent covered services is made by a beneficiary, services shall be initiated within three business days for Opioid Treatment Programs and within 10 business days for other substance use services of the Contractor’s receipt of the request. When a request for urgent covered services is made by a beneficiary, services shall be initiated within 48 hours of the Contractor’s receipt of the request.

Contractor shall have a documented system for monitoring and evaluating accessibility of care, including a system for addressing problems that develop regarding waiting times and appointments. Contractor shall also have hours of operation during which services are provided to Medi-Cal beneficiaries that are no less than the hours of operation during which the provider offers services to non-Medi-Cal beneficiaries [State-County Intergovernmental Agreement, Exhibit A, Attachment I, Part V; State-County Intergovernmental Agreement, Exhibit A, Attachment I; MHSUS-ADP-18; BHRS-46]

1.8 Contractors that are Drug/Medi-Cal certified shall also comply with the applicable 42 CFR 438 Managed Care requirements and Drug/Medi-Cal Organized Delivery System Special Terms and Conditions (DMC-ODS STCs), including, but not limited to the following [State-County Intergovernmental Agreement, Exhibit A, Attachment I]:

1.8.1 Culturally Competent Services: Contractors are responsible to provide culturally competent

services. Contractors must ensure that their policies, procedures, and practices are consistent with the principles outlined and are embedded in the organizational structure, as well as being upheld in day-to-day operations. Contractor shall make oral interpretation services in all non-English languages, including use of auxiliary aids such as TTY/TDA and American Sign Language, available at no cost to the beneficiary. Contractor shall make written translation available in prevalent languages. [State-County Intergovernmental Agreement, Exhibit A, Attachment I; 42 CFR 438]

1.8.2 Medication Assisted Treatment: Contractors will have procedures for linkage/integration for

beneficiaries requiring medication assisted treatment. Contractor staff will regularly communicate with physicians of beneficiaries who are prescribed these medications unless the beneficiary refuses to consent to a 42 CFR, Part 2 compliant release of information for this purpose. Beneficiaries shall not be denied access to services based on their use of or need for prescribed Medication Assisted Treatment for substance use disorders.

1.8.3 Evidence-Based Practices (EBPs): Contractors will implement and assess fidelity to at least

two of the following EBPs per service modality: Motivational Interviewing, Cognitive-Behavioral Therapy, Relapse Prevention, Trauma-Informed Treatment and Psycho-Education.

1.8.4 Beneficiary Informational Materials: Contractor shall make available at initial contact, and

shall notify beneficiaries of their right to request and obtain the following information at least once a year and thereafter upon request: DMC-ODS Beneficiary Booklet and Provider Directory. Contractor shall also post notices explaining grievance, appeal and expedited appeal processes in all program sites, as well as make available forms and self-addressed envelopes to file grievances, appeals and expedited appeals without having to make a verbal or written request to anyone. The County will produce required beneficiary informational materials in English and Spanish, and in alternative formats as requested. Contractor shall request materials from the County, as needed.

1.8.5 Notice of Adverse Benefit Determination (NOABD): Contractor shall immediately notify

BHRS of any action that may require a NOABD be issued to a beneficiary, including, but not limited to: failing to provide the beneficiary with an initial face-to-face assessment appointment within three business days of the request for Opioid Treatment Programs or 10 business days of the request for all other substance use

services; or determining that a beneficiary does not meet medical necessity for any substance use disorder treatment services. [BHRS-33]

1.8.6 Verifying Medi-Cal Eligibility: Contractor shall verify the Medi-Cal eligibility of each

beneficiary for each month of service prior to billing for Drug/Medi-Cal services to that beneficiary for that month. Medi-Cal eligibility verification should be performed prior to rendering service, in accordance with and as described in the DHCS’s DMC Provider Billing Manual. [State-County Intergovernmental Agreement, Exhibit A, Attachment I]

1.8.7 American Society of Addiction Medicine (ASAM) Criteria: Contractor shall be trained in the

ASAM Criteria prior to providing services. At a minimum, providers and staff conducting assessments are required to complete the two e-Training modules entitled “ASAM Multidimensional Assessment” and “From

Assessment to Service Planning and Level of Care”. [State-County Intergovernmental Agreement, Exhibit A, Attachment I]

1.9 No Unlawful Use or Unlawful Use Messages Regarding Drugs: Contractor agrees that information produced through these funds, and which pertains to drugs and alcohol related programs, shall contain a clearly written statement that there shall be no unlawful use of drugs or alcohol associated with the program. Additionally, no aspect of a drug or alcohol - related program shall include any message on the responsible use, if the use is unlawful, of drugs or alcohol (HSC Section 11999-11999.3). By signing this Contract, Contractor agrees that it will enforce, and will require its Subcontractors to enforce, these requirements. [State County Contract, Exhibit A, Attachment I, Part I]

1.10 Restriction on Distribution of Sterile Needles: No SABG funds made available through this Contract shall be used to carry out any program that includes the distribution of sterile needles or syringes for the hypodermic injection of any illegal drug unless the State chooses to implement a demonstration syringe services program for injecting drug users. [State County Contract, Exhibit A, Attachment I, Part I]

1.11 Limitation on Use of Funds for Promotion of Legalization of Controlled Substances: None of the funds made available through this Contract may be used for any activity that promotes the legalization of any drug or other substance included in Schedule I of Section 202 of the Controlled Substances Act (21 USC 812). [State-County Contract, Exhibit A, Attachment I]

2. Program Evaluation

2.1 Formal evaluation of the program shall be made annually through a Provider Self-Audit and on-site visit. This evaluation shall result in a written report to the Contractor within fifteen (15) working days of the site visit. Any report that results from a site visit shall be submitted to the Contractor within fifteen (15) working days. Contractor shall submit a written response within the timeframe outlined in the site visit report, and such response shall be part of the official written report provided for in this section.

2.2 Contractor shall meet the requirements of and participate in the management information system of BHRS, and maintain fiscal, administrative, and programmatic records and such other data as may be required by the County Alcohol and Drug Administrator for program and research requirements.

2.3 Contractor shall notify the County Alcohol and Drug Administrator within two business days of receipt of any DHCS report identifying non-compliance services or processes requiring a Corrective Action Plan (CAP). Contractor shall submit the CAP to DHCS with the designated timeframe specified by DHCS and shall concurrently send a copy to the County Alcohol and Drug Administrator.

3. Records

3.1 Contractor and the County mutually agree to maintain the confidentiality of Contractor’s participant

records, including billings, pursuant to Sections 11812(c) and 11879, Health & Safety Code and Federal Regulations for Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2, dated June 9.1987), the federal Health Insurance Portability and Accountability Act (HIPAA) and all other applicable State and Federal laws and any

amendments. Contractor shall inform all its officers, employees, and agents of the confidentiality provisions of said regulations, and provide all necessary policies and procedures and training to ensure compliance. Contractor shall ensure staff participate in information privacy and security training at least annually, and prior to accessing protected health information (hereinafter PHI) or personal information (hereinafter PI), sign a confidentiality statement that includes, at a minimum, General use, Security and Privacy Safeguards, Unacceptable Use, and Enforcement Policies. The statement must be renewed annually and shall be retained for a period of six (6) years following termination of this contract. [State-County Contract, Exhibit F, Attachment I]

3.2 Where contracts exceed $10,000 of state funding – the Contractor shall be subject to examination and audit of the Department of Auditor General for a period of three (3) years after final payment under contract (Government Code § 8546.7).

3.3 For Substance Abuse Prevention and Treatment Block Grant (SABG) funded services, Contractor agrees to maintain and preserve, until three years after termination of the SABG State-County Contract and final payment from DHCS to the Contractor, to permit DHCS or any duly authorized representative, to have access to, examine or audit any pertinent books, documents, papers and records related to this contract and to allow interviews of any employees who might reasonably have information related to such records.

3.4 For Medi-Cal funded services, DHCS, CMS, the Office of the Inspector General, the Comptroller General, and their designees may, at any time, inspect and audit any records or documents of the Contractor, or its subcontractors, and may, at any time, inspect the premises, physical facilities, and equipment where Medi-Cal related activities are conducted. The right to audit exists for 10 years from the final date of the State/County Intergovernmental Agreement or from the date of completion of any audit, whichever is later. [State-County Intergovernmental Agreement, Exhibit A, Attachment I]

3.5 Contractor, if applicable, shall maintain medical records and other records showing a Medi-Cal beneficiary’s eligibility for services, the service(s) rendered, the Medi-Cal beneficiary to whom the service was rendered, the date of the services, the medical necessity of the service and the quality of care provided. Records shall be maintained in accordance with Title 22 California Code of Regulations, W & I Code, Section 14214.1 and 42 CFR 433.32.

3.6 Contractor shall retain, as applicable, the following information: beneficiary grievance and appeal records in 42 CFR 438.416 and the data, information and documentation specified in 42 CFR 438.604, 438606, 438.608 and 438.610 for a period of no less than 10 years. [State-County Intergovernmental Agreement, Exhibit A, Attachment I]

3.7 Contractor is responsible for the repayment of all exceptions and disallowances taken by local, State and Federal agencies, related to activities conducted by Contractor under the Agreement. Where unallowable costs have been claimed and reimbursed, they will be refunded to County. When a financial audit is conducted by the Federal Government, the State, or the California State Auditor directly with Contractor, and if the Contractor disagrees with audit disallowances related to its programs, claims or services, County shall, at the Contractor’s request, request an

appeal to the State via the County. [State-County Intergovernmental Agreement, Exhibit B]

3.8 Financial records shall be kept so that they clearly reflect the source of funding for each type of service for which reimbursement is claimed. These documents include, but are not limited to, all ledgers, books, vouchers, time sheets, payrolls, appointment schedules, client data cards, and schedules for allocating costs. Fiscal records shall contain sufficient data to enable auditors to perform a complete audit and shall be maintained in conformance with the procedures and accounting principles set forth in the State Department of Health Care Services’

Cost Reporting/Data Collection Systems.

3.9 If Contractor uses electronic medical records, the Contractor agrees to use a system that is consistent with privacy and information security requirements pertaining to technical security controls, audit controls and business continuity/disaster recovery controls outlined in the State-County Contract Exhibit F. If Contractor does not use electronic medical records, the Contractor agrees to adhere to paper document controls outlined in the State-County Contract, Exhibit F and BHRS Policy and Procedure BHRS-SUS-06.

3.10 If Contractor uses electronic medical records, the Contractor agrees to submit staff updates, including changes in roles or new or separated staff, to the Marin WITS Administrator within the timeframes outlined in the BHRS Policy and Procedure BHRS-SUS-08. The notification shall include submission of the Marin WITS Electronic Signature Agreement and Marin WITS User Request/Change Form, as applicable. If a user suspects that their electronic signature may be comprised, Contractor shall notify the Marin WITS Administrator within the timeframes outlined in the BHRS Policy and Procedure BHRS-SUS-08.

4. Unusual Occurrence and Incident Reporting

4.1 Contractor shall report unusual occurrences to the County of Marin Substance Use Services’

Program Manager or designee. An unusual occurrence is any event which jeopardizes the health and/or safety of clients, staff and/or members of the community, including but not limited to physical injury and death.

4.2 Unusual occurrences are to be reported to the County within five (5) calendar days of the event or as soon as possible after becoming aware of the unusual event. Reports are to include the following elements:

4.2.1 Complete written description of event including outcome;

4.2.2 Written report of Contractor’s investigation and conclusions;

4.2.3 List of persons directly involved and/or with direct knowledge of the event.

4.3 The County and DHCS retain the right to independently investigate unusual occurrences and Contractor will cooperate in the conduct of such independent investigations.

4.4 Residential substance use treatment facilities licensed by DHCS shall also comply with reporting unusual incidents as outlined in Title 9 CCR, Chapter 5, Subchapter 3, Article 1. Contractor shall notify the County Alcohol and Drug Administrator concurrently, which is a telephonic report within one (1) working day of the event, followed by a copy of the written report submitted to DHCS within seven (7) days of the event.

5. Applicable Fee(s)

5.1 Contractor shall charge participant fees. No one shall be denied services based solely on ability or inability to pay.

5.2 Contractor shall perform eligibility and financial determinations in accordance with a fee schedule approved by the County Alcohol and Drug Administrator for this purpose. Individual income, expenses, and number of dependents shall be considered in formulating the fee schedule and in its utilization.

5.3 Contractor agrees to have on file with the County a schedule of Contractor’s published charges, if

applicable.

5.4 Contractor shall conduct community-centered fundraising activities, as appropriate.

6. Non-Discrimination

6.1 Contractor shall develop and implement policies and procedures that ensure: non-discrimination in the provision of services based on a diagnosis of Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related Complex (ARC), or upon testing positive for Human Immunodeficiency Virus (HIV); the prohibition of the use of HIV antibody testing as a screening criterion for program participation; training of all staff and all participants regarding high-risk behaviors, safer sex practices, and perinatal transmission of HIV infection; and development of procedures for addressing the special needs and problems of those individuals who test positive for antibodies to HIV. No individual shall be required to disclose his or her HIV status.

6.2 The contractor and/or any permitted sub-contractor shall not discriminate in the provision of services because of race, color, religion, national origin, sex, sexual orientation, age or mental or physical handicap as provided by State and Federal law. For the purpose of this contract, distinctions on the grounds of race, color, religion, national

origin, age or mental or physical handicap include but are not limited to the following: denying a Medi-Cal beneficiary any service or benefit which is different, or is provided in a different way manner or at a different time from that provided to other beneficiaries under this contract; subjecting a beneficiary to segregation or separate treatment in any matter related to receipt of any service; restricting a beneficiary in any way in the enjoyment, advantage or privilege enjoyed by others receiving ant service or benefit; treating a beneficiary differently from others in determining whether the beneficiary satisfied any admission, eligibility, other requirement or condition which individuals must meet in order to be provided any benefit; the assignment of times or places for the provision of services on a basis of the race, color, religion, national origin, sexual orientation, age or mental or physical handicap of the beneficiaries to be served.

6.3 The Contractor shall take affirmative action to ensure that services to intended Medi-Cal beneficiaries are provided without regard to race, color, religion, national origin, sex, sexual orientation, age or mental or physical handicap.

6.4 Contractor shall develop and implement policies and procedures that ensure non-discrimination in access to or the provision of services because of the prescribed use of or need for Medication Assisted Treatment for substance use disorders.

7. Required Program Submissions

7.1 Contractor agrees to maintain, and provide to County upon request, job descriptions, including minimum qualifications for employment and duties performed, for all personnel whose salaries, wages, and benefits are reimbursable in whole or in part under this Agreement.

7.2 Contractor agrees to maintain, and to provide to County upon request, an organizational chart that reflects the Contractor’s current operating structure.

7.3 Contractor shall maintain, and provide to County upon request, the complaint procedure to be utilized in the event that there is a complaint regarding services provided under this Agreement. Contractor shall ensure that recipients of service under this Agreement have access to and are informed of Contractor’s complaint procedure.

7.4 Upon Contractor’s completion of services under this Agreement to County’s satisfaction, payment to

Contractor shall be made monthly in accordance with the procedures set forth in Exhibit B. All billings and reports shall clearly reflect and in reasonable detail give information regarding the services for which the claim is being made. It is understood and agreed that County may withhold payment until receipt of billings and reports in the prescribed detail and format. Billings and reports shall be made and forwarded to County of Marin Health & Human Services Division of BHRS promptly at the end of each calendar month; no later than the 10th day of the month following the month in which the services, for which billing is made, were rendered. Payments received after that date may result in a delay in payment until the next monthly billing cycle. The payment for the month of September may be withheld pending receipt of the preceding year’s Cost Report on continuing services contracts.

7.5 Contractor shall provide County with an annual Cost Report no later than sixty (60) days after the termination of this agreement. In addition to the annual Cost Report, Contractor shall furnish County, within one hundred and eighty (180) days of close of contractor fiscal year, a certified copy of an Audit Report from an independent CPA firm. This Audit Report shall cover Contractor’s fiscal year which most nearly coincides with County’s fiscal year.

Contractors receiving federal funds shall comply with Office of Management and Budget (OMB) Circular Number A-133, Uniform administrative Requirements for Grants and Other Agreements with Institutions of Higher Education, Hospitals, and other Nonprofit Organizations. Cost Report settlements shall be made when a proper Cost Report has been submitted to the County. The findings of the annual Cost Report shall be subject to an audit by County and State. The State of California may make such audits as it deems necessary for the purpose of determining reimbursement due to the County.

7.6 Contractor will have an MOU in place with all approved subcontractors that defines the services to be provided by the subcontractors and is consistent with and fully reflects the services and conditions described in this contract. Such MOUs will be made available to County within a reasonable time upon request.

7.7 Contractor will report all data and outcomes, such as CalOMS and DATAR, as required by state or county and as required by the State-County Contract.

8. Contractor’s Compliance with Privacy and Security Provisions of State Contract

8.1 The County receives funding from DHCS pursuant to an annual contracting arrangement (hereinafter “State Contract”). The State Contract contains certain requirements pertaining to the privacy and security of PI and/or PHI and requires that County contractually obligate any of its sub-contractors to also comply with these requirements. Contractor hereby agrees to be bound by, and comply with, any and all terms and conditions of the State Contract pertaining to the privacy and/or security of PI and/or PHI. This include ensuring that all workstations, laptops and removable media devices that process and/or store DHCS PHI or PI must be encrypted using a FIPS 140-2 certified algorithm which is 256bit or higher. A hard copy of the State-County Contract will be provided to the Contractor upon request, and an electronic copy can be found on the BHRS website at www.MarinHHS.org/BHRS.

8.2 Additionally, in the event the State Contract requires the County to notify the State of a breach of privacy and/or security of personally identifiable information (hereinafter PII) and/or PHI, Contractor shall, immediately upon discovery of a breach of privacy and/or security of PII and/or PHI by Contractor, notify County of such breach by telephone and email or facsimile to the following contact: BHRS Privacy Officer – Ph: (415) 473-6948, e-mail: [email protected] or Fax: (415) 473-2627. Contractor further agrees that it shall notify County of any such breaches prior to the time the County is required to notify the State pursuant to the State Contract.

8.3 In the event the State Contract requires the County to pay any costs associated with a breach of privacy and/or security of PII and/or PHI, including but not limited to the costs of notification, Contractor shall pay on County’s behalf any and all such costs arising out of a breach of privacy and/or security of PII and/or PHI by Contractor.

8.4 Contractor shall maintain personnel controls to protect PHI or PI, including, but not limited to ensuring all workforce members accessing or disclosing PHI or PI: complete information privacy and security training at least annually; sign a confidentiality statement prior to accessing PHI or PI and annually thereafter; and performing a background check and evaluating the results to assure that there is no indication of a risk to the security or integrity of confidential data. Records shall be retained pursuant to the State-County Contract, Exhibit F.

9. Compliance with Anti-Kickback Statute

Contractor shall comply with the provisions of the “Anti-Kickback Statute” (42 U.S.C. § 1320a-7b) as they pertain to Federal healthcare programs.

10. Davis-Bacon Act

Contractor must comply with the provisions of the Davis-Bacon Act, as amended (40 U.S.C. § 3141 et seq.). When required by Federal Medicaid Program legislation, all construction contracts awarded by the Contractor and its subcontractors of more than $2,000 must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. § 3141 et seq.) as supplemented by Department of Labor regulations (Title 29, CFR Part 5, “Labor Standards Provisions

Applicable to Contracts Governing Federally Financed and Assisted Construction”).

11. Conditions for Federal Financial Participation

11.1 Contractor shall meet all conditions for Federal Financial Participation, consistent with 42 CFR 438.802, 42 CFR 438.804, 42 CFR 438.806, 42 CFR 438.808, 42 CFR 438.810, 42 CFR 438.812.

11.2 Pursuant to 42 CFR 438.808, Federal Financial Participation (FFP) is not available to the

Contractor if the Contractor:

11.2.1 Is an entity that could be excluded under section 1128(b)(8) as being controlled by a sanctioned individual;

11.2.2 Is an entity that has a substantial contractual relationship as defined in section 431.55(h)(3), either directly or indirectly, with an individual convicted of certain crimes described in section 1128(8)(B); or

http://www.marinhhs.org/MHSUS


11.2.3 Is an entity that employs or contracts, directly or indirectly, for the furnishing of health care utilization review, medical social work, or administrative services, with one of the following: i. Any individual or entity excluded from participation in federal health care programs under section 1128 or section 1126A; or ii. An entity that would provide those services through an excluded individual or entity.

12. Certification of Non-Exclusion or Suspension from Participation in Federal Health Care Program 12.1 Federal and State Excluded, Suspension and Debarment List: The County and the Contractor shall comply with the provisions of Title 42 § 438.610 and Executive Orders 12549 and 12689, “Debarment and Suspension,” which excludes parties listed on the General Services Administration (GSA) list of parties excluded from federal procurement or non-procurement programs from having a relationship with the County or Contractor.

12.2 Prior to the effective date of this Contract, Contractor must certify that it is not excluded from

participation in Federal Health Care Programs under either Section 1128 or 1128A of the Social Security Act. Failure to so certify will render all provisions of this Contract null and void and may result in the immediate termination of the Contract.

12.3 Contractor shall certify, prior to the execution of the contract, that the Contractor does not employ staff or sub-contractors who are excluded from participation in federally funded health care programs. Contractor shall conduct initial and monthly Exclusion & Suspension searches of the following databases and provide evidence of these completed searches when requested by County, CA Department of Health Care Services or the US Department of Health & Human Services.

12.3.1 www.oig.hhs.gov/exclusions - LEIE Federal Exclusions 12.3.2 www.sam.gov/portal/SAM - GSA Exclusions Extract 12.3.3 www.Medi-Cal.ca.gov – Suspended & Ineligible Provider List 12.4 Contractor shall certify, prior to the execution of the contract that the Contractor does not employ

staff or sub-contractors that are on the Social Security Administration’s Death Master File. Contractor shall check the following database prior to employing staff or sub-contractors, and provide evidence of these completed searches when requested by County, CA Department of Health Care Services or the US Department of Health & Human Services.

12.4.1 https://www.ssdmf.com/ - Social Security Death Master File 12.5 Contractor is required to notify County immediately if they become aware of any information that may

indicate their (including employees and subcontractors) potential placement on an exclusions list.

13. License Verification

Contractor shall ensure that all staff and subcontractors providing services will have all necessary and valid professional certification(s) or license(s) to practice the contracted services. This includes implementing procedures of professional license checks, credentialing and re-credentialing, monitoring limitations and expiration of licenses, and ensuring that all providers have a current National Provider Identifier (NPI) through the National Plan and Provider Enumeration System (NPPES). Contractor shall provide evidence of these completed verifications when requested by County, DHCS or the US Department of Health & Human Services.

http://www.oig.hhs.gov/exclusions

http://www.sam.gov/portal/SAM

http://www.medi-cal.ca.gov/

https://www.ssdmf.com/

EXHIBIT M: BUSINESS ASSOCIATE AGREEMENT Page 1 of 8 Policy No. HHS-C-08/ Doc. No. HHS-C-004 [HIPAA Form 08-02] REV Aug 2, 2013

EXHIBIT M: BUSINESS ASSOCIATE AGREEMENT

TERMS AND CONDITIONS To the extent Contractor is a business associate as defined under the Federal Health Insurance Portability and Accountability Act (“HIPAA”) and the HITECH Act, Contractor shall comply with the additional terms and conditions set forth in this Exhibit (“M”) to the Professional Services Contract (“PSC” or “Contract”). This Business Associate Agreement Exhibit “M” supplements and is made a part of the Contract by and between the County of Marin, referred to herein as Covered Entity (“CE”), and ________________________________________, referred to herein as Business Associate (“BA”), to which this Exhibit “M” is an incorporated attachment. RECITALS CE and BA have entered into a business relationship through which BA may receive Protected Health Information (“PHI”) (defined below) from CE or create, collect, transmit, retain, process or otherwise use PHI on behalf of CE pursuant to the terms of the Contract. CE and BA intend to protect the privacy and provide for the security of PHI disclosed to, created by, or in any manner used by, BA pursuant to the Contract in compliance with the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (“HIPAA”), the Health Information Technology for Economic and Clinical Health Act, Public Law 111-005 (“the HITECH Act”), and regulations promulgated thereunder by the U.S. Department of Health and Human Services (the “HIPAA Regulations”) and other applicable laws. As part of the HIPAA Regulations, the Privacy Rule and the Security Rule (defined below) require CE to enter into a contract containing specific requirements with BA prior to the disclosure of PHI, as set forth in, but not limited to, Title 45, Sections 164.314(a), 164.502(e) and 164.504(e) of the Code of Federal Regulations (“C.F.R.”) and contained in this Exhibit “M”. In consideration of the mutual promises below and the exchange of information pursuant to this Exhibit “M”, the parties agree as follows: 1. Definitions

a. Breach shall have the meaning given to such term under the HITECH Act [42 U.S.C. Section 17921].

b. Business Associate shall have the meaning given to such term under the Privacy Rule,

the Security Rule, and the HITECH Act, including but not limited to, 42 U.S.C. Section 17938 and 45 C.F.R. Section 160.103. For purposes of this Exhibit “M”, use of the term Business Associate includes all Contractor agents, employees, contractors or other associates providing services or assistance to Contractor under the Contract.

c. Covered Entity shall have the meaning given to such term under the Privacy Rule and

the Security Rule, including, but not limited to, 45 C.F.R. Section 160.103. For purposes of this Contract, this term is intended to mean the County of Marin.

d. Data Aggregation shall have the meaning given to such term under the Privacy Rule,

including, but not limited to, 45 C.F.R. Section 164.501.


e. Designated Record Set shall have the meaning given to such term under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.501.

f. DHHS Secretary shall mean the Secretary of the U.S. Department of Health and Human

Services. g. Electronic Health Record shall have the meaning given to such term in the HITECH

Act, including, but not limited to, 42 U.S.C. Section 17921. h. Electronic Protected Health Information means Protected Health Information that is

maintained in or transmitted by electronic media.

i. Health Care Operations shall have the meaning given to such term under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.501.

j. Individual shall have the meaning given to such term under the Privacy Rule and the

Security Rule, including, but not limited to, 45 C.F.R. Section 160.103.

k. Privacy Rule shall mean the HIPAA Regulation that is codified at 45 C.F.R. Parts 160 and 164, Subparts A and E.

l. Protected Health Information or PHI means any information, whether oral or recorded

in any form or medium: (i) that relates to the past, present or future physical or mental condition of an Individual; the provision of health care to an Individual; or the past, present or future payment for the provision of health care to an Individual; and (ii) that identifies the Individual or with respect to which there is a reasonable basis to believe the information can be used to identify the Individual, and shall have the meaning given to such term under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.501. Protected Health Information includes Electronic Protected Health Information [45 C.F.R. Sections 160.103, 164.501].

m. Protected Information shall mean PHI provided by CE to BA or created or received by

BA on CE’s behalf.

n. Security Rule shall mean the HIPAA Regulation that is codified at 45 C.F.R. Parts 160 and 164, Subparts A and C.

o. Unsecured PHI shall have the meaning given to such term under the HITECH Act and

any guidance issued pursuant to such Act including, but not limited to, 42 U.S.C. Section 17932(h).

2. Obligations of Business Associate

a. Permitted Uses. BA shall not use Protected Information except for the purpose of performing BA’s obligations under the Contract and as permitted under the Contract and this Exhibit “M”. Further, and notwithstanding anything to the contrary above, BA shall not use Protected Information in any manner that would constitute a violation of the Privacy Rule or the HITECH Act if so used by CE. However, BA may use Protected Information (i) for the proper management and administration of BA, (ii) to carry out the legal responsibilities of BA, or (iii) for Data Aggregation purposes for the Health Care Operations of CE [45 C.F.R. Sections 164.504(e)(2)(ii)(A) and 164.504(e)(4)(i)].


b. Permitted Disclosures. BA shall not disclose Protected Information except for the

purpose of performing BA’s obligations under the Contract and as permitted under the Contract and this Exhibit “M”. Further, and notwithstanding anything to the contrary above, BA shall not disclose Protected Information in any manner that would constitute a violation of the Privacy Rule or the HITECH Act if so disclosed by CE. However, BA may disclose Protected Information (i) for the proper management and administration of BA; (ii) to carry out the legal responsibilities of BA; (iii) as required by law; or (iv) for Data Aggregation purposes for the Health Care Operations of CE. If BA discloses Protected Information to a third party, BA must obtain, prior to making any such disclosure, (i) reasonable written assurances from such third party that such Protected Information will be held confidential as provided pursuant to this Exhibit “M” and only disclosed as required by law or for the purposes for which it was disclosed to such third party, and (ii) a written agreement from such third party to immediately notify BA of any breaches of confidentiality of the Protected Information, to the extent it has obtained knowledge of such breach [42 U.S.C. Section 17932; 45 C.F.R. Sections 164.504(e)(2)(i), 164.504(e)(2)(i)(B), 164.504(e)(2)(ii)(A) and 164.504(e)(4)(ii)].

c. Prohibited Uses and Disclosures. BA shall not use or disclose Protected Information

for fundraising or marketing purposes. BA shall not disclose Protected Information to a health plan for payment or health care operations purposes if the patient has requested this special restriction, and has paid out of pocket in full for the health care item or service to which the PHI solely relates 42 U.S.C. Section 17935(a). BA shall not directly or indirectly receive remuneration in exchange for Protected Information, except with the prior written consent of CE and as permitted by the HITECH Act, 42 U.S.C. section 17935(d)(2); however, this prohibition shall not affect payment by CE to BA for services provided pursuant to the Contract.

d. Appropriate Safeguards. BA shall implement appropriate administrative, physical and

technical safeguards as are necessary to prevent the use or disclosure of Protected Information otherwise than as permitted by the Contract that reasonably and appropriately protect the confidentiality, integrity and availability of the Protected Information, in accordance with 45 C.F.R. Sections 164.308, 164.310, and 164.312. [45 C.F.R. Section 164.504(e)(2)(ii)(B); 45 C.F.R. Section 164.308(b)]. BA shall comply with the policies and procedures and documentation requirements of the Security Rule, including, but not limited to, 45 C.F.R. Section 164.316. [42 U.S.C. Section 17931]

e. Reporting of Improper Access, Use or Disclosure. Unless stricter reporting

requirements apply in accordance with federal or state laws or regulations, other provisions of the Contract, or this Exhibit “M”, BA shall report to CE in writing of any access, use or disclosure of Protected Information not permitted by the Contract and this Exhibit “M”, and any Breach of Unsecured PHI of which it becomes aware without unreasonable delay and in no case later than five (5) business days after discovery [42 U.S.C. Section 17921; 45 C.F.R. Section 164.504(e)(2)(ii)(C); 45 C.F.R. Section 164.308(b)]. BA shall provide notice to CE as set forth in paragraph 6.

f. Business Associate’s Agents. BA shall ensure that any agents, including

subcontractors, to whom it provides Protected Information, agree in writing to the same restrictions and conditions that apply to BA with respect to such PHI and implement the safeguards required by paragraph d above with respect to PHI [45 C.F.R. Section 164.504(e)(2)(ii)(D); 45 C.F.R. Section 164.308(b)]. BA shall implement and maintain


sanctions against agents and subcontractors that violate such restrictions and conditions and shall mitigate the effects of any such violation (see 45 C.F.R. Sections 164.530(f) and 164.530(e)(1)).

g. Access to Protected Information. BA shall make Protected Information maintained by

BA or its agents or subcontractors in Designated Record Sets available to CE for inspection and copying within ten (10) business days of a request by CE to enable CE to fulfill its obligations under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.524 [45 CF.R. Section 164.504(e)(2)(ii)(E)]. If BA maintains an Electronic Health Record, BA shall provide such information in electronic format to enable CE to fulfill its obligations under the HITECH Act, including, but not limited to, 42 U.S.C. Section 17935(e). If any Individual requests access to protected Information directly from BA or its agents or subcontractors, BA shall inform the CE of the request without unreasonable delay, in any event no later than three (3) days of receipt of the request. If the CE permits the disclosure, the CE will inform the BA within two (2) days of the receipt of the request from BA, Whereupon the BA will be authorized to provide access to the client.

h. Amendment of PHI. Within ten (10) business days of receipt of a request from CE for

an amendment of Protected Information or a record about an Individual contained in a Designated Record Set, BA or its agents or subcontractors shall make such Protected Information available to CE for amendment and incorporate any such amendment to enable CE to fulfill its obligations under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.526. If any Individual requests an amendment of Protected Information directly from BA or its agents or subcontractors, BA must notify CE in writing within five (5) business days of the request. Any approval or denial of amendment of Protected Information maintained by BA or its agents or subcontractors shall be the responsibility of CE [45 C.F.R. Section 164.504(e)(2)(ii)(F)].

i. Accounting Rights. Within ten (10) business days of notice by CE of a request for an

accounting of disclosures of Protected Information, BA and its agents or subcontractors shall make available to CE the information required to provide an accounting of disclosures to enable CE to fulfill its obligations under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.528, and the HITECH Act, including but not limited to 42 U.S.C. Section 17935(c), as determined by CE. BA agrees to implement a process that allows for an accounting to be collected and maintained by BA and its agents or subcontractors for at least six (6) years prior to the request. However, accounting of disclosures from an Electronic Health Record for treatment, payment or health care operations purposes are required to be collected and maintained for only three (3) years prior to the request, and only to the extent that BA maintains an Electronic Health Record and is subject to this requirement. At a minimum, the information collected and maintained shall include: (i) the date of disclosure; (ii) the name of the entity or person who received Protected Information and, if known, the address of the entity or person; (iii) a brief description of Protected Information disclosed and (iv) a brief statement of purpose of the disclosure that reasonably informs the Individual of the basis for the disclosure, or a copy of the Individuals’ authorization, or a copy of the written request for disclosure. In the event that the request for an accounting is delivered directly to BA or its agents or subcontractors, BA shall within five (5) business days of a request forward it to CE in writing. However, it shall be BA’s responsibility to prepare and deliver any such accounting requested and to do so in accordance with law. BA shall not disclose any Protected Information except as set forth in Sections 2.b. of this Exhibit “M” [45 C.F.R. Sections 164.504(e)(2)(ii)(G) and 165.528].


j. Governmental Access to Records. BA shall make its internal practices, books and

records relating to the use, disclosure and privacy protection of Protected Information available to CE and to the DHHS Secretary for purposes of determining BA’s compliance with the Privacy Rule [45 C.F.R. Section 164.504(e)(2)(ii)(H)]. BA shall provide to CE a copy of any Protected Information that BA provides to the DHHS Secretary concurrently with providing such Protected Information to the DHHS Secretary.

k. Minimum Necessary. BA and its agents or subcontractors shall request, use and

disclose only the minimum amount of Protected Information necessary to accomplish the purpose of the request, use, or disclosure. [42 U.S.C. Section 17935(b); 45 C.F.R. Section 164.514(d)(3)] BA understands and agrees that the definition of “minimum necessary” is in flux and shall keep itself informed of guidance issued by the DHHS Secretary with respect to what constitutes “minimum necessary.”

l. Data Ownership. BA acknowledges that BA has no ownership rights with respect to the

Protected Information. The CE is the owner of all protected information and/or records containing such PHI provided to BA pursuant to the Contract or this Exhibit “M.”

m. Notification of Breach. Unless stricter reporting requirements apply in accordance with

federal or state laws or regulations, other provisions of the Contract, or this Exhibit “M”, BA shall notify CE within twenty-four (24) hours of any suspected or actual breach of security, intrusion or unauthorized use or disclosure of PHI of which BA becomes aware and/or any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations. Unless CE provides BA with written notice within 3 (three) business days that it will undertake such obligations on behalf of BA, BA shall take (i) prompt corrective action to cure any such deficiencies and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. The parties agree that CE has the sole discretion to determine whether or not it will undertake such obligations on behalf of BA and that, if it does, CE has the right to require BA to pay for any or all costs associated therewith. BA shall provide notice to CE as set forth in paragraph 6.

n. Breach Pattern or Practice by Covered Entity. Pursuant to 42 U.S.C. Section

17934(b), if the BA knows of a pattern of activity or practice of the CE that constitutes a material breach or violation of the CE’s obligations under the Contract or this Exhibit “M” or other arrangement, the BA must take reasonable steps to cure the breach or end the violation. If the steps are unsuccessful, the BA must terminate the Contract or other arrangement if feasible, or if termination is not feasible, report the problem to the DHHS Secretary. BA shall provide written notice to CE of any pattern of activity or practice of the CE that BA believes constitutes a material breach or violation of the CE’s obligations under the Contract or this Exhibit “M” or other arrangement within five (5) business days of discovery and shall meet with CE to discuss and attempt to resolve the problem as one of the reasonable steps to cure the breach or end the violation. BA shall provide notice to CE as set forth in paragraph 6.

o. Audits, Inspection and Enforcement. Within ten (10) days of a written request by CE,

BA and its agents or subcontractors shall allow CE to conduct a reasonable inspection of the facilities, systems, books, records, agreements, contracts, policies and procedures relating to the use or disclosure of Protected Information pursuant to this Exhibit “M” for the purpose of determining whether BA has complied with this Exhibit; provided,


however, that (i) BA and CE shall mutually agree in advance upon the scope, timing and location of such an inspection, (ii) CE shall protect the confidentiality of all confidential and proprietary information of BA to which CE has access during the course of such inspection; and (iii) CE shall execute a nondisclosure agreement, upon terms mutually agreed upon by the parties, if requested by BA. The fact that CE inspects, or fails to inspect, or has the right to inspect, BA’s facilities, systems, books, records, agreements, contracts, policies and procedures does not relieve BA of its responsibility to comply with this Exhibit “M”, nor does CE’s (i) failure to detect or (ii) detection, but failure to notify BA or require BA’s remediation of any unsatisfactory practices, constitute acceptance of such practice or a waiver of CE’s enforcement rights under the Contract or this Exhibit “M”. BA shall notify CE within ten (10) business days of learning that BA has become the subject of an audit, compliance review, or complaint investigation by the Office for Civil Rights.

3. Termination of Contract

a. Material Breach. A breach by BA of any provision of this Exhibit “M”, as determined by CE, shall constitute a material breach of the Contract and shall provide grounds for immediate termination of the Contract, any provision in the Contract to the contrary notwithstanding. [45 C.F.R. Section 164.504(e)(2)(iii)].

b. Judicial or Administrative Proceedings. Notwithstanding any provision in the Contract

to the contrary, CE may terminate the Contract, effective immediately, if (i) BA is named as a defendant in a criminal proceeding for a violation of HIPAA, the HITECH Act, the HIPAA Regulations or other security or privacy laws or (ii) a finding or stipulation that the BA has violated any standard or requirement of HIPAA, the HITECH Act, the HIPAA Regulations or other security or privacy laws is made in any administrative or civil proceeding in which the party has been joined.

c. Effect of Termination. Upon termination of the Contract for any reason, BA shall, at the

option of CE, return or destroy all Protected Information that BA or its agents or subcontractors still maintain in any form, and shall retain no copies of such Protected Information. If return or destruction is not feasible, as determined by CE, BA shall continue to extend the protections of Section 2 of this Exhibit “M” to such information, and limit further use of such PHI to those purposes that make the return or destruction of such PHI infeasible. [45 C.F.R. Section 164.504(e)(ii)(2(I)]. If CE elects destruction of the PHI, BA shall certify in writing to CE that such PHI has been destroyed.

4. Indemnification In addition to any other indemnification and defense obligation under the Contract, BA will indemnify, defend and hold harmless CE and it’s respective employees, directors, officers, subcontractors, agents and affiliates from and against all claims, actions, damages, losses, liabilities, fines, penalties, costs or expenses, including without limitation reasonable attorney’s fees, suffered by CE from or in connection with any breach of Exhibit “M”, or any negligent or wrongful acts or omissions in connection with this Exhibit “M”, by BA or its employees, directors, officers, subcontractors or agents.


5. Insurance BA shall maintain insurance with respect to BA’s obligations under the Contract and this Exhibit “M” reasonably satisfying to CE and provide from time to time as requested by CE proof of such insurance. 6. Notices Any notice to be given under this Exhibit “M” to CE shall be made via overnight mail or hand delivery at CE’s address given below and by providing telephonic notification as specified below. Any such notice shall be deemed given when so delivered to or received at the proper address. Notice to CE:

a. Privacy Officer – Department of Health and Human Services, 20 N. San Pedro, San Rafael, CA 94903.

b. Compliance and breach reporting line – (415) 473-6948. Notice to BA: [insert address] 7. Disclaimer CE makes no warranty or representation that compliance by BA with this Exhibit “M”, HIPAA, the HITECH Act, or the HIPAA Regulations will be adequate or satisfactory for BA’s own purposes. BA is solely responsible for all decisions made by BA regarding the safeguarding of PHI. 8. Certification To the extent that CE determines that such examination is necessary to comply with CE’s legal obligations pursuant to HIPAA relating to certification of its security practices, CE or its authorized agents or contractors, may, at CE’s expense, examine BA’s facilities, systems, procedures and records as may be necessary for such agents or contractors to certify to CE the extent to which BA’s security safeguards comply with HIPAA, the HITECH Act, the HIPAA Regulations or this Exhibit. 9. Amendment

a. Amendment to Comply with Law. The parties acknowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of the Contract or this Exhibit “M” may be required to provide for procedures to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement the standards and requirements of HIPAA, the HITECH Act, the Privacy Rule, the Security Rule and other applicable laws relating to the security or confidentiality of PHI. The parties understand and agree that CE must receive satisfactory written assurance from BA that BA will adequately safeguard all Protected Information. Upon the request of either party, the other party agrees to promptly enter into negotiations concerning the terms of an amendment to this Exhibit “M” embodying written assurances consistent with the standards and requirements of HIPAA, the


HITECH Act, the Privacy Rule, the Security Rule or other applicable laws. CE may terminate the Contract upon thirty (30) days written notice in the event (i) BA does not promptly enter into negotiations to amend the Contract or this Exhibit “M” when requested by CE pursuant to this Section or (ii) BA does not enter not enter into an amendment to the Contract or this Exhibit “M” providing assurances regarding the safeguarding of PHI that CE, in its sole discretion, deems sufficient to satisfy the standards and requirements of applicable laws.

b. Amendment of Exhibit “M”. This Exhibit “M” may be modified or amended at any time

without amendment of the Contract, but only by written agreement of the parties. 10. Assistance in Litigation of Administrative Proceedings BA shall make itself, and any subcontractors, employees or agents assisting BA in the performance of its obligations under the Contract, available to CE, at no cost to CE, to testify as witnesses, or otherwise, in the event of litigation or administrative proceedings being commenced against CE, its directors, officers or employees based upon a claimed violation of HIPAA, the HITECH Act, the Privacy Rule, the Security Rule, or other laws relating to security and privacy, except where BA or its subcontractor, employee or agent is a named adverse party. 11. No Third-Party Beneficiaries Nothing expressed or implied in the Contract or this Exhibit “M” is intended to confer, nor shall anything herein confer, upon any person other than CE, BA and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. 12. Effect on Contract Except as specifically required to implement the purposes of this Exhibit “M”, or to the extent inconsistent with this Exhibit “M”, all other terms of the Contract shall remain in force and effect. 13. Interpretation The provisions of this Exhibit “M” shall prevail over any provisions in the Contract that may conflict or appear inconsistent with any provision in this Exhibit “M”. This Exhibit “M” and the Contract shall be interpreted as broadly as necessary to implement and comply with HIPAA, the HITECH Act, the Privacy Rule and the Security Rule. The parties agree that any ambiguity in this Exhibit “M” shall be resolved in favor of a meaning that complies and is consistent with HIPAA, the HITECH Act, the Privacy Rule and the Security Rule. 14. Survival of Provisions Excepting only the provisions regarding BA’s use or disclosure of Protected Information for the purpose of performing BA’s obligations under the Contract, the terms of this Exhibit “M” shall survive the termination of the Contract so long as PHI obtained or generated during the term of the Contract is retained by BA.