COMPLETED BOARD ORDER"�|E� (�23
Before the Board of Supervisors in and for the
County of Monterey, State of California
Agreement No. A-11985
a. Approve and authorize the Director of Health to
sign a three fiscal year term Mental Health
Services Agreement July 1, 2011 to June 30,
2014) with Psynergy Programs, Inc. for provision
of mental health services for Monterey County
adult residents with severe psychiatric disabilities
in the amount of $272,757.44 for Fiscal Year FY)
2011-12, $272,757.44 for FY 2012-13, and
$272,757.44 for FY 2013-14 for a total Agreement
amount of $818,272.32; to replace Agreement A-
11379 which expires June 30, 2011; and
b. Authorize the Director of Health, to sign up to
three future amendments to this Agreement where
the amendments do not exceed 10% of the annual
amount and do not significantly change the scope
of work or result in an increase in County General
Fund Contribution
Upon motion of Supervisor Potter, seconded by Supervisor Salinas, and carried by those
members present, the Board hereby;
a. Approved and authorized the Director of Health to sign a three fiscal year term Mental
Health Services Agreement July 1, 2011 to June 30, 2014) with Psynergy Programs, Inc.
for provision of mental health services for Monterey County adult residents with severe
psychiatric disabilities in the amount of $272,757.44 for Fiscal Year FY) 2011-12,
$272,757.44 for FY 2012-13, and $272,757.44 for FY 2013-14 for a total Agreement
amount of $818,272.32; to replace Agreement A-11379 which expires June 30, 2011; and
b. Authorized the Director of Health, to sign up to three future amendments to this
Agreement where the amendments do not exceed 10% of the annual amount and do not
significantly change the scope of work or result in an increase in County General Fund
Contribution.
PASSED AND ADOPTED on this 17th day of May, 2011, by the following vote, to wit:
AYES: Supervisors Armenta, Calcagno, Salinas, Parker, and Potter
NOES: None
ABSENT: None
I, Gail T. Borkowski, 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 75 for the meeting on May 17, 2011.
Dated: May 17, 2011 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
Deputy
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COMPLETED BOARD ORDER"�|E� (�COUNTY OF MONTEREY
MENTAL HEALTH SERVICES AGREEMENT
Contract Number:
COUNTY Department Contract Representative:
Ray Bullick
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 PSYNERGY
PROGRAMS, INC. 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: provide community based living and normalizing experiences for adults with severe
psychiatric disabilities.
II. EXHIBITS
The following exhibits are attached and incorporated by reference as a part of this
Agreement:
EXHIBIT A: PROGRAM DESCRIPTION
EXHIBIT B: PAYMENT PROVISIONS includes Cost Reimbursement Invoice Form)
EXHIBIT C: CONFIDENTIALITY OF PATIENT INFORMATION
EXHIBIT D: ASSURANCE OF COMPLIANCE WITH SECTION 504 OF THE
REHABILITATION ACT OF 1973, AS AMENDED
Psynergy Programs, Inc.
FY 2011-12 thru FY 2013-14
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COMPLETED BOARD ORDER"�|E� (�EXHIBIT E: ASSURANCE OF COMPLIANCE WITH MONTEREY COUNTY
CULTURAL COMPETENCY POLICY
EXHIBIT F: BUSINESS ASSOCIATE AGREEMENT
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 July 1, 2011 and shall remain in effect
until June 30, 2014.
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:
1. 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
Psynergy Programs, Inc. 2
FY 2011-12 thru FY 2013-14
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COMPLETED BOARD ORDER"�|E� (�under this Agreement with regard to payment for services rendered prior to
termination or required to be rendered after termination as provided above;
and
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 Law. 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
Psynergy Programs, Inc. 3
FY 2011-12 thru FY 2013-14
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COMPLETED BOARD ORDER"�|E� (�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, 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 C 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
Psynergy Programs, Inc. 4
FY 2011-12 thru FY 2013-14
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INCREASE-U012
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COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�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.
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: 1) the name and address of the injured/deceased person; 2)
the time and location of the incident; 3) the names and addresses of
CONTRACTOR'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
Psynergy Programs, Inc. 5
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�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 Evidence of Coverage:
Prior to commencement of this Agreement, the CONTRACTOR shall provide a Certificate
of Insurance" certifying that coverage as required herein has been obtained. Individual
endorsements executed by the insurance carrier shall accompany the certificate. In addition
the CONTRACTOR upon request shall provide a certified copy of the policy or policies.
This verification of coverage shall be sent to the County Contracts/Purchasing Department,
unless otherwise directed. The CONTRACTOR shall not receive a Notice to Proceed"
with the work under this Agreement until all insurance has been obtained as required and
approved by the COUNTY. This approval of insurance shall neither relieve nor decrease the
liability of the CONTACTOR.
B. Qualifying Insurers:
All coverage's, except surety, shall be issued by companies which hold a current policy
holder's alphabetic and financial size category rating of not less than A- VII, according to
the current Best's Key Rating Guide or a company of equal financial stability that is
approved by the County's Purchasing Manager.
C. 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:
1 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).
2. 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).
3. 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).
Psynergy Programs, Inc. 6
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�4. Professional Liability Insurance, if required for the professional service being
provided, e.g., those persons authorized by a licensed to engage in business of
profession regulated by the California Business and Professional 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 years following the expiration or earlier termination of this
A reement.
Exemption/Modification Justification attached; subject to approval).
D. 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
complete 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.
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.
Psynergy Programs, Inc. 7
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�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 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 withhold any future payments for work not covered
under COUNTY insurance requirements, and/or 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 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 or part of
the overpayment by means of an offset against any payments 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
Psynergy Programs, Inc. 8
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E�
(�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 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).
Psynergy Programs, Inc. 9
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E�
(�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 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);
Psynergy Programs, Inc. 10
FY 2011-11 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
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ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E�
(�7. Unruh Civil Rights Act, Cal. Civil Code 51, et seq.
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.R. 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.
I 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
Psynergy Programs, Inc. 1 1
FY 2011-12 thru FY2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E�
(�culturally unique needs, and promote congruent skills, behaviors, attitudes, and
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 be 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 and provides the
opportunity for services 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
Psynergy Programs, Inc. 12
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�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
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. CONTRACTOR 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.
Psynergy Programs, Inc. 13
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�I Governing Law. This Agreement shall be governed by and interpreted under the
laws of the State of California.
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 CONTRACTOR
Wayne W. Clark Christopher Zubiate, MSW, ACSW
Behavioral Health Director Chief Executive Officer
1270 Natividad Road 18225 Hale Avenue
Salinas, CA 93906 Morgan Hill, CA. 95037
831) 755-4509 408) 465-8287
Psynergy Programs, Inc. 14
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
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2014)-U012
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PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
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TO-U012
AGREEMENT-U012
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AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
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ANNUAL-U012
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COUNTY-U012
GENERAL-U012
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CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�IN WITNESS WHEREOF, COUNTY and CONTRACTOR have executed this Agreement as of
the day and year written below.
COUNTY OF MONTEREY
By:
Date:
Contracts/Purchasing Officer
W By:
Department Head if applicable)
Date:
By:
Board of Supervisors if applicable)
Date:
Approved as to Form
By:
Date:
By:
Date: RISK MANAGE
Cou* Counsel
/Zl l/
CONTRACTOR
By:
Psynergy Programs, Inc.
Cgictm, s Business Name*
Signature ef9tiair, President, or Vice-
Presiden
N acne an Title
Date:
c c f C~`f' J n 17~ 1~ a
Name and Title
Date:
Signature of Secretary, Asst. Secretary, CFO,
Treasurer or Asst. Treasurer)*
C-fo
COUNTY OF MONTEREY
ApprovAfPWOVrg it i P(rOv4MOEM N ITY/
INSURANCE LAN UAGE
By: keg) zo 1; &
By. rsk ana ement
Date: Date:
9County Board of Supervisors' Agreement Number:
*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 together 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 who has authority to
execute this Agreement on behalf of the partnership. If CONTRACTOR is contracting in an individual capacity, the individual
shall set forth the name of the business, if any, and shall personally sign the Agreement.
Psynergy Programs, Inc. 15
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
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16480-U05
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A.-U07
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1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
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TO-U012
AGREEMENT-U012
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AMENDMENTS-U012
DO-U012
EXCEED-U012
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OF-U012
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ANNUAL-U012
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OR-U012
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IN-U012
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COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�EXHIBIT A:
PROGRAM DESCRIPTION
1. IDENTIFICATION OF PROVIDER
Psynergy Programs, Inc.
18225 Hale Avenue and 806 Elm Street and 14 Park Avenue
Morgan Hill, CA 95037 Greenfield, CA 93927 Greenfield, CA 92927
Name of Facility:
Type of Facility:
II. SERVICE LOCATION:
Address of Delivery Site:
Operation Schedule:
Target # of Beds Provided:
III. SERVICE LOCATION:
Address of Delivery Site:
Operation Schedule:
Target # of Beds Provided:
IV. SERVICE LOCATIONS:
Cielo Vista
Address of Delivery Site:
Nueva Vista
Address of Delivery Site:
Psynergy Programs, Inc.
24-hour Adult Residential Care Facility
ADULT RESIDENTIAL CARE CIELO VISTA)
806 Elm Street, Greenfield, CA 93927
Provides residents twenty-four 24) hour care, seven
7) days a week.
Ten 10)
ADULT RESIDENTIAL INTENSIVE & DUAL
DIAGNOSIS LEVEL OF CARE NUEVA VISTA)
18225 Hale Avenue, Morgan Hill, CA 95037
Provides residents twenty-four 24) hour care, seven
7) days a week.
One 1)
CASE MANAGEMENT, MENTAL HEALTH SERVICES,
AND MEDICATION SUPPORT
14 Park Avenue, Greenfield, CA 93927
18225 Hale Avenue, Morgan Hill, CA 95037
Operation Schedule: Monday thru Friday, 8am to 5pm
Psynergy Programs, Inc.
FY 2011-12 thru FY 2013-14
16
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
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SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
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DO-U012
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OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�V. PROGRAM DESCRIPTION
The program will provide primary intervention services as certified and needed, to Medi-Cal
eligible clients to reduce psychiatric hospital stays, reduce Institute for Mental Disease
IMD) placements, and to ensure access to all services necessary to live in the least
restrictive community setting possible. The residential program assists residents with
medication and medical appointments as well as with a wide variety of daily living skills.
Residential care includes weekly residential council meetings, house meetings, staff
meetings, money management and structured activities. The facility is designed to enable
clients with severe mental illness to live in an unlocked setting that is designed to provide a
maximum level of supervision and structured mental health support services and treatment
programs that maximize functioning of the participants. Services provided by this facility
include:
A. Assisting clients in decreasing symptoms or behaviors that can result in utilization
of higher levels of care by providing a level of supervision and intensive
interaction that is consistent with the clients' needs as outlined in the client's
individualized care plan.
B. Providing Mental Health services which include, but are not limited to,
assessment, evaluation, mental health services, plan development, case
management and collateral contacts.
C. Provide a multi-disciplinary team which may include licensed social workers,
nurses, mental health coordinators, and mental health aides to offer
wellness/recovery oriented support services.
D. Mental Health Services to provide support while clients work toward individual
wellness/recovery goals and programs.
E. Self care development to become more responsible in taking medications as
prescribed by the treating physician. The facility will encourage the client to use
treatment services and develop continuing support systems.
VI. PROGRAM GOALS AND OBJECTIVES
The purpose of the Psynergy Programs, Inc. is to provide wellness/recovery oriented
integrated mental health services within a continuum of supervised and supportive
residential settings. Services are provided which focus on assisting clients to live in the least
restrictive level of care and to enhance ones quality of life. The program may utilize a
variety of tools that will assist individuals with Daily Living Skills, and will provide linkage
to employment, education and community integration.
Psynergy Programs, Inc. 17
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
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THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�In order to receive payment for the care of mentally ill clients who have been assessed by
the MCBHD, a residential care facility must be licensed by the State of California
Community Care Licensing. CONTRACTOR must provide the following services:
A. Participate with the MCBHD Case Coordinator, the client and others in the
development of an individualized needs assessment and care plan for each client
within the first thirty 30) days of placement and retain a signed copy of the
documented results in a client chart that is retained in the facility.
B. Work cooperatively with the staff and programs of the MCBHD to accomplish
each client's individualized treatment plan and will document significant ongoing
problems and/or progress.
C. Will attempt to reasonably manage those crisis situations so as to avoid
psychiatric hospitalization. The goal will be to reduce the client's need for acute
psychiatric services.
D. Will work cooperatively with and provide information to the MCBHD Case
Coordinator to facilitate the evaluation of those clients who have been discharged
due to medical necessity or to a facility providing a more acute level of care that are
deemed to require re-admission.
E. Will transport or arrange transportation for the client to, and/or will monitor,
visits for psychiatric treatment at MCBHD will attend scheduled medication
evaluation and planning appointments as well as work with MCBHD staff when
medications are changed.
F. Will store and assist residents with self-administered medications in an approved and
effective manner, following State guidelines and maintain an updated record of the
daily monitoring of medication, recording changes in dosages and types.
G. Arrange transportation for the client to attend services and programs as outlined in
each client's individual care plan as well as educate and encourage the client to use
the services of the MCBHD Adult Services Programs and other specialized services
identified in each client's individualized care plan. CONTRACTOR will cooperate
with the Case Coordinator and the staff of specialized services identified in each
client's individualized care plan.
H. Post, on a monthly basis, information about programs, groups and activities that are
provided by community agencies and activities that the facility will provide for
clients in the general and specialized needs and interests of the client
1. CONTRACTOR will encourage the client to develop regular daily activities or
routines and to teach self care such as maintaining an acceptable level of personal
hygiene and grooming, as well as physical and dental health. CONTRACTOR
will provide adequate supplies and materials to accomplish this goal.
Psynergy Programs, Inc. 18
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
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AMENDMENTS-U012
DO-U012
EXCEED-U012
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OF-U012
THE-U012
ANNUAL-U012
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SIGNIFICANTLY-U012
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OF-U012
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OR-U012
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IN-U012
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INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�J. CONTRACTOR will ensure that the client receives an annual medical evaluation
and will record the date and results of all medical and dental visits in the client's
folder. CONTRACT will monitor to ensure that the client follows up on any
established plan to care for identified medical and dental problems and will record
these actions in the client's folder.
K. The facility will provide services in a manner that reflects an understanding of the
specialized needs of the seriously mentally ill.
L. CONTRACTOR will ensure that all administrative staff and staff responsible for
the supervision of clients receive a minimum of twenty 20) hours of training.
The training schedule will be shared with MCBHD. The facility will document
and maintain a record of each staff person's attendance at approved training
programs.
M. CONTRACTOR will allow the staff of the MCBHD access to the facility, to the
extent authorized by law.
N. CONTRACTOR will work with the staff of the MCBHD to conduct client
assessments, monitor care, provide consultation, conduct record reviews and
evaluate the results of the services.
VII. ADMISSION CRITERIA
The CONTRACTOR shall admit adult clients referred by the COUNTY with DSM IV
serious mental illness Diagnostic Categories including but not limited to:
Schizophrenia
bipolar disorders
schizoaffective disorders
mental health disorders that substantially interfere with the person's ability to
carry out primary aspects of daily living in the community
VIII. CERTIFICATION/TYPE OF FACILITY LICENSE
The facility must show evidence of currently meeting all licensing requirements for
Community Care facilities authorized by the State Department of Social Services to provide
care and supervision to mentally disordered adults, as defined in Section 1502 of the Health
and Safety Code. The facility must retain ongoing licensure and be in full compliance with
licensing regulations. Any complaints received by the CONTRACTOR pertaining to
services performed pursuant to this Agreement must be referred to MCBHD.
Psynergy Programs, Inc. 19
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
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FUTURE-U012
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TO-U012
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IN-U012
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IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�IX. PROGRESS & OUTCOMES REPORTING REQUIREMENTS
Contractor will meet regularly with the designated Adult Behavioral Health Services
Manager to monitor progress on client and project outcomes. Contractor will be required to
report outcomes data regularly to MCBHD according to the requirements as set forth by the
State Department of Mental Health. MCBHD will provide to the Contractor the reporting
requirements, forms and instructions as required by DMH and the MCBHD which may
include the following:
Quarterly summary of treatment or progress
Quarterly psychiatric summaries
X. DESIGNATED CONTRACT MONITOR
Robert Jackson, MFT
1270 Natividad Road
Salinas, CA 93906
831) 755-6367
jacksonRL@co.monterey.ca.us
Psynergy Programs, Inc. 20
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�EXHIBIT B:
PAYMENT PROVISIONS
1. PAYMENT TYPES
Provisional Rate and Negotiated Rate.
II. PAYMENT RATE AMOUNTS
A. PROVISIONAL RATE: STATE MAXIMUM REIMBURSEMENT SMA)
Case Management, Mental Health Services, and Medication Support shall be paid at the
State Maximum Reimbursement SMA) rate, which is provisional and subject to all the cost
report conditions as set forth in this Exhibit B.
Service Description
Mode of
Service Service
Function
Code Estimated FY
2011-12 Units
of Service
SMA
Rate Estimated
FY 2011-12
Amount
Case Management 15 01- 09 10,560 $2.02 $21,331.20
Mental Health Services 15 40 29,304 $2.61 $76,483.44
Medication Support 15 60-69 10,560 $4.82 $50,899.20
Crisis Intervention 15 70-78 720 $3.88 $2,793.60
Total Services Billed to M edi-Cal: $151,507.44
1. The following program services will be paid in arrears, not to exceed the SMA rates for
a total maximum of $151,507.44 for FY 2011-12:
2. The following program services will be paid in arrears, not to exceed the SMA rates for
Service Description
Mode of
Service Service
Function
Code Estimated FY
2012-13 Units
of Service
SMA
Rate Estimated
FY 2012-13
Amount
Case Management 15 01- 09 10,560 $2.02 $21,331.20
Mental Health Services 15 40 29,304 $2.61 $76,483.44
Medication Support 15 60-69 10,560 $4.82 $50,899.20
Crisis Intervention 15 70-78 720 $3.88 $2,793.60
Total Services Billed to Medi-Cal: $151,507.44
a total maximum of $151,507.44 for FY 2012-13:
3. The following program services will be paid in arrears, not to exceed the SMA rates for
Service Description
Mode of
Service Service
Function
Code Estimated FY
2013-14 Units
of Service
SMA
Rate Estimated
FY 2013-14
Amount
Case Management 15 01- 09 10,560 $2.02 $21,331.20
Mental Health Services 15 40 29,304 $2.61 $76,483.44
Medication Support 15 60-69 10,560 $4.82 $50,899.20
Crisis Intervention 15 70-78 720 $3.88 $2,793.60
Total Services Billed to Medi-Cal: $151,507.44
a total maximum of $151,507.44 for FY 2013-14:
Psynergy Programs, Inc. 21
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
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TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
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WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�B. NEGOTIATED RATE: BOARD AND CARE
The following program service will be paid for actual client usage in arrears on a
monthly basis for a maximum total amount per fiscal year period as follows:
Total
Bed Est. # Estimated
Rate/ of Est. FY 2011- FY 2012- FY 2013- Bed/Day
Facility Service PC Day Clients Units 12 Total 13 Total 14 Total Cost
Board &
Cielo Vista Care
Basic 193 $31 10 3650 $113,150 $113,150 $113,150 $339,450
Board &
Nueva Vista Care
Intensive 194 $90 1 90 $8,100 $8,100 $8,100 $24,300
Maximum County Obli gation $121,250 $121,250 $121,250 $363,750
III. SCHEDULE OF RESIDENTAL RATES daily patch rate)
Intensive Residential Services Nueva Vista):
1St 90 days intensive $90 per client/day
Basic Residential Services Nueva Vista):
91St day and beyond $60 per client/day
Specialized Residential Services Nueva Vista):
Co-morbid medical $90 per client/day
Specialized Residential Services Nueva Vista):
Dually diagnosed $120 per client/day
Basic Residential Services Cielo Vista):
91St day and beyond is applicable when clients who are
transferred from Nueva Vista to Cielo Vista once the
90-day intensive care level has been completed.
91St day and beyond
Bed Hold Rate Nueva Vista): 5 day max
Bed Hold Rate Cielo Vista) 5 day max
$31 per client/day
$60 per client/day
$31 per client/day
Psynergy Programs, Inc. 22
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�IV. 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's
Behavioral Health Bureau. Specifically, CONTRACTOR shall submit its claims on
a form acceptable to COUNTY specified herein, so as to reach the Behavioral Health
Bureau 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 CONTRACTOR shall submit all claims for reimbursement under this Agreement
within thirty 30) days after the ending date of this Agreement. All claims not
submitted after thirty 30) days following the ending date of the Agreement will not
be subject to reimbursement by the COUNTY. Any obligations incurred" included
in claims for reimbursements and paid by the COUNTY which remain unpaid by the
CONTRACTOR after thirty 30) days following the ending date of the agreement
will be disallowed under audit by the COUNTY.
CONTRACTOR will submit a monthly claim for services rendered to:
Monterey County Health Department
Behavioral Health Bureau
1270 Natividad Road
Salinas, Ca. 93906
Attn: Accounts Payable
C 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.
D 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 then submit such certified claim to the COUNTY Auditor. The
County Auditor-Controller shall pay the amount certified within thirty 30) days of
receiving the certified invoice.
E 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.
Psynergy Programs, Inc. 23
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�V. MAXIMUM OBLIGATION OF COUNTY:
Subject to the limitations set forth herein, COUNTY shall pay to CONTRACTOR during
the term of this Agreement a maximum amount of $818,272.32 for services rendered under
this Agreement.
A. MAXIMUM ANNUAL LIABILITY:
FISCAL YEAR MAXIMUM LIABILITY AMOUNT
July 1, 2011 to June 30, 2012 $272,757.44
July 1, 2012 to June 30, 2013 $272,757.44
July 1, 2013 to June 30, 2014 $272,757.44
TOTAL MAXIMUM LIABILITY $818,272.32
B. 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.
C. If for any reason this Agreement is canceled, COUNTY'S maximum liability shall
be the total utilization to the date of cancellation not to exceed the maximum amount
listed above.
Psynergy Programs, Inc. 24
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
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OF-U012
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COMPLETED BOARD ORDER"�|E� (�This page is intentionally electronically blank to accommodate the
Cost Reimbursement Invoice Form under separate format.
Psynergy Programs, Inc. 25
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
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AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
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5/25/2011-U04
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16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
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OF-U07
HEALTH-U07
TO-U07
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A-U07
THREE-U07
FISCAL-U07
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TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
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5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
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PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
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MONTEREY-U012
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OF-U012
$272,757.44-U012
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2011-12,-U012
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2012-13,-U012
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FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
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OF-U012
HEALTH-U012
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TO-U012
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IN-U012
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GENERAL-U012
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COMPLETED BOARD ORDER"�|E� (�Behavioral Health Cost Reimbursement Invoice
1
W0. IPsynergy Programs Inc. Mental Health Services
ice' 1
gly-N M l
MUM
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4yzb+WA{:4S"++O4'+ 3I
18225 Hale Avenue
Morgan Hill, CA 95037
408-465-8285
408-465-8281
FY 201 1-12 thru FY 2012-13
K ng rlMental Health Services
I
Invoice Number
County PO No.,:,
Invoice Period,
Final Invoice Check if Yes)
1
1
1
BH Control Number
ervice Description
Mode of
Service
FC
Procedure
Code Rate of
Reimbursement
per Unit
Total
Contracted UOS
UOS Delivered
this Period Total UOS
Delivered as of
Last Period
UOS Delivered
to Date % Delivered
to Date of
Contracted
UOS
Remaining
Deliverables
%of Remaining
Deliverables
Total Contract
Amount
Dollar Amount
Requested this
Period
DollarAmount
Requested to Date
Dollar Amount
Remaining
% Remain of
Total contract
Amount
Board & Care Cielo) 5 193 31.001.
Board & Care Intensive Nueva) 5 194 90.00':
Board & Care Intensive Nueva) 5 199 120.00'
Case Management 15 01 301 2.02 #DIV10! #DIV/01 #DIV/O!
Medication Support 15 60 361 4.82 #DIV/01 #DIV101 #DIV/01
Mental Health Services 15 2.61 #DIV/01 #DIV/01 #DIV10!
Mental Health Services 15 45 381 2.61
Collateral 15 10 311 2.61
TOTALS #DIV10!
I certify that the information provided above is. to the best of my knowledge, complete and accurate; the amount requested for reimbursement is
in accordance with the contract approved for services provided under the provision of that contract. Full Justification and backup records for those
claims are maintained in our office at the address indicated.
Signature:
Title:
Send to: Behavioral Health Claims Section
1270 Natividad Road
Salinas, CA 93906
Medi-Cal Units of Service Invoice
Date:
Telephone:
Behavioral Health Authorization for Payment
Authorized Signatory
Date
oau rmmrve: r
55 PM
BIB]
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2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
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THE-U012
DIRECTOR-U012
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HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
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COMPLETED BOARD ORDER"�|E� (�EXHIBIT C:
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.
Psynergy Programs, Inc.
Business Name of Contractor
Signs of thorized Representative
x7-
Date
Name of Authorized Representative printed)
Chief Executive Officer
Title of Authorized Representative
Psynergy Programs, Inc. 26
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
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LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
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16480-U05
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YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
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ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
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COMPLETED BOARD ORDER"�|E� (�EXHIBIT D:
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.
B.
V\j
Employs fewer than fifteen persons;
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.
Contractor's Business Name Psynergy Programs, Inc.
Name of Contractor's Designee Christopher Zubiate, MSW, ACSW
Title of Designee Chief Executive Officer
Street: 18225 Hale Avenue
City: Morgan Hill State: CA Zip: 95037
IRS Employer Identification Number 74-3 1 3 1 675
I certify that the above information is complete and correct to the best of my knowledge and belief.
Date
Psynergy Programs, Inc. 27
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
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5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
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THE-U012
AMOUNT-U012
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$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
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DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
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COMPLETED BOARD ORDER"�|E� (�EXHIBIT E:
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/families and know about and respect
cultural and ethnic differences. They adapt their skills to meet each individual's/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, community defined, 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 in access to, and retention in, 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 33 1/3 %).
Developing recruitment, hiring, and retention plans that are reflective of the population focus,
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.
Psynergy Programs, Inc. 28
FY2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
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INC.-U012
PROVISION-U012
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ADULT-U012
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SEVERE-U012
PSYCHIATRIC-U012
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THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (� Have services available in the evening and on weekends to ensure maximum accessibility.
Offer services in Spanish and other necessary languages such as Tagalog, Vietnamese) for at
least 70% of all services.
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 DMH 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 be developed and implemented. Cultural Competence must be supported at all levels of the
system.
Framework for Eliminating Cultural, Linguistic, Racial and Ethnic Behavioral Health 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 Health Department Behavioral Health's Cultural Competency Policy as outlined
above), and will:
1. Develop organizational capacity to provide services in a culturally and linguistically competent
manner. This may include: hiring staff with the linguistic capabilities needed to meet the
diverse language needs in Monterey County for example, Spanish, Tagalog, Vietnamese,
American Sign Language ASL); 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, welcoming 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.
Psynergy Programs, Inc. 29
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
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SIGN-U07
A-U07
THREE-U07
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2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
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HEALTH-U012
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ADULT-U012
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SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
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COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� (�3. Provide a services delivery 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 consumers/families; staff that is knowledgeable of cultural
and ethnic differences and needs, and is able and willing to respond an appropriate and
respectful manner.
4. Support the county's goal to reduce disparities to care by increasing access and retention while
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 underserved
communities, in the advisory/governance body or committee for development of service
delivery, planning and evaluation County Goal: 33 1/3%).
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 Health Department Behavioral Health Director
or designee to monitor progress and outcomes of the project.
8. Ensure that 100% of staff, over a 3 year period, participate in cultural competency training
including, but not limited to, those 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.
Psynergy Programs, Inc.
Contractor Organization Name)
G 16h
I
X4~~ A AJ
Name of Authorized Representative printed)
Chief Executive Officer
Date
Psynergy Programs, Inc.
FY 2011-12 thru FY 2013-14
Title of Authorized Representative
30
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
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HEALTH-U07
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AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
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SERVICES-U012
MONTEREY-U012
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SEVERE-U012
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THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� !(�EXHIBIT F
BUSINESS ASSOCIATE AGREEMENT
This Agreement, hereinafter referred to as Agreement", is made effective July 1, 2011 by and
between the County of Monterey, a political subdivision of the State of California, on behalf of the Health
Department, hereinafter referred to as Covered Entity", and PSYNERGY PROGRAMS, INC.,
hereinafter referred to as Business Associate", individually, a Party" and collectively, the Parties").
WITNESSETH:
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 United States Congress has enacted the American Recovery and
Reinvestment Act of 2009 ARRA"), which amends HIPAA and the HIPAA Privacy Rule; and
WHEREAS, the State of California has enacted statutes designed to safeguard patient privacy
including, without limitation, the Confidentiality of Medical Information Act CMIA"), California Civil Code
56 et seq., Senate Bill 541, enacted September 30, 2008, and Assembly Bill 211, enacted September 30, 2008;
and
WHEREAS, the parties acknowledge that California law may include provisions more stringent and
more protective of the confidentiality of health information than the provisions of HIPAA; and
WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business
Associate will provide certain services to Covered Entity, hereby referred to as the Service Agreement" and,
pursuant to such arrangement, Business Associate may be considered a business associate" of Covered Entity
as defined in the HIPAA Privacy Rule and under California law; 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 Service Agreement,
compliance with the HIPAA Privacy Rule, as amended by ARRA, compliance with California law, 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, as
amended by ARRA, and California law 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. In the
event of an inconsistency between the provisions of this Agreement and mandatory provisions of CMIA or other
California law, California law shall control. Where provisions of this Agreement are different than those
Psynergy Programs, Inc. 31
FY 2011-I2 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� "(�mandated in the HIPAA Privacy Rule and California law, but nonetheless are permitted by the HIPAA Privacy
Rule and California law, 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.
Business Associate acknowledges and agrees that all Protected Health 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 be subject to this Agreement.
II. CONFIDENTIALITY REQUIREMENTS
a) Business Associate agrees:
i) to access, 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 Service Agreement if consistent with this Agreement the HIPAA Privacy Rule, and
California law), the HIPAA Privacy Rule, or California law and 3) as would be permitted by the
HIPAA Privacy Rule and California law if such use or disclosure were made by Covered Entity;
ii) at termination of this Agreement, the Service 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 access, 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 accessed, 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, within five calendar days of discovering
said breach of confidentiality;
ii) for data aggregation services, if to be provided by Business Associate for the health
care operations of Covered Entity pursuant to any agreements between the Parties evidencing their
Psynergy Programs, Inc. 32
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� #(�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 access to, use of, 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
access, use, or disclosure of Protected Health Information which is not in compliance with the terms of
this Agreement, the HIPAA Privacy Rule, as amended by ARRA, or under California law, of which it
becomes aware within five calendar days of discovering such improper access, use, or disclosure. In
addition, Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use, disclosure, or access of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
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 Service 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
Service Agreement immediately, and seek injunctive and/or declaratory relief in a court of law having
jurisdiction over Business Associate.
V.
MISCELLANEOUS
Except as expressly stated herein, in the HIPAA Privacy Rule, or under California law, 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 Service 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
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
Psynergy Programs, Inc. 33
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
FUTURE-U012
AMENDMENTS-U012
TO-U012
AGREEMENT-U012
THE-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
10%-U012
OF-U012
THE-U012
ANNUAL-U012
AMOUNT-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK-U012
OR-U012
RESULT-U012
IN-U012
AN-U012
INCREASE-U012
IN-U012
COUNTY-U012
GENERAL-U012
FUND-U012
CONTRIBUTION.-U012
COMPLETED BOARD ORDER"�|E� $(�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 parties, 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 or California law, such
party shall notify the other party in writing. For a period of up to thirty days, the parties shall attempt in
good faith to address such concern and amend the terms of this Agreement, if necessary to bring it into
compliance. If, at the conclusion of such thirty-day period, a party believes in good faith that the
Agreement still fails to comply with the HIPAA Privacy Rule or California law, then either party has
the right to terminate this Agreement and the Service Agreement upon written notice to the other party.
Neither party may terminate this Agreement without simultaneously terminating the Service
Agreement, unless the parties mutually agree in writing to modify this Agreement or immediately
replace it with a new Business Associate Agreement that fully complies with the HIPAA Privacy Rule
and California law.
above.
IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written
COVERED ENTITY: BUSINESS ASSOCIATE:
COUNTY OF MONTEREY PSYNERGY PROGRAMS, INC.
Date:
Title: Director of Health Title: Chief Executive Officer
By: By:
Date:` Z/
Psynergy Programs, Inc. 34
FY 2011-12 thru FY 2013-14
BIB]
40723-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99754-U03
AS99780-U03
AS99782-U03
AI101729-U03
DO102581-U03
C1-U03
GENERAL-U03
DOCUMENTS-U03
5/25/2011-U04
BORENM-U04
16480-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
SIGN-U07
A-U07
THREE-U07
FISCAL-U07
YEAR-U07
TERM-U07
MENTAL-U07
HEALTH-U07
SERVICES-U07
AGREEMENT-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
5/4/2011-U011
JULY-U012
1,-U012
2011-U012
TO-U012
JUNE-U012
30,-U012
2014)-U012
PSYNERGY-U012
PROGRAMS,-U012
INC.-U012
PROVISION-U012
OF-U012
MENTAL-U012
HEALTH-U012
SERVICES-U012
MONTEREY-U012
COUNTY-U012
ADULT-U012
RESIDENTS-U012
SEVERE-U012
PSYCHIATRIC-U012
DISABILITIES-U012
IN-U012
THE-U012
AMOUNT-U012
OF-U012
$272,757.44-U012
FISCAL-U012
YEAR-U012
FY)-U012
2011-12,-U012
$272,757.44-U012
FY-U012
2012-13,-U012
$272,757.44-U012
FY-U012
2013-14-U012
A-U012
TOTAL-U012
AGREEMENT-U012
AMOUNT-U012
OF-U012
$818,272.32;-U012
TO-U012
REPLACE-U012
AGREEMENT-U012
A-11379-U012
EXPIRES-U012
JUNE-U012
30,-U012
2011;-U012
B. AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
HEALTH-U012
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COMPLETED BOARD ORDER"�|E� %(� NOTEXTPAGE
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COMPLETED BOARD ORDER"�|E� &(�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: May 17, 2011 AGENDA NO.: Consent 23
SUBJECT: a. Approve and authorize the Director of Health to sign a three fiscal year term
Mental Health Services Agreement July 1, 2011 to June 30, 2014) with
Psynergy Programs, Inc. for provision of mental health services for Monterey
County adult residents with severe psychiatric disabilities in the amount of
$272,757.44 for Fiscal Year FY) 2011-12, $272,757.44 for FY 2012-13, and
$272,757.44 for FY 2013-14 for a total Agreement amount of $818,272.32; to
replace Agreement A-11379 which expires June 30, 2011; and
b. Authorize the Director of Health, to sign up to three future amendments to this
Agreement where the amendments do not exceed 10% of the annual amount
and do not significantly change the scope of work or result in an increase in
County General Fund Contribution.
DEPARTMENT: Health Behavioral Health Bureau
RECOMMENDATION
It is recommended that the Board of Supervisors:
a. Approve and authorize the Director of Health to sign a three fiscal year term Mental Health
Services Agreement July 1, 2011 to June 30, 2014) with Psynergy Programs, Inc. for
provision of mental health services for Monterey County adult residents with severe
psychiatric disabilities in the amount of $272,757.44 for Fiscal Year FY) 2011-12,
$272,757.44 for FY 2012-13, and $272,757.44 for FY 2013-14 for a total Agreement amount
of $818,272.32; to replace Agreement A-11379 which expires June 30, 2011; and
b. Authorize the Director of Health, to sign up to three future amendments to this Agreement
where the amendments do not exceed 10% of the annual amount and do not significantly
change the scope of work or result in an increase in County General Fund Contribution.
SUMMARY/DISCUSSION
Psynergy Programs, Inc. operates two 2) licensed residential care facilities: 1) Cielo Vista,
located in the City of Greenfield, which provides the maximum levels of care to assist clients
who are at risk of being admitted to a facility requiring a higher level of care, and 2) Nueva
Vista, located in the City of Morgan Hill, which provides intensive levels of care for clients
recently discharged from locked skilled facilities. The Psynergy Programs, Inc. residential care
facilities provide normalizing experiences and supervision necessary for clients with serious and
persistent mental illnesses.
The approval of this Agreement will provide the necessary resources and increase the options for
clients to be placed in a facility that best suits their needs and to live in the least restrictive
community setting as possible. This Agreement meets the requirements of the State Welfare and
Institutions Code 5600 Bronzan-McCorquodale Act), the California Code of Regulations Titles
9 and 22, and sustains the continuity of core services to seriously mentally ill clients of Monterey
County.
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COMPLETED BOARD ORDER"�|E� '(�This Agreement contains the County's standard 30-day no cause" provision Section IV, A) and
an additional defunding provision Section IV, D), which provides the County the ability to
amend or terminate the Agreement in the event of a reduction and/or termination of funding.
OTHER AGENCY INVOLVEMENT
The County Counsel, Auditor-Controller, and Risk Management have reviewed and approved
this Agreement as to legal form, fiscal provisions, and insurance requirements. This Agreement
is on file with Clerk of the Board.
FINANCING
This Agreement is funded by Realignment 73%) and Medi-Cal 27%) revenues. The funds for
this Agreement $272,757.44) are included in the Health Department's Behavioral Health
HEA002) Unit 8073 Fiscal Year 2011-12 Requested Budget. Approval of this action has no
impact on the County General Fund Contribution. The Agreement is brought before the Board
for approval with the understanding that realignment funding has been proposed for reduction in
the State's Budget May Revise. Should the funding be reduced or terminated, Behavioral Health
will implement a plan to transition consumers receiving services as required and/or terminate this
Agreement as needed.
Prepared by:
4 11
Gloria Rodriguez, 755-89916
Management Analyst
Lljkd
Date
Attachment: Agreement is on file with Clerk of the Board
Approved by:
Ray c
Director of Health
Date
cc: Charles J. McKee, County Counsel
Michael Miller, Auditor-Controller
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COMPLETED BOARD ORDER"�|E� ((� NOTEXTPAGE
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