COMPLETED BOARD ORDER�2��W32
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No: A-11199
a. Approve and authorize the Director of Health to sign an Agreement
with Edgewood Center for Children and Families, for the provision
of mental health services effective April 24, 2008 through June 30,
2009, for a total amount not to exceed $133,182, to supersede
Agreement A-10990; and
b. Authorize the Director of Health to sign up to three 3) future
amendments to this Agreement where the amendments do not exceed
ten percent 10%) of the total contract amount and do not
significantly change the scope of work.
Upon motion of Supervisor Salinas, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby:
a. Approved and authorized the Director of Health to sign an Agreement with Edgewood
Center for Children and Families, for the provision of mental health services effective April
24, 2008 through June 30, 2009, for a total amount not to exceed $133,182, to supersede
Agreement A-10990; and
b. Authorized the Director of Health to sign up to three 3) future amendments to this
Agreement where the amendments do not exceed ten percent 10%) of the total contract
amount and do not significantly change the scope of work.
PASSED AND ADOPTED this 24th day of June, 2008, by the following vote, to wit:
AYES: Supervisors Armenta, Calcagno, Salinas, Mettee-McCutchon, Potter
NOES: None
ABSENT: None
I, Annette D'Adamo, Interim Clerk of the Board of Supervisors of the County of Monterey, State of California,
hereby certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and
entered in the minutes thereof of Minute Book 74 for the meeting on June 24, 2008.
Dated: June 26, 2008 Annette D'Adamo, Interim Clerk of the Board of Supervisors
County of Monterey, State of California
By
r-Deputy
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EXECUTED AGREEMENTX���� �COUNTY OF MONTEREY
MENTAL HEALTH SERVICES AGREEMENT
Contract Number: A-11199
COUNTY Department Contract Representative:
Len Foster
Director of Health
1270 Natividad Road, Salinas, CA 93906
THIS CONTRACT is made and entered into by and between the COUNTY OF MONTEREY, a
political subdivision of the State of California hereinafter COUNTY") and EDGEWOOD
CENTER FOR CHILDREN AND FAMILIES, hereinafter CONTRACTOR").
RECITALS
WHEREAS, COUNTY desires to enter into an Agreement whereby CONTRACTOR will
provide community mental health services in accordance with the requirements of the Bronzan-
McCorquodale Act California Welfare and Institutions Code 5600, et seq.), Part 2.5 of Division 5
of the California Welfare & Institutions Code, and Titles 9 and 22 of the California Code of
Regulations; and
WHEREAS, CONTRACTOR is able to furnish such services under the terms and conditions
of this Agreement and in accordance with applicable law, including all federal and state rules and
regulations pertaining to the provision of Medi-Cal services.
NOW, THEREFORE, IT IS HEREBY AGREED AS FOLLOWS:
1. SERVICES TO BE PROVIDED
CONTRACTOR shall provide the services set forth in this Agreement, including the
program services detailed in Exhibit A, to the recipient population and to the COUNTY, in
compliance with the terms of this Agreement. These services can be summarized as
follows: Short-Doyle/Medi-Cal community based day treatment and mental health
supervision.
II. EXHIBITS
The following exhibits are attached and incorporated by reference as a part of this
Agreement:
EXHIBIT A:
EXHIBIT B:
EXHIBIT C:
EXHIBIT D:
EXHIBIT E:
EXHIBIT F:
EXHIBIT G:
PROGRAM DESCRIP'T'ION
PAYMENT PROVISIONS
BEHAVIORAL HEALTH COST REIMBURSEMENT INVOICE
CONFIDENTIALITY OF PATIENT INFORMATION
ASSURANCE OF COMPLIANCE WITH SECTION 504 OF THE
REHABILITATION ACT OF 1973, AS AMENDED
ASSURANCE OF COMPLIANCE WITH MONTEREY COUNTY
CULTURAL COMPETENCY POLICY
BUSINESS ASSOCIATE AGREEMENT
*Approved by County Board of Supervisors on
Edgewood Center FY 2007-2009
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EXECUTED AGREEMENTX���� �III. PAYMENT BY COUNTY
A Payment shall be made pursuant to the terms and conditions set forth in Exhibit B attached
hereto and by this reference made a part hereof.
B CONTRACTOR shall hold harmless the State of California and any recipients of services in the
event COUNTY does not reimburse CONTRACTOR for services performed under this
Agreement.
IV. TERM AND TERMINATION
A Term. This Agreement shall be effective April 24, 2008 and shall remain in effect until June
30, 2009.
B Termination without Cause. Either party may terminate this Agreement at any time without
cause by serving thirty 30) days' advance written notice upon the other party. The notice shall
state the effective date of the termination.
C Termination with Cause. COUNTY may cancel and terminate this Agreement for good cause
immediately upon written notice to CONTRACTOR. Good cause" includes, but is not limited
to, failure of CONTRACTOR to perform a material requirement of the Agreement. Good
cause" shall also include CONTRACTOR's failure to implement corrective action in a timely
fashion pursuant to Section IX of this Agreement.
D Reduction and/or Termination of Government Funding. Notwithstanding any other provision of
this Agreement, if the state or federal government terminates or reduces its funding to the
COUNTY for services that are to be provided under this Agreement, then COUNTY may, after
consultation with the CONTRACTOR, elect to terminate this Agreement by giving written
notice of termination to CONTRACTOR effective immediately or on such other date as
COUNTY specifies in the notice. Alternatively, it is mutually agreed that the Agreement shall
be amended to reflect any reduction in funding.
E Survival of Obligations after Termination. Upon termination of this Agreement, COUNTY will
no longer refer clients to the CONTRACTOR under this Agreement, and the rights and duties of
the parties shall be terminated, except that the following obligations shall survive termination:
I. CONTRACTOR shall, pursuant to this Agreement and upon approval of the Behavioral
Health Director, continue treatment of clients then receiving care from CONTRACTOR
until completion of treatment or until continuation of the client's care by another provider
can be arranged by COUNTY;
2. COUNTY shall arrange for such transfer of treatment no later than sixty 60) days after
Agreement termination if the clients' treatment is not by then completed;
3. COUNTY, any payer, and CONTRACTOR will continue to remain obligated under this
Agreement with regard to payment for services rendered prior to termination or required
to be rendered after termination as provided above, except that COUNTY's post-
termination payment obligations shall not exceed ten percent 10%) of the maximum
amount payable to the CONTRACTOR under this Agreement as specified in Exhibit B;
Edgewood Center FY 2007-2009 2
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EXECUTED AGREEMENTX���� �4. CONTRACTOR will continue to remain obligated with respect to the confidentiality and
auditing requirements of this Agreement.
V. COMPLIANCE WITH APPLICABLE LAW AND TERMS OF GRANT
A Compliance with L,aw. In providing services under this Agreement, CONTRACTOR shall
comply with all applicable laws, regulations, and administrative requirements adopted by federal,
state, and local governments including, but not limited to, Welfare and Institutions Code,
Divisions 5, 6, and 9; California Code of Regulations, Titles 9 and 22; any Short-Doyle and
Short-Doyle/Medi-Cal policies as identified in Department of Mental Health letters and in the
Cost Reporting/Data Collection CR/DC) Manual. In addition, if CONTRACTOR is providing
Medi-Cal services pursuant to this Agreement, CONTRACTOR shall comply with Title XIX of
the Social Security Act, and all other applicable federal laws, regulations and guidelines
pertaining to federally funded mental health programs, including all requirements necessary for
Medicaid/Medi-Cal reimbursement for mental health treatment services.
B Compliance with Terms of State and/or Federal Grants. If this Agreement is funded with monies
received by the COUNTY pursuant to contract(s) with the state and/or federal government in
which the COUNTY is the grantee, CONTRACTOR will comply with all provisions of said
contract(s), to the extent applicable to CONTRACTOR as a subgrantee under said contract(s),
and said provisions shall be deemed a part of this Agreement as if fully set forth herein. Upon
request, COUNTY will deliver a copy of said contract(s) to CONTRACTOR at no cost to
CONTRACTOR.
VI. LICENSURE AND STAFFING REQUIREMENTS
A Licensure and Certification. CONTRACTOR shall furnish qualified professional personnel as
prescribed by Title 9 of the California Code of Regulations, the Business and Professions Code,
the Welfare and Institutions Code, and all other applicable laws for the type of services rendered
under this Agreement. All personnel providing services pursuant to this Agreement shall be
fully licensed in accordance with all applicable law and shall remain in good professional
standing throughout the entire duration of this Agreement. CONTRACTOR shall comply with
all COUNTY and state certification and licensing requirements and shall ensure that all services
delivered by staff are within their scope of licensure and practice.
B Staffing. CONTRACTOR shall ensure that all personnel, including any subcontractors
performing services under this Agreement, receive appropriate training and supervision.
CONTRACTOR shall also maintain appropriate levels of staffing at all times when performing
services under this Agreement.
VII. PATIENT RIGHTS
A CONTRACTOR shall comply with all applicable patients' rights laws including, but not limited
to, the requirements set forth in Welfare and Institutions Code, Division 5, Part 1, sections 5325,
et seq., and California Code of Regulations, Title 9, Division 1, Chapter 4, Article 6 860, et
seq.).
B As a condition of reimbursement under this Agreement, CONTRACTOR shall ensure that all
recipients of services under this Agreement shall receive the same level of services as other
patients served by CONTRACTOR. CONTRACTOR shall ensure that recipients of services
under this Agreement are not discriminated against in any manner including, but not limited to,
Edgewood Center FY 2007-2009
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EXECUTED AGREEMENTX���� �admissions practices, evaluation, treatment, access to programs and or activities, placement in
special wings or rooms, and the provision of special or separate meals.
VIII. MAINTENANCE AND CONFIDENTIALITY OF PATIENT INFORMATION
A CONTRACTOR shall maintain clinical records for each recipient of service in compliance with
all state and federal requirements. Such records shall include a description of all services
provided by the CONTRACTOR in sufficient detail to make possible an evaluation of services,
and all data necessary to prepare reports to the State, including treatment plans, records of client
interviews, and progress notes. CONTRACTOR shall retain clinical records for a minimum of
seven 7) years and, in the case of minors, for at least one 1) year after the minor has reached the
age of majority, but for a period of no less than seven years.
B CONTRACTOR shall comply with the confidentiality requirements set forth in Exhibit D and
incorporated by reference as if fully set forth herein.
IX. CONTRACT MONITORING AND QUALITY CONTROL
A The State Department of Mental Health, COUNTY, and other appropriate state and federal
agencies shall have the right to inspect and evaluate the quality, appropriateness and timelines of
services performed under this Agreement.
B The Behavioral Health Director shall assign a Contract Monitor to ensure compliance with the
terms and conditions of this Agreement. The Contract Monitor and CONTRACTOR shall meet
at intervals deemed appropriate by COUNTY. In addition, the Contract Monitor shall review at
regular intervals all statistical reports, financial records, clinical records, and other documents
concerning services provided under this Agreement. In addition, CONTRACTOR shall at all
times cooperate with the COUNTY's Quality Improvement QI") Plan.
C CONTRACTOR shall conduct reviews at regular intervals of the quality and utilization of
services for all recipients of service under this Agreement. CONTRACTOR shall furnish all
required data and reports in compliance with State Department of Mental Health Client and
Service Information System CSI"). Units of time reporting, as stipulated in the Cost
Reporting/Data Collection CR/DC") manual, are subject to special review and audit.
D If the COUNTY discovers any practice, procedure, or policy of the CONTRACTOR which
deviates from the requirements of this Agreement, violates federal or state law, threatens the
success of the program conducted pursuant to this Agreement, jeopardizes the fiscal integrity of
such program, or compromises the health or safety of recipients of service, the COUNTY may
require corrective action, withhold payment in whole or in part, or terminate this Agreement
immediately. If COUNTY notifies CONTRACTOR that corrective action is required,
CONTRACTOR shall promptly initiate and correct any and all discrepancies, violations or
deficiencies to the satisfaction of the COUNTY within thirty 30) days, unless the COUNTY
notifies the CONTRACTOR that it is necessary to make corrections at an earlier date in order to
protect the health and safety of recipients of service.
E If CONTRACTOR is an in-patient facility, CONTRACTOR shall submit its patient admissions
and length of stay requests for utilization review through existing hospital systems or
professional standards review organizations.
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EXECUTED AGREEMENTX���� �X. REPORTS OF DEATH, INJURY, DAMAGE, OR ABUSE
A Reports of Death. Injury, or Damage. If death, serious personal injury, or substantial property
damage occur in connection with the performance of this Agreement, CONTRACTOR shall
immediately notify the Behavioral Health Director by telephone. In addition, CONTRACTOR
shall promptly submit to COUNTY a written report including: I) the name and address of the
injured/deceased person; 2) the time and location of the incident; 3) the names and addresses of
CONIRACTOR's employees or agents who were involved with the incident; 4) the names of
COUNTY employees, if any, involved with the incident; and 5) a detailed description of the
incident.
B Child Abuse Reporting. CONTRACTOR shall ensure that all known or suspected instances of
child abuse or neglect are promptly reported to proper authorities as required by the Child Abuse
and Neglect Reporting Act, Penal Code 11164, et seq. CONTRACTOR shall require that all of
its employees, consultants, and agents performing services under this Agreement who are
mandated reporters under the Act sign statements indicating that they know of and will comply
with the Act's reporting requirements.
C Elder Abuse Reporting. CONTRACTOR shall ensure that all known or suspected instances of
abuse or neglect of elderly people 65 years of age or older and dependent adults age 18 or older
are promptly reported to proper authorities as required by the Elder Abuse and Dependent Adult
Protection Act Welfare and Institutions Code 15600 Code, et seq.). CONTRACTOR shall
require that all of its employees, consultants, and agents performing services under this
Agreement who are mandated reporters under the Act sign statements indicating that they know
of and will comply with the Act's reporting requirements.
XI. INDEMNIFICATION
CONTRACTOR shall indemnify, defend, and hold harmless the County, its officers, agents, and
employees, from and against any and all claims, liabilities, and losses whatsoever including damages to
property and injuries to or death of persons, court costs, and reasonable attorneys' fees) occurring or
resulting to any and all persons, firms or corporations furnishing or supplying work, services, materials,
or supplies, in connection with the performance of this Agreement, and from any and all claims,
liabilities, and losses occurring or resulting to any person, firm, or corporation for damage, injury, or
death arising out of or connected with the CONTRACTOR'S performance of this Agreement, unless
such claims, liabilities, or losses arise out of the sole negligence or willful misconduct of the County.
CONTRACTOR'S performance" includes CONTRACTOR'S action or inaction and the action or
inaction of CONTRACTOR'S officers, employees, agents and subcontractors.
XII. INSURANCE
A Insurance Coverage Requirements. Without limiting CONTRACTOR'S duty to indemnify,
CONTRACTOR shall maintain in effect throughout the term of this Agreement a policy or
policies of insurance with the following minimum limits of liability:
Commercial general liability insurance, including but not limited to premises and operations,
including coverage for Bodily Injury and Property Damage, Personal Injury, Contractual
Liability, Broadform Property Damage, Independent Contactors, Products and Completed
Operations, with a combined single limit for Bodily Injury and Property Damage of not less than
$1,000,000 per occurrence.
Exemption/Modification Justification attached; subject to approval).
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EXECUTED AGREEMENTX���� �Business automobile liability insurance, covering all motor vehicles, including owned, leased,
non-owned, and hired vehicles, used in providing services under this Agreement, with a
combined single limit for Bodily Injury and Property Damage of not less than $1,000,000 per
occurrence.
Exemption/Modification Justification attached; subject to approval).
Workers Compensation Insurance, if CONTRACTOR employs others in the performance of this
Agreement, in accordance with California Labor Code section 3700 and with Employer's
liability limits not less than $1,000,000 each person, $1,000,000 each accident and $1,000,000
each disease.
Exemption/Modification Justification attached; subject to approval).
Professional Liability Insurance, if required for the professional services being provided, e.g.,
those persons authorized by a licensed to engage in a business or profession regulated by the
California Business and Professions Code), in the amount of not less than $1,000,000 per claim
and $2,000,000 in the aggregate, to cover liability for malpractice or errors or omissions made in
the course of rendering professional services. If professional liability insurance is written on a
claims-made" basis rather than an occurrence basis, the CONTRACTOR shall, upon the
expiration or earlier termination of this Agreement, obtain extended reporting coverage tail
coverage") with the same liability limits. Any such tail coverage shall continue for at least three
ears following the expiration or earlier termination of this Agreement.
Exemption/Modification Justification attached; subject to approval).
B Other Insurance Requirements. All insurance required by this Agreement shall be with a
company acceptable to the County and issued and executed by an admitted insurer authorized to
transact insurance business in the State of California. Unless otherwise specified by this
Agreement, all such insurance shall be written on an occurrence basis, or, if the policy is not
written on an occurrence basis, such policy with the coverage required herein shall continue in
effect for a period of three years following the date CONTRACTOR completes its performance
of services under this Agreement.
Each liability policy shall provide that the COUNTY shall be given notice in writing at least
thirty days in advance of any endorsed reduction in coverage or limit, cancellation, or intended
non-renewal thereof. Each policy shall provide coverage for CONTRACTOR and additional
insureds with respect to claims arising from each subcontractor, if any, performing work under
this Agreement, or be accompanied by a certificate of insurance from each subcontractor
showing each subcontractor has identical insurance coverage to the above requirements.
Commercial general liability and automobile liability policies shall provide an endorsement
naming the County of Monterey, its officers, agents, and employees as Additional Insureds with
respect to liability arising out of the CONTRACTOR's work, including ongoing and completed
operations, and shall further provide that such insurance is primary insurance to any insurance
or self-insurance maintained by the County and that the insurance of the Additional Insureds
shall not be called upon to contribute to a loss covered by the CONTRACTOR's insurance. The
required endorsement form for Commercial General Liability additional Insured is the ISO
Form CG 20 10 11-85 or CG 20 10 10 01 in tandem with CG 20 37 10 01 2000). The required
endorsement form for Automobile Additional Insured is ISO Form CA 20 48 02 99.
Edgewood Center FY 2007-2009 6
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EXECUTED AGREEMENTX���� �Prior to the execution of this Agreement by the County, CONTRACTOR shall file certificates of
insurance with the County's contract administrator and the County's Contracts/Purchasing
Division, showing that the CONTRACTOR has in effect the insurance required by this
Agreement. The CONTRACTOR shall file a new or amended certificate of insurance within
five calendar days after any change is made in any insurance policy, which would alter the
information on the certificate then on file. Acceptance or approval of insurance shall in no way
modify or change the indemnification clause in this Agreement, which shall continue in full
force and effect.
CONTRACTOR shall at all times during the term of this Agreement maintain in force the
insurance coverage required under this Agreement and shall send, without demand by County,
annual certificates to County's Contract Administrator and County's Contracts/Purchasing
Division. If the certificate is not received by the expiration date, County shall notify
CONTRACTOR and CONTRACTOR shall have five calendar days to send in the certificate,
evidencing no lapse in coverage during the interim. Failure by CONTRACTOR to maintain such
insurance is a default of this Agreement, which entitles County, at its sole discretion, to terminate
this Agreement immediately.
XIII. ANNUAL COST REPORT
A Submission of Year-End Cost Report. For each fiscal year or portion thereof that this Agreement
is in effect, CONTRACTOR shall provide to the COUNTY one 1) original and one 1) copy of
an annual cost report within ninety 90) days following the close of each fiscal year. Such
reports shall be prepared in accordance with generally accepted accounting principles, cost report
forms, and instructions provided by the COUNTY.
B Submission of Cost Report Upon Early Termination. If this Agreement is terminated or canceled
prior to June 30th of any year, CONTRACTOR shall prepare a cost report for the Agreement
period which ends on the termination or cancellation date, and shall submit two 2) copies of that
report to the COUNTY within sixty 60) days after the termination or cancellation date.
C Reimbursement for Medi-Cal Services. If CONTRACTOR is seeking reimbursement for Medi-
Cal services provided pursuant to this Agreement, reimbursement for such services shall be
based upon the lower of the actual cost of providing those services as determined by the cost
report or CONTRACTOR's usual and customary charges for such services. No amount of
reimbursement for Medi-Cal services shall exceed the Schedule of Maximum Allowance SMA)
as established annually by the State Department of Mental Health for Short-Doyle/Medi-Cal
services.
D Reimbursement by CONTRACTOR of Overpayment of Medi-Cal Costs. If, as a result of the
cost report, a discrepancy is found between the total allowable Medi-Cal costs paid to the
CONTRACTOR and the total allowable Medi-Cal costs that should have been reported, the
CONTRACTOR shall reimburse the amount of the overpayment in a single payment to the
COUNTY within thirty 30) days after the COUNTY notifies the CONTRACTOR of the interim
settlement with the State of California. As an alternative or supplemental remedy, the COUNTY
may elect to recover all of part of the overpayment by means of an offset against any payments
Edgewood Center FY 2007-2009 7
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EXECUTED AGREEMENTX���� �then or thereafter owing to the CONTRACTOR by the COUNTY under this or any other
contract.
XIV. ACCESS TO AND AUDIT OF RECORDS
A Maintenance of Records. CONTRACTOR shall maintain records indicating the nature and
extent of all services performed and all payments received under this Agreement for a period of
five 5) years after completion of all services pursuant to this Agreement or until all disputes,
claims, litigation, or audits have been resolved, whichever occurs later. CONTRACTOR shall
maintain such records in a form comporting with generally accepted standards and applicable
law. Government Code 8546.7 makes any expenditure of public funds over $10,000 subject to
the examination and audit of the State Auditor for a period of three 3) years after final payment
under the Agreement.
B Right to Inspect Records. The COUNTY, State Department of Mental Health, the Comptroller
General of the United States, the U.S. Department of Health and Human Services, and other
authorized federal and state agencies shall have the right to inspect any and all books, records,
and facilities maintained by CONTRACTOR during normal business hours to evaluate the use of
funds and the cost, quality, appropriateness, and timeliness of services.
C Overpayment. If the results of any audit show that the funds paid to CONTRACTOR under this
Agreement exceeded the amount due, then CONTRACTOR shall pay the excess amount to
COUNTY in cash not later than sixty 60) days after the final audit settlement; or, at
COUNTY'S election, COUNTY may recover the excess or any portion of it by offsets made by
COUNTY against any payment(s) owed to CONTRACTOR under this or any other Agreement.
D Responsibility for Audit Exceptions. Any and all audit exceptions by COUNTY or any state or
federal agency resulting from an audit of CONTRACTOR's performance of this Agreement, or
actions by CONTRACTOR, its officers, agents, and employees shall be the sole responsibility of
the CONTRACTOR.
E Availability of Records for Grievances and Complaints by Recipients of Service.
CONTRACTOR shall ensure the availability of records for the prompt handling of grievances or
complaints filed by recipients of services. Release of records shall be subject to the
confidentiality provisions set forth in this Agreement.
F Reports. CONTRACTOR shall prepare any reports and furnish all information required for
reports to be prepared by the COUNTY as may be required by the State of California or
applicable law.
XV. NON-DISCRIMINATION
A Non-discrimination. During the performance of this Agreement, CONTRACTOR shall not
unlawfully discriminate against any person because of race, religion, color, national origin,
ancestry, mental or physical handicap, medical condition, marital status, age over 40), sex, or
sexual preference, either in CONTRACTOR's employment practices or in the furnishing of
services to recipients. CONTRACTOR shall insure that the evaluation and treatment of its
employees and applicants for employment and all persons receiving and requesting services are
free of such discrimination. The provision of services primarily or exclusively to such target
population as may be designated in this Agreement shall not be deemed to be unlawful
F.dgewood Center FY 2007-2009
8
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EXECUTED AGREEMENTX���� �discrimination. In addition, CONTRACTOR's facility access for the disabled shall comply with
504 of the Rehabilitation Act of 1973, as amended 29 U.S.C. 794).
B Discrimination defined. The term discrimination," as used in this Agreement, is the same term
that is used in Monterey County Code, Chapter 2.80 Procedures for Investigation and
Resolution of Discrimination Complaints"); it means the illegal denial of equal employment
opportunity, harassment including sexual harassment and violent harassment), disparate
treatment, favoritism, subjection to unfair or unequal working conditions, and/or discriminatory
practice by any Monterey County official, employee or agent, due to an individual's race, color,
ethnic group, national origin, ancestry, religious creed, sex, sexual preference, age, veteran's
status, cancer-related medical condition, physical handicap including AIDS) or disability. The
term also includes any act of retaliation.
C Application of Monterey County Code Chapter 2.80. The provisions of Monterey County Code
Chapter 2.80 apply to activities conducted pursuant to this Agreement. CONTRACTOR and its
officers and employees, in their actions under this Agreement, are agents of the COUNTY within
the meaning of Chapter 2.80 and are responsible for ensuring that their workplace and the
services that they provide are free from discrimination, as required by Chapter 2.80. Complaints
of discrimination made by recipients of services against CONTRACTOR may be pursued by
using the procedures established by or pursuant to Chapter 2.80. CONTRACTOR shall establish
and follow its own written procedures for prompt and fair investigation and resolution of
discrimination complaints made against CONTRACTOR by its own employees and agents or
recipients of services pursuant to this Agreement, and CONTRACTOR shall provide a copy of
such procedures to COUNTY on demand by COUNTY.
D Compliance with Applicable Law. During the performance of this Agreement, CONTRACTOR
shall comply with all applicable federal, state and local laws and regulations which prohibit
discrimination including, but not limited to, the following:
1. California Code of Regulations, Title 9, 526, 527;
2. California Fair Employment and Housing Act, Govt. Code 12900, et seq.), and the
administrative regulations issued thereunder, Cal. Code of Regulations, Title 2, 7285, et
seq.;
3. Govt. Code 11135-11139.5 Title 2, Div. 3, Part 1, Chap. 1, Art. 9.5) and any
applicable administrative rules and regulations issued under these sections;
4. Federal Civil Rights Acts of 1964 and 1991 see especially Title VI, 42 U.S.C. 2000(d),
et seq.), as amended, and all administrative rules and regulations issued thereunder see
especially 45 C.F.R. Parts 80);
5. Sections 503 and 504 of the Rehabilitation Act of 1973, as amended 29 U.S.C. 793
and 794); all requirements imposed by the applicable HHS regulations 45 C.F.R. Part
84); and all guidelines and interpretations issued pursuant thereto;
6. Americans with Disabilities Act of 1990, 42 U.S.C. 12101, et seq., and 47 U.S.C.
225 and 611, and any federal regulations issued pursuant thereto see 24 C.F.R. Chapter
Edgewood Center FY 2007-2009
9
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EXECUTED AGREEMENTX����
�1; 28 C.F.R. Parts 35 and 36; 29 C.F.R. Parts 1602, 1627, and 1630; and 36 C.F.R. Part
1191
7. Unruh Civil Rights Act, Cal. Civil Code 51, et seq.; and
8. Government Code section 12900 A-F) and California Code of Regulations, Title 2,
Division 4, Chapter 5.
In addition, the applicable regulations of the Fair Employment and Housing Commission
implementing Government Code 12990 as set forth in Chapter 5, Division 4 of Title 2 of the
California Code of Regulations are incorporated into this Agreement by reference and made a
part hereof as if set forth in full.
E Written Assurance. Upon request by COUNTY, CONTRACTOR will give any written
assurances of compliance with the Civil Rights Acts of 1964 and 1991, the Rehabilitation Act of
1973, as amended, and the Americans with Disabilities Act of 1990, as may be required by the
federal government in connection with this Agreement, pursuant to 45 C.F.R. sec. 80.4 or C.F.K.
84.5 or other applicable state or federal regulations.
F Written Statement of Non-discrimination Policies. CONTRACTOR shall maintain a written
statement of its non-discrimination policies and procedures. Such statement shall be consistent
with the terms of this Agreement and shall be available to CONTRACTOR's employees,
recipients of services, and members of the public upon request.
G Notice to Labor Unions. CONTRACTOR shall give written notice of its obligations under this
section to labor organizations with which it has a collective bargaining or other agreement.
H Access to Records by Government Agencies. CONTRACTOR shall permit access by COUNTY
and by representatives of the State Department of Fair Employment and Housing and any state or
federal agency providing funds for this contract upon reasonable notice at any time during
normal business hours, but in no case less than 24 hours' notice, to such of its books, records,
accounts, facilities, and other sources of information as the inspecting party may deem
appropriate to ascertain compliance with these nondiscrimination provisions.
Binding on Subcontractors. The provisions above shall also apply to all of CONTRACTOR's
subcontractors who provide services pursuant to this Agreement. CONTRACTOR shall include
the non-discrimination and compliance provisions set forth above in all its subcontracts to
perform work or provide services under this Agreement.
XVI. CULTURAL COMPETENCY AND LINGUISTIC ACCESSIBILITY
A CONTRACTOR shall provide services in a culturally competent manner to assure access to
services by all eligible individuals as required by Department of Mental Health regulations and
policies and other applicable laws. Cultural competency is defined as a congruent set of practice
skills, behaviors, attitudes, and policies that enable staff to work effectively in providing
contractual services under this Agreement in cross-cultural situations. Specifically,
CONTRACTOR'S provision of services shall acknowledge the importance of culture, adapt
services to meet culturally unique needs, and promote congruent skills, behaviors, attitudes, and
Edgewood Center FY 2007-2009
10
BIB]
39655-U01
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EXECUTED AGREEMENTX����
�policies enabling all persons providing services to function effectively in cross-cultural
situations.
B CONTRACTOR shall provide linguistically accessible services to assure access to services by
all eligible individuals as required by Department of Mental Health regulations and policies and
other applicable laws. Specifically. CONTRACTOR shall provide services to eligible
individuals in their primary language through linguistically proficient staff or interpreters.
Family members, friends, or neighbors may he used as interpreters only in emergency situations.
C For the purposes of this Section. access" is defined as the availability of medically necessary
mental health services in a manner that promotes. provides the opportunity for and facilitates
their use.
XVII. DRUG FREE WORKPLACE
CONTRACTOR shall submit to the COUNTY evidence of compliance with the California Drug-Free
Workplace Act of 1990, Government Code sections 8350, et seq., to provide a drug-free workplace by
doing all of the following:
A Publishing a Statement notifying employees that the unlawful manufacture, distribution,
dispensation, possession, or use of a controlled substance is prohibited in the person's or
organization's workplace and specifying the actions that will be taken against employees for
violations of the prohibitions.
B Establishing a drug-free awareness program to inform employees about all of the following:
1. The dangers of drug abuse in the workplace;
2. The person's or organization's policy of maintaining a drug-free workplace;
3. Any available drug counseling, rehabilitation, and employees assistance programs;
4. The penalties that may be imposed upon employees for drug abuse violations;
5. Requiring that each employee engaged in the performance of the Agreement or grant be
given a copy of the company's drug-free policy statement and that, as a condition of
employment on the contract or grant, the employee agrees to abide by the terms of the
statement.
XVIII. INDEPENDENT CONTRACTOR
In the performance of work, duties, and obligations under this Agreement, CONTRACTOR is at all
times acting and performing as an independent contractor and not as an employee of the COUNTY. No
offer or obligation of permanent employment with the COUNTY or particular COUNTY department or
agency is intended in any manner, and CONTRACTOR shall not become entitled by virtue of this
Agreement to receive from COUNTY any form of employee benefits including, but not limited to sick
leave, vacation, or retirement benefits, workers' compensation coverage, insurance, disability benefits,
or social security benefits, or unemployment compensation or insurance. CONTRACTOR shall be
solely liable for and obligated to pay directly all applicable taxes including, but not limited to, federal
and state income taxes and social security, arising out of CONTRACTOR's compensation for
Edgewood Center FY 2007-2009 11
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$133,182,-U012
TO-U012
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B.-U012
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EXECUTED AGREEMENTX����
�performance of this Agreement. In connection therewith, CONTRACTOR shall defend, indemnify, and
hold the COUNTY harmless from any and all liability COUNTY may incur because of
CONTRACTOR's failure to pay such taxes when due.
XIX. SUBCONTRACTING
CONTRACTOR may not subcontract any services under this Agreement without COUNTY's prior
written authorization. At any time, COUNTY may require a complete listing of all subcontractors
employed by the CONTRACTOR for the purpose of fulfilling its obligations under the terms of this
Agreement. CON"I'RACTOR shall be legally responsible for subcontractors' compliance with the terms
and conditions of this Agreement and with applicable law. All subcontracts shall be in writing and shall
comply with all COUNTY requirements, state requirements, and applicable law. In addition,
CONTRACTOR shall be legally responsible to COUNTY for the acts and omissions of any
subcontractors and persons either directly or indirectly employed by them.
XX. GENERAL PROVISIONS
A Amendment. This Agreement may be amended or modified only by an instrument in writing
signed by all the parties hereto.
B Waiver. Any waiver of any terms and conditions of this Agreement must be in writing and
signed by the parties hereto. A waiver of any of the terms and conditions of this Agreement shall
not be construed as a waiver of any other terms or conditions in this Agreement.
C Assignment. This Agreement shall not be assigned by CONTRACTOR, either in whole or in
part, without the prior written consent of the COUNTY. Any assignment without such consent
shall automatically terminate this Agreement.
D Contractor. The term CONTRACTOR" as used in this Agreement includes CONTRACTOR's
officers, agents, and employees acting on CONTRACTOR's behalf in the performance of this
Agreement.
E Headings. The section and paragraph headings are for convenience only and shall not be used to
interpret the terms of this Agreement.
F Counterparts. This Agreement may be executed in two or more counterparts, each of which shall
be deemed an original, but all of which together shall constitute one and the same Agreement.
G Authori Any individual executing this Agreement on behalf of an entity represents and
warrants hereby that he or she has the requisite authority to enter into this Agreement on behalf
of such entity and bind the entity to the terms and conditions of the same.
H Integration. This Agreement, including the exhibits hereto, shall represent the entire Agreement
between the parties with respect to the subject matter hereof and shall supersede all prior
negotiations, representations, and/or agreements, either written or oral, between the parties as of
the effective date hereof.
I Governing Law. This Agreement shall be governed by and interpreted under the laws of the
State of California.
Edgewood Center FY 2007-2009
12
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
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FO64075-U03
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AS69434-U03
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DO71621-U03
C7-U03
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7/25/2008-U04
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6/12/2008-U011
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EXECUTED AGREEMENTX����
�J Non-exclusive Agreement. This Agreement is non-exclusive and both parties expressly reserve
the right to contract with other entities for the same or similar services.
K Construction of Agreement. The parties agree that each party has fully participated in the review
and revision of this Agreement and that any rule of construction to the effect that ambiguities are
to be resolved against the drafting party shall not apply in the interpretation of this Agreement or
any amendment hereto.
L Severability. In the event of changes in law that effect the provisions of this Agreement, the
parties agree to amend the affected provisions to conform to the changes in the law retroactive to
the effective date of such changes in law. The parties further agree that the terms of this
Agreement are severable and, in the event of changes in law as described above, the unaffected
provisions and obligations of this Agreement will remain in full force and effect.
M Time is of the essence. Time is of the essence in each and all of the provisions of this
Agreement.
XXI. NOTICES AND DESIGNATED LIAISONS
Notices to the parties in connection with this Agreement may be given personally or may be delivered
by certified mail, return receipt requested, addressed to:
COUNTY OF MONTEREY
Wayne W. Clark, Ph.D.
Behavioral Health Director
1270 Natividad Road, Room 200
Salinas, CA 93906
831) 755-4509
CONTRACTOR
Debra Menaker
CFO/COO
Edgewood Center for Children and Families
1801 Vicente St.
San Francisco, CA 94116
415) 681-3211
XXII. SUPERSE PRIOR AGREEMENTS
Upon execution of this Agreement, Agreement No. A-10990 between the parties is superseded and
replaced by the terms and conditions of this Agreement.
Edgewood Center FY 2007-2009 13
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
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AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
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7/25/2008-U04
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11911-U05
11-U06
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6/12/2008-U011
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SERVICES-U012
EFFECTIVE-U012
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EXECUTED AGREEMENTX���� �IN WITNESS WHEREOF, County and CONTRACTOR have executed this Agreement as of the day and year written
below.
By:
COUNTY OF MONTEREY
Mike Derr, Purchasing Manager
Len Foster, Director o
Approved as to Form
By:
2
Lee Blankenship, Assistant County Counsel
Date: 4~ / 6-t / 0 46
CUNT'{ OP L', LY
Approved 4 Lq, T bof M CEMN!
By: LUFi~',ivCE LANGUAGE
St e Maucl sk Manag et
Date: t %' LAS
Approved as to Content
By:
Date:
Wayne ark, Behavioral Health Director
Bv:
Date:
By:
Date:
County Board of Supervisors' Agreement Number:
CONTRACTOR
Edgewood Center for Children and
Families
Contractor*
NancyjKATn- Pr sideni and CEO
INSTRUCTIONS. If CONTRACTOR is a corporation. including limited liability and non-profit corporations, the full legal name of the corporation shall be set forth above tc
with the signatures of two specified officers. If CONTRACTOR is a partnership, the name of the partnership shall be set forth above together with the signature of a partner w
authority to execute this Agreement on behalf of the partnership
Approval by Risk Management is necessary only if changes are made in paragraph 8 or 9.
z
Approval by County Counsel is necessary only if changes are made to the standard provisions of the MUSA
Edgewood Center FY 2007-2009
14
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
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EXECUTED AGREEMENTX���� �EXHIBIT A: PROGRAM DESCRIPTION
1. IDENTIFICATION OF PROVIDER
Edgewood Center for
Children and Families
1801 Vicente St.
San Francisco, CA 941 16
II. PROGRAM NARRATIVE
Edgewood Center for Children and Families will provide Day Treatment Intensive Services, Therapeutic
Behavioral Services, Medication Support, and Mental Health Services to youth that require the highest
level of residential care or that would require periodic inpatient hospitalization, placement at out-of-state
facilities, or in a juvenile justice facility.
III. PROGRAM GOALS
To return the youth to living at home or a lower level of care by reducing emotional/behavioral
symptoms.
IV. OBJECTIVES
A. Reduce inappropriate behavior and/or psychiatric symptoms to a level that the youth can return
home or to a lower level of care.
B. Help youth develop age appropriate potential and functionality within the youth's community.
C. Improve academic achievement.
V. TREATMENT SERVICES
A. Mode of Service: Day Treatment Intensive and Outpatient
B. Contracted Units of Service by Type and Mode Each Year:
FY 2007-08:
1. 76 estimated days of Day Treatment Intensive client full day)
services
2. 540 estimated minutes of Medication Support services
3. 2,160 estimated minutes of Mental Health services
FY 2008-09:
I. 365 estimated days of Day Treatment Intensive client full day)
services
2. 2,880 estimated minutes of Medication Support services
3. 12,480 estimated minutes of Mental Health services
C. Delivery Site:
Edgewood Center for Children and Families
1801 Vicente St.
San Francisco, CA 94116
D. Hours of Operation:
Day Treatment Intensive services shall operate more than 4 hours per day, seven days a week.
Mental Health services, other than family therapy, will be offered on non-day treatment days.
Medication Support services will be available by appointment.
Edgewood Center FY 2007-2(X)9
Exhibit A-I
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
HEALTH,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
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TO-U012
AGREEMENT-U012
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EXECUTED AGREEMENTX���� �VI. POPULATION/CATCHMENT AREA TO BE SERVED
This current agreement is for one eligible resident of Monterey County. New eligible residents of
Monterey County referred to Edgewood will require an amendment to this agreement.
VII. FINANCIAL ELIGIBILITY
Monterey County youth who are full scope Medi-Cal eligible and have been screened through the
County interagency placement committee or any youth that have been placed through the Individualized
Education Plan IEP). Undocumented youth require pre-authorization by the Behavioral Health Director
of Monterey County.
VIII. LIMITATION OF SERVICE/PRIOR AUTHORIZATION
Referrals for admission to this program will be initiated exclusively by the Mental I lealth Division Case
Management staff after an initial screening. Admission to the program will involve youth who are
voluntary participants or who are wards or dependents of the court. Screening criteria will be based on
degree of emotional disturbance, a designated funding source, and the inability to utilize a less
restrictive placement. Admission will be the sole authority of the CONTRACTOR. I)ay Treatment
services require prior authorization and this authorization must be renewed every three 3) months for
Day Treatment Intensive. Mental Health Services also requires prior authorization. Medication Support,
beyond two visits per month, requires prior authorization. The contracted duration of treatment is
limited to one year; any extension requires consultation with the Mental Health Case Manager and
approval of the Contract Monitor.
IX. CLIENT DESCRIPTION/CHARACTERISTICS
The population served: Children and adolescents ages 5-18 with:
A. Severe emotional and behavioral disturbances.
B. Axis I diagnosis indicating mental impairment or behavioral disturbance and substantial
C. Impairment in two of the following areas:
1. Self care
2. Family relationships
3. Ability to function in the community
4. School functioning; and
One or all of the following:
1. Severe acting out episodes
2. History of self-destructive behavior
3. Catastrophic reactions to every day occurrences
4. History of inpatient hospitalization
X. LEGAL STATUS
Voluntary or juvenile dependents and wards W&I Code, Sections 300 et seq. and Sections 601 & 602 et
seq.).
XI. COVERAGE
Five days a week for Day Treatment Intensive services. Mental Health and Medication Support services
determined to be medically necessary and designated on the service plan.
Edgewood Center FY 2007-2009
Exhibit A-2
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
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EXECUTED AGREEMENTX���� �XII. DESIGNATED CONTRACT MONITOR
Marti Barton
Children's Behavioral Health Services Manager
951 Blanco Circle, Suite B
Salinas, CA 93901
831) 784-2180
Edgewood Center FY 2007-2009:
Exhibit A-3
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
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DO71621-U03
C7-U03
COUNTY-U03
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7/25/2008-U04
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11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
HEALTH,-U012
TO-U012
SIGN-U012
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TO-U012
THREE-U012
3)-U012
FUTURE-U012
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TO-U012
AGREEMENT-U012
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DO-U012
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10%-U012
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TOTAL-U012
CONTRACT-U012
AMOUNT-U012
DO-U012
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EXECUTED AGREEMENTX���� �EXHIBIT B:
PAYMENT PROVISIONS
1. PAYMENT TYPE
Cost Reimbursed CR) up to maximum contract amount
II. PAYMENT CONDITIONS
A In order to receive any payment under this Agreement, CONTRACTOR shall submit reports and
claims in such form as may be required by the County of Monterey, Department of Health.
Behavioral Health Division. Specifically, CONTRACTOR shall submit its claims on a form
acceptable to COUNTY so as to reach the Behavioral Health Division no later than the 30th day
of the month following the month of service. Upon termination of this Agreement.
CONTRACTOR shall submit its final claim for payment no later than thirty 30) days after the
completion of services.
B If CONTRACTOR fails to submit claims for services provided under the term of this Agreement
as described above, the COUNTY may, at its sole discretion, deny payment for that month of
service and disallow the claim.
C COUNTY shall review and certify CONTRACTOR's claim either in the requested amount or in
such other amount as COUNTY approves in conformity with this Agreement, and shall promptly
submit such invoice to the COUNTY Auditor-Controller for payment. The County Auditor-
Controller shall pay the amount certified within 30 days of receiving the certified invoice.
D If COUNTY certifies payment at a lesser amount than the amount requested COUNTY shall
immediately notify the CONTRACTOR in writing of such certification and shall specify the
reason for it. If the CONTRACTOR desires to contest the certification, the CONTRACTOR
must submit a written notice of protest to the COUNTY within twenty 20) days after the
CONTRACTOR's receipt of the COUNTY notice. The parties shall thereafter promptly meet to
review the dispute and resolve it on a mutually acceptable basis. No court action may be taken on
such a dispute until the parties have met and attempted to resolve the dispute in person.
III. PAYMENT RATE
The mental health patch shall be paid at a published rate of $302 per day 7 days a week) for Fiscal Year
2007-08 and Fiscal Year 2008-09 7 days a week) for the client at the CONTRACTOR'S licensed
facility in San Francisco and be subject to all the cost report provisions set forth in Section XIII of this
Agreement.
Edgewood Center FY 2007-2009
Exhibit B-1
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
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11911-U05
11-U06
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APPROVE-U07
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HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
HEALTH,-U012
TO-U012
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TO-U012
THREE-U012
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WORK.-U012
EXECUTED AGREEMENTX���� �IV. MAXIMUM OBLIGATION OF COUNTY
A. Subject to the limitations set forth herein, COUNTY shall pay to CONTRACTOR during the
term of this Agreement a maximum amount of $133,182 for services provided by CONTRACTOR
that have been authorized pursuant to Exhibit A to this agreement, as hereinafter set forth. It is the sole
responsibility of the Monterey County Department of Social and Employment Services to reimburse
Behavioral Health for the patch owed for each Fiscal Year 2007-08 and 2008-09 in the amounts of
$4,999.96 and $13,168.10 respectively.
Total Total
Estimated Rate of FY 2007-08 Estimated Rate of FY 2008-09
Service Description Mode of
Service Service Function
Code Contracted
Units of
Reimbursement pe
Contract Contracted
Units of
Reimbursement per
Contract
Unit Amount Unit Amount
Service Service
ay reatmen
Intensive Day) 10 85 48 $20243 $9,717 250 20243 $50,608
Medication Support
Services Minute) 15 60 540 $4.82 $2.603 2,880 482 $13,882
enta Health Services
Minute)
Collateral 15 10
Individual Therapy 15 40
Group Therapy 15 50 2,160 $261 $5,638 12.480 261 $32.573
TOTAL DTI and Meds PER YEAR $17,957 $97,062
DENitAt DAYS 76 $302.00- $22,952.00 385 $302:00 $110230.00
Dept. of Social and Employment Services Patch owed
to Behavioral Health $4,994.96 $13,168.10
MAXIMUM AGREEMENT AMOUNT 07-08 $22.95
MAXIMUM AGREEMENT AMOUNT 08-09 $110.23
TOTAL MAXIMUM AGREEMENT LIABILITY $135,18
B. Maximum A reement Liabilit
C. If, as of the date of signing this Agreement, CONTRACTOR has already received payment from
COUNTY for services rendered under this Agreement, such amount shall be deemed to have
been paid out under this Agreement and shall be counted towards COUNTY's maximum liability
under this Agreement.
D. If for any reason this Agreement is cancelled, COUNTY's maximum liability shall be the total
utilization to the date of cancellation not to exceed the maximum amount listed above.
V. CLAIM TO BE FILED BY CONTRACTOR
In order to receive any payment under this Agreement, CONTRACTOR shall submit reports and claim
forms as required by the County of Monterey's Mental Health Division. Specifically, CONTRACTOR
shall submit the following on a monthly basis:
A. Day Care Activity Report for Day Care Services;
B. Claim Form summarizing service costs.
Edgewood Center FY 2007-2009
Exhibit B-2
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
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FO64075-U03
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AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
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11911-U05
11-U06
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HEALTH-U07
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AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
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SUSIE-U09
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6/12/2008-U011
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PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
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B.-U012
AUTHORIZE-U012
DIRECTOR-U012
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EXECUTED AGREEMENTX���� �VI. PAYMENT METHOD
A County will pay CONTRACTOR for the services provided by CONTRACTOR that have been
authorized pursuant to this agreement, as hereinafter set forth.
B CONTRACTOR will submit a monthly claim for services rendered to:
Monterey County I Iealth Department
Behavioral Health Division
1270 Natividad Road, Room 200
Salinas, CA 93906
ATTN: Accounts Payable
Edgewood Center FY 2007-2009
Exhibit B-3
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
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24,-U012
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THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
HEALTH,-U012
TO-U012
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WORK.-U012
EXECUTED AGREEMENTX���� �EXHIBIT D:
CONFIDENTIALITY OF PATIENT INFORMATION
Confidentiality of Patient Information and Records. All patient information and records are confidential.
CONTRACTOR shall maintain the confidentiality of all patient records, including billings and
computerized records. in accordance with all state and federal law relating to confidentiality of patient
records and patient information, including but not limited to: Welfare and Institutions Code sections 5328,
et seq., 14100.2, and 10850, et seq; Title 45 Code of Federal Regulations section 205.50, and Title 42,
CFR, section 431.300 et seq.
Patient information" or confidential information" includes any patient/recipient of services identifying
information including, but not limited to: name, identifying numbers, symbol, fingerprint, photograph or
voice print. In addition, patient information" or confidential information" includes all information
CONTRACTOR has obtained about a patient/recipient of services whether or not a documentary record
of such information exists.
Use and Disclosure of Patient Information Confidential information gained by CONTRACTOR from
access to records and from contact with patients/recipients of service and complainants shall be used by
CONTRACTOR only in connection with its performance under this Agreement. CONTRACTOR shall
not disclose patient records or information, including the identities of patients/recipients of service,
without proper consent to such disclosure or a court order requiring disclosure. In addition,
CONTRACTOR shall obtain COUNTY's authorization to such disclosure prior to any release of
confidential information. The COUNTY, through the Behavioral Health Director, shall have access to
such confidential information.
Penalty for Unauthorized Disclosure. CONTRACTOR understands that disclosure of patient information
in violation of law may subject the party releasing the information to a minimum of $10,000 in civil
damages, as set forth in Welfare and Institutions Code Section 5330.
Duty to Warn. CONTRACTOR understands that persons providing services under this Agreement may,
in certain situations involving a patient or recipient of services who is a danger to himself or others, have
a duty to warn third parties of such danger and should consult supervisory staff and/or legal counsel about
such duty to warn as appropriate.
Dissemination of these Confidentiality Provisions. CONTRACTOR shall inform all its officers,
employees, agents, and subcontractors providing services hereunder of these provisions.
By my signature below, as the authorized representative of the CONTRACTOR named below, I certify
acceptance and understanding for myself and the CONTRACTOR of the above confidentiality
provisions.
Edgewood Center for Children & Families
Name of Contractor
ignature of Authorized llepresentative Debra Menaker
Name of Authorized Representative print)
CFO/COO
Date
Title of Authorized Representative
Edgewood Center FY 2007-2009
Exhibit D-1
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
HEALTH,-U012
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WORK.-U012
EXECUTED AGREEMENTX���� �EXHIBIT E:
ASSURANCE OF COMPLIANCE WITH SECTION 504 OF THE REHABILITATION ACT OF
1973, AS AMENDED
CONTRACTOR hereby agrees that it will comply with: 1) Section 504 of the Rehabilitation Act of
1973, as amended 29. U.S.C. 794), 2) all requirements imposed by the applicable HHS Regulations 45
C.F.R. Part 84) and, 3) all guidelines and interpretations issued pursuant thereto.
Pursuant to Section 84.5(a) of the Regulation 45 C.F.R. 84.5a) CONTRACTOR gives this Assurance in
consideration of and for the purpose of obtaining any and all federal grants, loans, contracts except
procurement contracts and contracts of insurance or guaranty), property, discounts or other federal
financial assistance extended after the date of this Assurance, including payments or other assistance
made after such date on applications for federal financial assistance which will be extended in reliance on
the representations and agreements made in this Assurance. The United States will have the right to
enforce this Assurance through lawful means. This Assurance is binding on CONTRACTOR, its
successors, transferees and assignees. The person or persons whose signatures appear below are
authorized to sign this Assurance on behalf of CONTRACTOR.
This Assurance obligates CONTRACTOR for the period during which federal financial assistance is
extended or, where the assistance is in the form of real or personal property, for the period provided for in
section 84.5(b) of the Regulations 45 C.F.R. 84.5b).
In addition, CONTRACTOR gives this assurance for the purpose of obtaining payment from the
COUNTY under this Agreement, regardless of the funding source. This assurance obligates the
CONTRACTOR during the entire term of this Agreement.
CONTRACTOR: Please check A or B)
A. Employs fewer than fifteen persons;
B.
1
Employs fifteen or more persons, and pursuant to Section 84.7(a) of the Regulations
45 C.F.R. 84.7a), has designated the following person(s) to coordinate its efforts to comply
with the HHS regulations.
C.
Contractor's Name Ed ewood Center for Children and Families
Name of Designee Debra Menaker
Title of Designee CFO/COO
Street 1801 Vicente St.
city San Francisco State CA zip 94116
IRS Employer Identification Number 94-1186168
I certify that the above information is complete and correct to the best of my knowled
Sinature of Contractor c.Date 1 ge and belief.
3
Iidgewood Center FY 2007-2009. Exhibit F-I
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
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SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
FAMILIES,-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
AUTHORIZE-U012
DIRECTOR-U012
OF-U012
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EXECUTED AGREEMENTX���� �EXHIBIT F:
ASSURANCE OF COMPLIANCE WITH
MONTEREY COUNTY'S CULTURAL, COMPETENCY POLICY
In a culturally competent system, each provider organization shows respect for and responds to
individual differences and special needs. Services are provided in the appropriate cultural context and
without discrimination related to race, national origin, income level, religion, gender, sexual
orientation, age, or physical disability, to name a few. Culturally competent caregivers are aware of the
impact of their own culture on their relationships with consumers and know about and respect cultural
and ethnic differences. They adapt their skills to meet each family's values and customs. Cultural
competence is a developmental and dynamic process one that occurs over time.
Organizations in a Culturally Competent Service System Promote:
Quality Improvement
Continuous evaluation and quality improvement
Supporting evidence-based, promising and emerging practices that are congruent with
ethic/racial/linguistic group belief systems, cultural values and help-seeking behaviors.
Collaboration
Collaborating with Behavioral Health and other community programs
Resolving barriers to partnerships with other service providers
Access
Providing new services to unserved and underserved children, youth, adults and/or older adults
Reducing disparities to care as identified in the Mental Health Services Act Plan
Ensuring representation of mental health services consumers, family members of a mental
health services consumer, and/or representatives from unserved communities on their
advisory/governance body or committee for development of service delivery and evaluation
with a minimum target of 25%).
Developing recruitment, hiring, and retention plans that are reflective of the target
communities' ethnic, racial, and linguistic populations.
Cultural Competent Services:
Are available, accessible and welcoming to all clients regardless of race, ethnicity, language,
age, and sexual orientation.
Provide a physical environment that is friendly, respectful and inclusive of all cultures.
Provide information, resources and reading materials in multilingual formats.
Promote and foment culturally accepted social interactions, respect and healthy behaviors
within the family constellation and service delivery system.
Provide options for services, which are consistent with the client's beliefs, values, healing
traditions, including individual preferences for alternative, spiritual and/or holistic approaches
to health.
Offer services in unserved and underserved communities.
Have services available in the evening and on weekends to ensure maximum accessibility.
Offer services in Spanish and other necessary languages such as Tagalog) for at least 50% of
all services.
Edgewood Center FY 2007-2009: Exhibit F-l
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
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FO64075-U03
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DO71621-U03
C7-U03
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CODE-U03
7/25/2008-U04
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EFFECTIVE-U012
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EXECUTED AGREEMENTX���� �Definitions for Cultural Competency
Cultural Competence is defined as a set of congruent practice skills, knowledge, behaviors,
attitudes, and policies that come together in a system, agency, or among consumer providers, family
members, and professionals that enables that system, agency, or those professionals and consumers,
and_ family member providers to work effectively in cross-cultural situations.
Adapted from Cross, et al., 1989; cited in DM1I Information Notice No.02-03).
Cultural Competence is a means to eliminating cultural, racial and ethnic disparities. Cultural
Competence enhances the ability of the whole system to incorporate the languages, cultures, beliefs
and practices of its clients into the service. In this way all clients benefit from services that address
their needs from the foundation of their own culture. Strategies for elimination of these disparities
must he developed and implemented. Cultural Competence must be supported at all levels of the
system.
Framework for Eliminating Cultural, Linguistic, Racial and Ethnic Behavioral I lealth Disparities pg 9)
A set of congruent behaviors, attitudes, and policies that come together in a system, agency or amongst
professionals and consumers and enables that system, agency or those professionals and consumers to
work effectively in cross-cultural situations.
Cross, Bazron, Dennis & Issacs. 1989)
The ability to work effectively with culturally diverse clients and communities.
Randall David, 1994)
CONTRACTOR hereby agrees that it will comply with the principles and guidelines set forth in
Monterey County's Cultural Competency Policy as outlined above), and will:
Develop organizational capacity to provide services in a cultural competent manner. This may
include: hiring staff with the linguistic capabilities needed to meet the diverse language needs
in Monterey County for example, Spanish and Tagalog); providing staff with training in
cultural competency; making services accessible at locations and times that minimize access
barriers, and ensuring that staff have an open and positive attitude and feel comfortable
working with diverse cultures.
2. Create a physical environment that ensures people of all cultures, ages and sexual orientation
feel welcome and cared for. This may include: decorating waiting and treatment areas with
pictures that reflect the diverse cultures of Monterey County; providing reading materials,
resources and magazines in varied languages, at appropriate reading levels and suitable for
different age groups, including children and youth; consideration of cultural differences and
preferences when offering refreshments; ensuring that any pictures, symbols or materials on
display are not unintentionally disrespectful to another culture.
3. Provide an emotional environment that ensures people of all cultures, ages and sexual
orientation feel welcome and cared for. This may include: respect for individual preferences
for alternative, spiritual and/or holistic approaches to health; a reception staff that is competent
in the different languages spoken by clients; staff that is knowledgeable of cultural and ethnic
differences and needs and is able and willing to respond to them in an appropriate and
respectful manner.
Edgewood Center FY 2007-2009: Exhibit F-2
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
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FO21330-U03
FO62956-U03
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AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
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11911-U05
11-U06
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OF-U07
HEALTH-U07
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CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
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PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
EFFECTIVE-U012
APRIL-U012
24,-U012
2008-U012
THROUGH-U012
JUNE-U012
30,-U012
2009,-U012
A-U012
TOTAL-U012
AMOUNT-U012
TO-U012
EXCEED-U012
$133,182,-U012
TO-U012
SUPERSEDE-U012
AGREEMENT-U012
A-10990;-U012
B.-U012
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OF-U012
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EXECUTED AGREEMENTX���� �4. Support the county's goal to reduce disparities to care by increasing access and decreasing
barriers to services by unserved and underserved communities.
5. Include the voice of multi-cultural youth, client and family members, including: monolingual
and bilingual clients and family members and representatives from unserved and underscrved
communities, in the advisory/governance body or committee for development of service
delivery and evaluation County Goal: 25%).
6. Participate in outcome evaluation activities aimed at assessing individual organizations as well
as countywide cultural competency in providing mental health services.
7. As requested, meet with the Monterey County Behavioral Health Director or designee to
monitor progress and outcomes and report regularly to Behavioral Health coordinating bodies
on the progress and outcome(s) of the project.
8. As appropriate, participate in cultural competency trainings offered by Monterey County
Behavioral Health.
Dissemination of these Provisions. CONTRACTOR shall inform all its officers, employees, agents.
and subcontractors providing services hereunder of these provisions.
By my signature below, as the authorized representative of the CONTRACTOR named below, I
certify acceptance and understanding for myself and the CONTRACTOR of the above provisions.
Edgewood Center for Children & Families
Name of Contractor
Signature of Authortzed epresentative Debra Menaker
Name of Authorized Representative print)
CFO/COO
Date Title of Authorized Representative
Edgewood Center FY 2007-2009 Exhibit F-3
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
MG69409-U03
AS69434-U03
AS69436-U03
AI70367-U03
DO71621-U03
C7-U03
COUNTY-U03
CODE-U03
7/25/2008-U04
BARAJASRM-U04
11911-U05
11-U06
32.-U07
A.-U07
APPROVE-U07
AUTHORIZE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
AN-U07
AGREEMENT-U07
EDGEWOOD-U07
CENTER-U07
CHILDREN-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/12/2008-U011
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PROVISION-U012
OF-U012
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EXECUTED AGREEMENTX���� �EXHIBIT G
BUSINESS ASSOCIATE AGREEMENT
This Agreement is made effective the 24th day of April, 2008, by and between the County of
Monterey, hereinafter referred to as Covered Entity", and Edgewood Center for Children and
Families, hereinafter referred to as Business Associate", individually, a Party" and collectively, the
Parties").
W'ITNESSEi'I 1:
WHEREAS. Sections 261 through 264 of the federal Health Insurance Portability and
Accountability Act of 1996. Public Law 104-191, known as the Administrative Simplification
provisions." direct the Department of Health and Human Services to develop standards to protect the
security, confidentiality and integrity of health information; and
WHEREAS, pursuant to the Administrative Simplification provisions, the Secretary of Health and
Human Services has issued regulations modifying 45 CFR Parts 160 and 164 the HIPAA Privacy
Rule"); and
WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business
Associate will provide certain services to Covered Entity, and, pursuant to such arrangement, Business
Associate may be considered a business associate" of Covered Entity as defined in the HIPAA
Privacy Rule the agreement evidencing such arrangement is entitled Mental Health Services
Agreement, and is hereby referred to as the Arrangement Agreement"); and
WHEREAS, Business Associate may have access to Protected Health Information as defined
below) in fulfilling its responsibilities under such arrangement;
THEREFORE, in consideration of the Parties' continuing obligations under the Arrangement
Agreement, compliance with the HIPAA Privacy Rule, and other good and valuable consideration. the
receipt and sufficiency of which is hereby acknowledged, the Parties agree to the provisions of this
Agreement in order to address the requirements of the HIPAA Privacy Rule and to protect the interests
of both Parties.
1. DEFINITIONS
Except as otherwise defined herein, any and all capitalized terms in this Section shall have the
definitions set forth in the HIPAA Privacy Rule. In the event of an inconsistency between the
provisions of this Agreement and mandatory provisions of the HIPAA Privacy Rule, as amended,
the HIPAA Privacy Rule shall control. Where provisions of this Agreement are different than
those mandated in the HIPAA Privacy Rule, but are nonetheless permitted by the HIPAA Privacy
Rule, the provisions of this Agreement shall control.
The term Protected health Information" means individually identifiable health information
including, without limitation, all information, data, documentation, and materials, including
without limitation, demographic, medical and financial information, that relates to the past,
present, or future physical or mental health or 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 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.
Edgewood Center PY 2007-2009: Exhibit G-I
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
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EXECUTED AGREEMENTX���� �Business Associate acknowledges and agrees that all Protected Ilealth Information that is created
or received by Covered Entity and disclosed or made available in any form, including paper
record. oral communication, audio recording, and electronic display by Covered Entity or its
operating units to Business Associate or is created or received by Business Associate on Covered
Entity's behalf shall he subject to this Agreement.
II. CONFIDENTIALITY REQUIREMENTS
A Business Associate agrees:
i)
to use or disclose any Protected Health Information solely: 1) for meeting its
obligations as set forth in any agreements between the Parties evidencing their
business relationship or 2) as required by applicable law, rule or regulation, or by
accrediting or credentialing organization to whom Covered Entity is required to
disclose such information or as otherwise permitted under this Agreement, the
Arrangement Agreement if consistent with this Agreement and the HIPAA
Privacy Rule), or the IIIPAA Privacy Rule, and 3) as would be permitted by the
HIPAA Privacy Rule if such use or disclosure were made by Covered Entity;
at termination of this Agreement, the Arrangement Agreement or any similar
documentation of the business relationship of the Parties), or upon request of
Covered Entity, whichever occurs first, if feasible, Business Associate will return
or destroy all Protected Health Information received from or created or received by
Business Associate on behalf of Covered Entity that Business Associate still
maintains in any form and retain no copies of such information, or if such return or
destruction is not feasible, Business Associate will extend the protections of this
Agreement to the information and limit further uses and disclosures to those
purposes that make the return or destruction of the information not feasible; and
iii) to ensure that its agents, including a subcontractor, to whom it provides Protected
Health Information received from or created by Business Associate on behalf of
Covered Entity, agrees to the same restrictions and conditions that apply to
Business Associate with respect to such information. In addition, Business
Associate agrees to take reasonable steps to ensure that its employees' actions or
omissions do not cause Business Associate to breach the terms of this Agreement.
B Notwithstanding the prohibitions set forth in this Agreement, Business Associate may use
and disclose Protected Health Information as follows:
i) if necessary, for the proper management and administration of Business Associate
or to carry out the legal responsibilities of Business Associate, provided that as to
any such disclosure, the following requirements are met:
a) the disclosure is required by law; or
b) Business Associate obtains reasonable assurances from the person to whom
the information is disclosed that it will be held confidentially and used or
further disclosed only as required by law or for the purpose for which it was
disclosed to the person, and the person notifies Business Associate of any
instances of which it is aware in which the confidentiality of the
information has been breached;
Edgewood Center FY 2007-2009: Exhibit G-2
BIB]
39655-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO21330-U03
FO62956-U03
FO64075-U03
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AS69434-U03
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AI70367-U03
DO71621-U03
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EXECUTED AGREEMENTX���� �ii) for data aggregation services, ifto be provided by Business Associate for the health
care operations of Covered Entity pursuant to any agreements between the Parties
evidencing their business relationship. For purposes of this Agreement, data
aggregation services means the combining of Protected Health Information by
Business Associate with the protected health information received by Business
Associate in its capacity as a business associate of another covered entity, to permit
data analyses that relate to the health care operations of the respective covered
entities.
C Business Associate will implement appropriate safeguards to prevent use or disclosure of
Protected Health Information other than as permitted in this Agreement. The Secretary of
Health and Human Services shall have the right to audit Business Associate's records and
practices related to use and disclosure of Protected Health Information to ensure Covered
Entity's compliance with the terms of the HIPAA Privacy Rule. Business Associate shall
report to Covered Entity any use or disclosure of Protected Health Information which is
not in compliance with the terms of this Agreement of which it becomes aware. In
addition, Business Associate agrees to mitigate, to the extent practicable, any harmful
effect that is known to Business Associate of a use or disclosure of Protected Health
Information by Business Associate in violation of the requirements of this Agreement.
III. AVAILABILITY OF PHI
Business Associate agrees to make available Protected Health Information to the extent and in the
manner required by Section 164.524 of the HIPAA Privacy Rule. Business Associate agrees to make
Protected Health Information available for amendment and incorporate any amendments to Protected
Health Information in accordance with the requirements of Section 164.526 of the HIPAA Privacy
Rule. In addition, Business Associate agrees to make Protected Health Information available for
purposes of accounting of disclosures, as required by Section 164.528 of the HIPAA Privacy Rule.
IV. TERMINATION
Notwithstanding anything in this Agreement to the contrary, Covered Entity shall have the right to
terminate this Agreement and the Arrangement Agreement immediately if Covered Entity determines
that Business Associate has violated any material term of this Agreement. If Covered Entity
reasonably believes that Business Associate will violate a material term of this Agreement and, where
practicable, Covered Entity gives written notice to Business Associate of such belief within a
reasonable time after forming such belief, and Business Associate fails to provide adequate written
assurances to Covered Entity that it will not breach the cited term of this Agreement within a
reasonable period of time given the specific circumstances, but in any event, before the threatened
breach is to occur, then Covered Entity shall have the right to terminate this Agreement and the
Arrangement Agreement immediately.
V. MISCELLANEOUS
Except as expressly stated herein or the HIPAA Privacy Rule, the parties to this Agreement do not
intend to create any rights in any third parties. The obligations of Business Associate under this Section
shall survive the expiration, termination, or cancellation of this Agreement, the Arrangement
Agreement and/or the business relationship of the parties, and shall continue to bind Business
Associate, its agents, employees, contractors, successors, and assigns as set forth herein.
This Agreement may be amended or modified only in a writing signed by the Parties. No Party may
assign its respective rights and obligations under this Agreement without the prior written consent of
Edgewood Center FY 2007-2009: Exhibit G-3
BIB]
39655-U01
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EXECUTED AGREEMENTX���� �the other Party. None of the provisions of this Agreement are intended to create, nor will they be
deemed to create any relationship between the Parties other than that of independent parties contracting
with each other solely for the purposes of' effecting the provisions of this Agreement and any other
agreements between the Parties evidencing their business relationship. This Agreement will be
governed by the laws of the State of California. No change. waiver or discharge of any liability or
obligation hereunder on any one or more occasions shall be deemed a waiver of performance of any
continuing or other obligation, or shall prohibit enforcement of any obligation, on any other occasion.
The parties agree that, in the event that any documentation of the arrangement pursuant to which
Business Associate provides services to Covered Entity contains provisions relating to the use or
disclosure of Protected Health Information which are more restrictive than the provisions of this
Agreement, the provisions of the more restrictive documentation will control. The provisions of this
Agreement are intended to establish the minimum requirements regarding Business Associate's use
and disclosure of Protected Health Information.
In the event that any provision of this Agreement is held by a court of competent jurisdiction to be
invalid or unenforceable, the remainder of the provisions of this Agreement will remain in full force
and effect. In addition, in the event a party believes in good faith that any provision of this Agreement
fails to comply with the then-current requirements of the HIPAA Privacy Rule, such party shall notify
the other party in writing. For a period of up to thirty days, the parties shall address in good faith such
concern and amend the terms of this Agreement, if necessary to bring it into compliance. If, after such
thirty-day period, the Agreement fails to comply with the IIIPAA Privacy Rule, then either party has
the right to terminate upon written notice to the other party.
IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year
written above.
COVERED ENTITY:
COUNTY OF MONTERE
BUSINESS ASSOCIATE:
EDGEWOOD CENTER FOR CHILDREN &
FAMILIES
Edgewood Center FY 2007-2009: Exhibit G-4
BIB]
39655-U01
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