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FY2021 09/16/2020 Kevin Madok, CPA %c`.. ,r Clerk of the Circuit Court&Comptroller—Monroe County, Florida DATE: September 21, 2020 TO: Janet Gunderson Senior Grant& Finance Analyst 1 FROM: Pamela G. Hanco4.C. SUBJECT': September 16t'BOCC Meeting Attached is an electronic copy of each of die following items for your handling: J4 Two agreements with Guidance/Care Center (G/CC) for: I) Substance Abuse Mental Health Services (SAMH) in die amount of $877,500.00. The County funding for SAMH services are die local match required by Florida Statute.; and, 2)Jail In-House Program in the amount of$151,273.00 for Fiscal Year 2021. Should you have any questions please feel free to contact me at (305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 AGREEMENT This Agreement is made and entered into this 16th day of September 2020, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profit corporation, hereinafter referred to as "PROVIDER." WHEREAS, the County participates in funding substance abuse and mental health (SAMH) Services within the County pursuant to Section 394.76(9)(a), Florida Statutes; and WHEREAS, the PROVIDER is a not-for-profit corporation that provides SAMH services within Monroe County; and WHEREAS, it is a legitimate public purpose to provide substance abuse and mental health services for individuals, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: FUNDING 1. GRANT OFFER TO THE PROVIDER. The County hereby agrees to provide local matching funds pursuant to Section 394,76(9)(a), Florida Statutes, and in accordance with the contracts between the PROVIDER and South Florida Behavioral Health Network (ME225-11-27, P- 04, and Amendments #1 and #2 to Contract No. P-04) attached here in (Attachment D) to provide substance abuse and mental health services; such funds shall be expended for alcohol, drug abuse, or mental health service programs and including services as the Designated Receiving Facility. 2. AMOUNT OF AGREEMENT. The County shall reimburse the PROVIDER for the local match portion of the PROVIDER'S expenditures as billed by the PROVIDER, in consideration of substantially and satisfactorily performing Substance Abuse and Mental Health services for clients qualifying for such services under applicable state and federal regulations and eligibility determination procedures, for alcohol, substance abuse and mental health treatment. This cost shall not exceed a total reimbursement of EIGHT HUNDRED SEVENTY-SEVEN THOUSAND, FIVE HUNDRED AND NO/100 DOLLARS ($877,500.00) In fiscal year 2021. 3. TERM. This Agreement shall commence on October 1, 2020, and terminate September 30, 2021, unless earlier terminated pursuant to other provisions herein. 4. PAYMENT. Payment will be paid monthly as hereinafter set forth. The monthly financial report is due in the office of the Clerk of the Board no later than the 15th day of the following month. After the Clerk of the Board pre-audits the certified report, the Board shall reimburse the Provider for its monthly expenses, The County shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Monroe County Code of Ordinances, State laws and regulations and Attachment A - Expense Reimbursement Requirements, Any funds expended in violation of this Agreement or in violation of appropriate Federal, State, and County requirements shall be refunded in full to the County. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a notarized certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within thirty days after the termination date of this contract shown in Article 3 above. However, the total of said monthly payments in the aggregate sum shall not exceed the total amount shown in Article 2, above, during the term of this agreement. Baker Act and SAMH Billing Summary Forms, certified monthly financial and service load reports will be made available to the Board to validate the delivery of services under this contract. To preserve Guidance Care Center-SAMH Contract FY21;page 1 client confidentiality required by law, copies of individual client bills and records shall not be available to the Board for reimbursement purposes but shall be made available only under controlled conditions to qualified auditors for audit purposes. S. AVAILABILITY OF FUNDS. The County reserves the right to withhold/reduce the funds to the Provider in the event that the Department of Children and Families eliminates/reduces the State contract funding provided for Services as set forth in the Prime Contract with the South Florida Behavior Health Network. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER, The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 6. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County, and shall be accounted for pursuant to statutory requirements. Funding under this agreement shall not be used to purchase capital assets. RECORDKEEPING 7. RECORDS AND RIGHT TO AUDIT. PROVIDER shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for four years following the termination of this Agreement. If an auditor employed by the County or Clerk determines that monies paid to PROVIDER pursuant to this Agreement were spent for purposes not authorized by this Agreement, the PROVIDER shall repay the monies together with interest calculated pursuant to Sec. 55.03, FS, running from the date the monies were paid to PROVIDER. Right to Audit. Availability of Records. The records of the parties to this Agreement relating to the Project, which shall include but not be limited to accounting records (hard copy, as well as computer readable data if it can be made available; general ledger entries detailing cash and if applicable trade discounts earned, insurance rebates and dividends; any other supporting evidence deemed necessary by County or the Monroe County Office of the Clerk of Court and Comptroller (hereinafter referred to as "County Clerk") to substantiate charges related to this agreement, and all other agreements, sources of information and matters that may in County's or the County Clerk's reasonable judgment have any bearing on or pertain to any matters, rights, duties or obligations under or covered by any contract document (all foregoing hereinafter referred to as "Records") shall be open to inspection and subject to audit and/or reproduction by County's representative and/or agents or the County Clerk. County or County Clerk may also conduct verifications such as, but not limited to, counting employees at the job site, witnessing the distribution of payroll, verifying payroll computations, overhead computations, observing vendor and supplier payments, miscellaneous allocations, special charges, verifying information and amounts through interviews and written confirmations with employees, Subcontractors, suppliers, and contractor's representatives. The County Clerk possesses the independent authority to conduct an audit of Records, assets, and activities relating to this Project. The right to audit provisions survives the termination of expiration of this Agreement. In addition, if PROVIDER is required to provide an audit as set forth in in Section 9(e) below, the audit shall be prepared by an independent certified public accountant (CPA) with a current license, in good standing with the Florida State Board of Accountancy. 8. PUBLIC ACCESS. The County and PROVIDER shall keep and maintain public records, as defined by Chapter 119, Florida Statutes that are required to perform the services required by the Guidance Care Center-SAMH Contract FY21;page 2 contract. Care Center upon request from the County's custodian of public records, provide the County with a copy of the requested public records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed that provided in Chapter 119, Florida Statutes, or as otherwise provided by law. County shall ensure that public records that are exempt or that are confidential and exempt from public record disclosure are not disclosed, except as authorized by law for the duration of the contract term and following completion of this Agreement if Care Center does not transfer the public records to the County. Upon completion of this Agreement, Care Center shall transfer to the County at no cost, all public records in possession of Care Center or; keep and maintain public records required by the County to perform the Agreement services in accordance with the public records retention schedule set forth by the Florida Department of State, Division of Library and Information Services. If Care Center transfers all public records to the County upon completion of the Agreement, Care Center will destroy any duplicate public records that are exempt or confidential and exempt. All records stored electronically must be provided to the County, upon request of the County's custodian of public records, in a formal that is compatible with the information technology systems of the County. The County may unilaterally terminate this Agreement if Care Center refuses to allow access to all public records made or maintained by Care Center in conjunction with this Agreement, unless the records are exempt from section 24(a) of Art. I of the State Constitution and Chapter 119, Florida Statutes. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the County the following (items A-L must be provided prior to the payment of any invoices): (a) IRS Letter of Determination and GUI ETA printout indicating current 501(c)(3) status; (b) Proof of registration with the Florida Department of Agriculture, as required by Florida Statute 496.405, and the Florida Department of State, as require by Florida Statute 617.01201, or proof of exemption from registration as per Florida Statute 496.406. (c) List of the Organization's Board of Directors of which there must be at least 5 and for each board member please indicate when elected to serve and the length of term of service; (d) Evidence of annual election of Officers and Directors/Directors At-Large or bi-annual election of Officers and Directors/Directors At-Large as applicable; (e) Unqualified audited financial statements from the most recent fiscal year for all organizations that expend $150,000 a year or more; if qualified, include a statement of deficiencies with corrective actions recommended/taken; audit shall be prepared by an independent certified public accountant (CPA) with a current license, in good standing with the Florida State Board of Accountancy. If the PROVIDER receives $100,000 or more in grant funding from the County: a. The CPA that prepares the audit must also be a member of the American Institute of Certified Public Accountants (AICPA); b. The CPA must maintain malpractice insurance covering the audit services provided and c. The County shall be considered an "intended recipient" of said audit. (f) Copy of a filed IRS Form 990 from most recent fiscal year with all attached schedules; (g) Organization's Corporate Bylaws, which must include the organization's mission, board and membership composition, and process for election of officers; (h) Organization's Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol-free workplace provisions, and equal employment opportunity provisions; (i) Specific description or list of services to be provided under this contract with this grant (see Attachment C, per contract ME225-10-27 and P-04); (j) All legally required licenses; (k) Any updates/amendments throughout the fiscal year to the South Florida Behavioral Network contract with Guidance/Care Center (ME225-11-27 and P-04); (1) Annual Performance Report describing services rendered during the most recently completed grant period (to be furnished within 30 days after the contract end date.) The performance report shall include statistical information regarding the types and frequencies of services provided, a profile of clients (including residency) and numbers served, and outcomes achieved; Guidance Care Center-SAMH Contract FY21;page 3 (m) Cooperation with County monitoring visits that the County may request during the contract year; and (n) Other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may request during the contract year. ® AUDIT. The Provider shall provide the County with an annual audit pursuant to Section 394.76(10), Florida Statutes, which separately reflects the funds received from the County and related expenditures of said funds during the 2019-2020 fiscal year. Provider audits shall be performed at no cost to the County and shall be provided to the County no later than January 1, 2021. RESPONSIBILITIES ® SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and provide the services outlined in Attachment C to residents of Monroe County, Florida. ® ATTORNEY'S FEES AND COSTS. The County and PROVIDER agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an award against the non- prevailing party, and shall include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. 13. BINDING EFFECT. The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the County and PROVIDER and their respective legal representatives, successors, and assigns. 14. CODE OF ETHICS. County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain Information. ® NO SOLICITATION/PAYMENT. The County and PROVIDER warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the PROVIDER agrees that the County shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. 16. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. COMPLIANCE ISSUES 7® COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation Guidance Care Center SAMH Contract FY21;page 4 of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. ® PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. ® NON-DISCRIMINATION. The COUNTY and PROVIDER agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. The COUNTY and PROVIDER agree to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VII of the Civil Rights Act of 1964 (PL 88-352), which prohibits discrimination in employment on the basis of race, color, religion, sex, and national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC §§ 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC § 794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC §§ 6101-6107), which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, §§ 523 and 527 (42 USC §§ 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC §§ 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC §§ 12101), as amended from time to time, relating to nondiscrimination in employment on the basis of disability; 10) Monroe County Code Chapter 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11) any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. AMENDMENTS, CHANGES, AND DISPUTES ® MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by both parties hereto. ® ADJUDICATION OF DISPUTES OR DISAGREEMENTS. County and PROVIDER agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. The PROVIDER and County staff shall try to resolve the claim or dispute with meet and confer sessions to be commenced within 30 days of the dispute or claim. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this agreement or by Florida law, Any claims or dispute that the parties cannot resolve shall be decided by the Circuit Court, 161h Judicial Circuit, Monroe County, Florida. 22. COOPERATION. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, County and PROVIDER agree to participate, to the extent reasonably required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. County and PROVIDER specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. Guidance Care Center-SAMH Contract FY21;page 5 ASSURANCES 23. COVENANT OF NO INTEREST. County and PROVIDER covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Agreement, and that only interest of each is to perform and receive benefits as recited in this Agreement. 24. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 25. NON-WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the County and the PROVIDER in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the County be required to contain any provision for waiver, 26. ATTESTATIONS. PROVIDER agrees to execute such documents as the County may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug- Free Workplace Statement. 27. AUTHORITY. Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law, INDEMNITY ISSUES 28. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims and causes of action for medical malpractice, medical negligence, bodily injury (including death), personal Injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 29. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the County, when performing their respective functions under this Agreement within the territorial limits of the County shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the County. 30. NO PERSONAL LIABILITY. No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. 31. LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to Guidance Care Center SAMH Contract FY21;page 6 the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County, except to the extent permitted by the Florida constitution, state statute, and case law. ® NON-RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely upon the terms of this Agreement to enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or program contemplated hereunder, and the County and the PROVIDER agree that neither the County nor the PROVIDER or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. GENERAL ® EXECUTION IN COUNTERPARTS. This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by signing any such counterpart. 34. ® Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: Grants Administrator and Monroe County Attorney 1100 Simonton Street PO Box 1026 Key West, FL 33040 Key West, FL 33041 For PROVIDER Craig Knierim, Deputy COO Guidance/Care Center 1205 Fourth Street Key West, FL 33040 Copies of all default notices, notices of breach, termination, legal claim, or indemnity copied to: WestCare Foundation, Inc. Attn: Executive Vice President 1711 Whitney Mesa Drive Henderson, Nevada 89014 ® GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND ® This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the County and PROVIDER agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. The County and PROVIDER agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. Guidance Care Center SAMH Contract FY21;page 7 36. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 37. SEVERABILITY. If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The County and PROVIDER agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. ® CLAIMS FOR FEDERAL OR STATE AID: PROVIDER and COUNTY agree that each shall be, and is, empowered to apply for, seek, and obtain federal and state funds to further the purpose of this Agreement. Any conditions imposed as a result of funding that effect the Scope of Services will be provided to each party. 39. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. [THIS SPACE INTENTIONALLY LEFT BLANK WITH SIGNATORY PAGE TO FOLLOW] Guidance Care Center-SAMH Contract FY21;page 8 IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of `° -''a `nd year first written above. Gil t,. BOARD OF COUNTY COMMISSIONERS . IN MADOK, CLERK OF MONROE CO NTY, ORIDA ®, • ! / By �Y�ir.^'i� /� As Dep ty Clerk ayor Irman Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profitor corporation /� ,,1-44 �i , (Federal ID No.✓ —�4�83�'T ) �//�'��7VI witless (�f/!/L -" (Jy/ By Witness Director Executed Pursuant to Resolution WCGCC 2020-02 MONROE COUNTY ATTORNEY nL}Lt 4fluf i` ARROW➢aia AS STINELINRERT.6.VROEY ASSIOREAMCOjMrI'�]TyPNEY AlF 81�O�ILLUU •T 3 2 0 2 m - a 0r - -n N Co fry '9 7S1 MC m o N Jr.' a, O Guidance Cars Center-SAMH Contract FY2ry page 9 ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service and Community-Based Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from the Monroe County Code of Ordinances and State laws and regulations. A cover letter (see Attachment B) summarizing the major line items on the reimbursable expense request needs to also contain the following notarized certified statement: "I certify that the above checks have been submitted to the vendors as noted and that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and paid payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: pay period, check amount, check number, date, payee, and support for applicable paid payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Guidance Care Center-SAMH Contract FY21;page 10 Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel and Meal Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel reimbursement requests must be submitted and will be paid in accordance with Monroe County Code of Ordinances and State laws and regulations. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting, a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Mileage reimbursement shall be at the rate established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving from one's home to the airport for a business trip is not a reimbursable expense. Meal reimbursement shall be at the rates established by ARTICLE XXVI, TRAVEL, PER DIEM, MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. Guidance Care Center-SAMH Contract FY21;page 11 ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for (Organization name) for the time period of_to _. Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending 05/28/01 XXX.XX (A) Total $ X,XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X'XXX.XX. (D) Total contract amount $ X,XXX<XX Balance of contract (D-C) VXIAMAX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of County of m The foregoing instrument was acknowledged before me, by means of❑ physical presence or ❑ online notarization, this day of (month), , (year), by (name of officer or agent, title of officer or agent) of (name of entity). Personally Known Produced Identification: Type of ID and Number on ID (SEAL) Signature of Notary Name of Notary (Typed, Stamped or Printed) Notary Public, State of Contract-Guidance Care Center-Jail Program-FY21;page 12 ATTACHMENT C Specific description and list of services to be provided under this contract: Local match portion of State-Funded Substance Abuse Mental Health (SAMH) and Designated Centralized Receiving Facility services, inclusive of Baker Act services, per Florida Statutes, and contracts between Guidance/Care Center and the South Florida Behavioral Health Network (ME 225- 11-27, P-04 and Amendments #1 and #2 to Contract No. P-04). Guidance Care Center-SAMH Contract FY21;page 13 ATTACHMENT D Contractual Agreements ME225-11-27 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. d/b/a Thriving Mind South Florida P-4 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. Amendment #1 to Contract P-4 Amendment #2 to Contract P-4 ATTACHMENT D (Continued) Contractual Agreements ME225-11-27 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. d/b/a Thriving Mind South Florida THRIVING MIND SOUTH FLORIDA" CFDA No(s).See Post Award Notice Client Services❑x Non-Client Services ❑ CSFA No(s).See Post Award Notice Subrecipient ❑x Vendor ❑ Federal Funds 0 State Funds ❑x STANDARD CONTRACT THIS CONTRACT is entered into between the South Florida Behavioral Health Network, Inc., d.b.a Thriving Mind South Florida("SFBHN") hereinafter referred to as the "Managing Entity" (ME) and Guidance/Care Center, Inc., hereinafter referred to as the"Network Provider". 1. Contract Document The Network provider shall provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, and documents incorporated by reference which constitute the contract document. 2. Provisions of the Prime Contract All provisions, terms and conditions, or amendments, addendum, changes or revisions applicable to the Network Provider made subsequent to the initial execution of the Prime Contract, i.e.,the Contract entered into between the Department of Children and Families("DCF"or"Department")and SFBHN(ME), not in conflict with this Contract,shall be binding upon the Network Provider and the Network Provider agrees to comply with same.The Prime Contract is incorporated by reference in this Contract.A copy of the Prime Contract can be found at the ME's website at www.thrivinl mind.orl;. In case of conflict with the provisions, terms and conditions of the Prime Contract and this Contract,the provisions, terms and conditions of this Contract will prevail.In the event of a conflict between the provisions of the documents of this Contract,the documents shall be interpreted in the order of precedence listed in Section 55. of this Standard Contract. 3. Effective and Ending Dates This contract shall begin on July 1,2020.It shall end at midnight,local time in Miami-Dade County, Florida on June 30,2021, subject to the survival of terms of Section 52. 4. Official Payee and Representatives(Names,Addresses,Telephone Numbers and E-Mail Addresses) a. The Network Provider name and mailing address of the b. The name, address, and telephone of the Contract official payee to whom the payment shall be made is: Manager for the ME for this contract is: Guidance/Care Center, Inc. Elba Taveras 3000 41st Street, Ocean South Florida Behavioral Health Network, Marathon, FL 33050 Inc. d.b.a.Thriving Mind South Florida 7205 Corporate Center Drive, Suite 200 Miami, FL 33126 Tel. (786) 507-7462 E-Mail:Etaveras@thrivingmind.org C. The name of the contact person and street address where d. The name, address, and telephone number of the the Network Provider's financial and administrative representative of the Network Provider responsible for the records are maintained is: administration of the program under this contract is: Kristen Chaffee,Regional Controller 100 2nd Avenue South#901 Maureen Dunleavy,Vice President St.Petersburg, FL 30100 WestCare/Guidance/Care Center,Inc. Office number:727-490-6767 x 30111 1205 Fourth Street Mobile number:727-465-6083 Key West, FL 33040-3707 Fax number:727-825-0573 Email: maureen.dunleavy@westcare.com E-Mail: kristen.chaffee@westcare.com Office:(305)434-7660 ext.31221 Cell:(305) 896-5964 Standard Contract Page 1 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" The ME's Contract Manager is the primary point of contact through which all contracting information flows between the ME and the Network Provider. Upon change of representatives(names,addresses,telephone numbers and e-mail addresses) by either party,notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 5. Contract Amount The ME shall pay for contracted services according to the terms and conditions of this Contract in an amount not to exceed $8,356,413.00,subject to the availability of funds and satisfactory performance of all terms by the Network Provider.Of the total Contract amount, the ME will be required to pay $6,963,678.00, subject to the delivery and billing for services. The remaining amount of $1,392,736.00, represents "Uncompensated Units Reimbursement Funds", which the ME, at its sole discretion and subject to the availability of funds, may pay to the Network Provider, in whole or in part, or not at all, for Exemplary Performance by the Network Provider. Exemplary Performance will be determined by the Network Provider delivering and billing for services in excess of those units of service the ME will be required to pay. Should the Network Provider receive any funding from the "Uncompensated Units Reimbursement Funds", then the amount of Local Match as it appears on Exhibit B,Method of Payment and in Exhibit H,Funding Detail,will automatically change,utilizing the formula prescribed in the Method of Payment section of this contract.The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the Department.Any costs or services eligible to be paid for under any other contract or from any other source are not eligible for payment under this Contract. 6. Contract Payment a. The Network Provider shall request payment monthly through submission of a properly completed invoice, per the requirements of this Contract,within eight(8)calendar days following the end of the month for which payment is being requested. b. If no services are due to be invoiced from the preceding month,the network provider shall submit a written document to the ME indicating this information within eight(8)calendar days following the end of the month.Should the Network Provider fail to submit an invoice or written documentation (should no services be due to be invoiced from the preceding month), within thirty (30) calendar days following the end of the month, then the ME at its sole discretion will consider these funds as lapse and may reallocate these funds within the network of providers. If the Network Provider fails to submit an invoice or written documentation for two(2)consecutive months within a twelve(12)month period,the ME at its sole discretion can terminate the contract in whole or in part. c. The ME has ten (10) working days, subject to the availability of funds, and/or the ME's receipt of payment from the Department, to inspect, and approve for goods and services, unless the bid specifications, purchase order, or this Contract specify otherwise.The ME's determination of acceptable services shall be conclusive.The ME receipt of reports and other submissions by the Network Provider does not constitute acceptance thereof, which occurs only through a separate and express act of the Contract Manager or other designated ME employee. The MEs failure to pay the Network Provider within the ten (10)working days will result in penalties as referenced in the Prime Contract. Invoices returned to a Network Provider due to preparation errors will result in a non-interest-bearing payment delay. Interest penalties less than one (1) dollar will not be paid unless the Network Provider requests payment. Payment shall be made only upon written acceptance by the ME and shall remain subject to the subsequent audit or review to confirm contract compliance. 7. Overpayment and Offsets a. The Network Provider shall return to the ME any overpayments due to unearned funds or funds disallowed that were disbursed to the Network Provider by the ME and any interest attributable to such funds. Should repayment not be made promptly upon discovery by the Network Provider or its auditor or upon written notice by the ME,the Network Provider will be charged interest at the lawful rate of interest on the outstanding balance until returned. Payments made for services subsequently determined by the ME to not be in full compliance with contract requirements shall be deemed overpayments.The ME shall have the right at any time to offset or deduct from any payment due under this or any other contract or agreement any amount due to the ME from the Network Provider under this or any other contract or agreement. If this Contract involves federal or state financial assistance,the following applies:The Grantee shall return to the ME any unused funds; any accrued interest earned; and any unmatched grant funds,as detailed in the Final Financial Report, no later than 60 days following the ending date of this Contract. b. The funds paid to the Network Provider are continually subject to Review, Revision and Adjustment after evaluation of Utilization and Performance measures monitored by ME. 8. Financial Consequences for Network Provider's Failure to Perform Standard Contract Page 2 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" If the Network Provider fails to perform in accordance with this Contract or perform the minimum level of service required by this Contract, the ME will apply financial consequences as provided for in Section 9, Financial Penalties for Failure to take Corrective Action.The parties agree that the penalties provided for under Section 9. constitute financial consequences under sections 287.058(1)(h)and 215.971(1)(c),F.S.The foregoing does not limit additional financial consequences,which may include but are not limited to refusing payment,withholding payments until deficiency is cured,tendering only partial payments,applying payment adjustments for additional financial consequences orfor liquidated damages to the extent that this Contract so provides, or termination of this Contract per Section 10.and requisition of services from an alternate source.Any payment made in reliance on the Network Provider's evidence of performance, which evidence is subsequently determined to be erroneous, will be immediately due as an overpayment in accordance with Section 7., Overpayment and Offsets, to the extent of such error. Financial consequences directly related to the deliverables under this Contract. 9. Financial Penalties for Failure to Take Corrective Action a. In accordance with the provisions of section 402.73(1), F.S., and Rule 65-29.001, F.A.C., should the ME require a corrective action to address noncompliance under this Contract, incremental penalties listed in Section 9.b. (i)—(iii) shall be imposed for Network Provider failure to achieve the corrective action. These penalties are cumulative and may be assessed upon each separate failure to comply with instructions from the ME to complete corrective action, but shall not exceed ten (10%) of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. These penalties do not limit or restrict the ME's application of any other remedy available to it under law or this Contract. b. The increments of penalty imposition that shall apply,unless the ME determines that extenuating circumstances exist, shall be based upon the severity of the noncompliance,nonperformance,or unacceptable performance that generated the need for corrective action plan, in accordance with the following standards: (i) Noncompliance that is determined by the ME to have a direct effect on client health and safety shall result in the imposition of a ten percent (10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. (i i) Noncompliance involving the provision of service not having a direct effect on client health and safety shall result in the imposition of a five percent(5%) penalty. (iii) Noncompliance as a result of unacceptable performance of administrative tasks shall result in the imposition of a two percent(2%) penalty. c.The deadline for payment shall be as stated in the Order imposing the financial penalties. In the event of non-payment, the ME may deduct the amount of the penalty from invoices submitted by the Network Provider. 10. Termination a. This contract may be terminated by either party without cause upon no less than thirty(30) calendar days' notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the representative of the Network Provider responsible for administration of the program.This provision shall not limit the ME's ability to terminate this Contract for cause according to other provisions herein. b. In the event funds for payment pursuant to this Contract become unavailable, the ME may terminate this Contract upon no less than twenty-four(24) hours' notice in writing to the Network Provider.Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery. The ME shall be the final authority as to the availability and adequacy of funds. In the event of termination of this contract, the Network Provider will be compensated for any work satisfactorily completed through the date of termination. c. In the event the Network Provider fails to fully comply with the terms and conditions of this contract, the ME may terminate the Contract upon no less than twenty-four (24) hours' in writing to the Network Provider, excluding Saturday,Sunday,and Holidays.Such notice may be issued without providing an opportunity for cure if it specifies the nature of the non-compliance and states that provision for cure would adversely affect the interests of the State or is not permitted by law or regulation.Otherwise,notice of termination will be issued after the Network Provider's failure to fully cure such noncompliance within the time specified in a written notice of noncompliance issued by the ME specifying the nature of the noncompliance and the actions required to cure such noncompliance. The ME's failure to demand performance of any provision of this Contract shall not be deemed a waiver of such performance. The ME's waiver of any one breach of any provision of this Contract shall not be deemed to be a waiver of any other breach and neither event shall be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the ME's right to remedies at law or in equity. Standard Contract Page 3 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" d. Failure to have performed any contractual obligations with the ME in a manner satisfactory to the ME will be a sufficient cause for termination. To be terminated as a Network Provider under this provision, the Network Provider must have: (1) previously failed to satisfactorily perform in a contract with the ME, been notified by the ME of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of the ME; or(2) had a contract terminated by the ME for cause. Termination shall be upon no less than twenty-four(24) hour notice in writing. e. If this Contract is for an amount of$1 Million or more,the ME may terminate this Contract at any time the Network Provider is found to have submitted a false certification under section 287.135,F.S.,or,been placed on the Scrutinized Companies with Activities in Sudan List or the or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Regardless of the amount of this Contract, they may terminate this Contract at any time the Network Provider is found to have been placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel. 11. Transition Activities Continuity of service is critical when service under this Contract ends and service commences under a new contract.Accordingly, when service will continue through another provider upon the expiration or earlier termination of this Contract, the Network Provider shall, without additional compensation, complete all actions necessary to smoothly transition service to the new provider.This includes but is not limited to the transfer of relevant data and files,as well as property funded or provided pursuant to this Contract.The Network Provider shall be required to support an orderly transition to the next provider no later than the expiration or earlier termination of this Contract and shall support the requirements fortransition as specified in an ME-approved Transition Plan,which shall be developed jointly with the new provider in consultation with the ME. 12. Use of Funds for Lobbying Prohibited The Network Provider shall comply with the provisions of sections 11.062 and 216.347, F.S.,which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature,judicial branch,or a State agency. 13. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Financial Services.The duties of this office are found in section 215.422, F.S., which include disseminating information relative to prompt payment and assisting vendors in receiving their payments in a timely manner from a State agency.The Vendor Ombudsman may be contacted at(850)413- 5516. 14. Public Records a. The Network Provider shall allow public access to all documents, papers, letters,or other public records as defined in subsection 119.011(12), F.S. as prescribed by subsection 119.07(1) F.S., made or received by the Network Provider in conjunction with this Contract except that public records which are made confidential by law must be protected from disclosure.As required by section 287.058(1)(c), F.S., it is expressly understood that the Network Provider's failure to comply with this provision shall constitute an immediate breach of contract for which the ME may unilaterally terminate this Contract. b. As required by section 119.0701, F.S., to the extent that the Network Provider is acting on behalf of the Department or the ME within the meaning of section 119.011(2), F.S.,the Network Provider shall: (i) Keep and maintain public records that ordinarily and necessarily would be required by the Department and the ME in order to perform the service. (ii) Upon request from the ME or the Department's custodian of public records,provide to the ME or the Department a copy of requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law. (iii) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Network Provider does not transfer the records to the ME or the Department. (iv) Upon completion of the contract,transfer,at no cost,to the ME or the Department all public records in possession of the Network Provider or keep and maintain public records required by the Department to perform the service. If the Provider transfers all public records to the ME or the Department upon completion of the contract, the Network Provider shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Network Provider keeps and maintains public records upon completion of the contract, the Network Provider shall meet all applicable requirements for retaining public records.All records stored electronically must be provided to the ME or the Department, upon request from the Standard Contract Page 4 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" Department's or the ME's custodian of public records, in a format that is compatible with the information technology systems of the ME and the Department. C. IF THE PROVIDER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: (305) 858-3335 EXT. 7458;iro iriguez a)sfbhn.oir ; OR BY MAIL AT 7205 CORPORATE CENTER DRIVE,SUITE 200,MIAMI, FLORIDA 33126.YOU MAY ALSO CONTACT THE CUSTODIAN OF PUBLIC RECORDS FOR THE DEPARTMENT OF CHILDREN AND FAMILES AT 850-487-1111, OR BY EMAIL AT DCFCI.usto °Ian a)MYFLFAMILIES.COM, OR BY MAIL AT: DEPARTMENT OF CHILDREN AND FAMILIES, 1317 WINEWOOD BLVD.,TALLAHASSEE, FL 32399. 15. Audits, Inspections,Investigations, Records and Retention a. The Network Provider shall establish and maintain books,records and documents(including electronic storage media) sufficient to reflect all income and expenditures of funds(to include funds used to meet the local match requirements per 65E-14 F.A.C., if applicable), provided by the ME under this Contract. Upon demand, and at no additional cost to the ME or the Department, the Network Provider will facilitate the duplication and transfer of any records or documents during the term of this Contract and the required retention period in Section 15. b. below.These records shall be made available at all reasonable times for inspection, review,copying,or audit by Federal,State,ME,or other personnel duly authorized. b. Retention of all client records,financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this Contract shall be maintained by the Network Provider during the term of this Contract and retained for a period of seven (7) years after completion of the Contract or longer when required by law. In the event an audit is required under this Contract, records shall be retained for a minimum period of seven (7) years after the audit report is issued or until resolution of any audit findings or litigation based on the terms of this Contract, at no additional cost to the ME or the Department. c. At all reasonable times for as long as records are maintained, persons duly authorized by the ME, State, and Federal auditors, pursuant to 2 C.F.R. §200.336, shall be allowed full access to and the right to examine any of the Network Provider's contracts and related records and documents, regardless of the form in which kept. d. A financial and compliance audit shall be provided to the ME and other entities as specified in this contract and in Attachment II, Financial and Compliance Audit. e. The Network Provider shall comply and cooperate immediately with any inspections,reviews,investigations,or audits deemed necessary by The Office of the Inspector General (section 20.055, F.S.). f. The Network Provider shall include the aforementioned audit, inspections, investigations and record keeping requirements in all subcontracts and assignments. g. No record may be withheld nor may the Network Provider attempt to limit the scope of any of the foregoing inspections, reviews,copying,transfers or audits based on any claim that any record is exempt from public inspection or is confidential, proprietary or trade secret in nature; provided, however, that this provision does not limit any exemption to public inspection or copying to any such record. 16. Inspections and Corrective Action The Network Provider shall permit all persons who are duly authorized by the ME and the Department to inspect and copy any records, papers, documents,facilities,goods and services of the Network Provider which are relevant to this Contract, and to interview any clients, employees and subcontractor employees of the Network Provider to assure the ME of the satisfactory performance of the terms and conditions of this Contract. Following such review, the ME will deliver to the Network Provider a written report of its findings,and may direct the development, by the Network Provider,of a corrective action plan where appropriate. The Network Provider hereby agrees to timely correct all deficiencies identified in the corrective action plan.This provision will not limit the ME's choice of remedies under law, rule, or this Contract. Failure to implement corrective action plans to the satisfaction of the ME, after receiving due notice, shall be grounds for contract termination. 17. Federal Law If this Contract contains federal funds and it is determined by the ME that the Network Provider is a subrecipient, the Network Provider must adhere to the terms below: a. The Network Provider shall comply with the provisions of Federal law and regulations including, but not limited to, 2 CFR, Part 200, and other applicable regulations. b. If this Contract contains $10,000 or more of Federal Funds, the Network Provider shall comply with Executive Order Standard Contract Page 5 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR, Part 60 if applicable. c. If this Contract contains over $150,000 of Federal Funds, the Network Provider shall comply with all applicable standards,orders,or regulations issued under section 306 of the Clean Air Act, as amended (42 U.S.C.§7401 et seq.), section 508 of the Federal Water Pollution Control Act,as amended(33 U.S.C.§1251 et seq.), Executive Order 11738, as amended and where applicable, and Environmental Protection Agency regulations(2 CFR, Part 1500).The Network Provider shall report any violations of the above to the ME and to the Department. d. No Federal Funds received in connection with this Contract may be used by the Network Provider,or agent acting for the Network Provider,or subcontractor to influence legislation or appropriations pending before the Congress or any State legislature. If this Contract contains Federal funding in excess of$100,000,the Network Provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment III. All disclosure forms as required by the Certification Regarding Lobbying from must be completed and returned to the ME Contract Manager, prior to payment under this Contract. e. If this Contract provides services to children up to age 18, the Network Provider shall comply with the Pro-Children Act of 1994(20 U.S.C. §6081). Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation or the imposition of an administrative compliance order on the responsible entity,or both. f. If the Network Provider is a federal subrecipient or pass through entity,the Network Provider and its subcontractors who are federal subrecipients or pass-through entities are subject to the following: A contract award (see 2 CFR § 180.220)must not be made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines in 2 CFR, Part 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies,as well as parties declared ineligible under statutory or regulatory authority otherthan Executive Order 12549. g. If the Network Provider is a federal subrecipient or pass through entity,the Network Provider and its subcontractors who are federal subrecipients or pass-through entities, must determine whether or not its subcontracts are being awarded to a "contractor" or a "subrecipient," as those terms are defined in 2 CFR, Part 200. If a Network Provider's subcontractor is determined to be a subrecipient,the Network Provider must ensure the subcontractor adheres to all the applicable requirements in 2 CFR, Part 200. 18. Confidential Client and Other Information Except as provided by this Contract,the Network Provider shall not disclose but shall protect and maintain the confidentiality of any client information and any other information made confidential by Florida Law or Federal laws or regulations that is obtained or accessed by the Network Provider or its subcontractors incidental to performance under this Contract. State laws providing for confidentiality of client and other information include but are not limited to sections 39.0132,39.00145, 39.202, 39.809, 39.908, 63.162, 63.165, 383.412, 394.4615, 397.501, 409.821, 409.175, 410.037, 410.605, 414.295, 415.107, 741.3165 and 916.107,F.S. Federal laws and regulations to the same effect include section 471(a)(8) of the Social Security Act, section 106(b)(2)(A)(viii) of the Child Abuse Prevention and Treatment Act,7 U.S.C.§2020(e)(8),42 U.S.C.§602 and 2 CFR§200.303 and 2 CFR§200.337,7 CFR§272.1(c),42 CFR§§2.1-2.3,42 CFR§§431.300-306,45 CFR§205. A summary of Florida Statutes providing for confidentiality of this and other information are found in Part II of the Attorney General's Government in the Sunshine Manual,as revised from time-to-time. The Network Provider shall not use or disclose any information concerning a recipient of services under this Contract for any purpose prohibited by State or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 19. Health Insurance Portability and Accountability Act In compliance with 45 CFR§ 164.504(e),the Network Provider shall comply with the provisions of the Business Associate Agreement, incorporated herein by reference, governing the safeguarding, use and disclosure of Protected Health Information created, received, maintained, or transmitted by the Network Provider or its subcontracts incidental to the Network Provider's performance of this Contract. Standard Contract Page 6 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" 20. Client Risk Prevention a. If services to clients are to be provided under this Contract, the Network Provider and any subcontractors shall, in accordance with the client risk prevention system,report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6. The Network Provider shall immediately report any knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number(1-800-96ABUSE). As required by Chapters 39 and 415, F.S.,this provision is binding upon both the Network Provider and its employees. b. The ME monitors timely submissions of incident reports and may impose financial penalties as described in Section 8. Financial Consequences for Network Provider's Failure to Perform. 21. Human Subject Research The Network Provider shall comply with the requirements of CFOP 215-8 for any activity underthis Contract involving human subject research within the scope of 45 CFR,Part 46,and 42 U.S.C.section 289,et seq.,and may not commence such activity until review and approval by the Department of Children and Families Human Protections Review Committee and a duly constituted Institutional Review Board. 22. Support to the Deaf or Hard-of-Hearing a. The Network Provider and its subcontractors shall comply with section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §794, as implemented by 45 C.F.R. Part 84(hereinafter referred to as Section 504),the Americans with Disabilities Act of 1990, 42 U.S.C. 12131, as implemented by 28 C.F.R. Part 35 (hereinafter referred to as ADA), and the Children and Families Operating Instruction (CFOP) 60-10, Chapter 4, entitled "Auxiliary Aids and Services for the Deaf or Hard-of- Hearing. b. If the Network Provider or any of its subcontractors employs fifteen(15)or more employees,the Network Provider and subcontractor shall designate a Single-Point-of-Contact to ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504,the ADA,and CFOP 60-10,Chapter 4.The Network Provider's Single-Point-of-Contact and that of its Subcontractors will process the compliance data into the Department's HHS Compliance reporting Database by the 4th business day of the month, covering the previous month's reporting, and forward confirmation of submission to the Contract Manager. The name and contact information for the Network Provider's Single-Point-of-Contact shall be furnished to the Contract Manager prior to the execution of this Contract, within ten (10) calendar days of staffing change, or within fourteen (14) calendar days of the effective date of this requirement. c. The Network Provider shall,within thirty(30)days of the effective date of this requirement, contractually require that its subcontractors comply with section 504, the ADA, and CFOP 60-10, Chapter 4. A Single-Point-of-Contact shall be required for each subcontractor that employs fifteen (15) or more employees.This Single-Point-of-Contact will ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the Network Provider's Single-Point-of-Contact. d. The Single-Point-of-Contact shall ensure that employees are aware of the requirements, roles and responsibilities, and contact points associated with compliance with Section 504,the ADA, and CFOP 60-10, Chapter 4. Further,employees of the Network Provider and their subcontractors with fifteen (15)or more employees shall attest in writing that they are familiar with the requirements of Section 504,the ADA,CFOP 60-10,Chapter 4.This attestation shall be maintained in the employee's personnel file. e. The Network Provider's Single-Point-of-Contact will ensure that conspicuous Notices which provide information about the availability of appropriate auxiliary aids and services at no-cost to the deaf or hard-of-hearing customers or companions are posted near where people enter or are admitted within the agent locations. Such Notices must be posted immediately by the Network Provider and subcontractors. The approved Notice is available at: https://www.myflfamilies.com/service-programs/individual-with-disability/providers/. f. The Network Provider and its subcontractors shall document the customer's or companion's preferred method of communication and any requested auxiliary aids/services provided in the customer's record. Documentation, with supporting justification, must also be made if any request was not honored. The Network Provider shall distribute Customer Feedback forms to customers or companions and provide assistance in completing the forms as requested by the customer or companion. g. If customers or companions are referred to other agencies,the Network Provider must ensure that the receiving agency is notified of the customer's or companion's preferred method of communication and any auxiliary aids/service needs. h. The Department requires each contract/subcontract provider agency's direct service employees to complete training on serving our customers who are Deaf or Hard-of-Hearing: httr)s://v�ivivi.myflfamilies.com/service- Standard Contract Page 7 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" prol;rams/individual-with-disability/Iaroviders/ and sign the Attestation of Understanding. Direct service employees performing under this Contract will also print their certificate of completion, attach it to their Attestation of Understanding,and maintain them in their personnel file. 23. Emergency Preparedness If the tasks to be performed pursuant to this Contract include the physical care or supervision of clients, the Network Provider shall, within thirty (30) days of the execution of this contract, submit to the Contract Manager an emergency preparedness plan which shall include provisions for records protection,alternative accommodations for clients in substitute care, supplies, and a recovery plan that will allow the Network Provider to continue functioning in compliance with the executed contract in the event of an actual emergency. For the purpose of disaster planning,the term"supervision"includes a child who is under the jurisdiction of a dependency court.Children may remain in their homes, be placed in a non-licensed relative/non-relative home or be placed in a licensed foster care setting. No later than twelve months following the ME's original acceptance of a plan and every twelve (12) months thereafter, the Network Provider shall submit a written certification that it has reviewed its plan, along with any modifications to the plan, or a statement that no modifications were found necessary.The ME agrees to respond in writing within thirty(30)days of receipt of the original or updated plan, accepting, rejecting, or requesting modifications. In the event of an emergency, the Department or the ME may exercise oversight authority over such Network Provider in order to assume implementation of agreed emergency relief provisions. 24. Insurance a. Continuous adequate liability insurance coverage shall be maintained by the Network Provider during the existence of this Contract and any renewal(s)and extension(s)thereof and in accordance with the requirements in Attachment I.By execution of this Contract,unless it is a State agency or subdivision as defined by subsection 768.28(2),F.S.,the Network Provider accepts full responsibility for identifying and determining the type(s)and extent of liability insurance necessary to provide reasonable financial protections for the Network Provider and the clients to be served under this Contract. The limits of coverage under each policy maintained by the Network Provider do not limit the Network Provider's liability and obligations under this Contract. Upon the execution of this Contract,the Network Provider shall furnish the ME written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida.The ME reserves the right to require additional insurance as specified in this Contract.The Network Provider shall notify the Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance, to include but not limited to,cancellation or modification to policy limits. b. To the fullest extent permitted by law,and not withstanding any other provision of this Contract,the Network Provider by signing this Contract acknowledges the value of obtaining Cyber Liability insurance, has considered all of the risks, and assumes all of the risks and liability associated with not obtaining such insurance. The Network Provider will indemnify, defend, and hold the ME harmless from any and all claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs (including reasonable attorneys' and court fees and expenses) arising out of or related to any Breach or alleged Breach of Unsecured PHI created, received, maintained,transmitted, or otherwise used by the Network Provider and arising from the Network Provider's breach, or failure to perform pursuant to this Contract (collectively, a "Claim") up to and including the Appellate Court level and until the case is resolved. If the Network Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the ME shall be to the extent permitted by section 768.28, F.S. or other applicable law, and without waving the limits of sovereign immunity. 25. Indemnification a. The Network Provider shall be fully liable for the actions of its agents,employees,partners,or subcontractors and shall fully indemnify, defend, and hold harmless the ME, State and the Florida Department of Children and Families (DCF), and its officers,agents,and employees,from suits,actions,damages,and costs of every name and description,including attorneys'fees, arising from or relating to any alleged act or omission by the Network Provider, its agents,employees, partners, or subcontractors, provided, however,that the Network Provider shall not indemnify for that portion of any loss or damages caused by the negligent act or omission of the ME. b. The Network Provider shall fully indemnify, defend and hold harmless the ME, the State and the DCF, from any suits, actions, damages, and costs of every name and description, including attorneys' fees, arising from or relating to violation of infringement of a trademark, copyright, patent, trade secret or intellectual property right, provided, however, that the foregoing obligation shall not apply to the ME's misuse or modification of Network Provider's products or a ME's operation or use of Network Provider's products in a manner not contemplated by the contract or the purchase order. If any product is the subject of an infringement suit or in the Network Provider's opinion is likely Standard Contract Page 8 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" to become the subject of such a suit, the Network Provider may at its sole expense procure for the ME the right to continue using the product or modify it to become non-infringing. If the Network Provider is not reasonably able to modify or otherwise secure the ME the use, the ME shall not be liable for any royalties. The Network Provider's indemnification for violation or infringement of a trademark, copyright, patent, trade secret or intellectual property right shall encompass all such items used or accessed by the Network Provider, its officers, agents or subcontractors in the performance of this contract or delivered to the ME for the use of the ME, its employees, agents or contractors. c. The Network Provider shall protect, defend, and indemnify, including attorney's fees and cost, the ME for any and all claims and litigation (including litigation initiated by the ME)arising from or relating to Network Provider's claim that a document contains proprietary or trade secret information that is exempt from disclosure or the scope of the Network Provider's redaction, as provided for under Section 37.,Network Provider's Confidential and Exempt Information. d. The ME shall not be liable for any cost,expense,or compromise incurred or made by the Network Provider in any legal action. The Network Provider's inability to evaluate liability or its evaluation of liability shall not excuse its duty to defend and indemnify after receipt of notice. Only an adjudication or judgment after the highest appeal is exhausted finding the ME negligent shall excuse the Network Provider of performance under this provision,in which case the ME shall have no obligation to reimburse the Network Provider for costs of its defense. If the Network Provider is an agency or subdivision of the State,its obligation to indemnify,defend and hold harmless the ME s hall be to the extent permitted by section 768.28, F.S. or other applicable law,and without waiving the limits of sovereign immunity. 26. Independent Contractor a. In performing its obligations under this Contract,the Network Provider shall at all times be acting in the capacity of an independent contractor and not as an officer, employee, or agent of the ME or the State of Florida, except where the Network Provider is a State agency. Neither the Network Provider nor its agents, employees, subcontractors or assignees shall represent to others that it is an agent,officer or employee of or has the authority to bind the ME or the Department by virtue of this Contract, unless specifically authorized in writing to do so.This Contract does not create any right in any individual to State retirement, leave benefits or any other benefits of State employees as a result of performing the duties or obligations of this Contract. b. The ME will not furnish services of support(e.g., office space, office supplies,telephone service, secretarial or clerical support) to the Network Provider, or its subcontractor or assignee, unless specifically agreed to by the ME in this Contract. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Network Provider,the Network Provider's officers,employees, agents,subcontractors,or assignees shall be the sole responsibility of the Network Provider and its subcontractors.The parties agree that no joint employment is intended and that, regardless of any provision directing the manner of provision of services, the Network Provider and its subcontractors alone shall be responsible for the supervision, control, hiring and firing, rates of pay and terms and conditions of employment of their own employees. 27. Assignments and Subcontracts a. The Network Provider shall not assign the responsibility for this Contract to another party without prior written approval of the ME, upon the ME's sole determination that such assignment will not adversely affect the public interest; however,in no event may the Network Provider assign or enter into any transaction havi ng the effect of assigning or transferring any right to receive payment under this Contract which right is not conditioned on full and faithful performance of Network Provider's duties hereunder. Any sublicense, assignment, or transfer otherwise occurring without prior approval of the ME shall be null and void. The Network Provider shall not subcontract for any of the work contemplated under this Contract without prior written approval of the ME,which shall not be unreasonably withheld. b. The Network Provider shall ensure that all subcontract agreements, at any tier, for work contemplated under this Contract,adhere to all of the requirements of the ME's Prime Contract with the Department and all the requirements of this Contract. A copy of the Prime Contract can be found at the ME's website. vrvrvr.thrivinmind.ar . c. To the extent permitted by Florida Law, and in compliance with Section 25., Indemnification, of this Standard Contract, the Network Provider is responsible for all work performed and for all commodities produced pursuant to this Contract whether actually furnished by the Network Provider or its subcontractors.Any subcontracts shall be evidenced by a written document.The Network Providerfurther agrees that neitherthe ME nor the Department shall be liable to the subcontractor in any way or for any reason.The Network Provider,at its expense,will defend the ME against such claims. d. The Network Provider shall make payments to any subcontractor within seven (7) working days after receipt of payment from the ME in accordance with section 287.0585, F.S., unless otherwise stated in the contract between the Network Provider and subcontractor. Failure to pay within seven (7)working days will result in a penalty that Standard Contract Page 9 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" shall be charged against the Network Provider and paid by the Network Provider to the subcontractor in the amount of one-half of one percent(.005)of the amount due per day from the expiration of the period allowed for payment.Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15%) percent of the outstanding balance due. e. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under its contract with the ME to another governmental agency in the State of Florida or to a provider of the Department's selection,upon giving prior written notice to the ME.In the event the State of Florida approves transfer of the ME's obligations,the Network Provider remains responsible for all work performed and all expenses incurred in connection with the contract.This Contract shall remain binding upon the successors in interest of the Network Provider,the ME and the Department. f. The Network Provider shall include, or cause to be included, in all subcontracts (at any tier) the substance of all clauses contained in this Standard Contract that mention or describe subcontract compliance. as well as all clauses applicable to that portion of the Network Provider's performance being performed by or through the subcontract. 28. Civil Rights Requirements In accordance with Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act of 1990, or the Florida Civil Rights Act of 1992, as applicable the Network Provider shall not discriminate against any employee (or applicant for employment) in the performance of this contract because of race, color, religion, sex, national origin, disability, age, or marital status. Further,the Network Provider shall not to discriminate against any applicant, client, or employee in service delivery or benefits in connection with any of its programs and activities in accordance with 45 CFR 80, 83, 84, 90, and 91, Title VI of the Civil Rights Act of 1964, or the Florida Civil Rights Act of 1992, as applicable and CFOP 60-16. These requirements shall apply to all contractors,subcontractors,sub-grantees or others with whom it arranges to provide services or benefits to clients or employees in connection with its programs and activities.The Network Provider shall complete the Civil Rights Certificate, CF Form 707 and the Civil Rights Compliance Checklist, CF Form 946 in accordance with CFOP 60-16 and 45 CFR 80. 29. State and Federal Whistle-blower Act Requirements a. In accordance with subsection 112.3187, F.S., the Network Provider and its subcontractors shall not retaliate against an employee for reporting violations of law, rule, or regulation that creates substantial and specific danger to the public's health, safety, or welfare to an appropriate agency. Furthermore, agencies or independent contractors shall not retaliate against any person who discloses information to an appropriate agency alleging improper use of governmental office,gross waste of funds, or any other abuse or gross neglect of duty on the part of an agency, public officer, or employee. The Network Provider and any subcontractor shall inform its employees that they and other persons may file a complaint with the Office of Chief Inspector General, Agency Inspector General, the Florida Commission on Human Relations or the Whistle-blower's Hotline number at 1-800-543-5353. b. Pursuant to Section 11(c) of the OSH Act of 1970 and the subsequent federal laws expanding the act, the Network Provider is prohibited from discriminating against employees for exercising their rights under OSH Act. Details of the OSH Act can be found at this website: https://www.whistleblowers.gov/ 30. DEO and Workforce Florida The Network Provider understands the DCF,the Department of Economic Opportunity, and Worksource Florida, Inc., have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment.The ME encourages Network Provider participation with the Department of Economic Opportunity and Workforce Florida, Inc. 31. Transitioning Young Adults The Network Provider understands the Department's interest in assisting young adults aging out of the dependency system. The ME encourages Network Provider participation with the local Community-Based Care Lead Agency Independent Living Program to offer gainful employment to youth in foster care and young adults transitioning from the foster care system. 32. Sponsorship or Financial Support As required by section 286.25, F.S., if the Network Provider is a non-governmental organization which sponsors a program financed wholly or in part by State funds, including any funds obtained through this Contract, it shall, in publicizing, advertising, or describing the sponsorship of the program State: "Sponsored by(Network Provider's Name),Thriving Mind South Florida and the State of Florida, Department of Children and Families". If the sponsorship reference is in written material,the words"Thriving Mind South Florida" and "State of Florida, Department of Children and Families" shall appear Standard Contract Page 10 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" in at least the same size letters or type as the name of the organization. If the sponsorship reference includes any logos or marks, then the logo for Thriving Mind South Florida and for the Department of Children and Families shall appear at least the same size as that for the Network Provider or other entities referenced. 33. Publicity Without limitation, the Network Provider and its employees, agents, and representatives will not, without prior ME or Department written consent in each instance, use in advertising, publicity or any other promotional endeavor any ME or State mark,the name of the ME's or State's mark,the name of the ME,the State, or any ME or State affiliate or any officer or employee of the ME or the State,or represent,directly or indirectly,that any product or service provided by the Network Provider has been approved or endorsed by the ME or the State,or refer to the existence of this Contract in press releases, advertising or materials distributed to the Network Provider's prospective customers. 34. Public Entity Crime and Discriminatory Contractors Pursuant to section 287.133, F.S. and 287.134, F.S., the following restrictions are placed on the ability of persons on the convicted vendor list or the discriminatory vendor list.When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, or an entity or affiliate has been placed on the discriminatory vendor list, such person, entity or affiliate may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or the repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity;and may not transact business with any public entity; provided, however,that the prohibition on persons or affiliates placed on the convicted vendor shall be limited to business in excess of the threshold amount provided in section 287.017, F.S., for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. This provision applies to the Network Provider and all their subcontractors. 35. Employee Gifts The Network Provider agrees that it will not offer to give or give any gift to any ME or Department employee during the service performance period of this Contract and for a period of two (2) years thereafter. In addition to any other remedies available to the ME and the Department,any violation of this provision will result in referral of the Network Provider's name and description of the violation of this term to the Department of Management Services for the potential inclusion of the Network Provider's name on the suspended vendors list for an appropriate period.The Network Provider will ensure that its subcontractors, if any, comply with these provisions. 36. Intellectual Property a. It is agreed that all intellectual property, inventions, written or electronically created materials, including manuals, presentations, films, or other copyrightable materials, arising in relation to Network Provider's performance under this Contract, and the performance of all of its officers, agents and subcontractors in relation to this Contract, are works for hire for the benefit of the Department,fully compensated for by the contract amount,and that neither the Network Provider nor any of its officers,agents nor subcontractors may claim any interest in any intellectual property rights accruing under or in connection with the performance of this Contract. It is specifically agreed that the Department shall have exclusive rights to all data processing software falling within the terms of section 119.084, F.S., which arises or is developed in the course of or as a result of work or services performed under this Contract,or in any way connected herewith. Notwithstanding the foregoing provision, if the Network Provider is a university and a member of the State University System of Florida,then section 1004.23, F.S.,shall apply. b. If the Network Provider uses or delivers to the Department for its use or the use of its employees, agents or contractors, any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the compensation paid pursuant to this contract includes all royalties or costs arising from the use of such design,device,or materials in any way involved in the work contemplated by this contract. For the purposes of this provision, the term "use" shall include use by the Network Provider during the term of this contract and use by the ME, agents, or contractors and the Department during the term of this contract and perpetually thereafter. c. All applicable subcontracts shall include a provision that the Federal awarding agency reserves all patent rights with respect to any discovery or invention that arises or is developed in the course of or under the subcontract. Notwithstanding the foregoing provision, if the Network Provider or one of its subcontractors is a university and a Standard Contract Page 11 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" member of the State University of Florida, then section 1004.23, F.S., shall apply, but the Department shall retain a perpetual, fully-paid, non-exclusive license for its use and the use of its contractors of any resulting patented, copyrighted or trademarked work products. 37. Network Provider's Confidential and Exempt Information a. Unless exempted by law,all public records are subject to public inspection and copying under Florida's Public Records Law, Chapter 119, F.S.Any claim by Network Provider of trade secret(proprietary)confidentiality for any information contained in Network Provider's documents(reports, deliverables or work papers, etc., in paper or electronic form) submitted to the ME in connection with this Contract will be waived, unless the claimed confidential information is submitted in accordance with Section 37. b. below. b. The Network Provider must clearly label any portion of the documents, data or records submitted that it considers exempt from public inspection or disclosure pursuant to Florida's Public Records Law as proprietary or trade secret. The labeling will include a justification citing specific statutes and facts that authorize exemption of the information from public disclosure. If different exemptions are claimed to be applicable to different portions of the protected information, the Network Provider shall include information correlating the nature of the claims to the particular protected information. c. The ME, when required to comply with a public records request including documents submitted by the Network Provider, may require the Network Provider to expeditiously submit redacted copies of documents marked as confidential or trade secret in accordance with Section 37.b.above.Accompanying the submission shall be an updated version of the justification under Section 37. b. correlated specifically to redacted information, either confirming that the statutory and factual basis originally asserted remain unchanged or indicating any changes affecting the basis from the asserted exemption from public inspection or disclosure.The redacted copy must exclude or obliterate only those exact portions that are claimed to be proprietary or trade secret. If the Network Provider fails to promptly submit a redacted copy, the ME is authorized to produce the records sought without any redaction of proprietary or trade secret information. d. The Network Provider shall be responsible for defending its claim that each and every portion of the redactions of proprietary or trade secret information are exempt from inspection and copying under Florida's Public Records Law. 38. Real Property Any State funds provided for the purchase of or improvements to real property are contingent upon the Network Provider granting to the State a security interest in the property at least to the amount of the State funds provided for at least five (5)years from the date of purchase or the completion of the improvements or as further required by law.As a condition of receipt of State funding for this purpose, if the Network Provider disposes of the property before the Department's interest is vacated, the Network Provider will refund the proportionate share of the State's initial investment, as adjusted by depreciation. 39. Information Security a. An appropriately skilled individual shall be identified by the Network Provider to function as its Information Security Officer.The Information Security Officer shall act as the liaison to the ME's and the Department's security staff and will maintain an appropriate level of information security for the ME's and the Department's information systems or any client or other confidential information the Network Provider is collecting or using in the performance of this Contract. An appropriate level of security includes approving and tracking all who request or have access,through the Network Provider's access, to ME or Department information systems or any client or other confidential information. The Information Security Officer will ensure that any access to the ME or Department information systems or any client or other confidential information is removed immediately upon such access no longer being required for Network Provider's performance under this Contract. b. The Network Provider shall provide the latest Department Security Awareness Training to all who request or have access, through the Network Provider's access, to ME and/or Department information systems or any client or other confidential information. c. All who request or have access,through the All Network Provider access,to ME or Department information systems or any client or other confidential information shall comply with and be provided a copy of CFOP 50-2, and shall sign the DCF Security Agreement form CF 0114 annually or immediately upon hire and annually thereafter. The Network Provider shall maintain a copy of the signed DCF Security Agreement form CF 0114 in the personnel file. The Network Provider agrees to submit copies of each signed DCF Security Agreement form CF 0114 to the Contract Manager and the ME's Vice President of IT and Data Analytics upon request. A copy of CF 0114 may be obtained from the Contract Manager. Standard Contract Page 12 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" d. The Network Provider shall make every effort to protect and avoid unauthorized release of any personal or confidential information by ensuring both data and storage devices are encrypted as prescribed in CFOP 50-2.The Network Provider shall require the same of all subcontractors. e. The Network Provider agrees to notify the Contract Manager as soon as possible, but no later than four(4) business days following the determination of any potential or actual unauthorized disclosure or access to ME or Department information systems or to any client or other confidential information. The Network Provider shall require the same notification requirements of all subcontractors. f. The Network Provider shall prevent unauthorized disclosure or access,from or to ME and/or Department information systems or client or other confidential information. Client or other confidential information on systems and network capable devises shall be encrypted per CFOP 50-2. g. The Network Provider shall, at its own cost, comply with section 501.171. F.S. The Network Provider shall also, at its own cost, implement measures deemed appropriate by the ME and/or the Department to avoid or mitigate potential injury to any person due to potential or actual unauthorized disclosure or access to ME or Department information systems or to any client or other confidential information. The Network Provider shall adhere to the requirements of the Business Associate Agreement, incorporated herein by reference. A violation or breach of any of the assurances as stipulated in the Business Associate Agreement must constitute a material breach of this Contract. 40. Accreditation The ME is committed to ensuring provision of the highest quality services to the persons we serve.Accordingly,the ME has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service,the majority of the ME's Network Providers will take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2021. 41. Notice of Legal Action The Network Provider shall notify the ME of legal actions taken against them or potential actions such as lawsuits, related to services provided through this Contract or that may impact the Network Provider's ability to deliver the contractual services,or adversely impact the ME and/or the Department.The Contract Manager will be notified within ten(10)calendar days of Network Provider becoming aware of such actions or from the day of the legal filing,whichever comes first. 42. Unauthorized Aliens and Employment Eligibility Verification (E-Verify) Unauthorized aliens shall not be employed. Employment of unauthorized aliens shall be cause for unilateral cancellation of this Contract by the ME for violation of section 274A of the Immigration and Nationality Act(8 U.S.C. § 1324 a) and section 101 of the Immigration Reform and Control Act of 1986. The Network Provider and its subcontractors will enroll in and use the E-Verify system established by the U.S. Department of Homeland Security to verify the employment eligibility of its employees and its subcontractors' employees performing under this Contract. Employees assigned to the contract means all persons employed or assigned(including subcontractors)by the Network Provider or a subcontractor during the contract term to perform work pursuant to this contract within the United States and its territories. 43. Employment Screening The Network Provider shall ensure that all staff utilized by the Network Provider and its subcontractors (hereinafter, "Contracted Staff")that are required by Florida law and by CFOP 60-25,Chapter 2,which is hereby incorporated by reference to be screened in accordance with chapter435,F.S.,are of good moral character and meet the Level 2 Employment Screening standards specified by sections 435.04, 110.1127, and subsection 39.001(2), F.S., as a condition of initial and continued employment that shall include but not be limited to: a. Employment history checks; b. Fingerprinting for all criminal record checks; c. Statewide criminal and juvenile delinquency records checks through the Florida Department of Law Enforcement (FDLE); d. Federal criminal records checks from the Federal Bureau of Investigation via the Florida Department of Law Enforcement;and e. Security background investigation, which may include local criminal record checks through local law enforcement agencies. f. Attestation by each employee, subject to penalty of perjury, to meeting the requirements for qualifying for employment pursuant to chapter 435 and agreeing to inform the employer immediately if arrested for any of the disqualifying offenses while employed by the employer. Standard Contract Page 13 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" 44. Employment Screening Affidavit The Network Provider shall sign the Florida Department of Children and Families Employment Screening Affidavit each State fiscal year(no two such affidavits shall be signed more than 13 months apart) for the term of the Contract stating that all required staff have been screened or the Network Provider is awaiting the results of screening. 45. Office of Inspector General Request for Reference Check The Department requires,as applicable,the use of the Officer of Inspector General's Request for Reference Check form(CF 774),which states: "As part of the screening of an applicant being considered for appointment to a career service, selected exempt service, senior management, or OPS position with the Department of Children and Families or a Contract or sub- contract provider, a check with the Office of Inspector General (IG) is required to determine if the individual is or has been a subject of an investigation with the IG's Office.The request will only be made on the individual that is being recommended to be hired for the position if that individual has previously worked for the Contract or sub-contract provider, or if that individual is being promoted,transferred or demoted within the Contract or sub-contract provider." 46. Pride Articles which are the subject of or are required to carry out this Contract shall be purchased from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this Contract, the Network Provider shall be deemed to be substituted for the Department insofar as dealings with PRIDE.This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of products/services available from PRIDE may be obtained by contacting PRIDE,(800) 643-8459. 47. Recycled Products The Network Provider shall procure any recycled products or materials,which are the subject of or are required to carry out this Contract, in accordance with the provisions of sections 403.7065, F.S. 48. Renegotiations or Modifications Modifications of provisions of this contract shall be valid only when they have been reduced to writing and duly signed by both parties.The rate of payment and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment when these have been established through the appropriations process and subsequently included in the ME's prime contract with the Department. 49. Dispute Resolution a. The parties agree to cooperate in resolving any differences in interpreting the contract, including but not limited to, client eligibility and/or placement into the appropriate level of care,a general dispute arising out of, or relating to this contract, or contesting a financial penalty for failure to comply with requirements of a corrective action plan.Within five(5)working days of the execution of this contract,each party shall designate a Dispute Resolution Officer with the requisite authority to act as its representative for dispute resolution purposes and provide that information to the other p a rty. b. Within five(5)working days from delivery to the Dispute Resolution Officer of the other party of a written request for dispute resolution,the representatives will conduct a face-to-face meeting to resolve the disagreement amicably.If the parties are not able to meet within the five (5) working days due to scheduling difficulties, the meeting shall occur as mutually agreed to by the parties,but no laterthan ten(10)working days from the date of receipt of the written request for dispute resolution. If the representatives are unable to reach a mutually satisfactory resolution at the face-to-face meeting, the dispute resolution process in Section 49.c. shall be followed. In the event of a dispute regarding client eligibility and/or placement into the appropriate level of care,the dispute shall not preclude the Network Provider from providing the provision of services to eligible individuals until the dispute is resolved. c. If the representatives are unable to reach a mutually satisfactory resolution,either representative may request referral of the issue to the President/Chief Executive Officer of the respective parties. Upon referral to this next step, the President/Chief Executive Officer of the parties shall confer in an attempt to amicably resolve the issue. If the President/Chief Executive Officer of the parties cannot resolve the issue,the issue shall be presented at the discretion of the ME either to the Board of Directors Executive Committee and/or the ME's Board of Directors.Should the dispute not be resolved atthe Board of Directors Executive Committee and/or the ME'sfull Board of Directors level,the decision of the ME shall prevail subject to any legal rights that the Network Provider may have and/or wish to exercise.Venue for any court action will be in Miami-Dade County,Florida.This provision shall not limit the parties'rights of termination under Section 10. Standard Contract Page 14 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVING MIND SOUTH FLORIDA" 50. Notice Any notice that is required under this contract shall be in writing and sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery. Said notice shall be sent to the representative of the Network Provider responsible for administration of the program,to the designated address contained in this contract. 51. Final Invoice The final invoice for payment shall be submitted to the ME no more than twenty(20)days, per the requirements stipulated in the Method of Payment section of this Contract, after the contract ends or is terminated. If the Network Provider fails to do so, all rights to payment are forfeited and the ME will not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the Network Provider and necessary adjustments thereto, have been approved by the ME. 52. Survival of Terms Unless a provision hereof expressly states otherwise, all provisions hereof concerning obligations of the Network Provider and remedies available to the ME survive the ending date or an earlier termination of this Contract.The Network Provider's performance pursuant to such surviving provisions shall be without further payment, as the contract payments received during the term of this Contract are consideration for such performance. 53. Governing Law and Venue This Contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with Florida law,without regard to Florida provisions for conflict of laws.State Courts of competent jurisdiction in Florida shall have exclusive jurisdiction in any action regarding this Contract and venue shall be in Miami-Dade County, Florida. 54. Electronic Signature.This Contract may be executed by electronic signature as follows: a. a fax copy of this Contract with a signature page that displays the image of a handwritten signature;or b. a digital file that is transmitted by one party to the other which,when displayed on an electronic video display terminal, presents an image of this Contract with a signature page bearing the image of a handwritten signature. 55. All Terms and Conditions Included This contract and it attachments, I, II, III, &IV and any exhibits referenced in said attachments,together with any documents incorporated by reference,including the ME prime contract(which can be found at httr)_I vvvvvv.thrivingmind.org),contain all the terms and conditions agreed upon by the parties. There are no provisions,terms, conditions, or obligations other than those contained herein,and this contract shall supersede all previous communications, representations,or agreements,either verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable, the remainder of the contract shall remain in full force and effect and such term or provision shall be stricken. In the event of a conflict between the provisions of the documents,the documents shall be interpreted in the following order of precedence: a.Attachment I through Attachment I,11,III, &IV Exhibits,the Business Associate Agreement; b.Any documents incorporated into any Exhibit or Attachment by reference or included as a subset thereof; c.This Standard Contract; d.Any documents incorporated into this Contract by reference Standard Contract Page 15 of 16 Guidance Care Center, Inc. Contract No. ME225-11-27 THRIVRNG MIND iJ%0 !,,,?A" BY SIGNING THIS CONTRACT, THE PARTIES AGREE THAT THEY HAVE READ AND AGREE To THE ENTIRE CONTRACT, AS DESCRIBED IN SECTION 55.ABOVE. IN WITNESS THEREOF,the parties have caused this contract,attachments,exhibits,and any documents referenced herein,to be executed by their undersigned officials as duly authorized. NETWORK PROVIDER:Guidance/Care Center,Inc. SOUTH FLORIDA BEHAVIORA LTH NETWORK,INC. SIGNED / ��++ SIGNED BY: ✓ L BY: d NAME:Frank C,.,Rabbito NAME: John W. ewcomer M.D. TITLE:Chief og�erations Officer TITLE:_President and CEO DATE: 6130120 DATE: Federal Tax ID9#(or SSN)59-1458324 Network Provider Fiscal Year Ending Date V30 Pursuant to Authority in WCGCC 2020-02 Executed subject to dispute and negotiations over FL Statute 119 Language in Section 14 Standard Contract Page 16 of 16 Guidance Care Center,Inc. Contract No.ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 ATTACHMENT I A. Services to be Provided 1. Program/Service Specific Terms (1) "Behavioral Health Services" are mental health services and substance abuse prevention and treatment services as defined by s. 394.9082(2)(a), F.S., and in Chapter 397. F.S. (2) "Block Grants": The Community Mental Health Block Grant (CMHBG), pursuant to 42 U.S.C. s. 300x, et. seq., and the Substance Abuse Prevention and Treatment Block Grant (SAPTBG), pursuant to 42 U.S.C. s. 300x-21, et. seq. (3) "Care Coordination" means the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure service linkage. Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures. The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations. (4) "Citrus Family Care Network" is the Southern Region's (Circuit 11 & 16) Lead Agency for Community Based Care provider under contract with the State of Florida Department of Children and Families for the child protection and child welfare system. (5) "Collaborative Planning Group Systems, Inc." is the entity contracted with the Department of Children and Families that maintains the database called Performance Based Prevention System (PBPS) that Network Providers contracted to provide substance abuse prevention services must utilize to upload substance abuse prevention data required by this contract. (6) "Continuous Quality Improvement" is an ongoing, systematic process of internal and external improvements in service provision and administrative functions, taking into account both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. (7) "Contract Manager" is the ME employee who is responsible for enforcing the compliance with administrative and programmatic terms and conditions of a contract. The Contract Manager is the primary point of contact through which all contracting information flows between the ME and the Network Provider. All actions related to the contract must be initiated by or coordinated with the Contract Manager. (8) "Co-occurring Disorder" is any combination of mental health and substance use in any individual, whether or not they have been already diagnosed. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 1 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:fea th ��et���ark.l (%) /1W;2020 (9) "Co-occurring Disorder Service Capability" is the ability of any program to organize every aspect of its program infrastructure (policies, procedures, practices, documentation, and staff competencies), within its existing resources, to provide appropriately matched, integrated services to the individuals and families with co-occurring disorders that are routinely presenting for care in that program. Should services not be available at the Network Provider then then the individual served must be linked to an agency with the capability to meet the individual served needs. (10) "Coordinated System of Care", as described in section 394.4573, F.S.is the full array of behavioral and related services in a region or community offered by all service providers, whether participating under contract with a Managing Entity or by another method of community partnership or mutual agreement. (11) "Cost Analysis" is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. (12) "Cultural and Linguistic Competence" is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professional that enable effective work in cross-cultural situations that provides services that are respectful and/or responsive to cultural and linguistic needs. (13) "Department" means the State of Florida Department of Children and Families. (14) "Electronic Health Record (EHR)" is defined in s. 408.051(2)(a), F.S. (15) "Evidenced-Based Practices (EBP) are programs, practices or strategies that are supported by research. EBP's are programs that have demonstrated effectiveness with established generalizability (replicated in different settings and with different populations over time) through research. The Department has established two option. For a list of approved registries used to identify, evaluate, and select EBP programs and strategies, refer to the Department's Guidance Document 1, Evidence Based Guidelines available at the following link: https://www.mvflfa m i I ies.com/service-p rogra ms/sa m h/ma nagi ng-entities/i ndex.shtm I Note: Click on FY20-21 ME Templates and click on Guidance Document 1, Evidence Based Guidelines (16) "FASAMS DCF Pamphlet 155-2" is the Department of Children & Families, Pamphlet 155-2 - Mental Health and Substance Abuse Measurement and Data means a document promulgated by the Department that contains required data-reporting elements for substance use and mental health services, and which can be found at: https://www.myflfamilies.com/service-programs/samh/fasams/index.shtml (17) "Financial and Services Accountability Management System (FASAMS)" is the Department's information management and fiscal accounting system for providers of community substance use and mental health services. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 2 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (18) "Forensic Mental Health Services" are services provided to individuals with mental illness pursuant to Chapter 916, Florida Statutes. (19) "HIPAA" is the acronym for Health Insurance Portability and Accountability Act and must mean the Privacy, Security, Breach Notification, and Enforcement Rules at 42 U.S.C. §1320d, and 45 C.F.R. Parts 160, 162, and 164. (20) "Individual(s) Served" (synonymous with Client, Consumer, Participant) is an individual who receives substance use or mental health services, the cost of which is paid, either in part or whole, by Department appropriated funds or local match (matching). (21) "Knight Information Software (KIS)"is the ME's online data system which Network Providers that do not have their own data system are required to use to collect and report data and performance outcomes on individual served whose services are paid for, in part or in whole, by the ME's contract, Medicaid, local match, Temporary Assistance for Needy Families (TANF), Purchase of Therapeutic Services (PTS) and Title 21 . The KIS, or other system designated by the ME, must be utilized to upload individual served-related data as required by this contract. (22) "Lead Agency for Community-Based Care (CBC)" is an agency under contract with the Florida Department of Children and Families that provides care for children in the child protection and child welfare system. (23) "Local Match" means funds received from governing bodies of local government, including city commissions, county commissions, district school boards, special tax districts, private hospital funds, private gifts both individual and corporate, and bequests and funds received from community drives or any other sources. See § 394.67, F.S. F.S. and 65E-14.005, F.A.C. (24) "Managing Entity (ME)" as defined in section 394.9082(2)(e), F.S., is a corporation selected by and under contract with the Department to manage the daily operational delivery of behavioral health services through a coordinated system of care. (25) "Mental Health Services" is defined pursuant to Chapter 394.67 (15), F.S. (26) "Motivational Support Program" are services provided in Monroe County designed to reduce the incidence of child abuse and neglect resulting from parents' or caregivers' behavioral health and to improve outcomes for families in the child welfare system and/or community-based care. (27) "Network Provider" is an entity that contracts with the ME and receives funding to provide services to eligible individuals; in this contract the Network Provider is synonymous with network service providers, provider or subcontractor. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 3 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:fea th ��et���ark.l (%) /1W;2020 (28) "Outcome for Individual Service Recipient" is a measure of the quantified result, impact, or benefit of services on the individual service recipient. (29) "PBPS" is the Department's Performance Based Prevention System that collects data related to community assessments and plans and substance use prevention programs and activities. (30) "Performance Measures" are quantitative indicators, outcomes and outputs that are used by the Department to objectively measure performance and are used by the ME and Network Providers to improve services. (31) "Prevention" refers to the proactive approach to preclude, forestall, or impede the development of substance use or mental health related problems. These strategies focus on increasing public awareness and education, community-based processes, and incorporating evidence-based practices. Additional guidance regarding prevention services can be found in the Department's Guidance Document 10, Prevention Services and is available at the following link: https://www.myflfa m i I ies.com/service-p rogra ms/sa m h/ma nagi ng-entities/i ndex.shtm I Note: Click on FY20-21 ME Templates and click on Guidance Document 10, Prevention Services (32) "Prime Contract" is the contract between the Department of Children and Families and the ME. (33) "Program Descriptions" are the documents the Network Provider prepares and submits to the ME for approval prior to the start of the contract period, which provide detailed description of the services to be provided under the contract pursuant to Rule 65E-14, F.A.C. It includes but is not limited to the Network Provider's organizational profile, the service activity description, a detailed description of each program and covered service funded in the contract, the geographic service area, service capacity, staffing information, and target population to be served. (34) "Projects for Assistance in Transition from Homelessness (PATH)" is a federal grant to support homeless individuals with mental illnesses, who may also have co-occurring substance use and mental health treatment needs. (35) "Protected Health Information" (PHI) relates to any information whether oral or recorded in any form or medium that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and 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. (36) "Provider Network" (subcontractor or Network Provider) refers to the group of direct Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 4 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 service providers, facilities, and organizations under contract with a ME to provide a comprehensive array of emergency, acute care, residential, outpatient, recovery support, and support services including prevention services and any other services purchased by this contract. See section 394.9082, F.S. (37) "Quality Assurance" is a process that measures performance in achieving pre-determined standards, validates internal practice, and uses sound principles of evaluation to ensure that data are collected accurately, analyzed appropriately, reported correctly and acted upon in a timely manner. The process may employ peer review, and outcomes assessment to assess quality of care. (38) "Quality Improvement/Continuous Quality Improvement" is a management technique to assess and improve internal operations and network services. It focuses on organizational systems rather than individual performance and seeks to continuously improve quality. The process involves setting goals implementing systematic changes, measuring outcomes, and making subsequent appropriate improvements. Quality improvement activities will assess compliance with contract requirements, state and Federal law and associated administrative rules, regulations, and operating procedures and validate quality improvement systems and findings. (39) "Representative Payee" refers to an entity/individual that is legally authorized to receive Supplemental Security Income, Social Security Income, Veterans Administration benefits, or other federal benefits on behalf of an individual who is unable to manage or direct the management of his or her benefits. (40) "SAMH" stands for the Substance Abuse and Mental Health Programs within the Department. (41) "Seclusion and Restraint Data System" referred to as SANDR, is the Department of Children and Families' web-based data system used to collect and report the frequency and types of seclusion and restraint events that involve persons served in state-contracted and non-state contracted community substance use and mental health programs, and state mental health treatment facilities. All facilities, as defined in section 394.455(10), F.S., are required to report each seclusion and restraint event to the Department of Children and Families in accordance with but not limited to Rule 65E-5.180, F.A.C. (42) "SOAR" stands for Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access and Recovery and is a Substance Abuse and Mental Health Services Administration (SAMHSA) technical assistance initiative designed to help individuals increase earlier access to SSI and SSDI through improved approval rates on initial Social Security applications by providing training, technical assistance, and strategic planning to Network Providers. (43) "Stakeholder(s)" are individuals/groups with an interest in the provision of treatment services for substance use, mental health services, co-occurring disorders and prevention services in the county(ies) outlined in Section A.2.c.(2), of this Contract. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 5 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (44) "Statewide Inpatient Psychiatric Programs (SIPP)"" are residential inpatient facilities under contract with the Agency for Health Care Administration (AHCA) under the Medicaid Institutes for Mental Disease (IMD) 1915B waiver for children under age 18 to provide diagnostic and active treatment services in a secure setting. (45) "Substance abuse" as defined in Chapter 397, F.S., means the misuse or abuse of, or dependence on alcohol, illicit drugs, or prescription medications. As an individual progresses along this continuum of misuse, abuse, and dependence, there is an increased need for substance abuse intervention and treatment to help abate the problem. (46) "Substance Abuse and Mental Health Information System (SAMHIS)" is the Department's web-based data system for reporting data such as but not limited to, Demographic, Temporary Assistance to Needing Families data, Seclusion and Restraint data and Incident reports by the Managing Entity and all Network Service Providers in accordance with this contract. (47) TANF Participant" is a person or family member of that person defined in 45 C.F.R. Part 260.30 and section 414.1585 and subsection 414.0252(9), F.S. (48) "Temporary Assistance to Needy Families (TANF)" as defined by 42 U.S.C. ss. 601, et. seq., and ch. 414, F.S., is a federal block grant component which provides funding to states to help move recipients into work. In the context of the Department, Office of Substance Abuse and Mental Health (SAMH), TANF is a funding stream for providing substance use disorder services or mental health services to families receiving TANF cash assistance benefits. (49) "Third Party Payer" means commercial insurers such as workers' compensation, TRICARE, Medicare, Health Maintenance Organizations, Managed Care Organizations, or other payers liable, to the extent that they are required by contract or law, to participate in the cost of providing services to a specific individual. (50) "Warm Hand-off" as defined by the U.S. Department of Health and Human Services is a transfer of care between two members of the health care team, where the handoff occurs in front of the patient and family. This transparent handoff of care allows patients and families to hear what is said and engages patients and families in communication, giving them the opportunity to clarify or correct information or ask questions about their care. Warm handoffs engage the patient through structured communication and improve safety by helping prevent communication breakdowns. 2. General Description a. General Statement The services provided under this contract are community-based behavioral health services for an individual served-centered and family-focused recovery-oriented coordinated Attachment I HCO2 (a) Guidance Care Center, Inc. Page 6 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 system of care (ROSC). A ROSC is a value-driven, coordinated network of community- based services and supports that are person centered, self-directed, and build on the strengths and resiliencies of individuals and families to sustain long-term, community- based recovery. A ROSC promotes shared decision-making, enhances collaborations between the community and providers, and it empowers individuals to be active participants in their recovery. Services should instill hope, offer choice, elicit and honor each person's potential for growth, and attend to the person's overall health and wellness. The contract requires a qualified, direct service, community-based Network Provider who will provide services for children, adolescents, and adults as applicable, with behavioral health issues as authorized in section 394.9082, F.S., consistent with Chapters 394, 397, 916, section 985.03, F.S. (as applicable) and consistent with the Prime Contract (ME's contract with the Department), which is incorporated herein by reference. The Network Provider must work in partnership with the ME to better meet the needs of individuals with co-occurring substance use and mental health disorders and expand its array of services to provide trauma informed care, as appropriate. The partnership process will be open, transparent, dynamic, fluid, and visible. The process must also serve as an opportunity for collaboration to continuously improve the quality of services. During the course of the contract period, the ME will require that the Network Provider participate in the process of improving co-occurring disorder service capability system wide, trauma informed care services and ensure the integration of behavioral health services and primary care services to all the individuals in care in coordination with a Federally Qualified Health Center or other medical facility as required by this Contract. The Network Provider must work in collaboration and must assist, upon request of the ME, in fulfilling its contractual obligations pursuant to the Prime Contract with the Department of Children and Families including but not limited to the following functions: (1) System of Care Development and Management; (2) Quality Improvement; (3) Data Collection, Reporting, and Analysis; (4) Financial Management; (5) Disaster Planning and Responsiveness b. Authority Section 394.9082, F.S., and the Prime Contract provides the ME with the authority to contract for these services. c. Scope of Service The following scope of service applies to the contract period and any renewal or extension: (1) The Network Provider is responsible for the administration and provision of services to the target population(s) indicated in Exhibit A, Individuals to be Served, and in accordance with the tasks outlined in this contract. Services must also be delivered at the locations specified Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 7 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 in, and in accordance with the Program Description, as required by Rule 65E-14, F.A.C., which is herein incorporated by reference, and maintained in the ME's Contract Manager's file. (2) Unless otherwise authorized by the ME, services are to be delivered in the following county(ies): _Miami-Dade County X Monroe County _ Broward County d. Major Contract Goals The ME's goals for the SAMH Programs funded by this Contract are to improve access to care and promote service continuity and to support efficient and effective delivery of services, furthermore, the Florida Department of Children and Families is committed to partnering with stakeholders to transform Florida's substance use and mental health system into a recovery- oriented system of care (ROSC), and are as follows: (1) Provide access to quality, recovery-oriented system of care and community-based services and supports for persons with behavioral health disorders. (2) Community-based health and prevention promotion by encouraging overall emotional health and wellness and preventing substance use, reduce the spread of infectious diseases, prevent and reduce attempted and completed suicides, and reduce opioid related overdose deaths. (3) Integrate the Child Welfare and behavioral health systems. (4) Improve co-occurring capability, trauma informed care, cultural and linguistic competence, ensure the integration of behavioral health and primary health care services and expertise in all programs. (5) For funded substance use prevention services, the intent of substance use prevention is to promote and improve the behavioral health of Florida's Southern Region communities by strategically applying substance use prevention programs, and environmental strategies that are relevant to community needs as defined in a ME approved Comprehensive Community Action Plan (CCAP).The CCAP can be upon request to the ME's Director of Prevention Services. e. Minimum Programmatic Requirements The Network Provider must maintain the following minimum programmatic requirements: (1) System of Care The individual-centered and family-focused system of care will: (a) Be driven by the needs and choices of the individuals served; Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 8 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (b) Promote family and personal self-determination and choice; (c) Be ethically,socially,and culturally responsive;and (d) Be dedicated to excellence and quality results. There is a commitment to improve access to care, promote service continuity, support efficient and effective delivery of services that utilize evidence-based practices, recovery-oriented and peer involved approaches in accordance with priorities established by the ME and the Department for substance use, mental health treatment and/or co-occurring disorders and, substance use prevention services. (2) Guiding Principles Guiding principles specify that services are as follows: (a) Inclusive - involve and engage families and individuals served as full partners to participate in the planning and delivery of services; (b) Comprehensive - incorporating a broad array of service and supports (e.g. physical, emotional,clinical,social,educational, community and spiritual); (c) Individualized- meeting the individual's exceptional needs and strengths; (d) Strengths based — focus on the strengths of the individual served, not their deficits; (e) Community-based- provided in the least restrictive,clinically appropriate setting; (f) Coordinated-both at the system and service delivery levels to ensure that multiple services are provided and change as seamlessly as possible when warranted; (g) Cultural and linguistic competence; (h) Gender responsive; (i) Sexual orientation; and (j) Recovery-oriented and recovery-supported. 3. Individuals to be Served See Exhibit A,Individuals/Participants to be Served B. Manner of Service Provision 1. Service Tasks Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 9 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 The following tasks must be completed for each fiscal year covered in the contract period. a. Task List (1) Based on individual needs, the Network Provider agrees to provide appropriate services from the list of approved programs/activities described in Exhibit G, Covered Service Funding by OCA and the description of such services specified in the Program Description as required by Rule 65E-14, F.A.C. Any change in the array of services must be justified in writing and submitted to the ME's Contract Manager for review and approval. (2) The Network Provider must serve the number of persons indicated in Exhibit D, Substance Abuse and Mental Health Required Outcomes/Outputs. Failure to meet the minimum numbers served may result in a corrective action and an imposed financial penalty as described in the Standard Contract. (3) The Network Provider must assure the delivery of services is based on Evidence-Based Practices implemented with fidelity and in accordance with the approved Program Descriptions. (4) The Network Provider must adhere to treatment group size limitations not to exceed the group size limitations outlined in the current Medicaid Handbook. (5) The Network Provider must develop and implement policies so that all applicable providers' employees abide by the terms and conditions of Paragraph 39., Information Security, of the Standard Contract. The Network Provider must submit to the Managing Entities Contract Manager, by 08/03/2020, an attestation that all applicable Network Provider employees and subcontractors who have access to ME and Department information systems have completed the Security Agreement form as required in Paragraph 39. Information Security, of the Standard Contract. (6) For licensable services purchased by this Contract, the Network Provider must have and maintain correct and current Department of Children and Families, as required by Rule 65D- 30, F.A.C., Licensure Standards for Substance Abuse Services and Agency for Health Care Administration (AHCA) licenses and only bill for services under those licenses. In the event any of the Network Provider's license(s) is suspended, revoked, expired or terminated, the ME must suspend payment for services delivered by the Network Provider under such license(s) until said license(s) is reinstated. (7) Network Providers serving persons with substance use disorders must use the American Society of Addiction Medicine (ASAM) to determine placement and level of care as required by FASAMS DCF Pamphlet 155-2. (8) The Network Provider must ensure that individuals discharged from state mental health Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 10 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 treatment facilities will be maintained on the medication that was prescribed for them by the facility at discharge. Maintenance includes performing required lab tests, providing the medication,and providing appropriate physician oversight. (9) By 08/03/2020, the Network Provider must submit to the ME's Contract Manager an updated disaster plan consistent with Paragraph 23., Emergency Preparedness, of the Standard Contract. (10) Should the ME conduct a mock emergency drill, the Network Provider must participate by activating their emergency/disaster plan and reporting on preparedness activities, response activities, and post-recovery activities. (11) By 08/03/2020, the Network Provider must submit to the ME's Contract Manager an updated Civil Rights Compliance Checklist(CF0946). (12) By 08/03/2020, the Network Provider must submit to the ME's Contract Manager an updated Civil Rights Certificate (CF707), signed a dated by the Network Provider's contract signer. (13) By 08/03/2020, the Network Provider must submit to the ME's Contract Manager grievance procedures, which include an appeal process with the ME, should the grievance not be resolved at the Network Provider level, which applicants for, and recipients of, services being provided under this contract, may use to present grievances to the Network Provider, or to the ME about contracted services. Should any updates to the grievance procedures occur during the term of this contract, the Network Provider must submit the amended procedures to the Contract Manager within thirty (30) calendar days of the amendment. The Network Provider must post and provide copies of the grievance procedures to all individuals receiving services with funds provided for in this Contract. (14) By 08/03/2020, the Network Provider must submit to the ME's Contract Manager a Quality Assurance Plan that details how the Network Provider will ensure and document that quality services are being provided to the individuals served, which is herein incorporated by reference. The Network Provider must submit updates as amended of the Quality Assurance Plan within thirty (30) days of adoption. The Quality Assurance Plan should address the minimum guidelines for the Network Provider's continuous quality improvement program, including, but not limited to: (a) Individual care and services standards to include transfers and referrals, co-occurring supportive services, trauma informed services, cultural and linguistic competence, integrated care, recovery-oriented system of care principles. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 11 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (b) Individual records maintenance and compliance. (c) Staff development standards. (d) Service-environment safety and infection control standards. (e) Peer review procedures. (f) Incident reporting policies and procedures that include verification of corrective action and a provision that specifies that a person who files an incident report, in good faith, may not be subjected to any civil action by virtue of that incident report. (g) Fraud, waste, abuse and other potential wrongdoing auditing, monitoring, and remediation procedures. (h) Evidence-based practices (EBPs) utilized by the agency and how these EBPs are monitored to ensure fidelity to the model. (i) The Continuous Quality Improvement Initiatives identified in Section B.1.a.(23) below. (15) By 10/01/2020, the Network Provider must submit an attestation signed by the CEO/Executive Director indicating that all applicable staff funded by this Contract have received a copy of this fully executed contract and will receive copies of any amendments made to this Contract. (16) The Network Provider must operate under the principles of a Recovery Oriented System of Care (ROSC). ROSC principles promote a coordinated network of community-based services and supports that is person-centered, self-directed care, and builds on the strengths and resilience of individuals, families, and communities to achieve improved health, wellness, and quality of life. As such, the Network Provider should operate under a "no wrong door" model as defined in s. 394.4573, F.S., as well as the other guiding principles of ROSC. The network provider must also participate in all implementation activities and Technical Assistance provided by DCF and the ME. (17) The Network Provider must execute and/or maintain if executed a Memorandum of Understanding (MOU) with a Federally Qualified Health Center or other medical facility. The MOU provides for integration of behavioral health services and primary health care services to the medically underserved to achieve the goals specified in Section B.1.a.(23)(a) of this Attachment I. The Network Provider also agrees to accept referrals from the primary health care provider for eligible individuals who are in need of behavioral health services. Newly executed MOU's must be submitted within ninety (90) calendar days of the effective date of this contract to the ME's Contract Manager. The Network Provider must submit copies Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 12 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 of any amendment to the MOU, to the ME's Contract Manager, within thirty (30) calendar days of execution. Network Providers that operate Federally Qualified Health Centers are required to submit policies and procedures that explain the access to primary care services to the medically underserved behavioral health individual served. Any revisions to the policy and procedure must be submitted to the ME's Contract Manager within 30 calendar days of its adoption. (18) Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access,and Recovery(SOAR) If providing case management services to adults or children with mental illnesses or co- occurring disorders who are homeless or at risk of homelessness., the Network Provider must adhere to the requirements of Exhibit AN, Supplemental Security Income/Social Security Disability Insurance(SSI/SSDI)Outreach,Access,and Recovery(SOAR). (19) Linkage and Referral Process (a) The Network Provider's policies and procedures must address the referral and linkage process which include a "warm handoff" when referring individuals to all levels of services. This includes, but is not limited to, referrals within a Network Provider from one level of care to another, i.e. residential to outpatient; referrals outside of the Network Provider when a service is not offered by the Network Provider; and referrals to services upon discharge from the Network Provider, regardless if a planned or unplanned discharge. This also includes when an individual presents at the Network Provider for a service; however, they are not actually admitted to the service for varying reasons. Such referral services include, but are not limited to, detoxification services, linkages with community programs such as housing, employment, parenting supports, and primary health care. (b) A warm handoff consists of the Network Provider coordinating and facilitating the individual's admission to the next appropriate level of care by direct communication and follow-up with the receiving provider. These efforts must be documented and maintained in the individual's clinical record and should include detailed information including dates, times, and names of people spoken to. (c) When a referral is made for a service at another provider with the expectation to return to the referring provider, i.e. detoxification, the referring Network Provider should initiate the warm handoff and maintain follow-up with the receiving provider to coordinate entry back to the referring Network Provider. This must be documented and maintained in the individuals' clinical record and should include detailed information Attachment I HCO2 (a) Guidance Care Center, Inc. Page 13 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrq)t South �1�€a��ida �at�����or ill t:ea th ��et��� rk. (a) /1W;2020 including dates, times, names of people spoken to, and final disposition, i.e. date returned or justification when not returning. (20) The Network Provider must ensure provision of services to individuals with special needs The Network Provider must ensure the coordination of specialty services including employability skills training and linkage, victimization and trauma services, infant mental health services, and services to families in recovery. The Network Provider must also ensure the availability of appropriate services to individuals with special needs such as those who are blind, deaf or hard of hearing, developmentally disabled, physically handicap, criminally involved, or individuals with forensic involvement. The ME reserves the right to modify this list as the needs of the individuals change. (a) The Network Provider must provide early diagnosis and treatment intervention to enhance recovery and prevent hospitalization. (b) The Network Provider must work with the ME, the state, and other stakeholders to reduce the admissions and the length of stay for dependent children and adults with mental illness in residential treatment services. (21) System of Care Management The ME system of care staff ensures availability of and access to a broad, flexible array of effective, evidence-informed, community-based services and supports for children, youth, adults and their families that addresses their physical, emotional, social, and educational needs, including traditional and nontraditional services as well as informal and natural supports. The spectrum of effective, community-based services and supports is organized and coordinated through the Provider Network. The goals of the System of Care management activities include elimination/management of wait lists, the maximum utilization of treatment resources, and the delivery of clinically appropriate services in the least restrictive setting and most cost-effective manner. System of Care Management includes pre-service authorization for some services as well as management of continued stays and billing validation If the Network Provider contracts for services that are managed by the ME, the Network Provider must work in collaboration and assist the ME in fulfilling its contractual obligation and agrees to: (a) The Network Provider agrees to assist the ME in the reporting and managing of the waiting list for all applicable levels of care: Attachment I HCO2 (a) Guidance Care Center, Inc. Page 14 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 i. Substance Abuse Residential Treatment Level II ii. Mental Health Residential Treatment Level II iii. Care Coordination iv. Florida Assertive Community Treatment (FACT) v. Short-term Residential Treatment vi. Statewide Inpatient Psychiatric Program vii. Specialized Therapeutic Group Homes (b) The Network Provider agrees to submit real-time services data when required by the Prime Contract, state and/or federal rules, regulations, or the ME's policies and procedures, the Network Provider must submit to the ME real-time data in KIS Express, or other similar data structure, for services purchased by this contract. The Network Provider agrees to implement the new data reporting system(s) when notified and as directed by the ME. (c) The Network Provider will have a data system in place that adequately supports the collection, tracking, and analysis of data necessary to perform the system of care management activities, reviews of clinical/administrative performance related to levels of care, clinical outcomes, and adherence to clinical/administrative standards. (d) The Network Provider agrees to conduct financial screening to ensure maximization of fiscal resources including other third-party payors such as, but not limited to KidCare, Medicaid, Medicare, and other HMOs. These methods may include programs of intervention and/or diversion. System of Care management includes not only managerial and supervisory strategies, methods and tools to ensure timely access to care, but also includes processes to promote continuous improvement to manage resources. (e) The Network Provider will offer consumers a multi-level continuum of care services for treatment of behavioral health services and supports within the least restrictive, most normative environments that are clinically appropriate. (22) Continuous Quality Improvement Programs (a) The Network Provider must maintain a continuous quality improvement program and report on the continuous quality improvement activities. The program is the responsibility of the Director and is subject to review and approval by the governing board of the service Network Provider. Each director must designate a Quality Assurance Officer/Compliance Officer who will be responsible for the continuous quality improvement program. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 15 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 The continuous quality Improvement program should objectively and systematically monitor and evaluate the appropriateness and quality of care to ensure that services are rendered consistent with prevailing professional standards and identify and resolve problems. (b) The quality improvement program must include at minimum: i. Activities to ensure that fraud, waste and abuse do not occur. ii. Composition of quality assurance review committees and subcommittees, purpose, scope, and objectives of the continuous quality assurance committee and each subcommittee, frequency of meetings, minutes of meetings, and documentation of meetings. iii. A framework for evaluating outcomes, including: 1. Output measures, such as capacities, technologies, and infrastructure that make up the system of care. 2. Process measures, such as administrative and clinical components of treatment. 3. Outcome measures pertaining to the outcomes of services; iv. A system of analyzing those factors which have an effect on performance; V. A system of reporting the results of continuous quality improvement reviews; and, vi. Best practice models for use in improving performance in those areas which are deficient. vii. Establishment of a Seclusion and Restraint Oversight Committee per Chapter 65E-5.180, F.A.C. for agencies utilizing seclusion and/or restraint. (23) Continuous Quality Improvement Initiatives - Providers must comply with all of the provisions for the initiatives outlined below: (a) Integration of Behavioral Health Services and Primary Health Care It is the goal of the ME to ensure the integration of behavioral health services and primary care services to all the individuals in care. The integration will be ensured through linkage of the behavioral health provider with the primary health care provider of the individual through an electronic health record or other means of Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 16 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 contact (phone, in person, etc). Referral and linkage processes will be necessary for all individuals who do not have a primary health care provider at entry into the system of care. Follow up and coordination of services are essential to meeting an individual health and behavioral health needs. Many individuals with behavioral health issues have chronic health conditions and may have neglected their primary health needs for some time. The ME and the Southern Region are committed to developing an integrated system of care that incorporates comprehensive screening and monitoring tools that identify those affected by chronic health conditions and a system of care that meets their needs. Network Providers will be implementing Integrated Primary and Behavioral Health techniques and initiatives to meet this need. This initiative will be addressed through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the Health Integration Initiative. As part of the plan or component of the plan must include the following: i. Identification of at least two Integrated Healthcare Champions who will attend trainings and meetings. The names of the Integrated Healthcare Champions will be submitted upon request by ME staff. In the event of change in staff occur, the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days. ii. Identification of the Federally Qualified Health Center or other medical facility where individuals who have been identified as needing primary health care services are referred to or the process established by the Network Provider to coordinate services with individuals' private primary health care provider should such exist. iii. A process to track and report referrals of individuals of: • behavioral health services to primary health care services, and • from a primary health care provider to behavioral health services. The outcomes must be reported in the semi-annual Continuous Quality Improvement Updates. iv. Participation in the regional Healthcare Integration Committee meetings to develop the processes and training germane to this initiative. V. Attendance of appropriate staff at the regional trainings regarding Integrated Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 17 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 Healthcare, as requested by the ME staff. Participation in the trainings will be documented in the Continuous Quality Improvement Updates. (b) Trauma Informed Care Many individuals with behavioral health issues have experienced trauma that affects their development and adjustment. The ME and the Southern Region are committed to developing a system of care that incorporates comprehensive assessment tools that identify those affected by trauma and a system of care that meets their needs. Network Providers will be implementing the Trauma Informed Care (TIC) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the TIC initiative. As part of the plan or component of the plan must include the following: i. Identification of at least two TIC Champions who will attend trainings and meetings. The names of the TIC Champions will be submitted upon request by ME staff. In the event of change in staff occur, the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days. ii. Participation in the regional TIC meetings to develop the process for identifying and responding to those affected by trauma. iii. Attendance at the regional trainings regarding TIC as applicable. Applicable trainings will be documented in the Continuous Quality Improvement Updates. iv. Participation in all TIC related activities to ensure staff and agency become competent in all areas of trauma informed care. (c) Cultural and Linguistic Competence It is the goal of the ME to become a culturally and linguistically proficient network, through the full implementation of The National Standards for Cultural and Linguistically Appropriate Services (the National CLAS Standards). The National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and behavioral health care. In order to accomplish this task, the Network Provider: i. Identification of at least two CLC Champions who will attend trainings and meetings. The names of the CLC Champions will be submitted upon request by ME staff. In the event of change in staff occur, the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days. ii. Participation in the regional CLC meetings. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 18 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 iii. Collaborate with the ME to identify and utilize the Network Provider's data to (1) identify sub-populations (i.e., racial, ethnic, Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, or Two-Spirited (LGBTQI-2S), minority groups) vulnerable to disparities and (2) implement strategies to decrease the differences in access, service use, and outcomes among sub-populations. These strategies should include the use of the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care; iv. Agrees to implement effective language access services to meet the needs of individuals with limited-English-proficiency, and/or who are deaf or hard-of-hearing, and increase their access to behavioral health care by providing sign language, translation, and interpretive services required to meet the communication needs of the individual seeking and or receiving services as required by state and federal laws, including English, Spanish and Creole. Services will meet the cultural needs and preferences of the populations served. (d) Integration of Behavioral Health and the Child Welfare System i. The Network Provider will ensure that behavioral health services are available to individuals and families referred by the Community Based Care Organizations (CBC) or by the Department's Child Protective Investigators in cases where behavioral health indicators are present during the initial child abuse/neglect investigation or at any point during child protective supervision or out-of-home care. Priority will be given to cases where a child is at risk for immediate removal or has been removed from the family, with a goal of reunification in the family safety plan. Services may also be provided for the enrolled parent(s)'/caregiver(s)' family members, household residents, or significant others in need of behavioral health prevention or treatment services, as well as children in relative placements. For a detailed description of the consumer eligibility criteria please refer to the approved Motivational Support Program Protocols and Family Intensive Treatment Team Protocols, herein incorporated by reference, and available upon request to the MEs Contract Manager. ii. The coordination of efforts between the CBC, the ME and Network Providers is essential to the efficient service delivery for child-welfare involved families in behavioral health treatment. The ME and the Southern Region's Lead Agency for Community Based Care Provider are committed to developing an integrated system of care that meets the needs of children and their families. Network Providers will implement the Child Welfare Integration (CWI) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the CWI initiative. As part of the plan or component of the plan must include the following: Attachment I HCO2 (a) Guidance Care Center, Inc. Page 19 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 1. Identification of at least two CWI Champions who will attend trainings and meetings. The names of the CWI Champions will be submitted upon request by ME staff. In the event a change in staff occurs, the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days. 2. Participation in the CWI meetings to develop the process for identifying and responding to child-welfare involved families. 3. Attendance at the Integration Workgroup meetings. 4. Participation in all CWI related activities to ensure staff and agency become knowledgeable of the Child Welfare system. 5. Description of the process to monitor and ensure that requests for any requested reports from the CBC or a CBC Network Provider is provided in a timely manner. The Network Provider must provide the reports within five (5) business days of receipt of the written request from the requestor. In cases of emergencies, (less than 24-hour notice), the supervisor at the Network Provider will accept the telephone call request for the report(s). The supervisor will request and ensure receipt of a written request within twenty-four (24) hours following the initial telephone call. (e) Accreditation The Network Provider must take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2021, as required by this section, in order to promote best practices and the highest quality of care. The Network Provider must provide the ME with their full accreditation and licensing reports upon request. Network Provider applicants for licensure and licensed network providers must meet the most current best practice standards related to the licensable service components of the accrediting organization. Accreditation by an accrediting organization recognized by the Department, as required by Chapter 397, F.S., is a requirement for licensure renewal of clinical substance use treatment services. The licensable substance use treatment components are listed in subsection 65D- 30.002 (17), F.A.C. Failure to meet the accreditation requirements will be considered by the ME to be a breach of this Contract and this contract may be subject to termination. (24) Continuous Quality Improvement Updates Attachment I HCO2 (a) Guidance Care Center, Inc. Page 20 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 The Network Provider must submit semi-annual updates, by the dates specified in Exhibit C, Required Reports, on the implementation and progress of the following activities: (a) Integration of Behavioral Health Services and Primary Care; (b) Trauma Informed Care; (c) Cultural and Linguistic Competence; (d) Identification of the evidence-based practices (EBPs) utilized by the agency and address how these EBPs are monitored to ensure fidelity to the model; (e) Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; (f) Recovery-oriented system of care principles; (g) Monitoring processes to ensure that licensable substance use and mental health treatment services are appropriately licensed by either the Florida Department of Children and Families and/or the Agency for Health Care Administration, as applicable prior the start of services; (h) Evidence of the implementation of the integration of behavioral health services and primary health care, evidence of tracking and ensuring the successful referrals and linkages of individuals receiving of behavioral health services to primary health care services and individuals referred from the primary health care provider to the Network Provider for behavioral health services, and include progress on the implementation as described in the Network Provider's action plan to include the following: i. The number of individuals receiving behavioral health services that are identified as needing primary care. (25) Care Coordination Network Providers providing care coordination, are required to implement Care Coordination services as defined in section 394.4573(1)(a), F.S., and specified on DCF Guidance Document 4, Care Coordination, and the ME's Care Coordination Exhibit AX, all documents are incorporated herein by reference and available when requested to the ME's Contract Manager. Section 394.4573(1)(a), F.S., defines Care Coordination to "mean the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 21 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 service linkage. The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations." The priority populations are defined in the DCF Guidance Document 4, Care Coordination. Care Coordination serves to assist individuals who are not effectively connected with the services and supports they need to transition successfully from higher levels of care to effective community-based care. Care Coordination is not intended to replace case management. ME Care Coordination staff identifies individuals eligible for Care Coordination through data surveillance, refer individuals to the Network Provider, track individual's progress through the service continuum, ensure a linkages to a wide range of services and monitor outcome metrics. The Network Provider is also responsible for the identification of eligible for Care Coordination individuals through internal data surveillance. Upon identification of eligible individuals, the Network Provider refer individuals to their internal Care Coordination services internally, and to the ME Care Coordination Department (26) Transitional Voucher Program The Transitional Voucher project is a flexible, consumer-directed voucher system designed to bridge the gap for persons with behavioral health disorders as they transition from acute or more restrictive levels of care to lower levels of care. The intent of this project is to enable individuals to live independently in the community with treatment and support services based on need and choice and build a support system to sustain their independence, recovery, and overall well-being. For individuals identified as meeting criteria for the transitional voucher project, the Network Provider shall adhere to the Department's Guidance Document 29, the ME Care Coordination, Exhibit AX, and the Exhibit AV, Transitional Voucher Program. (27) Financial Audit Reports (a) The Network Provider must submit financial statements consisting of Balance Sheet and Statement of Activity (income statement) per the schedule and to the individual(s) identified in the Exhibit C, Required Reports. The Network Provider agrees to provide the ME with any requests for additional financial statements/documentation. (b) Network Providers who withhold income taxes, social security tax, or Medicare tax from employee's paychecks or who must pay the employer's portion of social security or Medicare tax must use Form 941, Employer's Quarterly Federal Tax Return, to report those taxes. On a quarterly basis, and by the dates specified in Exhibit C, Required Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 22 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:fea th ��et��� rk. (a) /1W;2020 Reports, the Network Provider, must submit an attestation that the 941 has been filed timely and any taxes due have been paid timely to IRS. (c) The Network Provider must complete and submit the Department-approved Local Match Calculation Form as a supplemental report to the annual financial audit reports as required by Attachment 11, Financial and Audit Compliance per the schedule and to the individual(s) identified in the Exhibit C, Required Reports. The Department-approved Local Match Calculation Form, Template 9— Local Match Calculation Form is available at the following website: https://www.myflfa m i l ies.com/service-progra ms/sa m h/ma nagi ng-entities/i ndex.shtm I Note: Click on FY20-21 ME Templates and click on Reporting Template 9 — Local Match Calculation Form (28) The Network Provider must ensure that its audit report will include the standard schedules that are outlined in Rule 65E-14, F.A.C. and submitted within the timeframes specified in Exhibit C, Required Reports. (29) The Network Provider must implement and maintain fiscal operational procedures. These must contain but, not be limited to procedures relating to overpayments, charge-backs that directly apply to subcontractors and documentation of cost sharing (match) that comply with state and federal rules, regulations and/or ME policies and procedures and must comply with the requirements in Section 7., Audits, Inspections, Investigations, Records, and Retention. (30) The Network Provider must make available upon request all plans, policies, procedures, and manuals to ME staff, Department staff, Network Provider staff, and to individuals served/stakeholders if applicable and appropriate. (31) The Network Provider must comply with Children and Families Operating Procedure 215-8, OVERSIGHT OF HUMAN SUBJECT RESEARCH AND INSTITUTIONAL REVIEW BOARD DESIGNATION. The policy and guidance can be found at: http://www.myflorida.com/apes/vbs/adoc/F2551 ITN09H13GC1Addendum10 CFOP2158.pdf Approval from the Department through the ME is mandatory for all research conducted by any employee, contracted organization or individual, or any public or private vendor, even if the aforementioned has their own Institutional Review Board which has granted approval. (32) The Network Provider must meet with the ME's staff at regularly scheduled or any called meetings when notified by the ME. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 23 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:fea th ��et��� rk. (a) /1W;2020 (33) The Network Provider must notify the ME within forty-eight (48) hours of conditions related to performance that may interrupt the continuity of service delivery or involve media coverage. (34) The Network Provider will promote personal self-determination and choice by following Recovery-Oriented principles: (a) Ensuring that the needs and preferences of individuals served, and their families drive treatment planning and service delivery, and that individuals served and their families (with consent) are involved in all aspects of treatment (pre, during and post); (b) Engaging service recipients, family members, and advocates in the design, development, and evaluation of services; (c) Giving individuals served a choice of provider and services,whenever possible; (d) Assessing and improving individual served satisfaction. (35) Referrals and Case Management Services to Individuals Residing in Assisted Living Facilities with a Limited Mental Health License (a) It is unlawful to knowingly refer a person for residency to an unlicensed assisted living facility; to an assisted living facility the license of which is under denial or has been suspended or revoked; or to an assisted living facility that has a moratorium pursuant to part II of chapter 408. Referrals to unlicensed facilities are not lawful and subject to sanctions by the Agency of Health Care Administration (AHCA). (b) The Network Provider is directed to only refer individuals receiving mental health services to Assisted Living Facilities with a Limited Mental Health License. It is the referring Network Provider's responsibility to verify licensure. AHCA licenses can be verified at the following website: http://www.floridahealthfinder.gov/facilitylocator/FacilitySearch.aspx (c) In circumstances where the Network Provider determines that placement of particular individual in an Assisted Living Facilities with a Limited Mental Health License is unsuitable, the Network Provider must document in the persons treatment plan or service plan the rationale for alternative placement in an ALF without a limited mental health license. (d) The Network Provider agrees to comply with provisions and the reporting requirements of Exhibit L, Assisted Living Facilities with a Limited Mental Health License, if services to such residents are offered. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 24 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (e) On a quarterly basis, the Network Provider must update and maintain in its files the ALF-LMHL Consumer Report in the required format as shown in Table 1, of Exhibit L, Assisted Living Facilities with a Limited Mental Health License. When requested by the ME, the ALF-LMHL Consumer Report must be submitted in a secured, password protected, or encrypted format. (36) Community Resource Manual The Network Provider must assist the ME in developing and maintaining the Community Resource Manual. This manual must be available for use by individuals served within each subcontractor location where services are provided. (37) Work and Social Opportunities for Peer Specialists Nationwide, health systems have accepted peers as a valuable part of the workforce. A shift to a more person-centered approach, a focus on integrated health, and a demand for more workers have increased the role peer specialists play in Florida's mental health and substance use systems. In keeping with Florida's goal of increasing the number of peer specialists, the Network Provider is encouraged to provide employment and social opportunities to individuals who have lived experience of mental health and/or substance use conditions and/or lived experience of trauma. If the Network Provider employs Peer Specialists anytime during the term of this Contract with funding from this Contract, the Network Provider must adhere the terms and conditions pursuant to Exhibit AO, Peer Services. (38) Assist Stakeholder Involvement in Planning,Evaluation,and Service Delivery (a) At the ME's request, the Network Provider will assist the ME in engaging local stakeholders, per section 394.9082 F.S., in its support activities for the Department's local plans. (b) The Network Provider must work with the ME to provide performance, utilization, and other information for the Department's Substance Abuse and Mental Health Services Plan, and annual updates thereof, and to provide appropriate information for the Department's Long-Range Program Plan and its Annual Business Plan. (39) Individual Served Satisfaction Survey(if applicable) The Network Provider must conduct satisfaction surveys of individuals served pursuant FASAMS DCF Pamphlet 155-2.The Network Provider must utilize a Department-approved satisfaction survey instrument. Failing to provide the required number of satisfaction surveys and/or utilizing a survey instrument other than that approved by the Department Attachment I HCO2 (a) Guidance Care Center, Inc. Page 25 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 will result in a corrective action and an imposed financial penalty as described in the Standard Contract. (40) Department-Sponsored Surveys The Network Provider must participate in any Department-sponsored satisfaction surveys. (41) Client Trust Funds(CTF) (a) The Network Provider must submit a letter to the Contract Manager certifying that they either are or are not the representative payee for Supplemental Security Income, Social Security Administration, Veterans Administration, Food Stamps, or other federal benefits on behalf of an individual served by August 3,2020. (b) If the Network Provider is the representative payee for Supplemental Security Income, Social Security Administration, Veterans Administration, or other federal benefits on behalf of the individual served, the Network Provider must comply with the applicable federal laws including the establishment and management of individual trust accounts (20 C.F.R. 416 and 31 C.F.R. 240). (c) Any Network Provider assuming responsibility for administration of the personal property and/or funds of individuals served must follow the Department's Accounting Procedures Manual 7 APM, 6, incorporated herein by reference. Department or the ME personnel or their designees upon request may review all records relating to this section. Any shortages of funds in an individual served account that are attributable to the Network Provider must be repaid, plus applicable interest, within one (1)week of the determination. (d) All reports specified in the Department's Accounting Procedures Manual 7 APM, 6, must be maintained onsite and available for review by Department or ME staff, and must be submitted to the ME upon request. (e) The Network Provider must also maintain and submit documentation of all payment/fees received on behalf of SAMH individuals served receiving Supplemental Security Income, Social Security Administration, Veterans Administration, Food Stamps, or other federal benefits upon request from the ME. b.Task Limits The Network Provider must perform services in accordance with applicable, rules, statutes, licensing standards and policies and procedures. The Network Provider agrees to abide by the approved Program Description, and is not authorized by the ME to perform any tasks related to the services purchased by this Contract other than those described in the approved Program Description and in this contract, without the express written Attachment I HCO2 (a) Guidance Care Center, Inc. Page 26 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 consent of the ME. The Network Provider must ensure that services are performed in accordance with applicable rules, statutes, and licensing standards. 2. Staffing Requirements a. Staffing Levels (1) The Network Provider must maintain staffing levels in compliance with applicable rules, statutes, licensing standards and policies and procedures. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations. (2) The Network Provider must engage in recruitment efforts to maintain as much as possible staff with the ethnic and racial composition of the individuals served. The ME, at its sole discretion may request documentation evidencing recruitment efforts. b. Professional Qualifications (1) The Network Provider must comply with applicable rules, statutes, requirements, and standards with regard to professional qualifications. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations. (2) The Network Provider must provide employment screening for all mental health personnel and all chief executive officers, owners, directors, and chief financial officers of service Network Providers using the standards for Level II screening set forth in Chapter 435, and s. 408.809 F.S., except as otherwise specified in s. 394.4572(1)(b)-(d), F.S. For the purposes of this contract, "Mental health personnel" includes all program directors, professional clinicians, staff members, and volunteers working in public or private mental health programs and facilities who have direct contact with individuals held for examination or admitted for mental health treatment. (3) Additionally, the Network Provider must provide employment screening for substance use personnel using the standards pursuant to Chapter 397.4073, F.S., (4) Network Providers who have programs for children are required to meet the requirements of s. 39.001(2), (a) and (b) F.S. c. Staffing Changes The Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days of staffing changes regarding the positions of Chief Executive Officer, Chief Financial Officer, Medical Director, Clinical Director, IT Director, Dispute Resolution Officer, Data Security Officer, and Single Point of Contact (section 504 of the ADA), or any individuals with similar functions. d. Subcontractors (1) This contract allows the Network Provider to subcontract for the provision of services related to the performance required under this Contract, subject to the provisions relating to Assignments and Subcontracts in the Standard Contract and referenced therein. Written Attachment I HCO2 (a) Guidance Care Center, Inc. Page 27 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 requests by the Network Provider to subcontract for the provision of services under this contract will be routed through the ME's Contract Manager for approval. The ME is not obligated nor, will it pay for any services delivered prior to its written approval of the act of subcontracting. The act of subcontracting will not in any way relieve the Network Provider of any responsibility for the contractual obligations of this contract. The pre-approval process applies to Subcontractors and not Independent Contractors as defined below. (2) The ME has adopted the following definitions for vendors, subcontractors and/or independent contractors who are contracted by the Network Provider to do work contemplated under this contract: (a) Vendor: A person or company offering something for sale. (b) Subcontractor: A business to business relationship; contracting a business or person outside of one's own company to do work as part of a larger project. (c) Independent Contractor: a person who is in an independent trade, business, or profession in which they offer their services and/or expert advice to an individual or organization. The general rule is that an individual is an independent contractor if the payer has the right to control or direct only the result of the work and not what will be done and how it will be done. The earnings of a person who is working as an independent contractor are subject to Self-Employment Tax. (3) The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non-profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. While the above-referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for- profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916 (a)(5), and 45 C.F.R., Part 96.135(a)(5)]. (4) Any vendor, subcontractor, or independent contractor the Network Provider contracts to do work contemplated under this contract, and who meets the definition of a Business Associate as defined in 45 C.F.R. 160.103, must sign a legally binding document with the Network Provider that contains the same restrictions and conditions of the Business Associate Agreement between the Network Provider with the ME. The binding document must meet the requirements of 45 C.F.R. s.164.504(e), Standard: Business Associate Contracts, the Privacy Rule, the Security Rule, the Breach Notification Rule, the Health Information Technology for Economic and Clinical Health ("HITECH") Act, the provisions included in the Network Provider's Business Associate Agreement with the ME, the ME's contractual requirements, and other laws and regulations pertaining to access, use, disclosure, and management of Protected Health Information ("PHI") without limitation, PHI in an electronic format (EPHI) created, received, maintained, or transmitted by the Network Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 28 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 Provider or its subcontractors incidental to Network Provider's performance of this Contract. (5) All agreements, for services contemplated under this contract, must adopt the applicable terms and conditions of the Network Provider's contract with the ME, including but not limited to, any Federal block grant requirements. In addition, all subcontract agreements must contain the applicable terms and conditions, and any amendments thereto, found in the ME's contract with the Department (Prime Contract), which is incorporated herein by reference. Subcontract agreements must include a detailed scope of work; term of the agreement, method of payment, clear and specific deliverables; and performance standards. (6) The Network Provider must maintain individual subcontractor files for each subcontractor and provide a copy of all subcontract's agreements prior to the execution of those subcontracts and any amendments to the ME's Contract Manager. (7) All independent contractor agreements, and subcontractor agreement, vendor agreements, and business associate agreements, or other legally binding agreements, for work contemplated under this contract must be available upon request by ME staff and at the time of monitoring. (8) The Network Provider must implement and maintain procedures for subcontract procurement, development, performance, and management that comply with state and federal rules, regulation, and/or ME policies and procedures, in addition to identifying the ME's pre-approval process for approving the Network Providers act of subcontracting. (9) The Network Provider must not subcontract for substance abuse/mental health services with any person,entity,vendor, purchase orders or any like purchasing arrangements that: (a) is barred, suspended, or otherwise prohibited from doing business with any government entity, or has been barred, suspended, or otherwise prohibited from doing business with any government entity in accordance with s. 287.133. F.S.; (b) is under investigation or indictment for criminal conduct, or has been convicted of any crime which would adversely reflect on their ability to provide services, or which adversely reflects their ability to properly handle public funds; (c) has had a contract terminated by the Department or ME for failure to satisfactorily perform or for cause; (d) has failed to implement a corrective action plan approved by the ME, the department,or any other governmental entity,after having received due notice, or (e) is ineligible for contracting pursuant to the standards in s. 215.473(2), F.S. (10) Regardless of the amount of the subcontract, the Network Provider must immediately terminate a subcontract for cause, if at any time during the lifetime of the agreement/subcontract, a subcontractor, person, entity,vendor, purchase orders or any like purchasing arrangements,is: Attachment I HCO2 (a) Guidance Care Center, Inc. Page 29 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (a) Found to have submitted a false certification under s. 287.135, F.S., or (b) Placed on the Scrutinized Companies with Activities in Sudan List or (c) Placed on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or (d) Placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel. (11) Unless the Department agrees to an alternative payment method as authorized in section 394.74, F.S., and prior to entering into any subcontract, or an amendment which modifies the previously negotiated unit cost rate or adds additional covered services, the Network Provider must conduct a cost analysis for said subcontract, in accordance with Rule 65E-14. F.A.C. A cost analysis is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. Subcontractors will be required to comply with Rule 65E-14.19, F.A.C., Methods of Paying for Services, including but not limited to, covered services, measurement standard, descriptions, program areas, data elements, maximum unit cost rates, required fiscal reports, program description, setting unit cost rates, payment for services including allowable and unallowable units and requests for payments. (12) The Network Provider must monitor the performance of all subcontractors and perform follow up actions as necessary. The Network Provider must notify the ME within forty-eight (48) hours of conditions related to subcontractor performance that could impair continued service delivery or involve media coverage. 3. Service Location and Equipment a. Service Delivery Location The location of services will be as specified in the approved Program Description required by Rule 65E- 14, F.A.C. b. Service Times (1) A continuum of services must be provided on the days and times as specified in the approved Program Description and/or Attachment IV, Prevention Scope of Work and/or Attachment V, Prevention Scope of Work — State Opioid Response, if prevention services are purchased through this contract. (2) The Network Provider must notify the ME's Contract Manager, in writing, at least ten (10) calendar days prior to any changes in days and times where services are being provided. c. Changes in Location The Network Provider must notify the ME's Contract Manager, in writing, at least ten (10) calendar days prior to any changes in location where services are being provided pursuant to Rule 65E-14, F.A.C. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 30 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 d. Equipment The Network Provider must furnish all appropriate equipment necessary for the effective delivery of the services purchased. In the event that the Network Provider is allowed to purchase any non-expendable property with funds under this contract, the Network Provider will ensure compliance with the Tangible Property Requirements, Department operating Policies and Procedures as outlined in CFOP 40-5, CFOP 80-2, Rule 65E-14, F.A.C., which are incorporated herein by reference and may be obtained from the ME's Contract Manager.The provider must submit an inventory report, as specified in the Network Provider Inventory List, incorporated herein by reference, and by the date(s) listed in Exhibit C, Required Reports.The Network Provider Inventory List form may be requested from ME Contract Manager. 4. Deliverables a. Services The Network Provider must deliver the services specified in and described in the Program Description submitted by the Network Provider in accordance with Exhibit G, Covered Services Funding by OCA and in Attachment IV, Prevention Scope of Work and/or Attachment V, Prevention Scope of Work — State Opioid Response, if prevention services are purchased through this contract. b. Reporting (1) The Network Provider must submit reports included in Exhibit C, Required Reports. In all cases, the delivery of reports, ad hoc or scheduled, must not be construed to mean acceptance of those reports. Acceptance, in writing, of required reports must constitute a separate act and must be approved by the ME's Contract Manager. The ME reserves the right to reject reports as incomplete, inadequate or unacceptable. (2) The Network Provider must provide performance information or reports other than those required by this agreement at the request of the ME, the Southern Region's SAMH Regional Director, or their designee. For requests that are complex and difficult to address, all parties will develop and implement a mutually viable work plan. (3) The ME, at its sole option, may allow additional time within which the Network Provider may remedy the objections noted by the ME or the ME may, after having given the Network Provider a reasonable opportunity to comply with the report requirements, declare this agreement to be in default. c. Electronic Data Submission The Network Provider agrees to comply with the data submission requirements outlined in FASAMS DCF Pamphlet 155-2, in SAMHIS, PBPS, as applicable, by the dates specified in Exhibit C, Required Reports. Upon request, the network provider must submit to the ME and the Attachment I HCO2 (a) Guidance Care Center, Inc. Page 31 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 Department information regarding the amount and number of services paid for by the Substance Abuse Prevention and Treatment Block Grant. The Network Provider must submit treatment data, as set out in subsection 394.74(3) (e), F.S. and FASAMS DCF Pamphlet 155-2. The Network Provider is instructed to report the modifiers to procedure codes in compliance with the FASAMS DCF Pamphlet 155-2. In addition to the modifiers to procedure codes that are currently required to be utilized as per FASAMS DCF Pamphlet 155-2, and in SAMHIS, as applicable, the Network Provider is directed to utilize the modifiers required for Block Grant funds, where applicable. The Network Provider also agrees to report to the ME and/or the Department, information regarding the amount and number of services paid for by the Community Mental Health Services Block Grant and/or the Substance Abuse Prevention and Treatment Block Grant. Service data must be submitted electronically, weekly, by 12:00 Noon every Wednesday. Final monthly service data will be submitted electronically to the ME no later than the 4th of each month following the month of service into KIS, SAMHIS, FASAMS or other data reporting system designated by the ME and/or the Department. If the 4th falls on a weekend or holiday, data will be due on the next business day. If the Network Provider is funded to provide substance use prevention services, the Network Provider must submit prevention services data to PBPS, maintained by Collaborative Planning Group Systems, Inc., or other data reporting system as directed by the ME, electronically no later than the 4th of each month following the month of service. The Network Provider must also: (a) To establish a unique client identifier for all individuals served, the Network Provider must submit the Demographic Data Set required by FASAMS DCF Pamphlet 155-2, within five (5) business days after the initial intake or admission. (b) Ensure that the data submitted clearly documents all individuals served admissions and discharges which occurred under this contract. Ensure that substance use prevention services data entered into PBPS maintained by Collaborative Planning Group Systems, Inc., or other data reporting system designated by the ME, clearly documents all program participants, programs and strategies which occurred under this contract, if applicable; (c) Ensure that all data submitted to KIS, SAMHIS, FASAMS, or other data reporting system designated by the ME is consistent with the data maintained in the Network Provider's individuals served files/EMR-EHR systems. Ensure that substance use prevention services data entered into PBPS, or other data reporting system designated by the ME and/or the Department, is consistent with the data maintained in the Network Provider service documentation and/or individual's served files, if applicable; (d) Review the ME's KIS error / download error reports to determine the number of records accepted and rejected. Based on this review, the Network Provider must make sure that the rejected records are corrected and resubmitted in KIS, SAMHIS, FASAMS, or other data Attachment I HCO2 (a) Guidance Care Center, Inc. Page 32 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 reporting system designated by the ME. Only error-free data as processed by KIS will be accepted by the ME for monthly state reporting and payment validation; (e) Resubmit corrected records no later than the next monthly submission deadline. The failure to submit any data set or the Network Provider's total monthly submission per data set, which results in a rejection rate of 5% or higher of the number of monthly records submitted will require the Network Provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected records will be corrected and resubmitted; and (f) In accordance with the provisions of section 402.73(1), F. S., and Rule 65-29.001, F.A.C., corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. Failure to implement corrective action plans to the satisfaction of the ME and after receiving due notice, must be grounds for contract termination. 5. Performance Specifications a. Performance Measures (1) The Network Provider must meet the performance standards and required outcomes as specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. For Prevention services providers the individualized performance measure standards are specified in Attachment IV, Prevention Services Scope of Work and/or Attachment V, Prevention Services Scope of Work—State Opioid Response. (2) The Network Provider agrees that KIS, PBPS, SAMHIS, and FASAMS, or other data reporting system designated by the ME, will be the source for all data used to determine compliance with performance standards and outcomes in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs or other data system as specified by the ME. Any conflicts will be clarified by the ME and the Network Provider must adhere to the ME's resolution. The Network Provider must submit all service-related data for individuals receiving services funded in whole or in part by SAMH funds, local match, or Medicaid. b. Performance Measurement Terms FASAMS DCF Pamphlet 155-2, provides the data files and file layout requirements for collecting and reporting data on persons served in state-contracted community substance use and mental health Network Provider agencies. The elements used for various performance measures which are quantitative indicators, outcomes, and outputs used by the ME to objectively measure a Network Provider's performance and contains policies and procedures for submitting the required data. Collaborative Planning Group Systems, Inc., or any other data system designated by the ME and/or the Department, maintains the procedures for submitting the required prevention data into PBPS. The ME will also monitor the Network Provider for the performance measures. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 33 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:fea th ��et��� rk. (a) /1W;2020 C. Performance Evaluation Methodology (1) The Network Provider must collect information and submit performance data and individual served outcomes, to the ME data system in compliance with FASAMS DCF Pamphlet 155-2, requirements. The specific methodologies for each performance measure may be found at the following website: https://www.myflfa m i l ies.com/service-progra ms/sa m h/fasa ms/i ndex.shtm I (2) The Network Provider is expected to have the capability to engage in organized performance improvement activities, and to be able to participate in partnership with the department and ME in performance improvement projects that are related to system wide transformation and improvement of services for individuals and families. (3) By execution of this contract the Network Provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth in this contract. If the Network Provider fails to meet these standards, the ME, at its exclusive option, may allow a reasonable period, not to exceed six (6) months, for the Network Provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the ME within the prescribed time and if no extenuating circumstances can be documented by the Network Provider to the ME's satisfaction, the ME must terminate the contract. The ME has the sole authority to determine whether there are extenuating or mitigating circumstances. (4) The ME will monitor the standards and outcomes specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. 6. Network Provider Responsibilities a. Network Provider Unique Activities (1) In the event of a dispute as to the ME's determination regarding eligibility for services for individuals and/or placement into the appropriate level of care,the ME's dispute resolution process, as described in the Standard Contract must be followed. An eligibility dispute must not preclude the provision of services to Individuals Served, unless the dispute resolution process reverses the ME's determination. (2) The Network Provider is responsible for the satisfactory performance of the tasks referenced in this contract. By executing this contract, the Network Provider recognizes its responsibility for the tasks, activities, and deliverables described herein and warrants that it has fully informed itself of all relevant factors affecting the accomplishment of the tasks, activities and deliverables and agrees to be fully accountable for the performance thereof whether performed by the Network Provider or its subcontractors. (3) The Network Provider agrees that services other than those set out in this contract will be provided only upon receipt of a written authorization from the ME's Contract Manager or an authorized ME staff member. The department through the ME has final authority to make any and all determinations that affect the health safety and well-being of the residents of the State of Attachment I HCO2 (a) Guidance Care Center, Inc. Page 34 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 Florida. (4) The Network Provider must be responsible for the fiscal integrity of all funds under this contract, and for demonstrating that a comprehensive audit and tracking system exists to account for funding by individual served and has the ability to provide an audit trail. The Network Provider's financial management and accounting system must have the capability to generate financial reports on individual service recipient utilization, cost, claims, billing, and collections for the ME. The Network Provider must maximize all potential sources of revenue to increase services, and institute efficiencies that will consolidate infrastructure and management functions in order to maximize funding. (5) The Network Provider must ensure that the invoices submitted to the ME reconcile with the amount of funding and services specified in this contract, as well as the Network Provider's agency audit report and information system and this information is reconciled with KIS, PBPS, SAMHIS, FASAMS, or other data reporting system designated by the ME. (6) The Network Provider must make available source documentation of units billed by Network Provider upon request from the ME staff. The Network Provider must track all units billed to the ME by program and by Other Cost Accumulator(OCA). (7) A Network Provider that receives block grant funding must comply with state or federal requests for information related to Substance Abuse Prevention and Treatment and Community Mental Health Services block grants. (8) Any compensation paid for an expenditure subsequently disallowed as a result of the Managing Entity's or any Network Service Providers' non-compliance with state or federal funding regulations must be repaid to the Department upon discovery. (9) The Network Provider must make available to the ME and the Department all records pertaining to service delivery. These records must be made available at all reasonable times for inspection, review, copying, or audit. Service delivery records include but are not limited to, invoicing, fiscal management, data management, incident reporting, clinical records for individuals served, and such documents determined to assure accountability of service provision and/or the expenditure of state and federal funds. (10) The Network Provider must assist the ME and the Department in developing legislative budget requests based upon identified needs of the community. (11) The Network Provider must provide to the ME, copies of, including but not limited to, evaluations, assessments, surveys, monitoring reports that pertain to licensure, accreditation, or other administrative or programmatic review, when those reports identify deficiencies that require corrective action. The Network Provider must submit to the ME all of the applicable reports, including copies of the corrective action plan(s) within ten (10) calendar days of receipt by the Network Provider from the reviewing entity. (12) The Network Provider must cooperate with the ME and the Department when investigations are conducted regarding a regulatory complaint of the Network Provider. When additional information or documentation is requested by the ME, the Network Provider will submit the Attachment I HCO2 (a) Guidance Care Center, Inc. Page 35 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 information within twenty-four (24) hours of the request unless otherwise specified in the ME's request. (13) The Network Provider must maintain human resource policies and procedures that provide safeguards to ensure compliance with laws, rules and regulations. Integrate current and/or new state/federal requirements and policy initiatives into its operations upon provision by the Department and/or ME of the same. (14) The Network Provider must maintain in one place for easy accessibility and review by ME and/or Department staff all policies, procedures, tools, and plans adopted by the Network Provider. The Network Provider's policies, procedures, and plans must conform to state and federal laws, the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/ requirements contained in applicable Department of Children and Families and ME operating procedures. (15) The Network Provider must maintain a mechanism for monitoring, updating,and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations,and the ME's policies and procedures. (16) The Network Provider must comply with all other applicable federal laws, state statutes and associated administrative rules as may be promulgated or amended. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations, and ME policies and procedures. Records relating solely to actions taken in carrying out the quality assurance and /or quality improvement program requirements of this contract and records obtained by the ME and/or the Department to determine a Network Provider's compliance of said programs in accordance with 394.907, F.S. and 397.4103 F.S. are confidential and exempt from s. 119.07(1) F.S. and s. 24(a), Article. I, Constitution of the State of Florida. (17) Coordination with other Providers/Entities (i) The Network Provider must fulfill their designated role in implementing and/or maintaining a system of care in support of the cooperative agreements with the judicial system and the criminal justice system which define strategies and alternatives for diverting persons from the criminal justice system and address the provision of appropriate services to persons with substance use, mental health and/or co- occurring disorders who are involved with the criminal justice system. These agreements address the provision of appropriate services to persons who have behavioral health problems and leave the criminal justice system. (ii) The Network Provider agrees to fulfill their designated role in implementing and/or maintaining a system of care in support of the ME Working Agreement, incorporated herein by reference, with the Community Based Care (CBC). The intent of the working agreement is to establish a formal linkage of partnerships with a shared vision for improving outcomes for families involved in the child welfare system by providing integrated community support and services. (iii) The Network Provider may be required to enter into agreements with other external stakeholders. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 36 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (iv) The failure of other providers or entities does not relieve the Network Provider of any accountability for tasks or services that the Network Provider is obligated to perform pursuant to this contract. b. State and Federal Laws, Rules, and Regulations See Exhibit F,SAMH Programmatic State and Federal Laws, Rules,and Regulations. 7. Managing Entity Responsibilities a. Managing Entity Obligations (a) The ME must only subcontract with entities that are fiscally sound, and that can adequately ensure the accountability of public funds. (b) The ME must assess the Network Provider's financial stability, using a risk assessment approach; the risk assessment approach will examine the impact of programmatic requirements on the Network Provider's financial stability. Any issues identified as a result of the financial risk assessment must be reported to the Department during the monthly reconciliation and performance review identified in the Prime Contract. (c) The ME will provide administrative and programmatic oversight to ensure that Network Providers comply with all behavioral health treatment and prevention service requirements and other requirements of this contract. (d) The ME is solely responsible for the oversight of the Network Provider and enforcement of all terms and conditions of this contract. Any and all inquiries and/or issues arising under this contract are to be brought solely and directly to the ME for consideration and resolution between the Network Provider and the ME. In any event, the ME's decision on all issues is final and solely subject to the ME's appeal process and legal rights of the Network Provider. (e) The ME reserves the right terminate this contract in whole or in part, for non-performance as determined by the ME and to procure the services purchased through this contract to another entity and/or Network Provider. (f) The ME is responsible for the administration, management, and oversight, and through subcontracts, the provision of behavioral health services in Miami-Dade and Monroe Counties. (g) The ME must monitor and take action when necessary so that services which meet the standards defined herein will be provided throughout the contract period. (h) The ME will ensure that the Network Provider utilizes the approved assessment and placement tool designated by the ME. Standardized tools and assessments approved by the Attachment I HCO2 (a) Guidance Care Center, Inc. Page 37 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 ME must be used to determine placement and level of care. (i) The ME must work with the Department to redirect administrative cost savings into improved access to quality care, promotion of service continuity, required implementation of EBPs, the expansion of the services array, and necessary infrastructure development. It acknowledges the benefits to be realized, include improved access to quality care, promotion of service continuity, implementation of EBPs, improved performance and outcomes, expansion of the service array, and necessary infrastructure development. b. Monitoring Requirements (1) The ME will monitor the Network Provider in accordance with this contract and the ME's Contract Accountability Policies and Procedures which can be obtained from the designated ME Contract Manager and is incorporated herein by reference. The Network Provider must comply with any coordination or documentation required by the ME's monitor(s) to successfully evaluate the programs and must provide complete access to all budget and financial information related to services provided under this contract, regardless of the source of funds. (2) Network Providers with electronic health record (EHR) or electronic medical record systems (EMR) must provide access to ME funded service and service data contained in these systems for individuals funded under this Contract to the ME's monitoring team and provide sufficient resources to facilitate the monitoring process of services provided under this contract. Resources is defined but is not limited to, personnel, terminals, guest read-only accounts, privileges for monitors to access clinical/service records, and/or remote access into the systems by the monitors. (3) The ME will monitor the Network Provider on its performance of all tasks and special provisions of the contract. (4) The ME will provide a written report to the Network Provider within thirty (30) calendar days of the exit conference. If the report indicates corrective action is necessary, the Network Provider will have ten (10) calendar days from receipt of the monitoring report to respond in writing to the request. In the sole discretion of the ME, if there is a threat to health, life, safety or well-being of the individuals receiving services, the ME may require immediate corrective action or take such other action as the ME deems appropriate. Failure to implement corrective action plans to the satisfaction of the ME subjects the Network Provider to the remedies expressed in the Standard Contract. c. Training and Technical Assistance (1) The ME's contract manager, or designee, will provide training and technical assistance concerning the terms and conditions of this contract. (2) The ME will provide technical assistance and support to the Network Provider to ensure the continued integration of services and support for individuals served, to include but not limited to, quality improvement activities to implement evidenced-based practice treatment protocols, Attachment I HCO2 (a) Guidance Care Center, Inc. Page 38 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 the application of process improvement methods to improve the coordination of access and services that are culturally and linguistically appropriate. (3) The ME will provide technical assistance and support to the Network Provider for the maintenance and reporting of data on the performance standards that are specified in Exhibit D,Substance Abuse and Mental Health Required Performance Outcomes/Outputs. (4) The ME implements a training program for its staff and the Network Provider staff. The trainings assure that staff receives externally mandated and internal training. The ME may coordinate training or directly provide training to Network Provider staff. (5)The ME will participate in the collaborative development and implementation of the working agreement with the Community Based Care and behavioral health Network Providers to ensure the integration of services and support within the community. The ME will support the development and implementation of the working agreement by providing an example of a policy working agreement, system of care information, data reporting requirements and technical assistance. (6)The ME has the right to review the Network Provider's policies, procedures, and plans. Once reviewed by the ME, the policies and procedures may be amended provided that they conform to state and federal laws, the state Administrative Code, and federal regulations. Substantive amendments to submitted policies, procedures and plans must be provided to the ME within thirty (30) calendar days of adoption. (7)The ME may request supporting documentation and review source documentation of units billed to the ME. d. Managing Entity Determinations The ME has exclusive authority to make the following determination(s) and to set the procedures that the Network Provider must follow in obtaining the required determi nation(s): (1) Whether the Network Provider is meeting the terms and conditions of this contract, to include the documents that constitute this contract, any documents incorporated into any exhibit or attachment by reference, Program Description, policies and procedures and any documents incorporated herein by reference. (2) The ME reserves the exclusive right to make certain determinations in these specifications. The absence of the ME setting forth a specific reservation of rights does not mean that all other areas of this contract are subject to mutual agreement. The ME reserves the right to make exclusively any and all determinations that it deems are necessary to protect the best interests of the State of Florida and the health, safety, and welfare of the individuals who are served by the ME either directly or through any one of its contracted Network Providers. (3) In the event of any disputes regarding the eligibility of individuals served, the Attachment I HCO2 (a) Guidance Care Center, Inc. Page 39 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 determination made by the ME is final and binding on all parties. C. Method of Payment Exhibit B, Method of Payment Exhibit G,Covered Service Funding by OCA Exhibit H, Funding Detail and Local Match Monthly Payment Request (Incorporated by reference and available from the MEs Contract Manager upon request) D. Special Provisions 1. The Network Provider is expected to maintain its administration cost to 10.00% or less for Fiscal Year 2020-2021 for SAMH services purchased under this contract. The cost savings must be reallocated to support the increase of direct services, improved access to quality care, promotion of service continuity, and the implementation and/or expansion in the use of evidence-based practices. The Network Provider's SAMH Projected Operating and Capital Budget must evidence the reduction and redistribution of the cost savings. 2. The ME contracts with Mobile Response Teams (MRT's) in both Miami-Dade and Monroe Counties. MRTs provide on-demand crisis intervention services in any setting in which a behavioral health crisis is occurring, including homes, schools and emergency rooms. MRTs are multi- disciplinary teams of behavioral health professionals and paraprofessionals with specialized crisis intervention and operations training. Mobile response services are available 24/7 with the ability to respond within 60 minutes. MRT staff triage calls in order to determine the level of severity and prioritize calls that meet the clinical threshold required for an in-person response. The primary goals of the MRTs is to lessen trauma, divert from emergency departments or juvenile/criminal justice, and prevent unnecessary psychiatric hospitalizations. MRTs are designed to be accessible in the community at any time. The Network Provider must provide the contact information for the Southern Region's Mobile Response Teams to parents and caregivers of children, adolescents, and young adults between the ages of 18 and 25, inclusive, who receive behavioral health services. For Miami-Dade County the MRT Network Provider is Banyan Health Systems, Inc. The 24-Hour Crisis Hotline is (305) 774-3616 or(305) 774-3617. Website: https://banyanhealth.org/service/mobile-response-team/ For Monroe County, the MRT Network Provider is Guidance Care/Center, Inc. The 24-Hour Crisis Hotline is: (305)434-7660, option#8. Website: http:// uidancecarecenter.org/ 3. Acute Care Service Utilization Reporting for Public Receiving Facilities, Detoxification and Addiction Receiving Facilities: Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 40 of 56 Contract No. ME225-11-27 0 0 �, (Contva thew oath �1�€a��ida �at�����orill t:fea th ��et��� rk. (a) /1W;2020 (a) Network Providers contracted to provide acute care services must submit acute care data (bed availability) in real time, as mandated under Section 394.9082(10), Florida Statutes. (b) Acute care data must be provided for every licensed bed, as listed by AHCA or DCF's PLAIDS system, whether funded through this contract or not. (c) The Network Provider must enter accurate and consistent data (all admissions and discharges) in the KIS Express Acute Care System, the ME's designated acute care system database. Arrangements to license and access the KIS Express Acute Care system should be coordinated through the ME's IT Department. The Acute Care reporting manual is found in the FASAMS DCF Pamphlet 155-2 Chapter 8, Acute Care Data and can be found at: https://www.myflfa m i l ies.com/service-progra ms/sa m h/fasa ms/i ndex.shtm I 4. Real-time Data Entry: When required by the Prime Contract, state and/or federal rules, regulations, or the ME's policies and procedures, the Network Provider must submit to the ME real-time data in KIS Express, or other similar data structure, for services purchased by this contract. The Network Provider agrees to implement the new data reporting system(s)when notified and as directed by the ME. 5. Waitlist Data Entry: The Network Provider must submit waitlist data information through upload or direct entry into KIS Express, or other similar data structure for services purchased by this Contract, to ensure compliance with several Block Grant regulations. Waiting lists records are created for individuals who have received an assessment and a recommended service but who are unable to receive recommended service. The Waiting List reporting manual is found in the FASAMS DCF Pamphlet 155-2 FASAMS Chapter 7,Waiting List and can be found at: https://www.myflfa m i l ies.com/service-progra ms/sa m h/fasa ms/i ndex.shtm I 6. Purchase Firearms by Mentally III Persons pursuant to Chapter 790, Florida Statute, Weapons and Firearms — Applicable to Receiving and/or Treatment Facilities as defined in s. 394.455, Florida Statute(Baker Act and for Involuntary Treatment under the Marchman Act) Current law prohibits dealers from selling firearms to persons who have been adjudicated mentally defective or has been committed to a mental institution by a court or as provided in subsection 790.065 (2)(a)4.b., F.S., and as a result is prohibited by state or federal law from purchasing a firearm. Subsection 790.065, F.S., provides conditions under which an individual who has been allowed to transfer to voluntary status in lieu of court-ordered involuntary commitment after being admitted for involuntary examination at a Baker Act receiving facility and is certified by an examining physician to be of imminent danger to himself of herself or others, may be prohibited from purchasing a firearm, and may not be eligible to apply for or retain a concealed weapon or firearms license. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 41 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 Within 24 hours after the person's agreement to voluntary admission, a record of the finding, certification, notice, and written acknowledgement("petition") must be filed by the administrator of the receiving or treatment facility, as defined in s. 394.455, F.S, with the clerk of the court for the county in which the involuntary examination occurred (790.065, (2) (a).4.c.(ll) F.S). No fee may be charged for such filing. 7. Medication-Assisted Treatment Services a. The Network Provider must discuss, offer, and document the option of medication-assisted treatment with individuals with opioid use disorders or alcohol use disorders. b. For individuals with opioid use disorders, the Network Service Provider must discuss, offer and document medication-assisted treatment using FDA-approved medications including but not limited to methadone, buprenorphine, and naltrexone. c. For individuals with alcohol use disorders, the Network Service Provider must discuss, offer, and document medication-assisted treatment using FDA-approved medications including but not limited to disulfiram, and acamprosate products. d. The Network Provider must actively link individuals to medication-assisted treatment providers upon request of the individual served or per the recommendation of the evaluating professional. e. Access to Services:The Network Provider must not deny eligible individual from accessing its program or services based on the individual's current or past use of FDA-approved medications for the treatment of substance use disorders. Specifically, the Network Provider must ensure that: i. The Network Provider's programs and services do not prevent the individual from participating in methadone treatment rendered in accordance with current federal and state methadone dispensing regulations from an Opioid Treatment Program when ordered by a physician who has evaluated the client and determined that methadone is an appropriate medication treatment for the individual's opioid use disorder; ii. The Network Provider must permit the individual to access medications for FDA- approved medication-assisted treatment by prescription or office-based implantation if the medication is appropriately authorized through prescription by a licensed prescriber or provider; iii. The Network Provider must permit continuation in medication-assisted treatment for as long as the prescriber or medication-assisted treatment provider determines that the medication is clinically beneficial; and iv. The Network Provider must prohibit compelling an individual to no longer use medication-assisted treatment as part of the conditions of any program or services if Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 42 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 stopping is inconsistent with a licensed prescriber's recommendation or valid prescription. V. The Network Provider must not deny access to their services for individuals that are currently prescribed or receiving Medication Assisted Treatment. 8. Prevention Services,if applicable: a. The prevention services provided under this contract are to fund rigorous, effective, evidence-based, substance use prevention programs and strategies and promotion of wellness (positive mental health) services as part of the continuum of behavioral health care for individuals and their families. The strategies, activities, and services must be consistent with the local community ME-approved local Needs Assessment Logic Model (HALM) and the Comprehensive Community Action Plan (CCAP). The Network Provider must work in collaboration with the funded ME Evaluation Entity, by participating in meetings and providing service data vital for the completion of a system- wide evaluation of the prevention services within the Strategic Prevention Framework. The evaluation of the prevention system is expected to be the systematic collection and analysis of information about program activities, characteristics, and outcomes to reduce uncertainty, improve effectiveness, and assist in decision-making. The information gathered from the evaluation process will help the ME, the State and communities become more skillful and exact in describing what they plan to do, monitor what they are doing, and improve the prevention system of care. Evaluation results can and should be used to determine what efforts should be sustained and to assist in sustainability planning efforts. The ME will provide substantial input, in collaboration with the Network Provider and the Evaluation Entity, both in planning and implementation of the evaluation process and activities and will make recommendations regarding the continuance of the activities. b. Data Submission in PBPS: Upon submission of the monthly data, the Network Provider's Director of Prevention/Supervisor, must send an e-mail to the ME's Director of Prevention Services attesting that the data submitted has been reviewed and approved. c. The Network Provider will accurately report the performance measures specified in Attachment IV, Prevention Services Scope of Work and/or Attachment V, Prevention Services Scope of Work—State Opioid Response. d. Based on individual needs, the Network Provider must adhere to services as outlined in the approved Prevention Program Description, incorporated herein by reference and as set forth in Attachment IV, Prevention Services Scope of Work and/or Attachment V, Prevention Services Scope of Work — State Opioid Response, in addition to providing services from the list of approved covered services listed in Exhibit G, Covered Service Funding by OCA. Any change in the array of services must be justified in writing and submitted to the ME's Contract Manager for review and approval. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 43 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 9. Intern Registration Requirements pursuant to section 491.0045,F.S. a. The Network Provider must monitor and ensure that an individual who has not satisfied the postgraduate or post-master's level experience requirements, as specified in s. 491.005(1)(c), (3)(c), or (4)(c), F.S., register as an intern in the profession for which he or she is seeking licensure before commencing the post-master's experience requirement or for an individual who intends to satisfy part of the required graduate-level practicum, internship, or field experience, outside the academic arena for any profession, the network provider must monitor and ensure that the individual registers as an intern in the profession for which he or she is seeking licensure before commencing the practicum, internship, or field experience. b. An intern registration is valid for five (5)years. c. A registration issued on or before March 31, 2017, expires March 31, 2022, and may not be renewed or reissued. Any registration issued after March 31, 2017, expires 60 months after the date it is issued. A subsequent intern registration may not be issued unless the candidate has passed the theory and practice examination described in s. 491.005(1)(d), (3)(d), and (4)(d), F.S. d. An individual who has held a provisional license issued by the board may not apply for an intern registration in the same profession. 10. Incident Reports a. The Network Provider must submit incident reports into the Incident Reporting and Analysis System (IRAS) on all reportable incidents per CFOP 215-6, within one (1) business day of the incident occurring. Failure to comply with the reporting requirements constitutes a lack of compliance with licensure status or contract provisions. The Network Provider may be assessed financial consequences for failure to perform pursuant to section 8., of the Standard Contract. In the event an incident has an immediate impact on the health or safety of a consumer, has potential media impact, or involves employee-related incidents of criminal activity, the Network Provider must notify the ME Continuous Quality Improvement Manager and the ME Contract Manager immediately upon discovery. Certain incidents may warrant additional follow-up by the ME. Follow-up may include on-site investigations or requests for additional information or documentation. When additional information or documentation is requested, the Network Provider will submit the information requested by the ME within 24 hours unless otherwise specified in the request. It is the responsibility of the Network Provider to maintain a monthly log listing all incidents occurring at the agency, including those submitted to the Office of the Inspector General and those not reportable in IRAS, with the following information: Consumer's initials, incident report Attachment I HCO2 (a) Guidance Care Center, Inc. Page 44 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:fea th ��et��� rk. (a) /1W;2020 tracking number from IRAS (if applicable), incident report category, date and time of incident, and follow-up action taken. b. All Network Providers (inpatient and outpatient) will report seclusion and restraint events in SAMHIS(SANDR) and in accordance with Rule 65E-5.180(7)(g), F.A.C. 11. Mandatory Reporting Requirements a. The Network Provider and any subcontractor must comply with and inform its employees of the following mandatory reporting requirements. Each employee of the Network Provider, and of any subcontractor, providing services in connection with this contract who has any knowledge of a reportable incident must report such incident as follows: 1) A reportable incident is defined in CFOP 180-4, which can be obtained from the ME's Contract Manager. 2) Reportable incidents that may involve an immediate or impending impact on the health or safety of a client shall be immediately reported to the ME's Continuous Quality Improvement Manager and the ME Contract Manager. 3) Other reportable incidents must be reported to the ME's and Department's Office of Inspector General. Notification to the Inspector General shall be through the Internet at https://www.myflfamilies.com/admin/ig/rptfraudl.shtml or by completing a Notification/Investigation Request (form CIF 1934) and emailing the request to the Office of Inspector General at IG.Complaints@myflfamilies.com. The Network Provider and subcontractor may also mail the completed form to the Office of Inspector General, 1317 Winewood Boulevard, Building 5, 2nd Floor, Tallahassee, Florida, 32399-0700; or via fax at (850)488-1428. b. In the event of a breach or potential breach of Protected Health Information, the Network Provider is directed to the reporting requirements delineated in the executed Business Associate Agreement, incorporated herein by reference. 12. Contracted Mental Health Network Providers must participate in the Department's aftercare referral process for formerly incarcerated individuals with severe and persistent mental illness or serious mental illness who are released to the community or who are determined to be in need of long-term hospitalization is required. Participation must be as specified in Children and Families Operating Procedure 155-47 (CFOP 155-47), Processing Referrals from the Department Of Corrections which can be obtained at: http://www.dcf.state.fl.us/admin/publications/policies.asp and is incorporated herein by reference. 13. Health, Safety, and Physical Environment Requirements for Substance Abuse and Mental Health Levels 1, 2, and 3 Residential Treatment Facilities Unless abridged by a court of law, the rights of individuals who are admitted into a residential treatment facility must be assured. Each residential treatment facility must be operated in a manner that protects the individual's rights, life, and physical safety while under the evaluation and treatment. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 45 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 To avoid high risk situations such as suicide, death, serious injury, violence, and abuse of any individual the contracted residential treatment network provider must ensure that its facilities are safe and secure, for example, exposed plumbing pipes are to be covered to prevent individual access. If for clinical reasons access to potentially dangerous grooming aids or other personal articles is contradicted for residents, staff must explain to the resident the conditions under which the articles may be used and must document the clinical rationale for these conditions in the resident's record. If clinically indicated, personal articles of residents may be kept under lock and key by staff. Such actions must be reviewed weekly for effectiveness and continued need. 14. Involuntary Commitment, Placements,Services,Treatment a. Mental Health Services Provider: The Network Provider agrees to provide services to persons who have been court ordered into involuntary outpatient services in accordance with section 394.4655, F.S., court ordered into involuntary inpatient placements as defined in section 394.467, F.S., and court ordered for involuntary examination under 394.463, F.S. b. Substance Use Services Provider: The Network Provider agrees to provide services to persons who have been court ordered into involuntary assessment and stabilization under section 397.6818, F.S., and/or court ordered into an involuntary substance use treatment under section 397.6957, F.S. It is the Network Provider's responsibility to be familiar with and ensure that the requirement's regarding involuntary admissions are followed pursuant to, including but not limited to ss. 397.6751, F.S. c. Pursuant to s. 394.4655(3)-(4), and (7), F.S. and s. 397.697(4), F.S., if the court orders involuntary services, the Network Provider must submit a copy of the order to the ME, to the individuals specified in Exhibit C, Required Reports, within one (1) working day after it is received from the court. Similarly, if the court orders a program or a service that is not available, Network Provider must notify the ME within one (1) working day after it is received from the court indicating that the requested program or service is not available. Documents may be electronically submitted as directed by the ME. Documents must be submitted in a secured, password protected, or encrypted format. 15. Service Provision Requirements for Federal Block Grants,if applicable. (a) A Network Provider that receives federal block grant funds from the Substance Abuse Prevention and Treatment or Community Mental Health Block Grants agrees to comply with Subparts I and II of Part B of Title XIX of the Public Health Service Act, s. 42 U.S.C. 300x-21 et seq. (as approved September 22, 2000) and the Health and Human Services (HHS) Block Grant regulations (45 C.F.R. Part 96). (b) A Network Provider that receives funding from the SAPTBG certifies compliance with all of the requirements of the Substance Abuse and Mental Health Services Administration (SAMHSA) Charitable Choice provisions and the implementing regulations of 42 C.F.R. s. 54a. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 46 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� �South �1�€ad�ida �at�����orall t:ea th ��et��d rk. (a) /1W;2020 (c) A Network Provider that receives block grant funding must monitor its compliance with block grant requirements and activities. (d) The Network Provider must comply with ME, state and federal requests for information related to the SAPT and CMHS block grants. (e) None of the funds provided under the following grants may be used to pay the salary of an individual at a rate in excess of Level II of the Executive Schedule: Block Grants for Community Mental Health Services, Substance Abuse Prevention and Treatment Block Grant, Projects for Assistance in Transition from Homelessness, Project Launch, Florida Youth Transition to Adulthood; and Florida Children's Mental Health System of Care Expansion Implementation Project. (f) As applicable, the Network Provider must comply with the requirements set forth in 45 C.F.R. Subpart L—Substance Abuse Prevention and Treatment Block Grant and with the requirements of 42 C.F.R. Part 2. (g) A Network Provider that receives SAPT block grant funding for the purpose of primary prevention of substance use, must comply with 45 C.F.R. s. 96.125. (h) Behavioral health services must be provided to persons pursuant to s. 394.674, F.S., including those individuals who have been identified as requiring priority by state or federal law. The identified priority populations are found in Exhibit A, Individuals/Participants to be Served, however persons in categories (i) and (ii) below are specifically identified as persons to be given immediate priority over those in any other categories. These individuals may not be placed on a wait list without receiving interim services within the required timeframes. (i) Pursuant to 45 C.F.R. s. 96.131, priority admission to pregnant women by Network Service Providers receiving SAPT Block Grant funding. If the clinically appropriate services cannot be provided for the pregnant woman, interim services, not later than forty (48) hours after the woman seeks treatment services, must be provided pursuant to 45 C.F.R. s. 96.123; (ii) Pursuant to 45 C.F.R. s. 96.126 (b), (1) and (2), adherence with the requirement to provide interim services for injection drug users by Network Service Providers receiving SAPT Block Grant funding and until the clinically appropriate level of treatment can be provided to the individual as follows: 45 C.F.R. s. 96.126 (b), (1)- (2) Capacity of treatment for intravenous substance abusers and any other requirement. (1) 14 days after making the request for admission to such a program;or (2) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services, including referral for prenatal care, are made available to the individual not later than 48 hours after such request. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 47 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (i) In accordance with 45 C.F.R. s. 96.131 (a) and (b), the Network Provider that receive Block Grant funds and that serve injection drug users must publicize the following notice: "This program receives federal Substance Abuse Prevention and Treatment Block Grant funds and serves people who inject drugs. This program is therefore federally required to give preference in admitting people into treatment as follows: 1. Pregnant injecting drug users; 2. Pregnant drug users; 3. People who inject drugs; and 4. All others." (j) In accordance with 45 CFR s. 96.123(a)(7) and s. 96.132(b), the Network Provider that receives block grant treatment or prevention funds (or both, as the case may be) shall ensure that continuing education in such services are available to the employees who provide such services or activities and this must be documented to demonstrate the provision of said education. (k) Outreach Services to Injection Drug Users: The Network Provider must carry out outreach activities to encourage injection drug users in need of treatment to undergo such treatment pursuant to the requirements in 45 C.F.R. s. 96.126(e)., The Network Provider must document the services to demonstrate the provision of these services per the documentation requirements for Outreach services specified in Rule 65E-14, F.A.C. (1) The Network Provider must ensure compliance with 45 C.F.R. Subpart C — Financial Management. (m)Only if such services are purchased through this contract is the Network Provider responsible for complying with the reporting requirements outlined in Exhibit AB, Substance Abuse Prevention and Treatment Block Grant (SAPTBG) Early Intervention Funded Services for Human Immunodeficiency Virus (HIV) by the dates and to the individual(s) listed in Exhibit C, Required Reports. Subject to other applicable state and/or federal requirements, the ME may require additional reports from the Network Provider. (n) Only if such services are purchased through this contract is the Network Provider responsible for complying with the for SAPTBG set-aside funded services for pregnant women and women with dependent children services, SAPTBG set-aside funded services for HIV Early Intervention Programs and the SAPTBG set-aside funds for Evidenced-based Outreach Services to Injection Drug Users as outlined in Exhibit C, Required Reports. (o) The Network Provider must make available, either directly or by arrangement with others, tuberculosis services to include counseling, testing, and referral for evaluation and treatment pursuant to 45 C.F.R. s.96.17 and in compliance with Ch. 65D-30..0042, 6.,. F.A.C. (p) The Network Provider must use SAPTBG funds provided under this contract to support both substance abuse treatment services and appropriate co-occurring disorder treatment services for individuals with a co-occurring mental disorder only if the funds allocated are used to support substance abuse prevention and treatment services and are tracked to the specific substance abuse activity as listed in Exhibit G, Covered Service Funding by OCA. (q) The Network Provider is required to participate in the peer-based fidelity assessment process to assess the quality, appropriateness, and efficacy of treatment services provided to individuals under this contract pursuant to 45 C.F.R. 96.136. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 48 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 (r) The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916(a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant(SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non-profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. While the above- referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916(a)(5), and 45 C.F.R., Part 96.135(a)(5)]. 16. The Network Provider agrees to maximize the use of state residents, state products, and other Florida- based businesses in fulfilling their contractual duties under this contract. 17. Option for Increased Services The Network Provider acknowledges and agrees that the contract may be amended to include additional, negotiated, services as deemed necessary by the ME. Additional services can only be increased if the Network Provider demonstrates competence in the provision of contractual services and meets whatever criteria are established by the ME from time to time. The ME in its sole discretion must determine at what time and to which Network Provider and what amounts are to be given to Network Providers for additional services. 18. Sliding Fee Scale The Network Provider must develop a sliding fee scale, that is updated annually, in conjunction with the Federal Poverty Guidelines and applies to individuals receiving services that are paid for by state, federal, or local matching funds. The Network Provider shall make a determination of ability to pay in accordance with the sliding fee scale for all individuals seeking substance abuse or mental health services in accordance with Rule 65E-14.018, F.A.C. Payment of fees shall not be a pre-requisite to treatment or the receipt of services. 19. Transportation Disadvantaged The Network Provider agrees to comply with the provisions of chapter 427, F.S., Part I, Transportation Services, and Chapter 41-2, F.A.C., Commission for the Transportation Disadvantaged, if public funds provided under this contract will be used to transport consumers. The Network Provider agrees to comply with the provisions of Children and Families Operating Procedures 40-50 (CFOP 40-5) Acquisition of Vehicles for Transporting Disadvantaged Consumers if public funds provided under this contract will be used to purchase vehicles which will be used to transport consumers. 20. National Provider Identifier(NPI) a. All Network Providers must obtain and use an NPI, a HIPAA standard unique health identifier for health care providers. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 49 of 56 Contract No. ME225-11-27 Thrido) Mind`mmtbFlorildm (Cmotvmutm)mm South HmliUmBchadomal HcmftbNcmvmrk.bm(%) I/W/2020 b. An application for an NP| may be submitted online at httpc//nppeszms.hhs.0ov/NPPES/S1a1icForvvard.do?forvvard=s1a1ic.npis1ar1. c. Additional information can be obtained from one of the following vxebsites: (I)The Florida Medicaid HIPAA located at: http:ZZwww.fdhc.state.fl.us/hipaaZindex.shtmI (2)The National Plan and Provider Enumeration System (NPPES) located at: h11ps://nppeszms.hhs.0ov/NPPES/VVe|come.do /3> h11p://vvvvvvzms.hhs.0ov/Na1iona|Prov|den1S1and/ 21. Ethical Conduct The Network Provider understands that performance under this contract involves the expenditure of public funds from both the state and federal governments, and that the acceptance of such funds obligates the Network Provider to perform its services in accordance with the very highest standards of ethical conduct. No employee, director, officer, agent of the Network Provider must engage in any business, financial or legal relationships that undermine the public trust, whether the conduct is unethical, or lends itself to the appearance of ethical impropriety. Network Providers' directors, officers or employees must not participate in any matter that would inure to their special gain and must recuse themselves accordingly. Public funds may not be used for purposes of lobbying, or for political contributions, or for any expense related to such activities, pursuant to Section 12., of the Standard Contract of this contract. The Network Provider understands that the ME contracts with the department, and as a subcontractor, recognizes that the department is a public agency which is mandated to conduct business in the sunshine, pursuant to section 286.011, F.S, and chapter 119, Florida Law, and that all issues relating to the business ofthe department, the ME and the Network Provider are public record and subject to full disclosure. The Network Provider understands that attempting to exercise undue influence on the ME, the department and its employees to a||ovx deviation or variance from the terms of this contract other than a negotiated, publicly disclosed amendment, is prohibited by the State of Florida, pursuant to section 286.011, F.S. The Network Provider's conduct is subject to all state and federal laws governing the conduct of entities engaged in the business of providing services with government funds. 22. Information Technology Resources If applicable, the Network Providers must receive written approval from the ME prior to purchasing any Information Technology Resource (|TR) with contract funds. The Contract Manager is responsible for serving as the liaison between the Network Provider and the ME during the completion of the process as instructed by the Contract Manager. The Network Provider will not be reimbursed for any |TR purchases made prior to obtaining the ME's written approval. 23. Programmatic,Fiscal&k Contractual Contract File References All of the documentation submitted by the Network Provider which may include, but not be limited to the Network Provider's original proposal, Program Descriptions, SAMH Projected Operating and Capital Budget, Agency Capacity Report, are herein incorporated by reference for programmatic, contractual and fiscal assurances of service provision. These referenced contractual documents will Attachment | HCUZ (a) Guidance Care Center, Inc. Page SUofS6 Contract No. mE225'11'27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 be part of the Contract Manager's file. Documents incorporated by reference in this contract are available in the ME Contract Manager's file. 24. Employee Loans Funds provided by the ME to the Network Provider under this contract must not be used by the Network Provider to make loans to their employees, officers, directors and/or subcontractors. Violation of this provision is considered a breach of contract and this contract will be terminated in accordance with Section 10., of the Standard Contract. A loan is defined as any advancement of money for which the repayment period extends beyond the next scheduled pay period. 25. Travel The Network Provider's internal procedures will assure that: travel voucher Form DFS-AA-15, State of Florida Voucher for Reimbursement of Traveling Expenses, incorporated herein by reference, be utilized completed and maintained on file by the Network Provider. Original receipts for expenses incurred during officially authorized travel, items such as car rental and air transportation, parking and lodging, tolls and fares, must be maintained on file by the Network Provider. Section 287.058 (1) (b) F.S., requires that bills for any travel expense must be maintained in accordance with Section 112.061, F.S. governing payments for traveling expenses. CFOP 40-1 (Official Travel of State Employees and Non-Employees) provides further explanation, clarification, and instruction regarding the reimbursement of traveling expenses necessarily incurred during the performance of business. The Network Provider must retain on file documentation of all travel expenses to include the following data elements: name of the traveler, dates of travel, travel destination, purpose of travel, hours of departure and return, per diem or meals allowance, map mileage, incidental expenses, signature of payee and payee's supervisor. 26. Property and Title to Vehicles a. Property (1)Nonexpendable property is defined as tangible personal property of a non-consumable nature that has an acquisition value or cost of $1,000 or more per unit and an expected useful life of at least one year, and hardback covered bound books that are not circulated to students or the general public, the value or cost of which is $250 or more. Hardback books with a value or cost of $100 or more should be classified as nonexpendable property only if they are circulated to students or to the general public. All computers, including all desktop and laptop computers, regardless of the acquisition cost or value are classified as nonexpendable property. Motor vehicles include any automobile, truck, airplane, boat or other mobile equipment used for transporting persons or cargo. (2)When state property will be assigned to a provider for use in performance of a contract, the title for that property or vehicle must be immediately transferred to the Network Provider where it must remain until this contract is terminated or until other disposition instructions are furnished by the ME's Contract Manager. When property is transferred to the Network Provider, the department must pay for the title transfer. The Network Provider's responsibility starts when the Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 51 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 fully accounted for property or vehicle is assigned to and accepted by the Network Provider. Business arrangements made between the Network Provider and its subcontractors must not permit the transfer of title of state property to subcontractors. While such business arrangements may provide for subcontractor participation in the use and maintenance of the property under their control, the ME must hold the Network Provider solely responsible for the use and condition of said property. Network Provider inventories must be conducted in accordance with CFOP 80-2. (3)If any property is purchased by the provider with funds provided by this contract, the Network Provider must inventory all nonexpendable property including all computers. A copy of which must be submitted to the along with the expenditure report for the period in which it was purchased. At least annually, the provider must submit a complete inventory of all such property to the ME whether new purchases have been made or not. (4)The Network Provider Inventory List, incorporated herein by reference, and available from the designated ME Contract Manager upon request, must include, at a minimum, the identification number; year and/or model, a description of the property, its use and condition, current location, the name of the property custodian, class code (use state standard codes for capital assets), if a group, record the number and description of the components making up the group, name, make, or manufacturer, serial number(s), if any, and if an automobile, the VIN and certificate number; acquisition date, original acquisition cost, funding source, information needed to calculate the federal and/or state share of its cost. (5)The ME's Contract Manager must provide disposition instructions to the Network Provider prior to the end of the contract period. The Network Provider cannot dispose of any property that reverts to the ME or department without the Contract Manager's approval. The Network Provider must furnish a Closeout Inventory Form no later than 30 days before the completion or termination of this contract. The Closeout Inventory Form must include all nonexpendable property including all computers purchased by the Network Provider. The Closeout Inventory Form must contain, at a minimum,the same information required by the annual inventory. (6)The Network Provider hereby agrees that all inventories required by this contract must be current and accurate and reflect the date of the inventory. If the original acquisition cost of a property item is not available at the time of inventory, an estimated value must be agreed upon by both the Network Provider and the ME and must be used in place of the original acquisition cost. (7)Title (ownership) to and possession of all property purchased by the Network Provider pursuant to this contract must be vested in the ME upon completion or termination of this contract. During the term of this contract, the Network Provider is responsible for insuring all property purchased by or transferred to the Network Provider is in good working order. The Network Provider hereby agrees to pay the cost of transferring title to and possession of any property for which ownership is evidenced by a certificate of title. The Network Provider must be responsible for repaying to the ME the replacement cost of any property inventoried and not transferred to the ME upon completion or termination of this contract. When property transfers from the Network Provider to the ME, the Network Provider must be responsible for paying for the title transfer. (8)If the Network Provider replaces or disposes of property purchased by the Network Provider Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 52 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 pursuant to this Contract, the Network Provider is required to provide accurate and complete information pertaining to replacement or disposition of the property as required on the Network Provider's annual inventory. (9)The Network Provider hereby agrees to indemnify the ME and the department against any claim or loss arising out of the Network Provider's operations of any motor vehicle purchased by or transferred to the Network Provider pursuant to this contract. (10) A formal contract amendment is required prior to the purchase of any property item not specifically listed in the approved contract budget. b.Title to Vehicles (1) Title (ownership) to, and possession of, all vehicles acquired with funds from this contract must be vested in the ME upon completion or termination of the contract. The Network Provider will retain custody and control during the contract period, including extensions and renewals. (2) During the term of this contract, title to vehicles furnished by the state or acquired at the direction of the state (using state or federal funds) must not be vested in the Network Provider. Subcontractors must not be assigned or transferred title to these vehicles. The Network Provider hereby agrees to indemnify the ME or the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. 27. National Voter Registration Act(NVRA) of 1993 a. The Network Provider must comply with the National Voter Registration Act (NVRA) of 1993, Pub. L. 103-31 (1993), ss. 97.021 and 97.058, F.S., and ch. 1S-2.048, F.A.C., in accordance with Guidance 25—National Voter Registration Act Guidance; b. As a Voter Registration Agency, the Network Providers must designate a Voting Registration Activities Coordinator and provide the contact information of the Coordinator by the date and to the individual(s) identified in Exhibit C, Required Reports. The Network Provider must notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding this position. c. As a Voter Registration Agency, the Network Provider must provide individuals seeking services and/or individuals served with an opportunity at admission or when they change an address, to either register or update their voter registration. The National Voter Registration Act Preference Form/Application are DS-DE77-ENG and DS-DE77-SPN, are available at the link provided in paragraph f., below d. The Network Provider must submit a NVRA Voter Registration Agencies Quarterly Activities Report Form, DS-DE131, by the dates and to the individual(s) identified in Exhibit C, Required Reports. The Quarterly Activity Report Form is available at the link provided in paragraph f., below. Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 53 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:fea th ��et��� rk. (a) /1W;2020 e. Any person aggrieved by a violation of either the National Voter Registration Act or a voter registration or removal procedure under the Florida Election Code may file a written complaint with the Department of State by completing and submitting the NVRA Complaint Form (DS-DE 18). f. The Department of State has published all form referenced herein, along with online training and additional guidance to implement NVRA at: http://dos.myflorida.com/elections/for-voters/voter-registration/national-voter-reistration- act 28. Special Insurance Provisions a. The Network Provider must notify the ME Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance including but not limited to, cancellation or modification to policy limits. b. The Network Provider acknowledges that, as an independent contractor,the Network Providers, and its subcontractors, at all tiers are not covered by the State of Florida Risk Management Trust Fund for liability created by s. 284.30, F.S. c. The Network Provider must obtain and provide proof to the ME's Contract Manager of comprehensive general liability insurance coverage (broad form coverage), specifically including premises, fire and legal liability to cover managing the Network Provider and all of its employees. The limits of Network Provider's coverage must be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. d. If any officer, employee, or agent of the Network Provider operates a motor vehicle in the course of the performance of its duties under this contract, the Network Provider must obtain and provide proof to the Department and the Managing Entity of comprehensive automobile liability insurance coverage. The limits of the Network Provider's coverage must be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. e. If any officer, employee, or agent of the Network Service Provider, at all tiers, provides any professional services or provides or administers any prescription drug or medication or controlled substance in the course of the performance of the duties of the Network Service Provider, the Managing Entity must cause the Network Service Provider, at all tiers, to obtain and provide proof to the Managing Entity and the Department of professional liability insurance coverage, including medical malpractice liability and errors and omissions coverage, to cover all Network Service Provider employees with the same limits. f. The ME and the Department must be exempt from, and in no way liable for, any sums of money that may represent a deductible or self-insured retention under any such insurance. The payment of any deductible on any policy must be the sole responsibility of the Network Provider purchasing the insurance. Attachment I HCO2 (a) Guidance Care Center, Inc. Page 54 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 g. All such insurance policies of the Network Providers, and its subcontractors at all tiers, must be provided by insurers licensed or eligible to do and that are doing business in the State of Florida. Each insurer must have a minimum rating of "A" by A. M. Best or an equivalent rating by a similar insurance rating firm and must name the ME and the Department as an additional insured under the policy(ies). The Network Provider must use its best good faith efforts to cause the insurers issuing all such general, automobile, and professional liability insurance to use a policy form with additional insured provisions naming the ME and the Department as an additional insured or a form of additional insured endorsement that is acceptable to the ME and the Department in the reasonable exercise of its judgment. h. The requirements of this section must be in addition to, and not in replacement of, the requirements of Section 24., Insurance, of the Standard Contract but in the event of any inconsistency between the requirements of this section and the requirements of the Standard Contract, the provisions of this section must prevail and control. i. If the Network Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the ME shall be to the extent permitted by section 768.28, F.S. or other applicable law, and without waving the limits of sovereign immunity. E. List of Exhibits The Network Provider agrees to comply with the requirements contained in the exhibits listed below. The following exhibits, or the latest revisions thereof, are incorporated in and made a part of the contract. 1. Exhibit A, Clients/Participants to be Served 2. Exhibit B, Method of Payment 3. Exhibit C, Required Reports 4. Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes and Outputs 5. Exhibit F, State and Federal Laws, Rules and Regulations 6. Exhibit G, Covered Service Funding by OCA 7. Exhibit H, Funding Detail & Local Match Plan 8. Exhibit I, Motivational Support (MSP) Provider Protocols 9. Exhibit K, SAMH Pre-Authorization Utilization Management Roster 10. Exhibit L,Assisted Living Facilities with Limited Mental Health License 11. Exhibit N, Special Provisions for the Indigent Drug Program 12. Exhibit O, Mental Health Residential Level II 13. Exhibit Q, Missing Children 14. Exhibit V, Special Provisions for the Forensic Services Program Attachment I HCO2 (a) Guidance Care Center, Inc. Page 55 of 56 Contract No. ME225-11-27 0 0 �, (Contva thrw� oath �1�€a��ida �at�����orill t:ea th ��et��� rk. (a) /1W;2020 15. Exhibit X, Special Provisions for Projects for Assistance in Transition from Homelessness (PATH) Services 16. Exhibit Y, Special Provisions for TANF SAMH Guidelines and TANF SAMH Incidental Expenditures for Housing Assistance 17. Exhibit AA, Motivational Support Specialist 18. Exhibit AC, Care Coordination Report Narrative and Chart 19. Exhibit Al, Family Intensive Treatment Team -Scope of Work 20. Exhibit AJ, Community Action Team 21. Exhibit AM, Return on Investment -Special Appropriations Projects for Fiscal Year 2020-21 22. Exhibit AN, Supplemental Security Income/Social Security Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR) 23. Exhibit AO, Peer Services 24. Exhibit AP, Mental Health Case Management 25. Exhibit AS, Central Receiving Facility 26. Exhibit AV,Transitional Voucher Program 27. Exhibit AY, Mobile Response Team, Monroe County 28. Exhibit BB - State Opioid Response Discretionary Grant Services - MAT (MSSM2 and MSSM3) Attachment 1 HCO2 (a) Guidance Care Center, Inc. Page 56 of 56 Contract No. ME225-11-27 h i0m) find mmth Florilda 0 0 �, (Contvacthrw r Ss uth I`ll€ riida xa.t�r�.�'Por ill IIficafth �@t.'�.'��ta€'k.ln(%) fiWi2020 EXHIBIT A Individuals/Participants to be Served A. GENERAL DESCRIPTION The Network Provider must provide services funded by this contract to the target population(s) checked below: Non-Prevention Prevention ® Adult Mental Health-Severe& Persistent Mental Illness ❑ Adult Substance Abuse ® Adult Mental Health-Serious&Acute Episodes of Mental ® Children's Substance Abuse Illness ® Adult Mental Health-Mental Health Problems ❑ Substance Abuse Community Coalition ® Adult Mental Health-Forensic Involvement ® Children's Mental Health-Serious Emotional Disturbances ® Children's Mental Health-Emotional Disturbances ® Children's Mental Health-At Risk of Emotional Disturbances ® Adult Substance Use ® Children's Substance Use B. INDIVIDUAL SERVED/PARTICIPANT ELIGIBILITY 1. The Network Provider agrees that all persons meeting the target population descriptions in the table above are eligible for services based on the availability of resources. To be eligible to receive substance abuse and mental health services funded by the Department, an individual must be indigent, uninsured, or underinsured and meet at least one of the target populations in s. 394.674, Florida Statutes. Link to s. 394.674, Florida Statute: http://www.leg.state.fl.us/STATUTES/index.cfm?Apr) mode=Display Statute&URL=0300- 0399/0394/0394.htm I 2. Behavioral Health services must be provided to persons pursuant to s. 394.674, F.S., including those individuals who have been identified as requiring priority by state or federal law. These identified priorities include, but are not limited to, the categories in sections (a) through (j), below. Persons in categories (a) and (b) are specifically identified as persons to be given immediate priority over those in any other sections. a. Pursuant to 45 C.F.R. s. 96.131, priority admission to pregnant women and women with dependent children by Network Providers receiving SAPT Block Grant funding; b. Pursuant to 45 C.F.R. s. 96.126, compliance with interim services, for injection drug users, by Network Providers receiving SAPT Block Grant funding and treating injection drug users; c. Priority for services to families with children that have been determined to require substance abuse and mental health services by child protective investigators and also meet the target populations in subsections (a) or (b), above. Such priority Exhibit A Guidance Care Center, Inc. Page 1 of 3 Contract No. ME225-11-27 IIfic 0 0 ill �, (Contvacthrw r S South I`ll€a€`ida xa.t�r�.�'Por afth �@t.'�.'��ork„1n(%) fiWi2020 must be limited to individuals that are not enrolled in Medicaid or another insurance program, or require services that are not paid by another payor source: (1) Parents or caregivers in need of adult mental health services pursuant to s. 394.674(1)(a)2., F.S., based upon the emotional crisis experienced from the potential removal of children; and (2) Parents or caregivers in need of adult substance abuse services pursuant to s. 394.674(1)(c)3., F.S., based on the risk to the children due to a substance use disorder. d. Individuals who reside in civil and forensic state Mental Health Treatment Facilities and individuals who are at risk of being admitted into a civil or forensic State Mental Health Treatment Facility; e. Individuals who are voluntarily admitted, involuntarily examined, or placed under Part I, Chapter 394, F.S.; f. Individuals who are involuntarily admitted under Part V, Chapter 397, F.S.; g. Residents of assisted living facilities as required in ss. 394.4574 and 429.075, F.S.; h. Children referred for residential placement in compliance with Ch. 65E-9.008, F.A.C.; i. Inmates approaching the End of Sentence pursuant to Children and Families Operating Procedure (CFOP) 155-47, "Processing Referrals from the Department of Corrections," and j. In the event of a Presidential Major Disaster Declaration, Crisis Counseling Program (CCP) services must be contracted for according to the terms and conditions of any CCP grant award approved by representatives of the Federal Emergency Management Agency (FEMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). 3. Mental health crisis intervention and crisis stabilization facility services, and substance abuse detoxification and addiction receiving facility services, must be provided to all persons meeting the criteria for admission, subject to the availability of beds and/or funds. C. INDIVIDUAL/PARTICIPANTS DETERMINATION 1. Determination for eligibility for services for individuals seeking and receiving services funded under this Contract is the responsibility of the Network Provider subject to the provision of Section C. 5, below. The Network Provider must adhere to the eligibility requirements as specified in Exhibit F, SAMH Programmatic State and Federal Laws, Rules, and Regulations. The ME reserves the right to review the Network Provider's determination of eligibility and override the determination of the Network Provider. When this occurs the Network Provider will immediately provide services to the individual until such time the individual completes his/her treatment, voluntarily leaves the program, or the ME's decision is overturned as a result of the dispute resolution. 2. In no circumstances must an individual's county of residence be a factor that denies access to service. Authorized services must only be provided within the serviced area(s) outlined in Attachment 1, Section A.2.c.(2), subject to the availability of funds. 3. In the event of a dispute regarding an individual's eligibility for services and/or placement into the appropriate level of care, the dispute must not preclude the Network Provider from Exhibit A Guidance Care Center, Inc. Page 2 of 3 Contract No. ME225-11-27 0 0 �, (Contvacthrw r South I`ll€a€lida xa.t�r�.�'Por ill IIficafth �@t.'�.'��ork„1C(%) fiWi2020 providing the services to eligible individuals until the dispute is resolved. The dispute resolution process is described in Paragraph 42. of the Standard Contract. 4. Participant eligibility (Direct Prevention) and target population eligibility (Community Prevention) must also be based upon the community action plan or on the relevant epidemiology data. 5. The Department, in accordance with state law, is exclusively responsible for defining Individuals Served for services provided through this Contract. In the event of a dispute, the determination made by the Department is final and binding on all parties. D. CONTRACT LIMITS 1. The Network Provider is not authorized to bill the ME for more units than can be purchased with the amount of funds specified in Exhibit G, Covered Service Funding by OCA, subject to the availability of funds. An exception is granted at the end of the contract term, when the ME at its sole discretion may pay, subject to the availability of funds, the Network Provider for "Uncompensated Units Reimbursement Funds", in whole or in part, or not at all, for Exemplary Performance by the Network Provider. Exemplary Performance will be determined by the Network Provider delivering and billing for services in excess of those units of service the ME will be required to pay. The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the DCF. 2. The Network Provider agrees that funds provided in this contract will not be used to serve persons outside the target population(s) specified in the paragraph above. NOTE: Prevention funds allocated to underage drinking programs and activities targeting eighteen (18) to twenty (20)year old individuals may be taken from Adult Substance Abuse Prevention funds. 3. The provision of services required under this contract are limited to eligible residents, children and adults receiving authorized services within the counties outlined in Attachment I, Section A. 2. c. (2) and limited by the availability of funds. 4. The Network Provider may not authorize or incur indebtedness on behalf of the ME or the Department. Exhibit A Guidance Care Center, Inc. Page 3 of 3 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 2020 EXHIBIT B METHOD OF PAYMENT 1. PAYMENT CLAUSES This is a hybrid Fee-for-Services,Capitation Rate contract. a. Fee-for-Service: This is a Fee-for-Service contract, paid in accordance with subsection 65E- 14.021(2), F.A.C. The unit prices for the covered services purchased under this contract are listed in Exhibit G, Covered Service Funding by OCA. The ME may pay the Network Provider for the delivery of service units provided in accordance with the terms and conditions of this contract for a total dollar amount not to exceed $6,213,678.00, subject to the availability of funds and satisfactory performance of all terms by the Network Provider. b. Case Rate:This contract purchases(N/A)services and is reimbursed by the ME using a Case Rate in accordance with subsection 65E-14.021(2), F.A.C. The ME shall pay the Network Provider for the delivery of services provided in accordance with the service delivery described in the approved Program Description, incorporated herein by reference, and terms and conditions of this contract for a total dollar amount not to exceed 0.00 , subject to the availability of funds. The approved Case Rate is listed in Exhibit G,Covered Services Funding by OCA. c. Capitation Rate: This contract purchases Community Action Treatment Team services and is reimbursed by the ME using a Capitation Rate in accordance with subsection 65E-14.021(2), F.A.C. The ME shall pay the Network Provider for the delivery of services provided in accordance with the service delivery described in the approved Program Description, incorporated herein by reference, and terms and conditions of this contract for a total dollar amount not to exceed $750,000.00 subject to the availability of funds.The Capitation Rate is listed in Exhibit G,Covered Services Funding by OCA under OCA MHCAT. d. Cost Reimbursement: The ME shall reimburse the Network Provider for allowable expenditures incurred pursuant to the terms of this contract and the terms in Exhibit M-1, Services to be Provided, for a total dollar amount not to exceed 0.00 , subject to the availability of funds and Exhibit M-2, Line Item Operating Budget. e. The total contract amount for services purchased through this contract is $8,356,413.00 of the total Contract amount, the ME will be required to pay$6,963,678.00 subject to the delivery and appropriate billing for services. The remaining amount of $1,392,736.00 represents "Uncompensated Units Reimbursement Funds", which the ME, at its sole discretion and subject to the availability of funds, may pay to the Network Provider, in whole or in part, or not at all,for Exemplary Performance by the Network Provider. Exemplary Performance will be demonstrated by the Network Provider's service delivery and billing for those services in excess of those units of service the ME will be required to pay. The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the Department. Any costs or services eligible to be paid for under any other contract or from any other source are not eligible for payment under this Contract. 2. GROUP SERVICES Exhibit B Page 1 of 7 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/ /2020 Aftercare, Intervention, Outpatient, and Recovery Support Services (Substance Abuse) are eligible for special group rates. Group services shall be billed based on a direct staff hour,at 25% of the contract's established rate for the individual services for the same covered service. Excluding Outpatient,total hourly reimbursement for group services shall not exceed the charges for fifteen (15) individuals per group. Group size limitations outlined in the current Medicaid Handbook apply to Outpatient group services funded under this contract. 3. FLEXIBILITY Unless otherwise notified in writing by the ME, the Network Provider is authorized to use the funds within each Other Cost Accumulator ("OCA"), and for the approved covered services within that OCA as listed in Exhibit G, Covered Services Funding by OCA, with 100% flexibility without the need for an amendment to this contract. 4. LOCAL MATCH REQUIREMENT a. Pursuant to s. 394.76(3), Florida Statutes (F.S.), the Network Provider agrees to provide local matching funds in the amount of$1,036,344.00 as indicated in Exhibit H, Funding Detail and Local Match Plan. b. Should the Network Provider receive any funding from the "Uncompensated Units Reimbursement Funds", then the amount of Local Match Plan as it appears on Exhibit H, Funding Detail, will automatically change, utilizing the following formula: The additional match required on the uncompensated units=Uncompensated Substance Abuse Services X 16.67%+Uncompensated Mental Health Services that is not exempt from local match requirements X 33.33%. * *The following MH services are exempt from the local match requirement i. Deinstitutionalization Projects Case Management Intensive Case Management Residential Services I-IV Supported Housing/Living Short Term Residential Treatment (not exempt if funded by Baker Act funds or operated by a public receiving facility) FACT Teams ii. CMH Programs (100435 Category & 102780 (PRTS) Category) that are not grant funded. 5. CORRECTIVE ACTION PLANS In accordance with the provisions of s. 402.73(1), F.S., and Rule 65-29.001, Florida Administrative Code (F.A.C.), corrective action plans may be required for noncompliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed, to include contract termination in whole or in part, for failures to implement or to make acceptable progress on such corrective action plans. Exhibit B Page 2 of 7 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2/ /2020 6. REDUCTION OR WITHOLDING OF FUNDS a. The ME may reduce or withhold funds pursuant to Rule 65-29.001, F.A.C.,if the Network Provider fails to comply with the terms of the contract and/or fails to submit client reports and/or data as required in DCF PAM 155-2, Rule 65E-14, F.A.C.and by the due dates listed on Exhibit C,Required Reports. b. The ME's decision to reduce or withhold funds will be submitted to the Network Provider in writing. The written notice will specify the manner in which the Network Provider has failed to comply with the terms of the contract.When, and if, compliance is achieved, the withheld funds will be disbursed to the Network Provider. 7. CLOSURE OR SUSPENSION OF SERVICES If the Network Provider closes or suspends the provision of services funded by this contract,the Network Provider agrees to notify the ME in writing thirty(30)calendar days prior to their intent to close,suspend or end service(s). If the Network Provider fails to notify the ME, the Network Provider hereby agrees not to request payment for services provided in prior months if the actual number of services in the month for which payment is being requested is less than twenty-five percent (25%) of the prorated amount of services by covered service as given on Exhibit G, Covered Service Funding by OCA, or twenty-five percent(25%)of the prorated share of the amount of funding as specified on Exhibit G,Covered Service Funding by OCA. 8. PURCHASE OF ADDITONAL SERVICES The ME in its sole discretion and subject to funding availability, may purchase from any Network Provider prior to the end of the contract period any service units provided at any time during the term of the contract. 9. ADDITIONAL RELEASE OF FUNDS At its sole discretion,the ME may approve the release of more than the monthly prorated amount when the Network Provider submits a written request justifying the release of additional funds, if funds are available and services have been provided. 10. THIRD PARTY BILLING a. For the purposes of payment,the Department nor the ME shall be considered a liable third-party payer for Medicaid or other publicly funded benefits assistance program. A Medicaid enrolled Network Provider shall not bill the ME for Medicaid covered services provided to a Medicaid eligible recipient.The Network Providers shall not bill the ME for: i. Any Covered Service that is partially compensated by Medicaid, or another publicly funded benefits program source.This shall include any difference in a network provider's rate for a Covered Service and any discount or contracted rate payable by another source, or ii. An individual's share of service cost, when that cost is reimbursable by Medicaid, or another publicly funded benefits program. Nothing in this section shall be construed to prevent payment for Covered Services that are not covered by Medicaid or another publicly funded benefits assistance program or provided to an Exhibit B Page 3 of 7 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc. 7/1/2020 individual who has depleted other fund sources. b. Department funds may not reimburse services provided to: L Individuals who have third party insurance coverage when the services provided are covered under the insurance plan; or ii. Medicaid enrollees or recipients of another publicly funded health benefits assistance program, when the services provided are covered by said program. c. Department funds may reimburse services provided to: i. Individuals who have lost coverage through Medicaid, or any other publicly funded health benefits assistance program coverage for any reason during the period of non-coverage; or ii. Individuals who have a net family income at or above 150 percent of the Federal Poverty Income Guidelines, subject to the sliding fee scale requirements in Rule 65E-14.018 F.A.C. iii. The Network Provider shall ensure that Medicaid funds are accounted for separately from funds for this contract. d. In no event shall Medicaid, any health insurance, another publicly funded health benefits assistance program, or the ME be billed for the same service provided to the same individual on the same day. e. Medicaid earnings cannot be used as local match. f. The Network Provider shall ensure that Medicaid payments are accounted for in compliance with federal regulations. g. The Network Provider shall ensure that Medicaid funds will be accounted for separately from funds for this Contract. This includes services such as Statewide Inpatient Psychiatric Program ("SIPP"), Florida Assertive Community Treatment ("FACT'), Community Action Treatment ("CAT"), Family Intensive Treatment("FIT"), and Central Receiving Facilities. 11. PAYMENT FROM MEDICAID HEALTH MAINTENANCE ORGANIZATIONS,PREPAID MENTAL HEALTH PLAN,OR PROVIDER SERVICE NETWORKS The Network Provider shall make every reasonable effort to identify and collect benefits from third-party payers for services rendered to eligible individuals. Third party payers are, unless waived in Section D (Special Provisions) of this contract, the Network Provider agrees that payments from commercial insurers such as worker's compensation, TRICARE, Medicare, Health Maintenance Organization, Managed Care Organizations, or other payers liable, to the extent that they are required by contract or law, to participate in the cost of providing services to a specific individual. 12. TEMPORARY ASSISTANCE TO NEEDY FAMILIES(TANF) BILLING, IF APPLICABLE The Network Provider's attention is directed to its obligations under applicable parts of Part A or Title IV Exhibit B Page 4 of 7 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, Mc.) 7/ /2020 of the Social Security Act and the Network Provider agrees that TANF funds shall be expended for TANF participants in accordance with Chapters 414, and 445, F.S. and the Department's State Plan for Temporary Assistance for Needy Families, renewal October 1, 2017 —September 30, 2020, or the latest revision thereof. Department's State Plan for Temporary Assistance for Needy Families can be obtained from the contract manager, or can be found at the following web site: https:JJwww.myflf�m i I i�s.com/s�rvic�-pro�r�msJ�cc�ssJdocsJTAN F-PIS n.pdf The contract shall specify the unit cost rate for each covered service contracted for TANF funding, which shall be the same rate as for non-TANF funding, but the contract shall not specify the number of TANF units or the amount of TANF funding for individual covered services. 13. INVOICE REQUIREMENTS a. The rates negotiated with any Network Provider may not exceed the rate as specified in in Exhibit G, Covered Service Funding by OCA and/or the amounts listed in Exhibit M-2, Line Item Operating Budget, where applicable. b. Network Providers are required to comply with Rule 65E-14.021, F.A.C., Schedule of Covered Services, including but not limited to, covered services, methods of payments, descriptions, program areas, data elements, required fiscal reports, program description, rate setting process, payment for services including allowable and unallowable units and requests for payments. c. For Network Providers that receive block grant funding, the invoice shall include the minimum data elements to satisfy the Department's application and reporting requirements. d. A Network Provider that receives block grant funding shall, in its invoice, provide sufficient detail that captures, reports, and tests the validity of expenditures and service utilization. e. The Network Provider shall request payment monthly through submission of a properly completed invoice, within eight (8) days following the end of the month for which payment is being requested for the delivery of service. Payment to the Network Provider by the ME is subject to the availability of funds and payments received from the Department. The invoice, Monthly Payment Request, is incorporated herein by reference and available upon request from the ME's Contract Manager. f. If no services are due to be invoiced from the preceding month, the Network Provider shall submit a written document to the ME indicating this information within eight (8) calendar days following the end of the month. Should the Network Provider fail to submit an invoice or written documentation if no services are due to be invoiced from the preceding month,within thirty(30) calendar days following the end of the month, then the ME at sole discretion can reallocate funds. If the Network Provider fails to submit an invoice or written documentation for two (2) consecutive months within a twelve (12) month period,the ME at sole discretion can terminate the contract. g. The Network Provider's final invoice must reconcile actual service units provided during the contract period with the amount paid by the ME. The Network Provider shall submit their fiscal year final invoice to the ME within twenty(20) days after the end of each state fiscal year in the contract period. Exhibit B Page 5 of 7 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7 2020 h. The Network Provider shall ensure that the year-to-date number of units of service reported on a request for payment or any associated worksheet shall reconcile with the total number of units reported and accepted in KIS, PBPS, FASAMS, or other data system designated by the ME. i. Pursuant to 65E-14.021(7)(a)2., F.A.C., the Network Provider shall not invoice for any Covered Services paid for under any other contract or from any other source. The Network Provider must subtract all units which are billable to Medicaid, and all units for SAMH client services paid from other sources, including Social Security, Medicare payments, Food Stamps, and funds eligible for local matching which include patient fees from first, second, and third-party payers, from each monthly request for payment. Should an overpayment be detected upon reconciliation of payments, the Network Provider must immediately refund any overpayment to the ME, including but not limited to services provided to a Medicaid-eligible individual prior to becoming a Medicaid recipient when those services are subsequently covered under a retroactive Medicaid reimbursement determination. For services provided based on bed-day availability,the Network Provider must report any payments received from all other sources on the"Schedule of Bed-Day Availability"at the end of the fiscal year and refund any overpayment. j. Invoices shall be submitted in detail sufficient for a proper pre-audit and post-audit. 14. SUPPORTING DOCUMENTAITON a. The Network Provider agrees to maintain and submit to the ME, if applicable, service documentation for each service billed to the ME pursuant to this contract. The Network Provider shall track all units billed to the ME by program and by Other Cost Accumulator(OCA). Proper service documentation for each SAMH covered service is outlined in Rule 65E-14.021, F.A.C., Exhibit Y,TANF SAMH Guidelines and TANF SAMH Incidental Expenditures for Housing Assistance, if applicable. b. The Network Provider shall maintain documentation to support all units billed to the ME and units subtracted for SAMH client services on each monthly request for payment. c. Upon request, the network provider must submit to the ME and the Department information regarding the amount and number of services paid for by the Substance Abuse Prevention and Treatment Block Grant. d. The Network Provider shall ensure that all services provided are entered into KIS, PBPS, FASAMS, or other data system designated by the ME. e. The ME, Department and the State's Chief Financial Officer, reserve the right to request supporting documentation at any time after actual units have been delivered. 15. The Network Provider shall comply with the policies set forth in the Department of Financial Services Reference Guide for State Expenditures for guidance regarding the requirements applicable to the disbursement of funds from the State Treasury, regardless of payment methods. The Reference Guide for State Expenditures can be obtained at the following website: Exhibit B Page 6 of 7 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/1/2020 The Network Provider shall also comply with active Comptroller/Chief Financial Officer Memoranda issued by the Division of Accounting and Auditing. The Division of Accounting and Auditing Memoranda vxebsiteis found in the link below: lG. FUNDING SWEEPS The Network Provider agrees that at the sole discretion of the ME and at such time and upon terms, conditions or criteria set by the ME, a review of the funding utilization rate or pattern of the Network Provider may be conducted by the ME. Based upon such review, if it is determined that the rate of utilization may result in a lapse of funds, then in that event the ME may amend the Network Provider's total amount of funding by reducing same to prevent the potential lapse. Additionally, the Network Provider's funding may be reduced and reallocated within the system of care, as determined by the ME and its sole discretion,to meet the changing needs of the system of care.The ME will notify the Network Provider in writing of the reduction prior to amending the total amount of funding. The ME's Lapse Policy is incorporated herein by reference. Exhibit Page 7of7 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 1 2020 Exhibit C Required Reports Required Reports Due Date #of Copies Send to Response to Within 10 business days from 1 (Electronic 1. ME Contract Manager Monitoring Reports the day the report is received Submission via E-mail) and Corrective Action 2. SFBHN staff member Plans issuing CAP External Quality Within 10 calendar days from 1 (Electronic 1. ME Contract Manager Assurance Reviews, the day the report is received, Submission via E-mail) Monitoring Reports, or as requested by the 2. Director of Contract Surveys and Contract Manager Accountability Corrective Actions,as applicable Memorandum of Within 90 calendar days of 1 (Electronic ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract between the ME and Federally Qualified the Network Provider(for Health Center(FQHC) newly executed MOU's); or Within 30 calendar days for Federally Qualified renewed MOU's; Updates to Health Centers are P&P for FQHC's shall be required to submit submitted within 30 calendar policies and days of adoption procedures that explain the access to primary care services to the medically underserved behavioral health client Sliding Fee Scale Prior to contract execution 1 (Electronic ME Contract Manager [reflecting the Submission via E-mail) uniform schedule of discounts referenced in 65E-14.018(4)] Final FY 2020-2021 Submitted annually prior to 1 (Electronic 1. ME Contract Manager (1) Projected Cost contract execution. Submit Submission via E-mail) Center Operating and updates within 30 calendar 2.VP of Finance Capital days of execution of an Budget, amendment to the contract (2) Budget Narrative, affecting the budget. (3) Network Providers Agency Service Capacity Report, (4) Cost Center Personnel Detail Report Exhibit C Page 1 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 1 2020 Exhibit C Required Reports Program Description Annually, prior to contract 1 (Electronic 1. ME Contract Manager (1)Organizational execution. Submit updates Submission via E-mail) Profile within 30 calendar days of 2.VP of Behavioral Health (2) Service Activity amendment Description (3) Supplemental Program Description(s) Affidavit Regarding Annually prior to contract 1 ME Contract Manager Debarment execution,or as requested by the Contract Manager Incident Report Within 24 hours of Submission through Submission through IRAS occurrence, in IRAS accordance with CFOP 215-6 and reportable incidents defined CFOP 180-4 Mandatory Reporting Requirements to the Office of the Inspector General Acute Care Service Real-time data submission as Electronically KIS Express Acute Care Utilization Reporting mandated by subsection System for Public Receiving 394.9082(10), Florida Statutes Facilities, Detoxification and Addiction Receiving Facilities. Monthly Data Service data shall be Electronically KIS, PBPS, or other data Required by DCF submitted electronically, system designated by the ME FASAMS PAM 155-2 weekly, by 12:00 Noon every or the Department Wednesday. Final monthly shall be submitted electronically to the ME no later than the 4th of each month following the month of service ADA Client By the 4th business day 1 (Electronic https://fsl6.formsite.com/D Communication following the Submission via E-mail) CFTraininL Monthly- Assessment Auxiliary reporting month Summary Aid Service Record Report/form login.html Monthly Summary Report (Applicable to agency's that employ Confirmation E-mail to the fifteen (15) or more ME Contract Manager employees) Exhibit C Page 2 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2/1/2020 Exhibit C Required Reports Monthly Service Monthly, by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day Department) after the month of service Invoice Review 1 As requested by ME staff Supporting Submitted with the monthly Documentation invoice,as appropriate, and/or as requested by SFBHN staff Exhibit K, Pre- Monthly,with the monthly 1 1. ME Sr.Accountant(Fiscal Authorization invoice by the eighth (8th) Department) Utilization calendar day Management Roster after the month 2. ME ASOC Manager for Substance Abuse of service and Mental Health 3. ME CSOC Manager Residential Level II Services Exhibit AC, Monthly Monthly by the 5th calendar 1 ME Care Coordinator Care Coordination day after the month of service Report Narrative and Chart Final Invoice 1 ME Sr.Accountant(Fiscal By July 20 of each fiscal year Department) and/or 20 days after contract end date Designation of Within 5 working days of 1 (Electronic ME Contact Manager Dispute Resolution contract execution Submission via E-mail) Officer Inventory Report ME Contract Manager 8/3/2020 1 (Electronic Submission via E-mail) Attestation of 8/3/2020 1 (Electronic ME Contract Manager Network Provider's Submission via E-mail) Verification that all applicable employees and subcontractors with access to ME and/or DCF information systems have signed a DCF Security Agreement form CF0114, per the Attachment I and Standard Contract Exhibit C Page 3 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Emergency 8/3/2020 1 (Electronic 1. ME Contract Manager Preparedness Plan Submission via E-mail) 2. ME Continuous Quality Improvement Manager Civil Rights 8/3/2020 1 (Electronic ME Contract Manager Compliance Checklist Submission via E-mail) (CF0946) Civil Rights 8/3/2020 1 (Electronic ME Contract Manager Certificate(CF707) Submission via E-mail) Client Trust Fund 8/3/2020 1 (Electronic ME Contract Manager Letter Submission via E-mail) Quality 8/3/2020 1 (Electronic 1. ME Contract Manager Assurance/Quality Submission via E-mail) Improvement Plan 2. ME Continuous Quality Improvement Manager Signed Florida 8/3/2020 1 (Electronic ME Contract Manager Department of Submission via E-mail) Children and Families Employment Screening Affidavit that all required staff have been screened or Network Provider is awaiting the results of screening Attestation signed by 10/1/2020 1 (Electronic ME Contract Manager the CEO/Executive Submission via E-mail) Director indicating that all applicable staff funded by this Contract have received a copy of the fully executed Contract and will receive a copy of any amendments made to this Contract. Exhibit C Page 4 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports NVRA Voter July 5,2020 1 (Electronic 1. ME Voter Registration Registration Agencies (Period:04/01/20-06/30/20) Submission via E-mail) Activities Coordinator Quarterly Activities October 5,2020 Report Form (DS- (Period:07/01/20-09/30/20) 2. ME Contract Manager DE131; effective January 5,2021 01/2012 or latest (Period: 10/01/20- 12/31/20) revision thereof, if April 5,2021 applicable (Period:01/01/21-03/31/21) July 5,2021 (Period:04/01/21-06/30/21) Quarterly Financial October 31,2020 1 (Electronic 1. ME VP of Finance Statements(Balance (Period:07/01/20-09/30/20) Submission via E-mail) Sheet and Statement January 31,2021 2. ME Contract Manager of Activity) (Period: 10/01/20- 12/31/20) April 30,2021 (Period:01/01/21-03/31/21) July 31,2021 (Period:04/01/21-06/30/21) Attestation indicating October 31,2020 1 (Electronic ME Contract Manager the filing of Form 941 (Period:07/01/20-09/30/20) Submission via E-mail) and payment of any January 31,2021 taxes due to the IRS (Period: 10/01/20- 12/31/20) have been paid. April 30,2021 (Period:01/01/21-03/31/21) July 31,2021 (Period:04/01/21-06/30/21) Quarterly Peer October 31,2020 One(1) Encrypted and ME Peer Services Manager Specialist Report (Period:07/01/20-09/30/20) password protected January 31,2021 Electronic Submission (Period: 10/01/20- 12/31/20) April 30,2021 (Period:01/01/21-03/31/21) July 31,2021 (Period:04/01/21-06/30/21) January 30,2021 1 (Electronic 1. ME Contract Manager Continuous Quality (Period:07/01/20- 12/31/20) Submission via E-mail) Improvement July 30,2021 2. ME Continuous Quality Updates (Period:01/01/21-06/30/21) Improvement Manager Year-End Financial Reports for Network Provider's Not Requiring Audits Per Attachment 11 Certification Due 180 days after the end of 1 (Electronic 1. ME Contract Manager indicating that the Network Provider's fiscal Submission via E-mail) recipient expended year or within 30 days of the 2.VP of Finance less than$750,000 in recipient's receipt of the audit Federal Awards or in report,whichever occurs first, directly to each of the Exhibit C Page 5 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 1 2020 Exhibit C Required Reports State Awards during following unless otherwise the fiscal year required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of State Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Earnings the Network Provider's fiscal Submission via E-mail) 2.VP of Finance year or within 30 days of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Projected Cost Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Center Operating and the Network Provider's fiscal Submission via E-mail) Capital Budget year or within 30 days of the 2.VP of Finance Actual Expenses& recipient's receipt of the audit Revenues Schedule report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Local Match Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Calculation Form - the Network Provider's fiscal Submission via E-mail) Template 9- year or within 30 days of the 2.VP of Finance Department of recipient's receipt of the audit Children and Families report,whichever occurs first, form,available at the directly to each of the following website: following unless otherwise required by Florida Statutes https://www.myflfa The schedule shall be based milies.com/service- on revenues and expenditures programs/samh/man recorded during the state's aging-entities/2020- fiscal year. contract-docs.shtml Exhibit C Page 6 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc. 7/1/2020 Exhibit C Required Reports Schedule of Bed-Day Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Availability Payments the Network Provider's fiscal Submission via E-mail) year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Agency Prepared Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Financial Statements the Network Provider's fiscal Submission via E-mail) (Balance Sheet and year or within 30 days of the 2.VP of Finance Statement of Activity recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Year-End financial Reports for Network Provider's Requiring Audits Per Attachment it Correspondence Due 180 days after the end of 1 (Electronic 1. ME Contract Manager from the Auditor the Network Provider's fiscal Submission via E-mail) showing proof of year or within 30 days of the 2.VP of Finance submission of the recipient's receipt of the audit Audit Report and report,whichever occurs first, Management Letter directly to each of the to the Network following unless otherwise Provider. required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Management letter Due 180 days after the end of 1 (Electronic 1. ME Contract Manager addressed to the the Network Provider's fiscal Submission via E-mail) Network Provider year or within 30 days of the 2.VP of Finance issued by the Auditor recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Exhibit C Page 7 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 1 2020 Exhibit C Required Reports Financial& Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Compliance Audit to the Network Provider's fiscal Submission via E-mail) include the necessary year or within 30 days of the 2.VP of Finance schedules per recipient's receipt of the audit Attachment II report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of State Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Earnings the Network Provider's fiscal Submission via E-mail) 2.VP of Finance year or within 30 days of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of Related Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Party Transaction the Network Provider's fiscal Submission via E-mail) Adjustments year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Local Match Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Calculation Form - the Network Provider's fiscal Submission via E-mail) Template 9- year or within 30 days of the 2.VP of Finance Department of recipient's receipt of the audit Children and Families report,whichever occurs first, form,available at the directly to each of the following website: following unless otherwise https://www.myflfa required by Florida Statutes milies.com/service- The schedule shall be based programs/samh/man on revenues and expenditures aging-entities/2020- recorded during the state's contract-docs.shtml fiscal year. Exhibit C Page 8 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc. 7/1/2020 Exhibit C Required Reports Projected Cost Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Center Operating and the Network Provider's fiscal Submission via E-mail) Capital Budget year or within 30 days of the 2.VP of Finance Actual Expenses& recipient's receipt of the audit Revenues Schedule report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of Bed-Day Due 180 days after the end of 1 (Electronic 1. ME Contract Manager Availability Payments the Network Provider's fiscal Submission via E-mail) year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Reports Required for Children's Mental Health Providers,as applicable Children's Crisis Per Exhibit S-Monthly Census One(1) Encrypted 1. ME Contract Manager Response Team Report by the 15th of every Electronic Submission (CCRT) month following the month of attachment to an 2. Children's System of Care service email to each Manager recipient Reports Required for Behavioral Health Network(BNet)Provider Alternative Services Within 15 calendar days after One(1) Encrypted 1. ME Contract Manager Provision end of month Electronic Submission Documentation attachment to an 2. ME BNet Coordinator (Other than email to each Pharmaceuticals) recipient 3.Children's Mental Health State Program Office Alternative Services Within 15 calendar days after One(1) Encrypted 1. ME Contract Manager Provision end of month Electronic Submission Documentation attachment to an 2. ME BNet Coordinator (Pharmaceuticals email to each only) recipient 3.Children's Mental Health State Program Office Statement of September 1 following close One(1) Encrypted 1. ME Contract Manager Program Cost of the contract year(June 30) Electronic Submission 2. ME BNet Coordinator attachment to an 3. Children's Mental email to each Health State Program recipient Office Exhibit C Page 9 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Reports Required for Project for Assistance in Transition from Homelessness(PATH)Providers PATH Monthly Monthly, by the 5th calendar 1 (Electronic Report(generated day Submission via E-mail) from the HMIS after the month ME Housing Coordinator system) of service PATH Monthly Client Monthly by the 10th calendar 1 (Electronic Tracker day after the month of service Submission via E-mail- Encrypted and ME Housing Coordinator Password Protected) Quarterly Summary No later than the 10th of the 1 (Electronic https://www.pathpdx.org/ Report month following the quarter Submission via E-mail) of services PATH Annual Data No later than November 17th 1 (Electronic https://www.pathpdx.org/ Report into the PATH Submission via E-mail) Data Exchange(PDX) data system Reports Required for Adult Mental Health Providers,as,applicable Assisted Living Provider to Maintain the 1 (Electronic Requestor Facility with a Report on file and submit Submission via E-mail) Limited Mental upon Request by ME staff Encrypted and Health License Client October 5,2020 Password Protected Quarterly Report, per (Period:07/01/20-09/30/20) Exhibit L January 5,2021 (Period: 10/01/20- 12/31/20) April 5,2021 (Period:01/01/21-03/31/21) July 5,2021 (Period:04/01/21-06/30/21) Report Required for Florida Assertive Community Treatment(FACT)Providers Vacant Position Monthly by the 7th of each 1 (Electronic Report per Section month following the month of Submission via E-mail) 1. ME Contract Manager II.H., Reports in service Exhibit AF 2. ME Director of the Adult System of Care FACT Enhancement October 5,2020 1 (Electronic Reconciliation Report (Period:07/01/20-09/30/20) Submission via E-mail) 1. ME Contract Manager per Section II.H., January 5,2021 Reports in Exhibit AF (Period: 10/01/20- 12/31/20) 2. ME Director of the Adult April 5,2021 System of Care (Period:01/01/21-03/31/21) July 5,2021 (Period:04/01/21-06/30/21) Exhibit C Page 10 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Ad-Hoc Quarterly October 5,2020 1 (Electronic Report per Section (Period:07/01/20-09/30/20) Submission via E-mail) 1. ME Contract Manager II.H., Reports in January 5,2021 Exhibit AF (Period: 10/01/20- 12/31/20) 2. ME Director of the Adult April 5,2021 System of Care (Period:01/01/21-03/31/21) July 5,2021 (Period:04/01/21-06/30/21) Outcomes and October 5,2020 1 (Electronic Output Performance (Period:07/01/20-09/30/20) Submission via E-mail) 1. ME Contract Manager Measures Report, January 5,2021 per Section II.H., (Period: 10/01/20- 12/31/20) 2. ME Director of the Adult Report in Exhibit AF April 5,2021 System of Care (Period:01/01/21-03/31/21) July 5,2021 (Period:04/01/21-06/30/21) Report Required for Miami-Dade Forensic Alternative(MDFAQ Providers Daily Census Report Daily, by 10:00 am, 1 (Electronic Regional Forensic Monday- Friday Submission via E-mail) Coordinator Monthly Program By the 15th of each month 1 (Electronic 1. ME Contract Manager Quality Review following the month of Submission via E-mail) Tracking Report services 2. ME Director of the Adult System of Care Monthly By the 15th of each month 1 (Electronic 1. ME Contract Manager Performance following the month of Submission via E-mail) Measures Report services 2. ME Director of the Adult System of Care Reports Required for Forensic Services Providers Monthly Report for By 15th of each month 1 Mental Health Administrator Individuals on Office Conditional Release, if applicable Statewide Forensic Weekly 1 ME Director of the Adult Bed Census Report, if (Every Thursday by 5:00 pm) System of Care applicable Reports Required for Forensic Multidisciplinary Team Provider Monthly Forensic By 10th of each month for the 1 (Electronic ME Director of Adult System Multidisciplinary preceding months' services Submission via E-mail) of Care Team Report—DCF Template 25: https://www.myflfa milies.com/service- programs/samh/man Exhibit C Page 11 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports aging-entit esZ2020- contract-docs.shtml Monthly Vacant By 10th of each month for the 1 (Electronic ME Director of Adult System Position(s) Reports preceding months' services Submission via E-mail) of Care Monthly Court By 10th of each month for the 1 (Electronic ME Director of Adult System Reports preceding months' services Submission via E-mail) of Care Reports Required for Consumer-Driven Agencies Enrollment/Member October 5,2020 1 (Electronic ME Contract Manager ship Report (Period:07/01/20-09/30/20) Submission via E-mail) January 5,2021 (Period: 10/01/20- 12/31/20) April 5,2021 (Period:01/01/21-03/31/21) July 5,2021 (Period:04/01/21-06/30/21) Reports Required for Substance Abuse Services Providers Report for HIV Early January 5,2021 1 (Electronic ME Contract Manager Intervention (Period:07/01/20- 12/31/20) Submission via E-mail) Services,SAPT Block July 5,2021 Grant Set Aside (Period:01/01/21-06-30-21) Funded Services Only Annual Report for Upon Request 1 (Electronic ME Contract Manager Evidenced-based Submission via E-mail) Injection Drug User Outreach Services, SAPT Block Grant Mandate, Designated Providers Only Annual Report for Upon Request 1 (Electronic ME Contract Manager Pregnant Women Submission via E-mail) and Women with Dependent Children SAPT Block Grant Set Aside Funded Services Only Monthly Outcomes Due monthly, by the 4th of 1 (Electronic 1. ME IT Office for Women's every month following the Submission via E-mail) Expansion Grant— month of service 2. ME Contract Manager Special Appropriation Exhibit C Page 12 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Reports Required for State Opioid Response Discretionary Grant Providers Monthly SOR Data Due monthly, by the 15th of 1 (Electronic ME Contract Manager Collection Report- every month following the Submission via E-mail) State Opioid month of service Encrypted and Response Password Protected Discretionary Grant Services(SOR) Medication Assisted Treatment Services, OCA: MSSOR- Exhibit BB Quarterly and Annual October 31,2020 1 (Electronic 1. ME Contract Manager Expenditure Report (Period:07/01/20-09/30/20) Submission via E-mail) (Exhibit BB) January 30,2021 2. VP of Finance (Period: 10/01/20- 12/31/20) April 30,2021 (Period:01/01/21-03/31/21) July 31,2021 (Period:04/01/21-06/30/21) Annual Expenditure Report Due: 7/15/2021 (Period:07/01/20—06/30/21) Reports Required for Substance Abuse Prevention Services Providers Monthly Data Prevention service data shall Electronically PBPS, or other data system Required by DCF be submitted electronically to designated by the ME or the FASAMS PAM 155-2 PBPS no later than the 4th of Department and/or PBPS each month following the month of service Monthly Data to the Monthly, by the 4th calendar Electronically DOES or any other format ME's contracted day after the month of service requested by BSRI evaluation entity- BSRI Monthly Service Monthly, by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day after the month Department) of service Invoice Review 1 ME Sr.Accountant(Fiscal Supporting Submitted with the monthly Department) Documentation- invoice from PBPS in a jpeg format Exhibit C Page 13 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Monthly E-Mail Monthly, by the 4th calendar 1 (Electronic 1. ME Director or Prevention Notification to the day after the month of service Submission via E-mail) Services ME Prevention Services Director and 2. ME Data Analyst ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. Refer to Scope of Work Attachment to the Contract for specifics Final Annual Site 8/31/2020 1 (Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Memorandum of Within 30 calendar days of 1 (Electronic 1. ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract(for newly executed 2. ME Director or Prevention Community Coalition MOU's) Services OR Within 30 calendar days for renewed MOU's Reports Required for Prevention Partnership Grant Providers Monthly E-Mail Monthly, by the 4th calendar 1 (Electronic 1. ME Director or Prevention Notification to the day after the month of service Submission via E-mail) Services ME Prevention Services Director and 2. ME Data Analyst ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. Refer to Scope of Work Attachment to the Contract for specifics Program Status July 15,2021 1 (Electronic 1. ME Contract Manager Report (Period:7/1/20-6/30/21) Submission via E-mail) 2. ME Director or Prevention Services Exhibit C Page 14 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Memorandum of Within 30 calendar days of 1 (Electronic 1. ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract(for newly executed 2. ME Director or Prevention Community Coalition MOU's) Services OR Within 30 calendar days for renewed MOU's Final Annual Site 8/31/2020 1 (Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Financial Report of July 31,2021 1 (Electronic 1. ME Contract Manager, Program Expenses (Period:07/01/20-06/30/21) Submission via E-mail) 2. ME VP of Finance,and 3. ME Director of Prevention Services Reports Required for Evaluation Entity for Prevention Services Monthly Service Monthly by 20th calendar day 1 (Electronic 1. ME Contract Manager Report after the month of service Submission via E-mail) (Deliverables per 2. ME Director of Prevention Attachment IV, Scope Services of Work) Quarterly October 31,2020 1 (Electronic 1. ME Contract Manager, Expenditure Report (Period:07/01/20-09/30/20) Submission via E-mail) January 30,2021 2. ME VP of Finance,and (Period: 10/01/20- 12/31/20) April 30,2021 3. ME Director of Prevention (Period:01/01/21-03/31/21) Services July 31,2021 (Period:04/01/21-06/30/21) Reports Required for Providers Receiving Specific Appropriations Initial Projected 7/10/2020 1 (Electronic 1. ME Contract Manager Return on Submission via E-mail) Investment-Per Exhibit AM Quarterly Updates on October 10,2020 1 (Electronic 1. ME Contract Manager Return on (Period:07/01/20-09/30/20) Submission via E-mail) Investment Report- January 10,2021 Per Exhibit AM (Period: 10/01/20- 12/31/20) April 10,2021 (Period:01/01/21-03/31/21) July 10,2021 (Period:04/01/21-06/30/21) Exhibit C Page 15 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Reports Required for the Navigate Program Provider Quarterly Services October 31,2020 1 (Electronic ME Contract Manager Report (Period:07/01/20-09/30/20) Submission via E-mail) January 30,2021 (Period: 10/01/20- 12/31/20) April 30,2021 (Period:01/01/21-03/31/21) July 31,2021 (Period:04/01/21-06/30/21) Navigate Program October 31,2020 1 (Electronic ME Contract Manager Quarterly (Period:07/01/20-09/30/20) Submission via E-mail) Expenditure Report January 30,2021 (Period: 10/01/20- 12/31/20) April 30,2021 (Period:01/01/21-03/31/21) July 31,2021 (Period:04/01/21-06/30/21) Reports Required for Information and Referral Services Providers Information and Due monthly, by the 30th of 1 (Electronic ME Contract Manager Referrals Provider's every month following the Submission via E-mail) Network(Jewish month of service Community Services of South Florida, Inc.) Exhibit P-1, Information and Referral Monthly Progress Report Reports Required for the Forensic Mental Health Services Program Appendix A, By the 10th of every month 1 (Electronic Director of Adult System of Conditional Release following the reporting month Submission via E-mail) Care Report Weekly Statewide Weekly by 12:00 Noon every 1 (Electronic Director of Adult System of Census Report Thursday Submission via E-mail) Care Appendix B, Monthly By the 10th of every month 1 (Electronic Director of Adult System of Diversion Report following the reporting month Submission via E-mail) Care Quarterly SMHFT Due within thirty(30) 1 (Electronic Director of Adult System of Visit Report calendar days of date of the Submission via E-mail) Care visit Staffing Report January 5,2021 1 (Electronic Director of Adult System of (Period:07/01/20- 12/31/20) Submission via E-mail) Care July 5,2021 (Period:01/01/21-06-30-21) Exhibit C Page 16 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Reports Rewired for the Community Action Treatment Team(CAT Team)Program Weekly Census Weekly by 12:00 noon,every 1 (Electronic Children's System of Care Report Monday Submission via E-mail) Manager Encrypted and Password Protected Monthly shall be submitted Electronically KIS, FASAMS,or other data Monthly Data electronically to the ME no system designated by the ME Required by DCF later than the 4th of each or the Department FASAMS PAM 155-2 month following the month of service Appendix 1-Persons By the 8th calendar day of the 1 (Electronic 1. Children's System of Care Served and month after the month of Submission via E-Mail) Manager Performance service 2. Contract Manager Measure Report Appendix 2- October 10,2020 1 (Electronic 1. Children System of Care Quarterly (Period:07/01/20-09/30/20) Submission via E-mail) Manager Supplemental Data January 10,2021 Report (Period: 10/01/20- 12/31/20) 2. Contract Manager April 10,2021 (Period:01/01/21-03/31/21) July 10,2021 (Period:04/01/21-06/30/21) Appendix 3-CAT Monthly, by the eighth (8th) 1 1. ME Sr.Accountant(Fiscal Team Monthly calendar day Department) Invoice after the month of service 2. Children's System of Care Manager Invoice Review Submitted with the monthly 1 1. ME Sr.Accountant(Fiscal Supporting invoice,as appropriate, Department) Documentation and/or as requested by SFBHN 2. Children's System of Care (incidental expenses) staff Manager Reports Required for the Mobile Response Teams Monthly MRT Monthly by the 10th following 1 (Electronic 1. ME Contract Manager Tracker the month of service Submission via E-mail) 2. ME Data Analysts - Encrypted, password protected Outreach Activities October 15,2020 1 (Electronic 1. ME Contract Manager Log (Period:07/01/20-09/30/20) Submission via E-mail) 2. ME Data Analysts January 15,2021 (Period: 10/01/20- 12/31/20) April 15,2021 (Period:01/01/21-03/31/21) July 15,2021 (Period:04/01/21-06/30/21) Exhibit C Page 17 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7 1 2020 Exhibit C Required Reports Reports Required for Family Intensive Treatment Team(FIT)Service Providers Weekly-Child Each Monday by close of 1 (Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit Al) Monthly Progress By the 13th day of the month 1 (Electronic 1. Contract Manager Report(Reporting following the month of Submission via E-mail) 2. Child Welfare Integration Template 17 is services Coordinator available at: https://www.myflfa milies.com/service- programs/samh/man aging-entities/2020- contract-docs.shtml Reports Required for the Families Engaged in Recovery and Safety(FERAS)Providers Weekly-Child Each Monday by close of 1 (Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit U) Monthly-Child By the 15th day of the month 1 (Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services Monthly-FERAS By the 8th day of the month 1 (Electronic Child Welfare Integration Outreach Log following the month of Submission via E-mail) Coordinator services Reports Required for Child Welfare Specialty Program Provider Weekly-Child Each Monday by close of 1 (Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit J) Monthly-Child By the 13th day of the month 1 (Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services Exhibit C Page 18 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/1/2020 Exhibit C Required Reports Monthly—Child By the 8th day of the month 1 (Electronic Child Welfare Integration Welfare Specialty following the month of Submission via E-mail) Coordinator Program Outreach services Log Reports Required for Child Welfare Integration&Support Teams(CWIST) Monthly Family Monthly by the 5th for the 1 (Electronic ME Child Welfare Navigator Tracker preceding month's services. Submission via E-mail) Integration Coordinator Monthly Behavioral Monthly by the 5th for the 1 (Electronic ME Child Welfare Consultant Activity preceding month's services. Submission via E-mail) Integration Coordinator Log Reports Required for Network Providers Providing SA Treatment Services to Pregnant Women,Mother's and their Affected Families(ACA's:MS027 and MS081) Women's Special By the 8th day of the month One(1) Password, Data Analysts Appropriation Data following the month of protected and Reporting-Per services encrypted Electronic Exhibit AE Submission Supported Employment Report—Special Proviso Funded Clubhouses Supported October 10,2020 One(1) Password, ME Peer Services Manager Employment (Period:07/01/20-09/30/20) protected and January 10,2021 encrypted Electronic (Period: 10/01/20- 12/31/20) Submission April 10,2021 (Period:01/01/21-03/31/21) July 10,2021 (Period:04/01/21-06/30/21) Reports Required for Network Providers screening for Supplemental Security Income/Social Security Disability Insurance(SSI/SSDI)Outreach,Access,and Recovery(SOAR) Certificate of online Within ten (10) business days 1 (Electronic SOAR Local Lead SOAR course of completion Submission via E-mail) completion Records review per October 15,2020 One(1) Password, SOAR Local Lead Exhibit AN,Section (Period:07/01/20-09/30/20) protected and 11, c. Individual January 15,2021 encrypted Electronic Records Review and (Period: 10/01/20- 12/31/20) Submission in Exhibit AN,Section April 15,2021 13.b.,Children's (Period:01/01/21-03/31/21) SOAR July 15,2021 (Period:04/01/21-06/30/21) Note:When a regular due date for a required report falls on a weekend or a legal holiday,the due date is extended to the next business day immediately following the weekend or holiday. Exhibit C Page 19 of 19 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/1/2020 EXHIBIT D Substance Abuse&Mental Health Required Performance Outcomes&Outputs Network Provider Name: Guidance/Care Center, Inc. Contract#: ME225-11-27 Date: 7/1/2020 Amendment#: The Network Provider is directed to the Department's Guidance Document 24, Performance Measurement Manual for program guidance on the measures in Tables 1 & 2 below. To access the Department's FY 20-21 Guidance Document 24, click on the link below: https://www.myflfamilies.com/service-programs/saml-i/magagin,�4-entities/index.shtml. Note: Click on FY20-21 MF Templates and click on Guidance Document 24—Performance Measurement Manual 1i,�t! i eft{ ;.f{ Y t s t;i��s £_ 1(f r},..Ai i? 5 ,i�rf ��� t£rl;�t�ti t 4 �t�ti:• t£ri �t�ti ti ��� t£rf t�ti t{!rf �t�ti r{!rf �t�ti t£rf;�t�ti t{!rf �t�tit{!rf �t�ti t£rl t t ..ini Adults Community Mental Health MH003 a. Average annual days worked for pay for adults with severe and persistent mental illness 40 MH703 b. Percent of adults with serious mental illness who are competitively employed 24% MH742 c. Percent of adults with severe and persistent mental illnesses who live in stable housing 90% environment MH743 d. Percent of adults in forensic involvement who live in stable housing environment 67% MH744 e. Percent of adults in mental health crisis who live in stable housing environment 86% Adult Substance Abuse SAA73 a. Percentage change in clients who are employed from admission to discharge 10% SA754 b. Percent change in the number of adults arrested 30 days prior to admission versus 30 days 15% prior to discharge SA755 c. Percent of adults who successfully complete substance abuse treatment services 51% SA756 d. Percent of adults with substance abuse who live in a stable housing environment at the 94% time of discharge Children's Mental Health MH012 a. Percent of school days seriously emotionally disturbed (SED)children attended 86% MH377 b. Percent of children with emotional disturbances(ED)who improve their level of 64% functioning MH378 c. Percent of children with serious emotional disturbances(SED)who improve their level of 65% functioning MH778 d. Percent of children with emotional disturbance(ED)who live in a stable housing 95% environment MH779 e. Percent of children with serious emotional disturbance(SED)who live in a stable housing 93% environment MH780 f. Percent of children at risk of emotional disturbance(ED)who live in a stable housing 96% environment Children's Substance Abuse SA725 a. Percent of children who successfully complete substance abuse treatment services 48% SA751 b. Percent change in the number of children arrested 30 days prior to admission versus 30 20% days prior to discharge SA752 c. Percent of children with substance abuse who live in a stable housing environment at the 93% time of discharge Exhibit D Guidance Care Center, Inc. Page 1 of 2 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, lnc.) 7/ /2020 Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Year FY20-21 Service Category FY Target Residential Care 23 �a Outpatient Care 1508 R Crisis Care 161 75 State Hospital Discharges N/A Q Peer Support Services 0 Residential Care N/A d.. _ w s Outpatient Care 485 a -_ Crisis Care N/A ' U a, Residential Care N/A Q Outpatient Care 430 v U = Detoxification 119 �a Women's Specific Services N/A +� Injecting Drug Users 65 Q Peer Support Services 24 Residential Care' 0 Outpatient Care' 204 Detoxification 0 c Q "Refer to Attachment IV,Scope Prevention of Work for the numbers served.** :c U Network Provider Compliance: Failure to meet the applicable standards established in Tables 1 and 2 shall be considered nonperformance pursuant to Standard Contract, Section 8. Financial Consequences for Network Provider's Failure to Perform. Exhibit D Guidance Care Center, Inc. page 2 of 2 Contract No. ME225-11-27 Thriving Mind South Florida (�ontractingas South Florida Behavioral Health Network, |ncj 7/1/2020 EXHIBIT F SAMH PROGRAMMATIC STATE AND FEDERAL LAWS, RULES, AND REGULATIONS The Network Provider and its subcontractors ehoU comply with all applicable state and federal |owe' rules and regulations,as amended from time to time, that affect the subject areas of the contract. Authorities include but are not limited to the following: F2-1 Federal Authority F2'11 Block Grants Regarding Mental Health and Substance Abuse F2411 Block Grants for Community Mental Health Services 42 U.G.C. ee. 300x' eteeq. F241.2 Block Grants for Prevention and Treatment of Substance Abuse 42U.G.C. ee. 300x-21 eteeq. 45CFR Part 90' Subpart L F24.2 Department of Health And Human Services,General Administration, Block Grants 45CFRPart. 90 F24.3 Charitable Choice Regulations Applicable to Substance Abuse Block Grant and PATH Grant 42CFR Part 54 F24.4 Confidentiality Of Substance Use Disorder Patient Records 42CFRPart 2 F24.5 Security and Privacy 45CFR Part 104 F24.6 Supplemental Security Income for the Aged, Blind and Disabled 2OCFR Part 410 F24.7 Temporary Assistance to Needy Families(TANF) 42U.G.C. ee. 001 019 45CFR' Part 200 F24.8 Projects for Assistance in Transition from Homelessness(PATH) 42U.G.C. ee. 290cc-21 —29Oco'35 F24.9 Equal Opportunity for Individuals with Disabilities (Americans with Disabilities Act of 1990) 42U.G.C. ee. 12101 12213 F24.10 Prevention of Trafficking(Trafficking Victims Protection Act of2OOO) 22U.G.C. e. 7104 2CFR Part 175 F24.11 Governmentwide Requirements for Drug-Free Workplace(Financial Assistance) 2CFR Part 182 2CFR Part 382 Exhibit Page & of4 Thriving Mind South Florid (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 F2-1.12 Maintenance of Effort 45 CFR Part 263 F2-2 Florida Statutes F2-2.1 Child Welfare and Community Based Care Ch. 39, F.S. Proceedings Relating to Children Ch. 402, F.S. Health and Human Services: Miscellaneous Provisions F2-2.2 Substance Abuse and Mental Health Services Ch. 381, F.S. Public Health: General Provisions Ch. 386, F.S. Particular Conditions Affecting Public Health Ch. 394, F.S. Mental Health Ch. 395, F.S. Hospital Licensing and Regulation Ch. 397, F.S. Substance Abuse Services Ch. 400, F.S. Nursing Home and Related Health Care Facilities Ch. 414, F.S. Family Self-Sufficiency Ch. 458, F.S. Medical Practice Ch. 464, F.S. Nursing Ch. 465, F.S. Pharmacy Ch. 490, F.S. Psychological Services Ch. 491, F.S. Clinical, Counseling, and Psychotherapy Services Ch. 499, F.S. Florida Drug and Cosmetic Act Ch. 553, F.S. Building Construction Standards Ch. 893, F.S. Drug Abuse Prevention and Control S. 409.906(8), F.S. Optional Medicaid Services—Community Mental Health Services F2-2.3 Developmental Disabilities Ch. 393, F.S. Developmental Disabilities F2-2.4 Adult Protective Services Ch. 415, F.S. Adult Protective Services F2-2.5 Forensics Ch. 916, F.S. Mentally III And Intellectually Disabled Defendants Ch. 985, F.S. Juvenile Justice; Interstate Compact on Juveniles S. 985.19, F.S. Incompetency in Juvenile Delinquency Cases S. 985.24, F.S. Use of detention; prohibitions F2-2.6 State Administrative Procedures and Services Ch. 119, F.S. Public Records Exhibit F Guidance Care Center, Inc. Page 2 of 4 Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Ch. 120, F.S. Administrative Procedures Act Ch. 287, F.S. Procurement of Personal Property and Services Ch. 435, F.S. Employment Screening Ch. 815, F.S. Computer-Related Crimes Ch. 817, F.S. Fraudulent Practices S. 112.061, F.S. Per diem and travel expenses of public officers, employees,and authorized persons S. 112.3185, F.S. Additional standards for state agency employees S. 215.422, F.S. Payments,warrants, and invoices; processing time limits; dispute resolution; agency or judicial branch compliance S. 216.181(16)(b), F.S. Advanced funds for program startup or contracted services F2-3 Florida Administrative Code F2-3.1 Child Welfare and Community Based Care Ch. 65C-13, F.A.C. Foster Care Licensing Ch. 65C-14, F.A.C. Child-Caring Agency Licensing Ch. 65C-15, F.A.C. Child-Placing Agencies F2-3.2 Substance Abuse and Mental Health Services Ch. 65D-30, F.A.C. Substance Abuse Services Office Ch. 65E-4, F.A.C. Community Mental Health Regulation Ch. 65E-5, F.A.C. Mental Health Act Regulation Ch. 65E-10, F.A.C. Psychotic and Emotionally Disturbed Children -Purchase of Residential Services Rules Ch. 65E-11, F.A.C. Behavioral Health Services Ch. 65E-12, F.A.C. Public Mental Health Crisis Stabilization Units and Short Term Residential Treatment Programs Ch. 65E-14, F.A.C. Community Substance Abuse and Mental Health Services-Financial Rules Ch. 65E-20, F.A.C. Forensic Client Services Act Regulation Ch. 65E-26, F.A.C. Substance Abuse and Mental Health Priority Populations and Services F2-3.3 Financial Penalties Ch. 65-29, F.A.C. Penalties on Service Providers F24 MISCELLANEOUS F24.1 Department of Children and Families Operating Procedures CFOP 155-10/175-40 Services for Children with Mental Health and Any Co-Occurring Substance Abuse or Developmental Disability Treatment Needs in Out- of-Home Care Placements CFOP 155-11 Title XXI Behavioral Health Network Exhibit F Guidance Care Center, Inc. Page 3 of 4 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Inc.) 7/1/2020 CFOP 155-47 Processing Referrals From The Department Of Corrections CFOP 215-6 Incident Reporting and Analysis System (IRAS) F24.2 Standards applicable to Cost Principles,Audits, Financial Assistance and Administrative Requirements S. 215.425, F.S. Extra Compensation Claims prohibited; bonuses; severance pay S. 215.97, F.S. Florida Single Audit Act S. 215.971, F.S. Agreements funded with federal or state assistance Ch. 651-42, F.A.C. Travel Expenses Ch. 691-5, F.A.0 State Financial Assistance Comptroller's Memorandum No. 03 (1999-2000) Florida Single Audit Act Implementation CFO's Memorandum No. 01 (-2019-2020) Contract and Grant Reviews and Related Payment Processing Requirements CFO's Memorandum No. 02 (2019-2020) Reference Guide for State Expenditures Comptroller's Memorandum No. 04 (2019-2020) Guidance on all Contractual Service Agreements Pursuant to Section 215.971, Florida Statutes CFO's Memorandum No. 20 (2019-2020) Compliance Requirements for Agreements 2 CFR, Part 180 Office of Management and Budget Guidelines to Agencies on Government Wide Debarment and Suspension (Non-procurement), 2 CFR, Part 200 Office of Management and Budget Guidance-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, available at https://federalregister.gov/a/2013-30465 2 CFR, Part 300.1 Department of Health and Human Services-Office of Management and Budget Guidance-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Adoption of 2 CFR Part 200 45 CFR, Part 75 Uniform Administration Requirements, Cost Principles,and Audit Requirements for HHS Awards F24.3 Data Collection and Reporting Requirements S. 394.74(3)(e), F.S. Data Submission S. 394.9082, F.S. Behavioral health managing entities S. 394.77, F.S. Uniform management information, accounting,and reporting systems for providers S. 397.321(3)(c), F.S. Data collection and dissemination system DCF PAM 155-2 Mental Health and Substance Abuse Measurement and Data Exhibit F Guidance Care Center, Inc. Page 4 of 4 Contract No. ME225-11-27 0 N 0 N r N N 0 0 0 0 0 0 0 00 0 o cv o o N Z s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 s3 U O Con 71 s3 0 0 0 0 0 0 0 0 0 0 0 0 U o 0 0 0 0 0 0 0 0 0 0 W r. A a a a w w LYi W 0 0 0 0 o ,r CJ o 0 0 0 F o , W N o 0 0 0 o cv cv 0 0 0 0 0 0 0 0 0 0 0 0 0 o o o o o ss cv o cv cv o o o o — o cv r. 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A a�i = �^ ~ •- %b A y .. : y N G'� a 7 �7 r7 v �a 'u' d ..�. >� F' 4+ R >•o a d > > > > c o 0 0 o Q a a m o o w c c ; x w4!1 o o 0 F4 � o ' R .° a' 4 O o o •�°• d d ,a ^? •�.4 :: a� a�.o W 0. Pa C '� C7 A A 3 3 3 0 U 0 F F W `•Q ° P4 F H' W�' F v :. .�. G H H N F4N 4 w 7 0 ' RN d' UUUf� f� 5W CCC9F4F49 9J4 CZ A F4 F QQawF4F4C4v� U V V wwwa � � d' � d' Ca W Ca W W U ;a N G � � v A A A A ..� EXHIBIT H-FUNDING DETAIL July 2020 Provider: Guidance/Care Center,Inc. Contract#: ME225-11-27 Amendment# ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NENV OCA AMOUNT OCA DESCRIPTION NENV OCA AMOUNT Residential Services MH001 $ 228529 Residential Services MH001 $ 1 Non-Residential Services MH009 $ 915,082 Non-Residential Services MH009 $ 470,000 Crisis and Baker Act Services MH018 ,$ 1,130,503 Crisis and Baker Act Services MH018 $ 15,677 Community Forensic Program MH072 $ 160,000 Special Appropriation-ICFH MHOBN $ FACT Team MH073 $ Purchased Residential Treatment(PATS) MH071 $ Indigent Drug Program MH076 ,$ 50 564 Community Action Treatment(CAT)Team MHCAT $ 750,000 Proviso Allocation-Citrus MH094 $ Mobile Crisis Team MHMCT $ 636,471 PATH Grant MHOPG ,$ 165,000 CSOC Grant Year 2 CSOC2 $ TANF Services MHOTB $ I Specialty Programs SPLTY $ Early Intervention-Psychotic Disorders MH026 $ $ Forensic Hospital Multidisciplinary Team MHOFH $ $ For Profit Sub-Recipeint-Key West LIMA MHSFP $ $ Supported Employment Services MHEMP .$ 75,000 $ Miami-Dade County Homeless Trust MH010 $ $ IOS Pilot Project MH021 $ $ MDC-Central Receiving Facility MDCRF $ $ Care Coordination MHOCN ,$ 83,130 a Care Coordination MHOCN - $ Carry Forward MHOCF $ Carry Forward MHOCF $ .. 7 Mobile Crisis Team MHMCT_ $ MIT Florida Hurricane-SERG MHFLH _ $ Specialty Programs SPLTY y $ CAT and MRT Enhancements MHCME TOTAL ADULT MENTAL HEALTH= $ 2,807,908 TOTAL CHILDREN MENTAL HEALTH= S 1,872,148 ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NENV OCA AMOUNT OCA DESCRIPTION NENV OCA AMOUNT Residential Services MS003 $ 1 Residential Services MS003 $ 1 Non-Residential Services MS011 _$ 271,791 Non-Residential Services MS011 _$ 253,773 Detox Services MS021 ,$ 486,643 Detox Services MS021 $ HIV Services MS023 $ HIV Services MS023 $ Prevention Services MS025 $ Prevention Services MS025 $ 199,063 Women's Services MS027 $ Prevention Partnership Grant MS0PP $ Pregnant Women Project MS081 $ TANF Services MS0U3 $ FIT Team MS091 ,$ 6 3,188 Proviso Allocation-Here's Help MS903 $ TANF Services MS0U3 $ Here's Help Opioid Training MS913 $ Proviso Allocation-New Hope CORPS MS908 $ Functional Family Therapy-EBA MS911 $ State Opioid Response Disc Grant-Hospital Bridge MSSOH $ SOR-Prevention Year 2 MSSP2 $ 22,4 3 7 Opioid Crisis MAT MSOPM $ SOR-Prevention Year 3 MSSP3 $ 67,310 Here's Help Opioid Training MS913 $ State Opioid Response Disc Grant-Child Welfare MSSOW $ Community Based Services MSCBS $ 50,000 1 Specialty Programs SPLTY $ MDC-Central Receiving Facility MDCRF $ $ Care Coordination MHOCN $ 2 651 Care Coordination MHOCN --------------- $ r Carry Forward MSOCF $ Carry Forward MSOCF $ SOR-MAT Year 2 MSSM2 .$ 66,692 SOR-MAT Year 3 MSSM3 $ 200,075,J State Opioid Response Disc Grant-Child Welfare MSSOW Specialty Progruns SPLTY .$............. TOTAL ADULT SUBSTANCE ABUSE= S 1,741,640 TOTAL CHILDREN SUBSTANCE ABUSE= S 542,582 FUNDS NOT REQUIRING MATCH: Drug Abuse Services $ 853,655 TOTAL ALL PROGRAMS= $ 6,963,678 Prevention $ 199,063 UNCOMPENSATED UNITS= $ 1,392,736 Deinstitutionalization Project $ 573,266 TOTAL= S 8,356,413 CMHProgrun $ 1,872,148 $ 356, -513 TOTAL FUNDS REQUIRING MATCH SOR Grant Q - $ 3,109,033 TOTAL FUNDS NOT REQUIRING MATCH S 3,854,644 LOCAL MATCH REQUIRED= S 1,036,344 NOTES FY 2019-20 Adjustments: '3/6/19 All the carry Forward funds are withdrawn as those were 1-time only allocations. $40,000 is reduced from MHAPG due to 1-time only allocation. All MSOPM funds are reuduced as the grant ended in FY 2018-19. $33,333 added to MSCBS to annualize the MSCBS funding allocation. $211,471 is added to MHMCT to annualize the Mobile Crisis Team funding allocation. '5/16/19 Path Funding is adjusted to$165,000 annual allocation. 6/25/19$75,000 is added to MHEMP for supportive employment at Personal Growth Clubhouse. 7/1/2019 The Central Receiving Facility funding allocated to GCC areas follows: $100,000-MSO11 and$300,000-MS021. '9/23/19 $33,333 is reduced from MSCBS and$9,075 is added to MSSM2 to align with the DCF Operating Budget. MSSOR funds can only be spent through 9/30/2019. $49,859 is added to MSSP2 to fund SOR Prevention through 6/30/19. MSSOP funds can only be expended through 9/30/2019. 'I1/13/19 $191,000 is added to MSSM2 for additional MAT services,1-time only. '11/25/19 $103,025 is added for Care Cordination utilizing CTI(1 CM Ca$45K+1 Peer Specialist Ca$35K)as follows: MHOCN-$28,461,MHOCF(MHOCN)-$48,190, MHOCN-$9,953,MSOCF(MHOCN)-$16,422. FY 2020-21 Adjustments: '2/5/20 All 1-time only funding including carry forward allocations are withdrawn. SOR funding allocation for FY 2020-21 is allocated as follows: MSSM2-$66,692(1st quarter)and MSSM3-$200,075(3 quarters):subject to appropriation in the FY 20-21. SOR Prevention funding allocation for FY 2020-21 is allocated as follows: MSSP2-$22,437(1st quarter)and MSSP3-$67,310(3 quarters):subject to appropriation in the FY 20-21. Guidance Care Center, Inc. Exhibit Contract No. ME225-11-27 Page 1 of 1 0 N O N ti N N x , N U W � O � Z U E'a O z x O O o cn cn O O o v v v o 0 0 � N M N l� O o0 H O M 1p .� Vl Vl G1 00 � N x , H H a H x moo o N o � o 0 00 N 41 H M vi lD r-i VV' O � M MC H M 7 N N H H H O x � CG t ai 7 r ti s7 o f Qwj r. Ftact bp m i . r�° ° O Y . o PI. 72 � o o o � a a� � °' °' o o o G � � � o o > > > �`w w U U w a: °' °' °' o a a a � o 0 0 ° ? U U ai ai v M v v o N � UUUGaGa . � � OOOGG w' w' w' vav) V")' . ge. ge. UUUFe. Fe. aP. P.P. U U U � - O �-i 7 - - - � M O �D l� 00 °� O 7 � �D l� 00 °� O �-i•7 � �D l� 00 °� O• (6 �-�I H H N N N N N N N N C Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 EXHIBIT I Motivational Support Program(K8S9) Treatment Provider Protocols Network Provider:Guidance/Care Center, Inc. |. POLICY: It is the policy ofSouth Florida Behavioral Health Network (SFBHN) to establish protocols for treatment providers that receive referrals and/or provide services to individuals that have been identified as eligible for MSP services.These protocols have been established to ensure that this high-risk, priority population receives expedited services. The MSP Protocols for Monroe County are incorporated herein by reference and available upon request tm the K8E Contract Manager. U. PURPOSE: The purpose of this program isto: * Engage and retain child-welfare involved families in behavioral health treatment; and * Keep families together, where appropriate, by preventing at-risk children from receiving an out- of-home placement. UL AUTHORITY: The Prime Contract between the ME and the Department provides the ME with authority to contract for these services. Refer to the Department of Children and Families Program Guidance 19, Integration with Child Welfare available at this this link: ToaccesstheDepartnnent'sFYZU'Z1GuidanceDocument19, dichonthe |inkbe|ovx: Note: Click onFYJU'J2ME Templates and click on Guidance Document 29, Integration with Child N/elfone |V. DEFINITIONS: a. CASE MANAGEMENT-Case management services consist of activities aimed at identifying the recipient's needs, planning services, linking the service system with the person, coordinating the various system components, monitoring service delivery,and evaluating the effect of the services received. b. CHILD WELFARE-Services provided directly or under contract with the Florida Department of Children and Families' Family Safety Program Office. c. DEPARTMENT TheDepartnnentofChi|drenandFami|yServices, createdpursuanttoSection 20.19, Florida Statues (F.Sl d. FLORIDA SAFE FAMILIES NETWORK ("FSFN") — A Department of Children and Families automated data system utilized to track child welfare cases. Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 e. FULL CASE MANAGEMENT AGENCIES Full case management agencies under contract with the lead Community Based Care ("CBC") agency, that provide support to children and families to help ensure the best possible outcomes for children and families who are involved in the child welfare system in Miami-Dade County. t INCIDENTAL EXPENSES This cost center provides for incidental expenses, such as clothing, medical care, educational needs, developmental services, FACT Team housing subsidies and pharmaceuticals (if not required by the RFP to be reimbursed through a separate cost reimbursement contract), and other approved costs. All incidental expenses must have prior written authorization by the ME's authorized staff member or be authorized in the contract. g. INTENSIVE FAMILY PRESERVATION SERVICES: Agencies under contract with the lead CBCto provide intensive in-home services intended to prevent high and imminent risk families from entering the Dependency Court system while increasing the families' level offunctionality. h. MOTIVATIONAL SUPPORT SPECIALISTS ("MSS") —Are staff positions (Case Manager) at the designated IVISP contracted network provider that provide ancillary support to the CBC Case Manager and the contracted ME treatment provider, perform linkage to the child welfare system to engage and support involved child welfare families in appropriate behavioral health treatment and recovery with a goal of improving both behavioral health treatment and child welfare outcomes. i. MOTIVATIONAL SUPPORT SPECIALISTS SUPERVISOR — A master's level supervisor who manages and oversees the Motivational Support Specialists. j. CITRUS FAMILY CARE NETWORK ("CFCN")'The Department of Children and Family Services Child Welfare Community Based Care (CBC) Lead Agency for the Southern Region. k. OUTREACH Outreach services are provided through aformal program to both individuals and the community. Community services include education, identification,and linkage with high- risk0roups. Outreach services for individuals are designed to: encourage, educate, and engage prospective individuals who show an indication of behavioral health needs. Enrollment for Individuals served are not included in Outreach services. |. QUALIFIED PROFESSIONAL A physician or physician assistant licensed under Chapter 4SOor 459, F.S., a psychiatrist licensed under chapter 458 or chapter 459; a psychologist as defined in s. 490.003(7); or a psychiatric nurse which means an advanced registered nurse practitioner certified under s. 464.012vxho has a master's or doctoral degree in psychiatric nursing, holds a national advanced practice certification as psychiatric mental health advanced practice nurse, and has Z years of post-master's clinical experience under the supervision of physician a professional licensed under Chapter 49Uor491, F.S, a professional as defined in s. 394.455(5), (7), (32), (35), or (36)notmithstandin0 any other provision of |av4 a person who was certified through a certification process recognized by the former Department of Health and Rehabilitative Services before January 1, 1995, may perform the duties of qualified professional with respect to substance abuse treatment services as defined in this chapter, and need not meet the certification requirements contained in s. 397.311(34) (ref. §397.416 F.S] . Individuals who are certified are permitted to serve in the capacity ofa qualified professional, but only within the Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 scope of their certification. mn. SCREENING —The first step needed to identify if there is a substance use or mental health disorder potentially impacting parenting protective capacity and the safety of the child. It is a process to determine the possibility that a behavioral health disorder may be present and to identify indicators when one suspects the presence ofadisorder. n. SUMMARY Avxritten statement summarizing the results of the screening relative to the perceived condition of the individual served and a further statement of possible needs based on the individuals' served condition to include the results of a urinalysis, when applicable, as specified in the Motivational Support Program Protocols, incorporated by reference herein. V. Referral to MSP Criterion:The identified danger threat level determines the urgency of the referral to MSP. Refer to the Motivational Support Program Protocols, incorporated by reference herein. l. Urgent Referral Case MSPvxi|| offer an immediate response and contact family/caregiver within 24 hours for cases that are considered urgent at the CPI level, following a consultation with CPI Supervisor (CP|S) or with the Behavioral Health Clinical Consu|tant(CCS). Referral Source: A CPI Supervisor (CP|S), a Program Administrator (PA); or a Behavioral Health Clinical Consultant(CCS)who has screened the case history or who has triaged a case during a pre- commencement orpostcomnnencennentconsu|tation. 2. Semi-Urgent Case MSP will offer a response and contact family/ caregiver within 48 hours for cases that are considered "SEMI-urgent" at the CPI level, following a consultation with CPI Supervisor orwith the Behavioral Health Clinical Consultant (CCS). The DCF Opioid Grant Behavioral Health Consultant can also make a recommendation for MSP involvement. If a recommendation has been made by the CCSorCP|Sfor an MSP referral to be submitted, the CP|SorCCS isto follow-up to ensure that the MSP referral has been completed. Referral Source: A CPI Supervisor (CP|S), a Program Administrator (PA); or a Behavioral Health Clinical Consu|tant (CCS) who has screened the case history orwho has triaged a case during a pre-commencement or post commencement consultation. 3. CBC Referrals MSPvxi|| offer response and contact family/ caregiver within 72 hours. These referrals are initiated during the later stages of the CPI investigation. Referral Source: The CBC Intake staff, at end of investigation, when CPI is closing and or transferring case to the Full Case Management Agency(FCMA] Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 VI. PROCEDURES The items delineated below are the contractually required protocols for any individual that has been identified as an MSP referral and has been referred to a contracted SFBHN Network Provider for behavioral health treatment. A. Referrals and Communication between the parties 1. The MSP case manager or Motivational Support Specialist ("MSS") will submit referral to treatment provider. Z. The treatment provider will ensure that an initial appointment takes place within seven (7) business days ofthe receipt of referral from MSS, regardless of the individua|'s ability to pay. 3. The treatment provider will ensure that the individual was financially assessed utilizing the sliding fee scale asspecified in the SFBHN main contract with the network provider. 4. The treatment provider shall notify the MSS, within 24 hours of the event, via email or documented phone call, when a referred individual presents with any crucial issues such as non- compliance with appointments, positive urinalysis, and/or lack of progress issues. S. The treatment provider must notify the MSS and submit Discharge Summary to the MSS upon completion of behavioral health treatment. 6. The Network Provider will coordinate with the MSS, and/or the DCF Protective Investigators (P|), and/or the CBC lead agency, Intensive Family Preservation Services ("|FPS"), Full Case Management Agencies ("FCMA") Providers to participate in staffing's as required. B. Substance Abuse Treatment Assessment 1. The treatment provider will complete and transfer the assessment tool to the MSS within twenty (ZU) calendar days of admission into outpatient substance abuse treatment. Z. The provider will complete and transfer the assessment tool to the MSS within five (S) calendar days of admission into residential substance abuse treatment. C. Mental Health Treatment Assessment 1. Thetreatnnentprovidervxi||connp|eteaBio'psychosoda|asseoment, uponconnp|etionof the intake process.This determines the type and frequency of services that the individual needs. In addition, the treatment provider will submit the completed Bio' psychosoda| assessment to the MSS within one (1) business day of its completion. Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 Z. The treatment provider must link the individual to recommended services based on the needs identified in the Bio'psychosoda| assessment and notify the MSS, within one (1) business day,via email. a. The email will contain all information deemed necessary by the treatment provider including but not limited to type of service, initial service date,therapist name and contact information. b. The treatment provider will utilize the assistance of the MSS, who will engage SFBHN for residential placement assistance, if necessary. 3. The MSS will then upload the Bio'Psychosoda| Assessment and add the treatment recommendations into FSFN. In instances when the treatment provider is unable to clinically meet the individual's needs,the treatment provider will link the individual (within two (Z) business days) to another behavioral health provider that is able to meet his/her treatment needs.The referring treatment provider will staff the case with the MSS and the Child Welfare Integration Coordinator at the ME and provide clinical justification for the transfer of case, prior to the transfer. The referring treatment provider will notify the MSS within one(1) business day of the transfer. All reports and documentation submitted to the MSS will be uploaded to Florida Safe Families Network ("FSFN") and will be used to inform decision making by the primary worker assigned to the child welfare case. O. Drug Testing: The initial drug test is conducted by the DCF Protective Investigator (P|) prior to the referral to the MSP. Subsequent weekly random drug testingwill be conducted by the MSS commencing the date of admission. All testing will be observed by the same gender staff as the individual served. At minimum, all MSP individuals must be drug tested once a week during the first Z weeks of treatment. After the initial Z weeks, random drug testing will occur by the provider based on the individual's progress in treatment and the results of those drug screening will be provided in FSFN until the case has been dosed. Should the individual be court involved, drug screenings will be conducted at the intervals required by the courts. E. Documentation: Monthly treatment summaries will be submitted to the MSS by until such time as the case is dosed with MSP.The MSP Monthly Treatment Summary Form found in Appendix I of this Exhibit. 1. The form must be submitted at the required intervals as specified above. Z. It must be completely filled out including: individual served demographic information, diagnostic information, progress in treatment, and urinalysis results (if applicable). 3. The form must be signed and dated by the treating clinician. Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 Appendix I Motivational Support Program Monthly Progress Report Initial o Monthly o Network Provider(Agency Name): Date: Client Name: Social Security Number: DOB: Progress in Treatment(to include compliance with sessions, resistance): Frequency of UATesting: Urinalysis Results: |, (Print Therapist Name), hereby attest that | will submit this completed form to the Motivational Support Program Specialist every 15th calendar day after the month of service. Therapist Signature and Title: Date: Exhibit | \ \ 2 § _ c Q / j an \ c 0 } % / ) C _ / / \ $ � : � / ® ■ bj)\ / � / � k - Qn E @ � o m U 7 e Ka a e m § ¥ 3 / w = $ U CO § / 3 m $ E ] O m � o Q ■ / « � ;ƒ « § 6 \ F 7 § ¥ \ 7 » \ � 7 » ■ \ 0-0a � . @ G - \ - m a ; \ 0 ? C3 \ km ~ 2 / Ta 3 \ D � Thriving Mind South Florida (�ontractingas South Florida Behavioral Health Network, |ncj 7/1/2020 ExhibitAssisted Living Facilities with Limited Mental Health License Authority: s. 394.4S74, F.S. |. Network Providers that enter into a cooperative agreement with anAssisted Living Facility-Limited Mental Health License (ALF'LMHL) that are also responsible for providing case management services to mental health residents in the ALF LMHL must: l> Ensure that the ALF'LMHL where the consumer is residing, or is referred to, maintains a current Agency for Health Care Administration (AHCA) license for ALF LMHLfad|ities. The Network Provider must maintain a copy of the AHCA ALF'LMHL facility license in each consumer file. Referrals to unlicensed ALF'LMHL are unlawful and are subject to sanctions by AHCA. The ME must monitor the Network Provider's compliance with the terms and conditions of this exhibit. 2> Ensure that a mental health resident as defined in s. 394.4574(1) F.S. has been assessed by a mental health professional and determined to be appropriate to reside in the ALF'LMHL. A copy of that documentation must be provided to the ALF administrator no later than 30 days following admission. 3> Ensure that case managers are assigned to all ALF'LMHL residents who meet criteria as a mental health resident. If the resident declines case management, case managers must attempt to engage the person for a period not less than 30 days and document efforts in the ALF records. |f the mental health resident continues to decline services, they must be encouraged to do so in writing, unless that is also refused. Documentation of resident's declination of case management services and stated reason for declination must be maintained in case records at the ALF LMHL. The resident's declination must also be filed in the mental health residents case record maintained by the Network Provider. 4> Ensure that individuals living in ALF'LMHL and meeting the definition of a mental health resident served by the Network Provider are offered mental health services needed, including but not limited to case management, psychiatric medication treatment, access todrop-in centers, clubhouses and other services where available. S> Ensure that a cooperative agreement to provide mental health services, including case management as required in s. 429.075 F.S., is developed between the Network Provider and administrator of the ALF'LMHL. G> Ensure that the cooperative agreement identifies, at minimum: mental health services available; contact information for both the ALF Administrator and mental health provider, including 24/7 emergency access information; transportation provision; and services and activities available atthe ALF'LMHL. The ALF'LMHLadministrators must also be given contact information for the managing entity, as appropriate. The cooperative agreement must contain a provision requiring the provider to maintain a file for each ALF'LMHL client with copies of all required documentation. All ALF'LMHL client records must be available for production by the Network Provider for monitoring purposes. A sample of the ME ALF Client Record monitoring tool can be obtained by contacting the ME's Contract Manager. Exhibit Thriving Mind South Florida (�ontractingas South Florida Behavioral Health Network, |ncj 7/1/2020 7) Ensure that the Cooperative Agreement is annually updated between the Network Provider and the ALF'LMHLAdministrator. Q> Ensure that an annual community living support plan, as defined in s. 429.02 F.S., is prepared by the assigned case manager and the resident served, in consultation with the ALF'LMHL administrator of the facility in face-to-face meetings. At a minimum, meetings will be held for initial plan development and annual updates to the plan. More frequent meetings must be held as necessary to resolve concerns expressed by the resident, case manager, orALF'LMHLAdministrator. The plan should be individualized and should include information about support services and special needs. A> The case manager must assist the mental health resident in carrying out the activities identified in the individua|'s community living support plan. lO> Each case manager must keep a record of the date and time of any face'to-face interaction with the resident and make the record available tothe ME for inspection. The record must be retained for at least two (Z) years after the date of the most recent interaction. ll> Adequate and consistent monitoring and enforcement of community living support plans and cooperative agreements are conducted by the resident's case manager. 12> Report all concerns related to health and safety violations to appropriate officials at the Agency for Health Care Administration and the Department's Abuse Hotline at 1-800-962-2873. 13> Ensure that the case management are delivered per the requirements of Exhibit A9 Mental Health Case Management Standards. ||. Attendance at Assisted Living Facility Public Meeting The Network Provider must attend the ME'o Assisted Living Facility with Limited Mental Health License Public Meeting as scheduled by the ME. |||. Required Report The Network Provider must maintain an ALF'LMHLConsumer Report the required format as shown in Table 1. below on file and update this list on a quarterly basis, by the dates identified in ExhibitC, Required Reports. The Network Provider must provide the ME with copies of the ALF'LMHL Consumer Report upon request. The ALF'LMHLConsumer Report must be submitted in a secured, password protected, or encrypted format. Left blank intentionally Exhibit LL LLLu § ! � ] 0 WD ) ) § ) / LL LL u) } \ 7 \ � \ � � o \ 2 :E 0wLL K � < ( \ ( � � ; k ! / k \ � : § J � « \ \ \ 2 0 = w \ � « G \ � \ « � 2 � \ ® \ \ - � — \ LL \ � { % \ \ ! i \ \ z \ ) ) Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 EXHIBIT N Indigent Psychiatric Medication Program, known as the Indigent Drug Program (IDP) The Network Provider must follow the guidelines established by the Florida Department of Children and Families defined in Incorporated Document 13, Indigent Drug Program, dated July 1, ZUZU, or the latest revision thereof, and ensure that all funds allocated for use of purchasing psychotropic medications, or medications used to treat addictions, or medications accessed through line of credit from the Indigent Psychiatric Medication Program, known as the Indigent Drug Program (|DP) are used for eligible individuals. l. Purpose The purpose of this guidance document isto: 1.1. Establish |DPadministration procedures; 1.2. Provide written guidelines to the Managing Entities and IDP Providers; and 1.3. Establish Florida State Hospital's (|DP/FSH Warehouse) medication order guidelines and processes for receiving, storing, and shipping |DPmedications. 2. Definitions 2.1. |O9 Dispensing Unit: A pharmacy holding a current permit from the Florida Board ofPharmacy that dispenses medication for the |DP. 2.2. |O9/FSHVVarehmuse: A physical space located on the campus ofFlorida State Hospital (FSH) at Chattahoochee, Florida. This space is reserved for receiving, storing, and shipping |DP medications. 2.3. Inventory: A listing of medications available through the IDP/FSH Warehouse that agencies that participate in the |DPcan use to order medications. An inventory is also known as formulary. 2.4. Patient Assistance Program (PAP):Any program offered through private agencies or pharmaceutical manufacturers designed to provide medication at low or no cost to uninsured individuals. 2.5. Psychiatric mr9sychotmmpicMedication: Any drug prescribed with the primary intent to stabilize or improve mood, mental status, behavioral symptomatology, or mental illness.The medications include the following major categories: 2.5.1. Antipsychotics; 2.5.2. Antidepressants; 2.5.3. Anvio|ytics; 2.5.4. Mood stabilizers; and 2.5.5. Cerebral or psychonnotorstinnu|ants. 2.5.6. Other medications commonly used may include beta b|ochers, anticonvu|sants, cognition enhancers, and opiate b|ochers. Exhibit Page lofS Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 2.6. Side Effect and Adverse Drug Reaction: Any effect other than the primary intended effect resulting from medication treatment. Side effects may be negative, neutral, or positive for the individual. An adverse drug reaction is an undesired or unexpected side effect, allergy, or toxicity that occurs with the administration ofmedication. Adverse drug reactions can range from mild side effects to very severe reactions, including death. Onset may be sudden, or it may take days to develop undesired or toxic reactions tomedications. 3. Program Administration 3.1. Managing Entities Responsibilities |f Managing Entities receive funding under the |DP, they will: 3.1.1. Approve organizations requesting to become |DP providers.To be eligible, organizations must be under contract with the regional Managing Entity. 3.1.2. Each July, provide a list of approved |DP providers tothe Department's Office of Substance Abuse and Mental Health (SAMH) and provide updates when there are changes. 3.1.3. Report bulk purchases into FASAMS. Using the EVINIT(non-client specific file upload) contractors should submit a service using the IDP OCA(MH076)with the Incidental Expense covered service (ZO) and the actual dollar amount for the units. 3.1.4. Ensure that agreements between IDP providers and participating pharmacies are current and executed. 3.1.5. Ensure that |DP providers use |DP funds for individuals who meet the criteria. 3.2. |O99rmxiders 3.2.1. |DP providers will: 3.2.l.l.Assess and enroll individuals in the |DPvxho meet the clinical and financial criteria established in Chapter394, F.S. 3.2.1.1.1.To meet the clinical criteria individuals: 3.2.1.1.1.1. Must be member ofat least one ofthe Department's priority populations; and 3.2.1.1.1.2. Must not reside in a state mental health treatment facility or an inpatient community unit. 3.2.1.1.2.To meet the financial eligibility criteria individuals: 3.2.1.1.2.1. Must have net family income that is at or below 150 percent of the Federal Poverty Income Guidelines, aspublished annually in the Federal Register; 3.2.1.1.2.2. Must |achthird'party insurance or other psychotropic medications funding sources; and 3.2.1.1.2.3. Must not participate in a program where other funding sources pay for psychotropic medications. |f individuals have third party insurance for psychotropic medications but were temporarily denied benefits for these medications, they may receive |DP medications until such time as coverage or eligibility is reestablished. Exhibit Page 2ofS Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 3.2.1.2. Provide information to individuals and staff working with |DPindividua|s regarding adverse effects, side effects, possible allergic reactions, and instructions on what todoin case ofanemergency; 3.2.1.3. Submit updated information to the IDP/FSH Warehouse and to the Managing Entity with the first medication order, and ensure that the following information is updated as needed: 3.2.1.3.1.The providers' |DP contact information including name, e'nnai|, and phone number; 3.2.1.3.2.The authorized person's name who approves the Supply Requisition (See Appendix 1); and 3.2.1.3.3.A copy of the pharmacy license(s). Keep a copy of the license and the permit issued in accordance with the requirements specified in s. 499.012(1)(d), F.S. 3.2.1.4. Use the Supply Requisition (See Appendix 2) obtained via email from the |DP/FSH Warehouse to place orders: 3.2.l.4.l.Submit orders only as needed; 3.2.1.4.2.Order no more than 12 different medications in each requisition; If ordering more than 12 different medications in one order, use an additional Supply Requisition; 3.2.1.4.3.Fax or e-mail the completed, signed, and approved Supply Requisition directly to the |DP/FSH Warehouse; and 3.2.1.4.4.Pay line of credit surpluses to |DP/FSH Warehouse before the Warehouse processes new orders. 3.2.1.5. Submit the last order and payment before May 15 of the fiscal year; 3.2.1.6. Review all orders for accuracy; 3.2.l.G.l.Review the medication with the Issue Document (See Appendix 3)to ensure accuracy; 3.2.1.6.2.If discrepancies are found, call the IDP/FSH Warehouse within 24 hours or email the Issue Document with corrections; and 3.2.l.G.3.Retain a copy of the Issue Document. 3.2.1.7. Ensure that |DP prescriptions meet the following conditions: 3.2.l.7.l.A prescription can be written for one year with four(9U'daysupply) refills. An appropriate prescription fora 90'daysupp|y may be written with up to 3 refills. One prescription cannot cover more than a 90'daysupp|y 3.2.1.7.2.Must be listed on the |DP Inventory; and 3.2.1.7.3.Must be filled at an |DP pharmacy. 3.2.1.8.Active|y participate in Patient Assistance Programs (PAP)that provide psychiatric medications without cost; Exhibit Page 3ofS Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 3.2.1.9. Review updated video presentations for medication guidelines or read the adult medication guidelines available through the Florida Mental Health Institute (FMH|) of the University of South Florida's Medicaid Drug Therapy Management Program for Behaviora| Hea|th, foundathttp://fnnedicaidbh.fnhiusf.edu/. 3.2.1.10. Review and validate the |DP/FSH Warehouse monthly statements. 3.2.1.11. Address emergency situations, including but not limited to: 3.2.1.11.1. Order additional psychiatric medications from either the |DP/FSH Warehouse ora pharmacy of their choice (for urgent needd; and 3.2.1.11.2. Pay dispensing fees to |DP Dispensing Unit for individuals who cannot afford them. 3.2.1.12. Implement medication receiving, storage, and administrative procedures that meet the current State approved prescribing instructions pursuant to s. 46S.U3S, F.S.; and 3.2.1.13. Contact via telephone or e-mail the |DP/FSH Warehouse to cancel backorders or portions of backorders; provide the Supply Requisition number. 3.2.2. |DP Providers may: 3.2.2.1. Return outdated medications: 3.2.2.1.1.For inventory management purposes include a packaging slip that contains an itemized medication list; and 3.2.2.1.2.C|ear|y mark the package as outdated. 3.2.2.2. Return overstocked medications: 3.2.2.2.l.Complete the Supply Requisition. Under the remarks section of the requisition state that overstocked medications are returned for credit and explain the reason for returning the medications; 3.2.2.2.2.Mail medications in package(s) clearly marked as overstocked; and 3.2.2.2.3.Only return unopened medications. 3.2.2.3. Submit check tothe |DP/FSH Warehouse accounting office to prepay orders to extend the line of credit.The remaining line of credit cannot be carried over into the next fiscal year. 3.3. The |O9/FSHWarehouse The |DP/FSH Warehouse will: 3.3.1. Process Supply Requisitions. 3.3.2. Mail back the packages to the providers that return their medication with an incorrect or incomplete Supply Requisition. 3.3.3. Provide monthly statements tothe Managing Entity no later than the 10th of the month following the end of the quarter.The statements will list each provider's approved line of credit and balance. If providers submit orders after the lines of credit have reached a zero balance, the |DP/FSH Warehouse accounting office will: Exhibit Page 4ofS Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 3.3.3.l. Calculate the actual cost of the order; and 3.3.3.2. Notify the provider of the cost. 3.3'4. Release providers' line of credit as follows: 3.3.4L1. Deduct administrative costs from providers' remaining line of credit to process orders; 3.3.4.2. Bill the difference to providers during the first three quarters of the fiscal year if the cumulative order(d amount exceeds the quarterly release; 3.3'4.3. Hold future order shipments if payment is missing; and 3.3'4'4. Call or email providers if orders exceed its line of credit during the fourth quarter. 3.3.5. Accept any returned medications with a minimum of a nine-month shelf-life left prior to their expiration dates upon receipt atthe |DP/FSH Warehouse; 3.3.6. Reject partially used medications, regardless of the expiration date; 3.3.7. E-mail providers the monthly Financial Report that shows their account credit amount; 3.3.8. Generate the Issue Document(See Appendices 3 and 4)to include actual costs billed for the medications; 3.3.9. Attach an Issue Document form to any backorders; 3.3.lO.Submit copies ofthe Issue Documents tothe pharmacies that receive the medication orders; 3.3.11.Not0ive credit to providers for returning outdated medications; and 3.3.12.Not accept orders or payments submitted after May 15 of the fiscal year. 3.4. Office mf Substance Abuse and Mental Health (SAK8H) The Office of SAMH will determine the IDP provider line of credit based on available resources and actual utilization including: 3'4.1. Previous fiscal year's annual line of credit; 3.4.2. Monthly expenditures; 3.4.3. End of year balance; and 3.4.4. Funds from other funding sources expended on |DP medications. 4. Contact Information For questions regarding |DP/FSH Warehouse contact: |eishaAkins'Hines Florida State Hospital Indigent Psychiatric Medication Pro0ram (|DP) Pharmacy Building 1Z3S, Room 113 Chattahoochee Florida 3Z3Z4 E'Mai|: |eisha.AkinsHines@myflfami|ieszonn Work No. (850) 663'7274 Fax No. (850) 663'7291 Exhibit Page SofS Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 Appendix 1 SIGNATURE AUTHORIZATION FORM nfmm �mnOeSands at�wmrr|wnmm C�epm�mmemtoK Children and FmmoUUmm Governor Chad9mppeU lip �A��~' Secretary &nfLuAw/ucozow Marvin Bailey Signature Authorization Chief Hospital Administrator Indigent Drug Program Florida State Hospital The following persons are authorized to submit drug orders to the Indigent Drug Program warehouse. Name Facility Signature Date SIGNATURE OF APPROVAL' TITLE' DATE (Needs to be approved by supervisor of highest-level employee listed above) Florida State Hospital 100 North Main Street/POB 1000-Chattahoochee, Florida 32324-1000 Mission:Work in partnership with local communities to protect the vulnerable, promote strong and economically self-sufficient fami|ies,and advance personal and family recovery and resiliency If you require Americans with Disabilities Act accommodations to participate in an event at Florida State Hospital, please notify Human Resources at(850)083'7585at least seven(7)days prior to the event. Deaf o,hard of hearing individuals may call 1'800' 855'8771 2012 F ACCREDITED GOVERNOR'S STERLING AWARD RECIPIENT Exhibit IN Page GofS Guidance Care Center, Inc. Contract No. mE225'11'27 Thriving IMind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 Appendix 2 SUPPLY REQUISITION SUPPLY INVENTORY MANAGEMENT SYSTEM Supply Requisition Supply Use Only TowComp let edu,Requester 1.Alction 2.11C 3.Organizational Code 4.Sub Code 5 Expansion 6.Other Cost TCode" U e] = 7.Grant 8.Grant 9.External Gen-eral Ledger 10 Agency Requistion Y ar Unique Number No uu°"^w"mb° 12ouanuty Unit Price Total Price o Unit°'Issue w nes"n'./°" Tmta| Remarks� 15.n=uesto/"Signature s.m"" o Signature°'Approval a.m"" =.n=ues°m Telephone Number(SubCo~xavailable) Filled By n= Received By ~~~ Exhibit Page 7ofS Thriving IMind South Florida ((..'ontraclting as South Florida Behavioral Health Network, Incl.) 7/l/2020 Appendix 3 ISSUE DOCUMENT TO CONFIRM EXAMPLE !SSUE DOCUMENT DELIVER TO FROM : DP - INDIGENT DRUG PROGRAM LOC CODE STOCK NUMBER TOT UNIT OF OBJECT REQUEST ISSUED BACK UNIT A.L ISSUE CODE ORDER PRICE 6505-001-0694-5 \1 _i-14002 30 30 36,9867 1109,60 6505-00 5-1399-1 131 344002 10 10 1) 6.3164 63,16 \41 RTAZAPI[NE: 15-kIGTAB(M-\41,'RON)30131 IND('400052-0105-30 650 q-00 1-33 9'39-9 13-1 3 0 1 57.618^ 472.92 PE RPIAL NAZI\E:4-MG I AB(l_KII_AI-0N) 100113 11,Nf-)( a001 72-3668-60,B\\ 1 6505-002-0117-4 L31 1 1 0 150,537A 150.=4 PERPHEINAZINE 16-M(i rAI3('I'RIl­kI:0N) 10013 I'l-NIX'-00172-3670-60,II%N 6505-005-1819-4 131 .344002 10 10 43110 Z111RASH)ONE:80-MG,CAPS(6FODONN)60 PIN 13()'I'1 I,F NIX':00049­3990=60 6505-00-1816-0 111 3.44002 6 6 36.9200 "1 ZWRASIDONE:20 .MG,CAPS(GLODON)60 PER Lio-r rl-E\DC:0,0049-39b0-60 6505-005­233,8-4 BT ',44002 a 9 19 1039,6i4-1 U()e1,14 QUE1 IAPINE FL\,IARATE XR:(SEROQ_f::I_)300,--'vI(i I ABS„60,130-11 IT 6505-005-2344-9 11T 344002 4 4 905.6200 "22'48 4,11 ETIAMNI.lq �MARA I E XR,",l'R0Qt,I'[,XR:_700.VI(_jLABS:60/13T 6'505-00 1-0 171-.1 BT 3-44002 9 9 0 2�,.0759 200,6 1 V ENI_AI AXINE,I,,SP: 150-NIG XR( %11(I'll IT X()R) I 00A3 IT\,()('P00008-0836- SH - CONFIRM SUPPLIES SHIPPED DURING PHYSICAL INVENTORY OR SYSTEM DOWN-TIME ------------------------------- - Exhibit IN Page 8 of 9 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida ((..'ontraclting as South Florida Behavioral Health Network, Incl.) 7/l/2020 Appendix 4 ISSUE DOCUMENT TO REVERSE EXAMPLE ISSUE DOCUMENT DELIVER TO FROM : DP - INDIGENT DRUG PROGRAM LOC CODE STOCK NUMBER UNIT OF OBJECT REQUEST ISSUED BACK UNIT TOTAL ISSUE CODE ORDER PRICE 695-001-0694-5 \'1 344002 30 30 0 16 9967 1 9(i9 60 I+A[.()PF,R]D.,'\l,DF'CANOATF: 100%4G,N41.(I[Al,[)()],,) I\ll­ATlII3X5 Nl)('�,,00045-0254 6505-005-1399-1 131 344002 10 10 0 6.3164 611,16 MIRTAZAPINE: 15-MG TAB(RE'OERONr 30l34'L.ND C' 100052-010-330 6505-001-3939-8 B1 344002 :3 3 0 157,6385 47',92 PERPFIENAZINL:4-MGTAB(rRILAFON) 100/B'1t..NDC 100172-3668-60,13'tN 1 650S-002-01174 13-T 344002 1 1 0 150.5378 1 0.44 I'FRPI iENAZINE: 16-MGTAB I 00,'B'l 1,ND('400 172-3670-60,BW 6505-005-1819-4 B'I 344002 10 10 0 43-2502 43150 ZIPRASIDONE:80-MG,CAPS(Gf-'ODON)60 PER BO'1'1'LE NDC:00,049-3990-60 6505-005-1916-0 f3l 344002 6 6 0 36.9200 22 L52 Z[TIRASIDONE!20-MG,CAPS(GEODON)60 PFIR BO T'T1,E\D(':00041)-,',960-60 6505-OOS-2338-4 131 344002 8 8 0 1038.6544 8309,24 QUT'TIAPINE Ft.,INAARATE XR:(SER0QUEL)300\,9G TABS,60f'BOTTI.E 6505 005-2344-9 BT 344002 4 4 80,,6200 3322149 QUETIAPINE FUIMARA 1-1-XR;Sl,,R0QUEl..,XR:200 MG TABS:60/13 i- 6505-001-0171-4 B'l 344002 8 8 25.0758 200.61 VENI,AFAXlN[­t-SP: 150-MC',XR CA 11(LIT F XOR) 100,'13 H,\D( v00008-0836- SH - CONFIRM SUPPLIES SHIPPED DURING PHYSICAL INVENTORY OR SYSTEM DOWN-TIME ----------- --------------------- ----------------------- ------- Exhibit IN Page 9 of 9 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 EXHIBIT Adult Mental Health Residential Level U Services The Network Provider is contracted to provide Mental Health Residential Level || services. Level || residential treatment facility provides a structured group treatment setting with 24 hour per day, 7 days per week supervision for five or more residents who range from those who have significant deficits in independent living skills and need extensive supervision, support and assistance to those who have achieved a limited capacity for independent living, but who require frequent supervision, support and assistance. Level 11 Mental Health Residential Treatment Facilities provide a long term, residential environment that provides care,support,assistance and limited supervision in daily living to adults diagnosed with a serious and persistent major mental illness who do not have another primary residence. A residential treatment facility under Rule 65E-4.016, F.A.C. must sustain a 60'day average or greater length of stay of residents, except as specifically provided for in Section 394.875(11), F.S. Community Mental Health Regulation.65E- 4For |eve| ||, eachconsumershaUreceiveserviceseachvxeekinaccordancevxithsubsection6SE-4, F.A.C. The Network Provider must adhere to the service, programmatic, and administrative requirements for mental health residential services pursuant to Chapter 6SE-4, F.A.C, L Criteria for Admission Persons who enter Level || residential treatment facilities must meet the following minimum criteria: l. Diagnosed as having a mental illness; 2. Age 1Oorolder; 3. Ambulatory orcapable of self-transfer; 4. Able to participate in treatment programming and services; S. Free ofmajor medical conditions requiring ongoing 24 hours per day, 7 days per week nursing services; G. Self-administers medication with staff supervision; 7. Does not exhibit chronic inappropriate behavior which disrupts the facility's activities or is harmful to self orothers; Q. Maintain personal hygiene and grooming with staff supervision; A. Initiate and participates in social interaction with staff supervision; lO. Perform assigned household chores with staff supervision; and ll. |s capable of self-preservation in accordance with subparagraph 6SE-4.U16(17) (b) Z, F.A.C. 12. Additiona| admission criteria may be developed if such criteria are needed to ensure that individuals admitted by the facility are compatible with the facility's capability to serve them or to further delineate the minimum skills or behaviors that a person needs to function in the facility's environment. U. Target Population l. Pregnant women and women with dependent children; Exhibit 9ugu 1 of Guidance Care Center, Inc. Contract No. mE225'11'27 Thriving Mind South Florida ((..'ontrcrr.i:ing as South Florida Behavioral H1t:`r1lth Network, Inc.) 7/1/ 020 2. Parents or caregivers in need of adult mental health services pursuant to s. 394.674(1)(a)2., F.S., based upon the emotional crisis experienced from the potential removal of children. 3. Persons who are been discharged from a state treatment facility; 4. Persons who are at risk of being admitted into a civil of forensic state Mental Health Treatment Facility; 5. Persons who are voluntarily admitted, involuntarily examined, or placed under Part I, Chapter 394, F.S.; 6. Inmates approaching the End of Sentence pursuant to Children and Families Operating Procedure (CFOP) 155-47; 7. Persons who are forensic consumers (have an incompetent to proceed or a not guilty by reason of insanity court order); 8. Persons who are at risk of institutionalization or incarceration for mental health reasons; 9. Persons who have had three (3) or more admissions to a crisis stabilization unit(CSU), short-term residential facility(SRT), or inpatient psychiatric unit; 10. Persons who are experiencing long-term or serious acute episodes of mental impairment that may put them at risk of requiring more intensive services. III. Procedures for Residential Placement III.A.The ME is the single point of contact for Mental Health Residential referrals. Referral packets must include the residential application, a psychiatric evaluation within the last 30 days, and ME consent form. 1. The ME reviews referrals for eligibility, logs eligible referrals in a centralized list, and forwards to the program within 72 hours of having received the referral so that a screening can be scheduled by the program. 1) For Forensic Referrals, the Mental Health Residential program must conduct screenings within 72 hours of having received the referral. 2) For Civil Referrals, the Mental Health residential program must conduct screenings within 5 business days of having received the referral. 2. The residential program must submit written referral disposition to the ME and the referral source within 48 hours of having completed the screening 3. If an individual is denied by the residential program,the disposition to the ME and referral source must be accompanied by written documentation of the rational for denial and recommendation for the appropriate level of care. III.B. Bed Availability: The Network Provider will update bed availability on a weekly basis and report availability to the ME's ASOC Specialist. III.C. Waitlist: 1) If a placement is not immediately available, The ME will place the consumer on the Centralized Wait List for Residential Services. While the consumer is on the wait list, the referral source will be responsible to continue obtaining a consumer release of information when the previous one expires. The ME's ASOC Specialist will continue to communicate with the referral source and the Network Provider while the consumer remains on the waitlist. 2) Interim Services: All consumers placed on the waitlist should be enrolled in services by the assessing Network Provider/referral source until residential placement is available. Exhibit O Page 2 of 4 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 3) The ME provides ongoing monitoring of the program to ensure compliance with length of stay (LOS), discharge procedures, and staffing of difficult individuals admitted to the program. |V. Technical Assistance l. The ME provides technical assistance to ensure compliance with contract requirements and applicable laws and regulations. 2. The ME provides technical assistance and coordination with other community Network Providers to ensure that individuals being discharged from the program have access to less restrictive residential levels of care. 3. The ME acts a liaison tothe program and assists in the elimination of barriers to discharge for individuals served in the program V. Initial Authorization l. An initial authorization number for the period of 120 days is generated if the consumer meets criteria based on the documentation received with the referral.The authorization will become effective only upon admission into the treatment agency. 2. Reimbursement will only be provided for service dates covered by the authorization. VL Continued Stay Criteria VLA. In addition to meeting all the criteria outlined in Section |, Criteria for Admission, on a continuing basis,the following criteria must also bemet: l. An individualized plan of active treatment is required. This plan should contain, at a minimum, clinical evidence of therapeutic goals that must be met before the consumer can return tothe previous or other suitable living situation. 2. Evidence of continued need for support 24 hours a day through a therapeutic living situation. 3. Evidence of coordination and access to active therapeutic interventions and services directed at the alleviation of clinical symptoms that are interfering with the consumer's ability to return to a less intensive level of care. VI.B. Procedures for Continued Stay Request:The Network Provider must review consumer's information and determine the primary clinical reasoning for extending services at the same level of care. l. The Network Provider must complete and submit the following tothe ME for review and determination. Incomplete requests will automatically be denied. 1) Connp|ete and sign the Adult Mental Health "Continued Stay Authorization Request Form Z)The initial individualized treatment plan along with all revisions and updates. 3) Requests are due 14 days prior to the expiration of the previous authorization. 2. It is the responsibility of the Network Provider to ensure that all submitted documentation has been received by the ME'o ASOC Specialist. Once all required documentation has been received,the request will be processed within 5 business days with the decision to authorize or deny payment for continued residential treatment. 3. Continued Stay authorizations are provided in 30 to 60'day intervals. Alternate authorization time intervals may be considered on an individual basis. VU. Invoice Validation Exhibit Page 3of4 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 1. The ME will monitor invoices submitted by Network Providers on a monthly basis to ensure that the billing is in congruence with the authorization period granted to each consumer for residential services. The invoice should reflect the period of time for which the consumer's stay was authorized. Z. Upon completion of the monthly review, the Network Provider will be notified of any discrepancies and the invoice will be adjusted accordingly. 3. The Network Provider must submit a completed Pre-Authorization Utilization Management Roster for Substance Abuse & Mental Health Residential Level || Services Only, per Exhibit K, along with then monthly invoicing that is due by the 8th of every month following the month of services. Exhibit Page 4oI4 Guidance Care Center, Inc. Contract No. mE225'11'27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 EXHIBIT Missing Children The Network Provider agrees that when services are provided to children who are adjudicated dependent, where the care of the child is assigned to the Department or Network Provider, that the procedures outlined in Rule 65C-30.019, F.A.C. and Rule 65C-29.013, F.A.C. and in Children and Families Operating Procedure (CFOP) 175-85, entitled "Prevention, Reporting, and Services to Missing Children" will be adhered to. The Network Provider will perform the Departmental functions as described in Rule 65C-30.019, F.A.C. and CFOP 175-85 which correspond to the functional role of this contract. The Network Provider also agrees that when services are provided to children in the community that are not adjudicated dependent, that it will comply with all licensing and contracting requirements. 1. Definitions a. Designee - a person, contractual network provider or other agency or entity named by the Department. b. Exigent Circumstances -situations that require immediate actions, such as the child is under the age of thirteen, believed to be out of the zone of safety for their age and development, mentally incapacitated, in a life-threatening situation, in the company of others who could endanger their welfare or is absent under circumstance inconsistent with established behaviors. c. FDLE-MCIC- Florida Department of Law Enforcement-Missing Children's Information Center. d. Family Services Counselor - a professional position responsible for case management for children placements. The term includes Department of Children and Families staff and staff working for an agency named as a designee. e. Missing Child - a person who is under the age of 18 years; whose location has not been determined; is currently placed in an out-of-home care setting; court order in-home placement; or is the subject of an active abuse investigation in which the child has been sheltered, would have been sheltered if their location had become known, or who was in the physical custody of the Department or a Network Provider when they went missing; and who has been or will be reported as missing to a law enforcement agency. 2. Reporting Missing Children a. The Network Provider agrees to immediately notify the family services counselor(s), their supervisor, and/or the CBC Lead agency, and the legal guardian to ensure that they are fully aware of the circumstances involving a missing child. b. The Network Provider shall ensure and document that the family services counselor(s), their supervisor, and/or the CBC Lead agency have assumed responsibility for taking all required steps to recover the missing child and are fully engaged. c. The Network Provider agrees to instruct caregivers, including relative and non-relative caregivers, and all other staff that might be required to report a child as missing to local law enforcement to immediately undertake the following activities, as applicable, and document all Exhibit Q Guidance Care Center, Inc. Page 1 of 4 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 actions and activities related to any efforts made to report and/or locate any child who is determined to be missing from their care or supervision: d. If exigent circumstances exist, the caregiver, family services counselor, or until the family services counselor is engaged, the Network Provider employee, who has identified that a child is missing from their care or supervision shall immediately call local law enforcement as soon as a determination has been made that a child is missing; and they shall request that the responding office: (1) Take a report of the missing child. (2) Assign a case number to the missing child report and provide the case number back to the caregiver or person who is reporting the child missing. (3) Provide local law enforcement with a recent high-quality photo of the child or provide local law enforcement with a recent high quality photo when one becomes available. (4) Request that a copy of the police report be provided to the family services counselor once a police report becomes available. (5) If the responding law enforcement officer refuses to take a missing child report, for any reason, the individual attempting to report the child as missing will document the officer's name and specific local law enforcement agency name and request to speak to the law enforcement agency Watch/Shift Commander. If the law enforcement agency Watch Commander refuses to take a missing child report and it is a caregiver that is attempting to report the child as missing, the caregiver will immediately contact the family services counselor or on-call staff and provide them with all information related to local law enforcement not issuing a missing child report. Once the family services counselor or on-call staff have learned that a local law enforcement agency will not issue a missing child report they will immediately seek assistance from the local area Community Based Care (CBC) Child Location Specialist or the Department of Children and Families Regional Criminal Justice Services Coordinator on resolving any issue related to reporting the child as missing to local law enforcement. (6) If it is a caregiver who has reported the child as missing to local law enforcement or attempted to report a child as missing to local law enforcement, they shall immediately notify the child's family services counselor or emergency on-call staff and provide them with the following information: (a) The law enforcement agency name that the child was reported as missing to or attempted to be reported as missing to; (b) The law enforcement missing child case number if one was issued by local law enforcement; (c) A copy of the law enforcement report when one is made available; (d) Detailed information on the child's overall state of mind and behavior prior to the child going missing; (e) Detailed description of what the child was last seen wearing; (f) Detailed information on possible locations that the child might be going to; and Exhibit Q Guidance Care Center, Inc. Page 2 of 4 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 (g) Detailed information on any individuals that the child might be traveling with. e. If exigent circumstances do not exist, the caregiver, family services counselor, or other Network Provider staff will within the first four(4) hours of learning that a child might be missing check to see what, if any, of the child's personal belongings are missing or if the child left a note; and, the caregiver, family services counselor, or other staff (if the family services counselor is not yet engaged), will: (1) Contact the following persons as appropriate to ascertain if the child has been seen, or has given any indications that may explain the child's missing status: (a) School/child's teachers and school resource officer; (b) The child's relatives/parents, both local and non-local, if appropriate, and the caregiver has the means for such contact; (c) Any friends or places that the child generally frequents, the local runaway shelter, if there is one in the community; and, (d) The child's employer, if applicable. (2) Write down any information gathered that might help locate the child. (3) Provide telephone/beeper numbers and ask for the individuals above to call back and share information if they have further information or see the child. f. If at any time during the initial four (4) hour search for the child, if the caregiver, family services counselor, or any other Network Provider employee (if the family services counselor is not yet engaged), becomes concerned about the immediate safety and well-being of the child, or the child's location remains unknown after four (4) hours from the time that the caregiver, family services counselor, or Network Provider employee learned that the location of the child was unknown, they shall immediately call local law enforcement and they shall follow the steps outlined in Section 2. above. g. If at any time, the child is located or returns to the caregiver's home after law enforcement has been notified of the missing child case, all law enforcement agencies and other agencies that were notified of the missing child episode must be contacted immediately by the caregiver, family services counselor, or other Network Provider employee who made the report. If at any time new information is obtained on a possible location of the missing child, the caregiver, family services counselor, or any other employee of the Network Provider shall immediately contact all law enforcement agencies and other agencies that were notified of the missing child episode as to the possible location of the child. If the Family Services Counselor has been engaged, the Network Provider shall also inform them and the legal guardian of the new information once law enforcement has been notified. h. All of the Department's documentation related to the missing child episode shall be completed and entered into the Department's approved missing child reporting system within one working day of the family services counselor, on-call staff, or Community Based Care (CBC) Child Location Specialist learning of a missing child episode regardless of whether local law enforcement has issued a missing child report number. This includes the uploading of a recent high-quality photograph of the child into the Department's approved missing child reporting system. If local Exhibit Q Guidance Care Center, Inc. Page 3 of 4 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 law enforcement has refused to issue a missing child report a dummy local law enforcement case number of 00000 and the name of the local law agency that refused to issue the missing child report shall be used to complete and enter the missing child episode into the Department's approved missing child reporting system. Exhibit Q Guidance Care Center, Inc. Page 4 of 4 Contract No. ME225-11-27 (��4§ntvaQ't11rwf South Hmlida xt(4a.Oorrill Theafth Nt.'n�ork„1C(%) EXHIBIT V Special Provisions for the Forensic Services Program The Network Provider will be responsible for ensuring the provision of mental health, substance abuse and ancillary services to individuals charged with felony offenses and that have been committed or may be at risk of commitment to the Department of Children and Families("Department"), pursuant to chapter 916, F.S. The Network Provider will participate in a comprehensive forensic program that meets all requirements of chapter 916, F.S., Forensic Client Services Act,this Forensic Services Program Exhibit, and any other applicable state and/federal rules, regulations, operating procedures established forensic performance measures. (a) All individuals referred for admission to a short-term residential treatment facility (SRT) by the Forensic Specialists must be granted an on-site face-to-face interview with 72 hours of referral. The Network Provider must submit written findings and recommendations to the referral source and within 48 hours of client interview.The Network Provider must discuss any denial of services with the Forensic Team prior to responding to the referral source.The Forensic Team must discuss denials of services with the ME's designated Forensic Coordinator within 72 hours of having received the disposition from the denying program. (b) All individuals referred for admission to a residential treatment facility by the Forensic Specialists will be granted an on-site face-to-face interview within a minimum of 72 hours of referral, for individuals residing within Miami-Dade, Monroe, or Broward Counties. For individuals who are referred for admission and who live outside of the above referenced counties, the Network Provider must coordinate the interview date for the client with the Forensic Specialist and if necessary, involve the ME's designated Forensic Coordinator. The Network Provider must submit written findings and recommendations to the referral source within 48 hours of client interview. The Forensic Team must discuss any denial of services with the ME's designated Forensic Coordinator within 72 hours of having received the disposition from the denying program. (c) The network providers' case manager will coordinate services and provide the court with routine progress reports as required by the conditional release order. (d) The network providers' case manager will immediately consult the Forensic Specialist regarding any apparent conditional release violation. Network Provider staff will be responsible for notifying the court and the Forensic Specialist of any conditional release violations via affidavit or sworn statement per s. 916.17(2), F.S. (e) The Network Provider will not return individuals on conditional release to court prior to consultation with the Forensic Specialist. The Forensic Team, when appropriate, should discuss proposed violations with the ME's Forensic Coordinator, except in cases of physical aggression by the individual in question. Exhibit V Guidance Care Center, Inc. Page 1 of 4 Contract No. ME225-11-27 (��4§ntvaQ't11rwf South Hmlida xt(4a.Oorrill Theafth Nt.'n�ork„1C(%) (f) Programs must provide services in English, Spanish and Creole. (g) Diversion- The Network Provider will be responsible for the provision of services and the monitoring of individuals charged with felonies in the Miami-Dade and Monroe County Jails who are at risk of commitment to the Department of Children and Families, but who may be diverted to the community by the Forensic Team. i. The Network Provider will facilitate and coordinate the provision of mental health treatment, competency restoration training, residential care or housing with supervision, medical and auxiliary services if appropriate, case management and monitoring of individuals who are being diverted from commitment to the Department of Children and Families, pursuant to chapter 916, F. S. ii. The Network Provider will facilitate and support the activities of the Forensic Team by providing accommodations for the provision of competency restoration training at the network provider's facility(ies). iii. The Network Provider will ensure attendance at court hearings,obtain conditional release orders and ensure individuals are monitored in the community in accordance with the terms of the conditional release order. (h) Discharge Planning — The Network Provider will be responsible for ensuring the active collaboration with the Forensic Specialists in discharge planning activities for forensic clients at state treatment facilities. i. The Network Provider will, per the request of the Forensic Specialists, participate in treatment team, and discharge planning meetings for forensic clients in state treatment facilities. ii. The Network Provider will assist the Forensic Team in the development and submission of conditional release plans, discharge plans to state treatment facilities and to the committing court. iii. If requested, the Network Provider will attend court hearings in the cases of individuals being discharged from state treatment facilities and ensure effective linkage to their service continuum. (i) Conditional Release Monitoring —The Network Provider will ensure that individuals on conditional release order in Dade and Monroe Counties, including individuals transferred into the counties from other circuits are monitored. Exhibit V Guidance Care Center, Inc. Page 2 of 4 Contract No. ME225-11-27 (��4§ntvaQ't11rwf South Hmlida xt(4a.Oorrill Theafth Nt.'n�ork„1C(%) i. The Network Provider will ensure that individuals on conditional release order are monitored in accordance with the court order to ensure compliance with the order and department rules. ii. The Network Provider will ensure the committing court is immediately notified by phone and in writing of any deviations from the conditional release order. The Network Provider will ensure the Forensic Specialist is copied on written correspondence to the court. iii. The Network Provider will ensure the review of required monthly monitoring reports in order to intervene in problematic situations, to provide alternative treatment modalities when necessary, and to identify trends and issues that illustrate opportunities for improvement in service delivery. The Network Provider will bring the aforementioned situations, trends and issues to the immediate attention of the Forensic Specialist. iv. The Network Provider will maintain current copies of conditional release orders. Q) Utilization Management - The Network Provider must facilitate the Forensic Specialists' requirement to manage the residential treatment beds funded by community forensic dollars in the Southern Region. (k) Community Forensic Residential Services i. Citrus Health Network, Inc.: The Network Provider agrees to make available eight (8) residential beds in the Safe Transition and Access to Recovery(STAR) Program,for eligible consumers on conditional release in need of forensic mental health services placed by the Forensic Team/ME pursuant to FRCrP 3.219(b), 3.217(b) and F.S. 916.17. The STAR Program provides intensive, short-term treatment to individuals who are temporarily in need of a structured therapeutic setting in a less restrictive but longer-stay alternative to acute hospitalization. It is agreed that during the term of this agreement,these beds Must may only be use for forensic individuals. The Network Provider agrees that the ME's decision for placement is final and binding on all parties. The Network Provider must submit weekly census reports by the dates and times specified in Exhibit C, Required Reports, and to the individuals identified. ii. Passageway Residence of Dade County, Inc.: The Network Provider agrees to make available up to fourteen (14) residential beds in both level II beds and in Room and Board with Supervision Level II for eligible consumers on conditional release from other circuits in need of forensic mental health services placed by the ME. Statewide admission to Exhibit V Guidance Care Center, Inc. Page 3 of 4 Contract No. ME225-11-27 (��4§ntvaQ't11rwf South Hmlida xt(4a.Oorrill Theafth Nt.'n�ork„1C(%) '/' /2020 Passageway Residence of Dade County, Inc. is for individuals committed to the Florida Department of Children and Families, in accordance with the provisions of Florida Statutes Chapter 916, Forensic Services Act and released pursuant to FRCrP 3.219(b), 3.217(b) and F.S. 916.17. It is agreed that during the term of this agreement these beds may only be used for forensic individuals . The Network Provider agrees that the ME's decision for placement is final and binding on all parties. The Network Provider must submit weekly census reports by the dates and times specified in Exhibit C, Required Reports, and to the individuals identified. iii. Psychosocial Rehabilitation Center,Inc.d/b/a Fellowship House: The Network Provider agrees to make available four (4) residential beds in both level II beds and in Room and Board with Supervision Level II level 2 beds for eligible consumers on conditional release from other circuits in need of forensic mental health services placed by the ME pursuant to FRCrP 3.219(b), 3.217(b) and F.S. 916.17. It is agreed that during the term of this agreement, these beds may only be used for forensic individuals. The Network Provider agrees that the ME's decision for placement is final and binding on all parties. The Network Provider must submit weekly census reports by the dates and times specified in Exhibit C, Required Reports,and to the individuals identified. Exhibit V Guidance Care Center, Inc. Page 4 of 4 Contract No. ME225-11-27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 EXHIBIT X Projects for Assistance in Transition from Homelessness (PATH) Services The Network Provider must adhere to the service delivery and reporting requirements described in this Exhibit, the approved Intended Use Plan, and the Department's Program Guidance for Contract Deliverables —Guidance Document 15, Projects for Assistance in Transition from Homelessness (PATH) Services. ToacceotheDepartnnent'sFYZU'Z1GuidanceDocument1S, dickonthe |inkbe|ovx: Note:Click on FY20-21 ME Templates and click on Guidance Document Projects forAssistance in Transition from Homelessness(PATH)Service |. The Network Provider receives federal PATH funds to provide support services for individual who: a. Have serious mental illnesses or serious mental illnesses and co-occurring substance use issues, and b. Are homeless or at imminent risk ofbecoming homeless. |L The Network Provider must: a. Submit an annual application packet which includes a budget and an Intended Use Plan (|UP) for Managing Entity and Department review and approval. The Department will provide a budget IUP template and due date. The IUP must cover needs and services for the following PATH Fiscal Year(O/1-7/31).The Network Provider should include hovxthe PATH services align with the priorities of the local Continuum of Care (CoC) plan, when appropriate. * The |UP must specify a plan to reach the areas in which the greatest number of individuals who are experiencing homelessness with a need for mental health, substance use disorder, and housing services are located. b. Establish a service plan for all PATH-enrolled individuals which is reviewed every three months and includes: i Community mental health services; ii Coordination and referrals for needed services such as shelter, daily living activities, personal and benefits planning, transportation, habilitation and rehabilitation services, prevocationa| and employment services, and permanent housing; and Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 iii Assistance obtaining income and income support services, Supplemental Nutrition Assistance Program (SNAP) benefits, and Supplemental Security Income/Social Security Disability Insurance(SS|/SSD|). c. Maintain individual medical records for each PATH participant containing an intake form, a determination of eligibility for PATH-funded services,a service plan,and progress notes. d. Submit an annual report no later than November 17m via the PDX at https://pathpdx.samhsa.0ov/account/|o0in e. Train designated staff on SOAR using the SOAR Online Course, available at: t Enter SSI/SSDI application data into the SOAR Online Application Tracking(OAT)database at in accordance with Managing Entity Contract Guidance 9, and in Exhibit AN, SOAR of this Contract. Q. Provide at least one dollar of local matching funds for every three dollars of PATH funds received and expend local matching funds to provide eligible services to PATH participants. Match-funded expenditures must align with the services identified in the local |UPbudget. * Calculating Match Example: $300,000federa| award Must provide$1 for every$3 in federal dollars Calculation: $3UU,UUU * 1/3 (or 33.33Y6) =$1UU,UUU match tobe provided TOTAL PATH EXPEND|TURES=$4UU,UUU h. Employ policies and procedures that ensure priority use of other available funding sources for services (i.e., Medicaid). i. Include consideration nf continuity nfcare needs specifically for people experiencing homelessness in disaster response plans. PATH providers shall assess, at least annually, and amend as appropriate, their disaster response plan to ensure it continues tn meet the service needs nf the target population. j. Participate and collect consumer data in the Homeless Management Information System /HM|S\ and establish plans for new hire training and continued training. k. Actively advance PATH services to meet the annual targets established in the Behavioral Health Disparity Impact Statement (D|S). |. The State PATH Contact(SPC) reserves the right to exclude a provider seeking to apply for PATH Grant funding. mn. Adhere to the standards established in the Florida PATH Program Manual. UL The Managing Entity will: a. Review instructions and participate in training(s) on data entry into the VVebBGASdata system and annually check for any changes that may have been updated since prior years. Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 b. Review and become familiar with the Funding Opportunity Announcement (FOA) requirements for the Grant Fiscal Year.The FOA is accessible through the Resource page in PDX. c. Check each PATH provider IUP and budget for accuracy, completeness,and adherence to the reporting requirements and submit to the SPCby the due date. d. Upload PATH application documents and enter the data for each provider into WebBGAS once approved by the SPC. e. Ensure budget costs charged to the grant are allowable as authorized under4S CFR y 75.403, and that housing expenses do not exceed the maximum 20 percent allowable per section SZZ(h) (4ZU.S. Code yZ9Ucc—ZZ). t Review and approve the PATH provider's annual report in PDX prior to submitting for SPC for approval. Review and approval include verification of PATH funds received, matching funds used in support of PATH, services, referrals, and activities. g. Designate lead staff responsible for managing, reviewing and ensuring accurate data input by PATH provider's in PDX. h. Monitor the PATH provider's progress toward annual targets in |UPsand Behavioral Health Disparity Impact Statement(D|S). reports. i. Encourage the Network Providers to develop and implement a quality improvement plan for the use of program data on access, use, and outcomes to support efforts to decrease the differences in access to, use, and outcomes of service activities. Providers may incorporate the quality improvement(Ql) plan as part of their larger QI plan provided that the PATH eligible population is considered. PATH providers are encouraged to collect and use data to: * Identify the number of individuals tobe served during the grant period; * Identify subpopulations (i.e., racial, ethnic, sexual, and gender minority groups) vulnerable to behavioral health disparities; and * Identify methods for the development of policies and procedures toensure adherence to the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. (Refer tothe most current version of the SAMH's Disparity Impact Statement(D|S)for more information.) j. Assist PATH providers in collaborating with local resources to link people with safe, affordable housing. k. Inform the SPC within three business days of any significant program changes or anticipated changes. If determined to be necessary by the SPC, a request detailing the planned revisions and justification must be submitted. Implementation of any significant changes are contingent upon Department approval. An example of a significant change includes, but is not limited, to the following: a corrective action issue, adding new or withdrawing ofa PATH provider, or changes in funding allocation. Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 |. MEs must select PATH providers based on areas in the state in which the greatest number of individuals who are experiencing homelessness with a need for mental health, substance use disorder, and housing services are located. mn. Use Section 4 and Appendix Fin the most current SPC Welcome Manual when conducting site visits.The manual is available inPDX. |V. Best Practice Considerations: PATH Enrollment In order to establish consistency across PATH programs it is recommended that the PATH Enrollment checklist below is used when enrolling PATH participants. V. PATH Enrollment Checklist Enrollment: PATH enrollment implies that there is the intent to provide services for an individual other than those provided in the outreach setting.The term enrolled means that there is a mutual intent for the services to begin. PATH enrollment iswhen: 1) The individual has been determined to be PATH eligible, Z) The individual and the PATH Provider have reached a point of engagement where there is a mutual agreement that services will be provided, and 3) The PATH Provider has started an individual file or record for the individual that includes, at a minimum: a. Basic demographic information needed for reporting, b. Documentation by the Provider of the determination of PATH eligibility, c. Documentation by the Provider of the mutual agreement for the provision of services, d. Documentation of services provided, and e. Service plan if the PATH enrollee is receiving case management services. has been determined eligible for PATH (Name of Person Served) enrollment based on meeting the following criteria: �� �� He/she has a mental health diagnosis of OR F—] There is an informed presumption that the individual has serious mental illness because: �� �� He/she is experiencing or displaying symptoms of mental illness and is experiencing difficulty in functioning asa result of these symptoms that indicates severity, �� �� He/she has shared or has a known history of engagement with mental health services, Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 �� �� He/she has symptoms and functioning that indicates there is a history of or expected tenure of significant mental health concerns AND F-1 � He/she lacks any housing, OR F-1 � His/her primary residence during the night is a supervised public or private facility that provides temporary living accommodations, OR F-1 He/she is a resident in temporary or transitional housing that caries time limits, OR F-1 � He/sheisinadoub|ed'up |ivin0arran0ennentvxherehis/hernameisnotonthe |ease, OR F-1 � He/she is living ina condemned building without a place to move, OR F-1 � He/she isin arrears in rent/utility payments, OR F-1 � He/she has received an eviction notice without a place to move, OR F—] He/she is being discharged from a health care or criminal justice institution without a place to live, OR �� �� He/she is living in substandard conditions that could result in homelessness due to local code enforcement, police action, voluntary action by the person, or inducements by service providers to0o to alternatives like short-term shelters whose residents are considered to be homeless. VI. Monthly Reporting Requirements 1. By the 5 th of each month following the month of services,the Network Provider will submit to the ME's Housing Coordinator, a monthly report containing the information submitted into the Homeless Management Information System (HMIS), and any other report(s) requested by the ME staff. Z. By the loth of each month following the month of services, the Network Provider will submit to the ME's Housing Coordinator, a monthly PATH Client Tracker with client's name and date of enrollment. The PATH Client Tracker must be submitted in a secure, password protected, encrypted e-mail. Exhibit Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 EXHIBIT Y Temporary Assistance for Needy Families(TANF)State Plan and TANF SAK8H Incidental Expenditures for Housing Assistance |. Temporary Assistance tm Needy Families(TANF) The network provider agrees to comply with the provisions of the Florida Department of Children and Families Temporary Assistance for Needy Families State Renewal Plan ("TANF State P|an^) for the period between October 1, ZU17 — September 3U, ZUZU, or the latest revision thereof, incorporated herein by reference, for any TANF services provided under this contract. The TANF State Plan may be obtained by clicking on the following link: ||. TANF SAK8H Incidental Expenditures for Housing Assistance a> The TANF SAMH incidental cost center may be used for temporary housing assistance to remove barriers (i.e, lack of affordable housing, public housing waiting list, homelessness, etc.) to treatment that are identified as challenges in the client's recovery process. Accessing the incidental cost center for temporary housing assistance should be used as a resource necessary to stabilize and maintain TANF eligible family members receiving treatment services when the provider has exhausted and documented in client's case file, all other available resources. The uses of these funds are short-term and temporary in nature and should not exceed four (4) consecutive months of temporary housing assistance for each family per fiscal year. The expenditure of SAMH TANF incidental funds will be reflected in the incidental cost center on the monthly invoice. This information must be monitored by the Managing Entity to ensure that the funds expended do not exceed the four(4) month time period. The cost per day for housing assistance may not exceed $SU.UU per day. b) Services tmbeProvided Services provided to families resulting from the use of the temporary housing assistance incidental expenditure will consist of direct and indirect client contact and will include but not be limited to: case management, aftercare, intervention, and prevention services. Additionally, documentation of the above services must clearly show improved outcomes towards economic self-sufficiency and permanent housing. All documentation must be clearly identified in the client's case record for monitoring purposes. c> Documentation mf the incidental expenses should include: * Client Name * Number of Days (Z4 hours) per month in rental housing unit(Census Log) Exhibit Guidance Care Center, Inc. Page 1 »fZ Contract No. mE225'11'27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, |ncj 7/1/2020 * The 0oaKd for SAMHTANF * Description of treatment services received each month * Rental Receipt * Approving authority signature with date Exhibit Guidance Care Center, Inc. Page Z »fZ Contract No. mEuus'11'ur Thriving Mind South Florida (Contracting South FloridaBehavioral Health Network, Mc.) 7/1 2 2 EXHIBIT AA Motivational Support Specialists Network Provider:Guidance/Care Center, Inc. The Network Provider agrees to comply with the provisions of this Exhibit, agrees to adhere to the requirements set forth in the approved Motivational Support Program Protocols ("Protocols"), incorporated by reference herein. The protocols for each circuit in the Southern Region (Miami Dade County and Monroe County) are available upon request to the ME's Contract Manager. The Network Provider also agrees to collaborate with the ME and the Department in executing the action steps identified in the Southern Region SAMH Integration with Child Welfare plan, herein incorporated by reference. 1. PURPOSE Motivational Support Specialist (MSS) are intended to reduce the incidence of child abuse and neglect resulting from parent(s)' or caregiver(s)' behavioral health condition and to improve outcomes for the families involved in the child welfare system. 2. AUTHORITY The Prime Contract between the ME and the Department provides the ME with the authority to contract for these services. 3. PROGRAM SPECIFIC TERMS a. CASE MANAGEMENT-Case management services consist of activities aimed at identifying the recipient's needs, planning services, linking the service system with the person, coordinating the various system components, monitoring service delivery, and evaluating the effect of the services received. b. CHILD WELFARE-Services provided directly or under contract with the Florida Department of Children and Families' Family Safety Program Office. c. DEPARTMENT-The Department of Children and Family Services, created pursuant to Section 20.19, Florida Statues (F.S.). d. FLORIDA SAFE FAMILIES NETWORK ("FSFN") — A Department of Children and Families automated data system utilized to track child welfare cases. e. FULL CASE MANAGEMENT AGENCIES - full case management agencies under contract with the lead Community Based Care ("CBC") agency, that provide support to children and families to help ensure the best possible outcomes for children and families who are involved in the child welfare system in Miami-Dade County. f. INCIDENTAL EXPENSES -This cost center provides for incidental expenses, such as clothing, medical care, educational needs, developmental services, FACT Team housing subsidies and pharmaceuticals (if not required by the RFP to be reimbursed through a separate cost reimbursement contract), and other approved costs. All incidental expenses must have prior written authorization by the ME's authorized staff member or be authorized in the contract. Exhibit AA Guidance Care Center, Inc. Page 1 of 5 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting South Florida Behavioral Health Network, Mc.) 7/ /2020 g. INTENSIVE FAMILY PRESERVATION SERVICES: Agencies under contract with the lead CBC to provide intensive in-home services intended to prevent high and imminent risk families from entering the Dependency Court system while increasing the families' level of functionality. h. MOTIVATIONAL SUPPORT SPECIALISTS ("MSS") — Are staff positions (Case Manager) that provide ancillary support to the CBC Case Manager, perform linkage to the child welfare system to engage and support involved child welfare families in appropriate behavioral health treatment and recovery with a goal of improving both behavioral health treatment and child welfare outcomes. i. MOTIVATIONAL SUPPORT SPECIALISTS SUPERVISOR — A master's level supervisor who manages and oversees the Motivational Support Specialists. j. CITRUS FAMILY CARE NETWORK ("CFCN")-The Department of Children and Family Services Child Welfare Lead Community Based Care (CBC)Agency for the Southern Region. k. OUTREACH - Outreach services are provided through a formal program to both individuals and the community. Community services include education, identification,and linkage with high- risk groups. Outreach services for individuals are designed to: encourage, educate, and engage prospective individual who show an indication of behavioral health needs. Client enrollment is not included in Outreach services. I. QUALIFIED PROFESSIONAL-A physician or physician assistant licensed under Chapter 458 or 459, F.S., a professional licensed under Chapter 490 or 491, F.S., notwithstanding any other provision of law, a person who is certified through a department-recognized certification process as provided for in ss. 397.311(33), and 397.416, F.S. Individuals who are certified are permitted to serve in the capacity of a qualified professional, but only within the scope of their certification. m. SCREENING —The first step needed to identify if there is a substance use or mental health disorder potentially impacting parenting protective capacity and the safety of the child. It is a process to determine the possibility that a behavioral health disorder may be present and to identify indicators when one suspects the presence of a disorder. n. SUMMARY - A written statement summarizing the results of the screening relative to the perceived condition of the client and a further statement of possible needs based on the client's condition to include the results of a urinalysis, when applicable, as specified in the Motivational Support Program Protocols, incorporated by reference herein. 4. GEOGRAPHIC AREA& LOCATION a. Services will be provided in Monroe County at the Network Provider's site and/or, or in the field (i.e. client's home, community service center, etc.) b. MSS services should be located in a place where they will be easily available and accessible to child welfare personnel. MSS locations,where client records are maintained, must be licensed for Intervention: General Intervention and Intervention: Case Management as required by Rule 65D- 30, F.A.C. Exhibit AA Guidance Care Center, Inc. Page 2 of 5 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting South Florida Behavioral Health Network, Mc.) 7/ /2020 5. PROFESSIONAL QUALIFICATIONS a. This contract provides for 1 staff, as per the approved operating budget, herein incorporated by reference. b. Changes to the staffing pattern must be prior approved by the ME. c. Staff shall preferably hold the appropriate clinical license or certification. The minimum qualifications for a MSS are a bachelor's degree in a social behavior science or related field and one (1) year of applicable experience. Preference should be given to certified addictions professionals or to individuals who have both behavioral health needs and child abuse/neglect knowledge and experience. All MSS services are to be provided under the supervision of a qualified professional, as required by Rule 65D-30, F.A.C. 6. FUNCTIONS A brief description of the duties of the MSP Screening processes are below, however,the Network Provider is referred to the approved Motivational Support Program Protocols, incorporated by reference herein, for a detailed description of the screening and referral process. a. The MSS, upon receipt of referral, will secure an SFBHN Consent to Release Information from the individual and will attach this consent as part of the referral packet to the behavioral health provider. If the individual refuses to sign the Consent to Release Information to MSS, then FSFN will be updated to indicate such. b. If the case is found not to have any behavioral indicators, MSS will enter a SAMH note in FSFN indicating the result of the assessment and upload the ME approved screening tool. The progress should be rated as "adequate". c. The MSS will utilize a screening tool to determine the need for behavioral health services for all referrals. The MSS will determine if there has been a screening completed within the previous 90 days and ascertain if another screening is necessary. d. The MSS will ensure that an intake appointment is made within seven (7) business days to a behavioral health treatment provider for a full assessment and linkage to recommended treatment services when the screening identifies behavioral health indicators. 7. DATA REPORTING REQUIREMENTS Data shall be submitted electronically to the ME by the 4th of each month following the month of service into KIS, SAMHIS, FASAMS or other data reporting system designated by the ME. MSS shall enter data using an MSS Staff ID as defined in FASAMS DCF Pamphlet 155-2 and by the dates specified in Exhibit C,Required Reports. Exhibit AA Guidance Care Center, Inc. Page 3 of 5 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting South FloridaBehavioral Health Network, Mc.) 7/ / 020 The MSS shall also utilize FSFN to regularly update the individuals' progress within the timeframes specified in the Motivational Support Program Protocols, incorporated by reference herein. 8. TRAINING a. The Network Provider agrees to ensure that MSS's participate in the MSS statewide meetings when they occur, any training provided by the Department specifically for MSS, and/or to attend a work-related conference. b. The MSS must participate in all ME required trainings including but not limited to all technical assistance, Child Welfare Champions Trainings, FSFN Training, etc. 9. INCIDENTAL EXPENSE FUNDS a. These funds may be used to remove barriers to treatment that are identified as problems in the client's intervention plan and to provide resources that are necessary to keep the family member in treatment. This funding may be used when no other resources are available. b. Uses of these funds include, but are not limited to, transportation, childcare, housing assistance, clothing, and educational/vocational assistance. Incidental funds may also be used for toxicology screens when they are identified as necessary in the client's screening or case management monitoring process, and in those instances when it is necessary to verify use or abstinence for a client in treatment. c. Although use of these funds for toxicology screens is allowable, this should only occur in situations where other resources are unavailable. Incidental Expense funds should primarily be used to fund clients' needs to remove barriers to treatment. d. Criteria for use of the incidental funds, procedures for accessing them, and the accounting for expenditures will be developed cooperatively between the provider, the MSS, and the ME's System of Care staff. The ME's System of Care staff will have final approval of the criteria, procedures, and accounting for these funds. e. Each month, the Network Provider shall submit a report to the ME's Sr. Accountant, which details year-to-date expenditures and the balance of the MSS incidental funds, along with the corresponding incidental fund request form(s). The expenditure of MSS incidental funds will be reflected in the incidental expenses cost center on the monthly invoice.This information must be monitored by the Network Provider agency to ensure that the funds allocated at the beginning of each fiscal year are not exceeded. f. The total amount of MSS funding for this contract is $100,000.00. This includes $0.00 that the Network Provider agrees to make available for Incidentals Expense funds. 10. INCIDENTAL FUND REQUEST FORM a. The incidental fund request must contain, at a minimum, the information below: i. Name of the MSS accessing funds; Exhibit AA Guidance Care Center, Inc. Page 4 of 5 Contract No. ME225-11-27 Thriving Mind South Florida (Contracting South FloridaBehavioral Health Network, Mc.) 7/ / 020 ii. Funds spent on behalf of(client name); iii. Referral type (protective investigation/supervision); iv. Date of request; V. Description of Goods/Services requested; vi. How the purchase is related directly to the intervention plan; vii. Goal/Reason for purchase amount requested; and viii. MSS and approving authority signature with date. Exhibit AA Guidance Care Center, Inc. Page 5 of 5 Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca Exhibit AC Care Coordination Services I. OVERVIEW A. DEFINITIONS Section 394.4573(1)(a), F.S., defines Care Coordination to "mean the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure service linkage. Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures.The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations." B. PURPOSE AND GOALS Care Coordination serves to assist individuals who are not effectively connected with the services and supports they need to transition successfully from higher levels of care to effective community- based care. This includes services and supports that affect a person's overall well-being, such as primary physical health care, housing, and social connectedness. Care Coordination connects systems including behavioral health, primary care, peer and natural supports, housing, education, vocation and the justice systems. It is time-limited, with a heavy concentration on educating and empowering the person served and provides a single point of contact until a person is adequately connected to the care that meets their needs. Care Coordination is not a service in and of itself, it is a collaborative effort to efficiently target treatment resources to needs, effectively manage and reduce risk, and promote accurate diagnosis and treatment due to consistency of information and shared information. It is an approach that includes coordination at the funder level, through data surveillance, information sharing across regional and system partners, partnerships with community stakeholders (i.e., housing providers, judiciary, primary care, etc.), and purchase of needed services and supports. At the Network Provider level, it includes a thorough assessment of needs, inclusive of a level of care determination, and active linkage and communication with existing and newly identified services and supports. Care Coordination assesses for and addresses behavioral health issues as well as medical, social, housing, interpersonal problems/needs that impact the individual's status. It is a mechanism for linking providers of different services to enable shared information,joint planning efforts, and coordinated/collaborative treatment. Engagement of available social supports to address identified basic needs for resources such as applying for insurance/disability benefits, housing, food, and work programs is essential Care Coordination also facilitates transitions between providers, episodes of care, across lifespan changes, and across trajectory of illness. At the person level, it incorporates shared decision making in planning and service determinations and emphasizes self-management. Persons served and family members should be the driver of their goals and recognized as the experts on their needs and what works for them. Care Coordination is not intended to replace case management. Based on the person's needs and wishes, case management may be a service identified in the person's care plan that he or she will be referred to. Exhibit AC Page 1 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hri0m) Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca Case management may be ongoing for those determined eligible for this service based on current standards. Once an individual is successfully linked with a case manager, they would assume the responsibilities of coordinating care. The short-term goals of implementing Care Coordination are to: • Improve transitions from acute and restrictive to less restrictive community-based levels of care; • Increase diversions from state mental health treatment facility admissions; • Decrease avoidable hospitalizations, inpatient care, incarcerations, and homelessness; and • Focus on an individual's wellness and community integration. The long-term goals of implementing Care Coordination are to: ■ Shift from an acute care model of care to a recovery model; and ■ Offer an array of services and supports to meet an individual's chosen pathway to recovery. C. CORE COMPETENCIES The Department has compiled a set of guiding principles and core competencies that must be considered in service design. The guiding principles stipulate that service delivery is recovery- oriented, choice and needs driven, flexible, unconditional, and data driven. Core competencies of Care Coordination include: 1. Single point of accountability—Care Coordination provides for a single entity responsible for coordination of services, supports, and cross system collaboration to ensure the individual's needs are met holistically. 2. Engagement with person served and their natural supports -the care coordinator goes to the individual and builds trust and rapport. The care coordinator actively seeks out and encourages the full participation of the individual' networks of interpersonal and community relationships.The care plan reflects activities and interventions that draw on sources of natural support. 3. Standardized assessment of level of care determination process — a standardized level of care assessment provides a common language across Network Providers that can assist in determining service needs. 4. Shared decision-making—family and person-centered, individualized, strength-based plans of care drive the Care Coordination process. The perspective of the individuals served are intentionally elicited and prioritized during all phases of the Care Coordination process. The care coordinator provides options and choices such that the care plan reflects the individual's values and preferences. 5. Community-based — services and supports take place in the most inclusive, most responsive, most accessible, and least restrictive settings possible that safely promote an individual's integration into home and community life. 6. Coordination across the spectrum of health care - this includes, but is not limited to, physical health, behavioral health, social services, housing, education, and employment. Exhibit AC Page 2 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heaf h Nemor .Inca 7. Information sharing — releases of information and data sharing agreements are used as allowed by federal and state laws, to effectively share information among Network Providers, natural supports, and system partners involved in the individual's care. 8. Effective transitions and warm hand-offs - current Network Providers directly introduce the individual to the care coordinator. The "warm hand-off" is both to establish an initial face- to-face contact between the individual and the care coordinator and to confer the trust and rapport the individual has developed with the provider to the care coordinator. 9. Culturally and linguistically competent - the Care Coordination process demonstrates respect for and builds on the values, preferences, beliefs, culture, and identity of the individual served, and their community. 10. Outcome based—Care Coordination ensures goals and strategies of the care plan are tied to observable or measurable indicators of success, monitors progress in terms of these indicators, and revises the plan accordingly. II. PRIORITY POPULATIONS A. Pursuant to s. 394.9082(3)(c), F.S., the Department has defined several priority populations to potentially benefit from Care Coordination. Utilizing at least 50% of funding allocated to Care Coordination in OCAS MHOCN and MSOCN, Managing Entities and Network Provider are expected to serve the following two populations who are not yet connected to a case manager or a team that includes case managers(i.e., FACT, Coordinated Specialty Care for Early Mental Illness,etc.): 1. Adults with a serious mental illness (SMI), substance use disorder (SUD), or co-occurring disorders who demonstrate high utilization of acute care services, including crisis stabilization, inpatient, and inpatient detoxification services. For the purposes of this document, high utilization is defined as: a. Adults with three (3)or more acute care admissions within 180 days; or b. Adults with acute care admissions that last 16 days or longer. 2. Adults with a SMI awaiting placement in a state mental health treatment facility (SMHTF) or awaiting discharge from a SMHTF back to the community. In addition to the priority population listed in section 11. 1 and 11.2, above, the following populations have been identified as potentially benefiting from Care Coordination and may be served: 3. Individuals referred, and enrolled in the Jail Diversion Program (JDP) who meet the following criteria: a. Individuals must meet the following criteria (1 and 2): H. Individuals must be receiving ME SAMH funded services or be willing to accept Care Coordination services from an ME Network Provider. iii. Individuals must have a confirmed SPMI and/or Co-Occurring diagnosis (Diagnosis of PTSD alone is not eligible). b. Individuals must meet at least one (1) of the following: (i) Individuals with 2 or more acute care admissions within 180 days and 2 or more Exhibit AC Page 3 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca arrests within 90 days. (ii) Individuals with an acute care admission that lasts 16 days or longer within 180 days and 2 or more arrests within 90 days. (iii) Individuals with 2 or more acute care admissions and 4 or more arrests within 180 days or individuals with 6 or more arrests within 365 days. AND during current arrest are classified as level 1 a or b or in Detox in the jail. 4. Individuals referred by, or to, a Law Enforcement Agencies and followed by that Law Enforcement: a. Individuals must meet the following criteria: i. Individuals must be receiving ME SAMH funded services or be willing to accept Care Coordination services from an ME Network Provider. ii. Individuals must have a confirmed SPMI and/or Co-Occurring diagnosis (Diagnosis of PTSD alone is not eligible). iii. Individual currently is in or has the potential to experience a state of crisis, substance abuse or dependence, and history of suicidal/homicidal ideation. b. Individuals must meet at least one (1) of the following: i. Have a history of violence/aggression towards others,themselves or animals and/or bullying. ii. Have a negative family dynamics, lack of support system, isolation, instability and/or recent traumatic event. 5. Children and youth referred from the Children System of Care(CSOC) Expansion Grant. a. Individuals must meet one of the following criteria: i. Individuals must be receiving CSOC Expansion Grant services and willing to accept Care Coordination services from an ME Network Provider. ii. Individual is aging out (at least 18 years old) of Children's System of Care and needs to transition into the Adult System of Care. iii. Individual has a history of serious emotional disturbances (SED), or has experience early onset SED/severe mental illness (SMI) in Miami-Dade County. B. The ME in collaboration with the local SAMH Program office may authorize the provision of Care Coordination services for other populations including but not limited to: 1. Persons with a SMI, SUD, or co-occurring disorders who have a history of multiple arrests, involuntary placements,or violations of parole leading to institutionalization or incarceration. 2. Individual requiring reentry services referred by the Prison Aftercare Program 3. Individuals exiting higher levels of care such as residential level II treatment. 4. Caretakers and parents with a SMI, SUD,or co-occurring disorders involved with child welfare. 5. Individuals identified by the Department, managing entities, or Network Service as potentially high risk due to concerns that warrant Care Coordination, as approved by the Exhibit AC Page 4 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass ',mmth Horiiida BehaOord Heafth Nemor Inca Department. 6. Individuals may be identified by the ME's Care Coordination Team or through the ME's Network Providers. C. Individuals served through Care Coordination must be ME-funded individuals. The following individuals are NOT eligible for Care Coordination: 1. Individuals who are currently receiving FACT services. 2. Individuals being followed by the CHI Forensic Team. 3. Individuals diagnosed with a Developmental Disability. 4. Individuals not funded through the ME (except individual diverted or discharged from the SMHTF or otherwise approved by the ME). 5. Individuals participating in the Navigate program for First Episode of Psychosis at Citrus Health Network, Inc. 6. Individuals participating in the Family Intensive Treatment Team program through Guidance Care Center. III. Managing Entity Responsibilities A. The ME is responsible for system level care coordination and supporting Network Provider care coordination activities: 1) The ME identifies individuals eligible for Care Coordination based on the priority populations identified in section II through surveillance/data runs from data submitted by Network Providers and/or confirm eligibility through collaboration with private receiving facilities. 2) The ME initiates referral to appropriate Network Provider by providing data obtained through the systematic data surveillance process or from private receiving facilities. 3) The ME Care Coordination staffs and track referrals and outcomes of those referrals: a) Submit completed Care Coordination Referral Form b) Staff referrals and provides information as appropriate c) Tracks and ensures received of referral disposition within reasonable time frame: i. acknowledgement of receipt of the referral within 72 hours of having received referral ii. Final disposition of referral within 30 days of referral submission iii. Successful and successful discharges Exhibit AC Page 5 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca ;;$ ;2 sit 4) Participate in team meeting and/or other weekly contacts with the Network Provider. 5) Monitor and support Network Provider's engagement,enrollment and timely service initiation for persons referred. 6) Facilitate communication and collaboration of Network Providers with other contracted and non-contracted providers,traditional and non-traditional community-based resources. 7) Track individuals enrolled in Care Coordination through data to monitor including but not limited to: a) Readmission rates for individuals served in acute care settings; b) Length of time between acute care admissions; c) Length of time an individual waits for admission into a SMHTF; d) Length of time an individual waits for discharge from a SMHTF; and e) Length of time from acute care setting and SMHTF discharge to linkage to services in the community. 8) Manage Care Coordination funds and purchase services based on needs identified by Network Providers. 9) Track service needs and gaps and redirect resources as needed, within available resources. 10) Assess and address quality of care issues, including fidelity review of adherence with Critical Time Intervention (CTI). 11) Ensure provider network adequacy and effectively manage resources. 12) Develop diversion strategies to prevent individuals who can be effectively treated in the community from entering SMHTFs. 13) Develop partnerships and agreements with community partners (i.e., managed care organizations, criminal and juvenile justice systems, community-based care organizations, housing providers, federally qualified health centers, etc.) to leverage resources and share data. 14) Provide technical assistance to Network Providers and assist in eliminating system barriers. 15) Work collaboratively with the Department to refine practice. 16) Implement a quality improvement process to establish a root cause analysis when Care Coordination fails. IV. NETWORK PROVIDER RESPONSIBILITIES The Network Provider will implement the delivery of Care Coordination services through the implementation of Critical Time Intervention as the service delivery model. Critical Time Intervention (CTI) is an intensive 9-month care coordination model designed to assist adults age 18 years and older with mental illness who are going through critical transitions, and who have functional impairments which preclude them from managing their transitional need adequately. CTI promotes a focus on recovery, psychiatric rehabilitation,and bridges the gap between institutional living and community services.CTI differs from traditional case management because it is time limited, focused, and follows a three phased approach. Unlike some other models, timing of movement Exhibit AC Page 6 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass ',mmth Horiiida BehaOord Heafth Nemor Inca through the phases is defined by the program model, not the readiness of the individual. As an evidence-based practice there are four core principles that define CTI and set it apart from other services: 1. Focuses on a critical transition period, and is time-limited 2. Enhances continuity of care and prevents recurrent homelessness and hospitalizations. 3. Identifies and strengthens formal and natural community supports. 4. Complements rather than duplicates existing services. CTI assist individuals not connected to other community-based services navigate critical transitions and meeting their needs. Critical transitions are, among other circumstances, discharge from psychiatric inpatient settings and transitioning from residential setting to independent living. CTI activities aim to prevent the reoccurrence of status that qualified the person for a referral to care coordination services. CTI is divided into three identified phases lasting three months each, not including Pre-CTI. Pre-CTI: Consist of outreach activities aimed to establish a relation and develop rapport with the person served. Pre-CTI services begin before an individual is discharged from a hospital or other institution in order to establish an initial relationship before the transition begins. Pre-CTI can also be used with an individual who is homeless prior to the individual moving into housing. Remainder of this page left blank intentionally Exhibit AC Page 7 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca Phase Transition Try-out Transfer of Care Timing Months 1-3 Months 4-6 Months 7-9 Purpose CTI provides assessment of social CTI supports an individual's CTI remains available to and health needs and develops and engagement and effective solve problems in implements an individualized participation in their own collaboration with the service plan to address immediate support system. Facilitates individual, and his/her needs related to critical transition and tests the individual's new providers and natural problem-solving skills supports prior to discharge In this phase, there is frequent This phase, promotes the contact with the individual in the In this phase,the team transfer from CTI to other community, focusing on active increasingly encourages community supports, both engagement with behavioral health individuals to manage formal and informal and services, and identifying and problems independently after termination of CTI services addressing housing-related issues in connecting them to occurs with a support order to prevent future episodes of supportive services. network safely in place. homelessness or housing instability. A transition plan is implemented while providing emotional support. Activities CTI worker engages the individual. CTI worker monitors the CTI worker provides This includes making home visits effectiveness of the support consultation but little direct or visits in the community network; service.The worker lets the including in shelters or on the Helps to modify network as individual solve their own street, introducing the individual necessary; problems. The worker to providers, and meeting with ensures key caregivers, helping the individual Continues case management caregivers/providers meet negotiate ground rules for activities as necessary; and agree on long term relationships, mediating conflicts, Continues community-based support system. and assess the potential of the visits; Reinforces the roles of individual's support system. support network members; Focuses on urgent/basic needs Provides psychoeducation such as food, immediate medical about self-management and Develops and begins to set care, shelter, warm clothing or successful navigation of the in motion plan for long-term blankets, access to essential service systems and Completes goals (e.g. employment, medications; any Phase I activities that still education, family need resolutions. Less reunification); May hold a Accompanies individuals to frequent meetings and party or some other community providers; Forges provides social crisis ceremonial recognition of connections to social service interventions and successful transition out of systems, and assists the individual troubleshooting. CTI services.A final meeting to apply for available benefits as is held to formally recognize indicated (phone, food and the end of interventions and nutrition benefits, Medicaid, relationship. Disability, etc.); Exhibit AC Page 8 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca V. Network Providers funded to provide Care Coordination Services are responsible for the following activities for individuals that are receiving services in the community: The Network Provider will: 1. Serve as single point of accountability for the coordination of an individual's care with all involved parties(i.e., criminal or juvenile justice, child welfare, primary care, behavioral health care, housing, etc.). 2. Conduct outreach and internal data surveillance to identify care coordination eligible candidates within their organization. Upon identification of care coordination eligible candidate, the Network Provider will self-refer and send referral for approval to the ME Care Coordination team. 3. Engage (Pre-CTI) the individual in their current setting, (e.g., crisis stabilization unit (CSU), SMHTF, homeless shelter, detoxification unit,addiction receiving facility,etc.)within 30 days of the person's expected discharge. Engagement (Pre-CTI) is critical to successfully establishing rapport with the person served. In addition, Pre-CTI offers an opportunity for the Network Provider Care Coordinator to obtain relevant clinical and personal information to assist the person in their transition to community-based care. f. Care Coordination serves the person in his/her environment. Individuals served should not be expected to come to the care coordinator 4. Maintains on-going communication with the ME Care Coordination team including: i. acknowledgement of receipt of the referral within 72 hours of having received referral ii. Final disposition of referral within 30 days of referral submission iii. Successful and successful discharges 5. Conduct at least seven engagement attempts, include multiple face-to-face attempts to locate or enroll a person. To maximize engagement opportunities Network Provider Care Coordinator will engage individuals before the transition to the community. If there is no contact with the referred individual after the required attempts Network Providers are to complete a non-enrollment form to close the referral. 6. Develop an intervention plan (or Phase Plan) with the individual based on shared decision making that emphasizes self- management, recovery and wellness, including transition to community- based services and/or supports. Intervention plans goals should be very simple,addressing no more than 3 areas at a time and evolving with respect to the individual's progress, participation, and choices. 7. Provide frequent contact for the first 30 days of services upon enrollment, ranging from daily to a minimum of three times per week, and at least six community-based meeting per month for the other two months in Phase 1. Care coordinators should consider the individual's safety needs, level of independence, and their wishes when establishing the optimal contact schedule. This includes telephone contact or face-to-face contact (which may be conducted electronically). Leaving a voicemail is not considered contact. If the individual served is not responding to attempted contacts, the Network Provider must document attempts on the record and make physical and active attempts to locate and engage the individual. 8. Provide 24/7 on-call availability.The CTI team will pro-actively assist individuals in the prevention of social crisis episodes. The CTI team is not expected to be on call as a "first responder" for crisis events, but is expected to assist the individual in the development of a detailed crisis plan, and to Exhibit AC Page 9 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca ;;$ ;2 sit assure that the plan is as widely distributed to key partners to the extent allowed by the individual. 9. Coordinate care across systems, to include behavioral and primary health care as well as other services and supports that impact the social determinants of health. 10. Assess the individual for eligibility of Supplemental Security Income(SSI),Social Security Disability Insurance(SSDI), Veteran's Administration benefits, housing benefits, and public benefits, and assist them in obtaining eligible benefits.When applying for SSI or SSDI benefits, providers must use the SSI/SSDI Outreach,Access,and Recovery(SOAR) application process. Free training is available at: https://soarworks.prainc.com/course/ssissdi-outreach-access-and-recovery-soar- online- training 11. For individuals who require medications, ensure linkage to psychiatric services within 7 days of discharge from higher levels of care. If no appointments are available,document this in the medical record and notify the ME Care Coordination team. 12. Coordinate with the ME Care Coordination team to identify service gaps and request purchase of needed services not available in the existing system of care. 13. Develop partnerships and agreements with community partners(i.e., managed care organizations, criminal and juvenile justice, community-based care organizations, housing providers, federally qualified health centers, etc.)to leverage resources and share data. 14. Providers of CTI services should utilize any tools, training, documents, forms, and learning opportunities provided by Thriving Mind. 15. Providers will ensure that any staff delivering care coordination completes, at a minimum, the Critical Time Intervention training provided by ME 16. Ensure that caseload ratios are observed.The maximum caseload ratio for a full-time CTI worker is 1:20. The maximum caseload ratio for a full-time CTI Supervisor and a Peer Specialist is 1:10 each. Due to the varying level of intensity of work during each phase, admission to the team should be staggered to maintain a caseload of individuals who are in each phase. 17. Peer Specialist staff should have a minimum of two years working with a mental health population and be a Certified Peer Specialist or work towards certification with the support and assistance of the Network Provider 18. CTI Supervisor should be a licensed professional or have extensive experience in the provision of service for the target population, preferably including clinical experience. In addition, to having experience in the provision of guidance, feedback, and training to team members to assure that quality services are provided to the individuals served and to maintain and facilitate the skills of the supervisee to assure all members of the team are utilizing and maintaining fidelity to the evidence-based CTI model. 19. CTI Teams meet weekly for supervision and to share practical strategies for working with individuals and their complex needs. Each meeting should include the following: a. Submit meeting invitations to the assigned Thriving Mind Care Coordinator b. Report on previous week's activities, starting with the to do list from the last supervision meeting c. Review any new cases/individuals referred to the CTI team d. Reinforcement of CTI principles and practices e. In depth discussion of high priority cases, usually between 4-8 individuals. Additionally, each individual should be discussed at minimum once a month Exhibit AC Page 10 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca f. Plan for resolving barriers to implementation of CTI g. Make a "To Do List"for upcoming week. VI. CARE COORDINATION ALLOWABLE COVERED SERVICES Pursuant to ch. 65E-14.014, F.A.C., Network Providers may not bill for services for individuals who have third party insurance, Medicaid, or another publicly funded health benefit coverage when the services provided are paid by said program. The Network Provider will delivery care coordination services as allowable and inch. 65E-14.021, F.A.C.: The Network Provider funded for Care Coordination agrees to invoice/document Care Coordination services under the following allowable covered services: 1. Outreach - allows the Network Provider to provide engagement and supervision activities associated with the model without requiring it to be direct client services events. 2. Intervention — allows the Network Provider the capture client specific service events without requiring the person to complete an "Intake" at the Network Provider agency. It also allows for the provider to maintain their services even when person served is referred and enrolled with another provider of service. 3. Recovery Supports — allows the Network Provider to deliver and measure the impact of peer services in the outcome of the intervention. VII. DATA COLLECTION AND MANAGEMENT 1. Care Coordination is a bundled service approach that is reported through an expenditure Other Cost Accumulator in accordance with DCF FASAMS Pamphlet 155-2 and using the following modifier codes in the Modifier 2 field: Modifier Code Short Description DO MHOCN Care Coordination MH DV MSOCN Care Coordination SA 2. Only the covered services specified in Guidance Document #4 may be reported using the modifier codes identified for Care Coordination. 3. Service data must be reported on the Network Provider detailed expenditure reporting in Templates 12 and 13. 4. Care Coordination Monthly Report shall be submitted to the ME Care Coordination Department by the 5th of the month for the previous month reporting period.Submission must be encrypted and/or password protected. Vill. SOAR APPLICATIONS SOAR application data (protected filing, approval or denial dates, etc) will be submitted through the Online Application Tracking (OAT) system as outlined in Exhibit AN, Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR). For access/registration questions, please contact soaroat@prainc.com. Exhibit AC Page 11 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hri0m) Mind �smth �lorillda �'santracthlo ass ',mmth Horiiida BehaOord Heafth Nemor Inca IX. REPORTING REQUIREMENTS 1. Monthly Care Coordination Report: The Network Provider must submit Care Coordination Monthly using the DCF Template 21 by the 51" of every month for data from the previous month. The Network Provider will submit the monthly report to the individuals listed in Exhibit C, Required Reports. 2. Ad Hoc Reports:The Network Provider agrees to submit any ad-hoc and/or additional reports as determined necessary by the ME, Department of Children and Families and/or Miami-Dade County. X. MEETINGS/TRAININGS 1. The Network Provider will ensure that its staff is properly trained on CTI model, goals and objectives, evidence-based practices and screenings. 2. The Network Provider shall meet with the ME's staff at regularly scheduled or specially called meetings and/or trainings when notified by the ME. Remainder of page left blank intentionally Exhibit AC Page 12 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass `mmth Horiiida BehaOord Heafth Nemor Inca Exhibit AC DCF Template 21 Monthly Care Coordination Report-Narrative Region of Service: Circuits: Managing Entity: Report Period: MonthNear This report serves to track the progress of care coordination activities statewide. Please do not repeat information, if you answered a question in previous months and nothing has changed, mark"No Changes". If applicable, describe a success story: ❑ N/A Care Coordination Practices Describe the evidence-based or innovative practices you are implementing: ❑ No Changes What standardized level of care determination are your providers using? ❑ASAM ❑ LOCUS ❑ Other: How many individuals in Baker Act Receiving Facilities who were either on a court order or voluntary status awaiting transfer to a SMHTF did you divert during this reporting period? Briefly describe diversionary strategies, provider partnerships, and other resources utilized: List any new partnerships established in the reporting period (i.e., Memoranda of Understandings, Referral Agreements, Data Sharing Agreements, common assessments,etc.): ❑No Changes Describe any service gaps or barriers identified and how they are being resolved (i.e., redirection of resources, purchase of out of network services, etc.): ❑No Changes Describe how contracted network service providers are implementing care coordination practices: ❑No Changes Describe SOAR activities: ❑Are SOAR applications reported in OAT For this reporting period, how many SOAR applications are: Pending Approved Not Eligible Reasons for ineligibility(i.e., immigration status) Exhibit AC Page 13 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 'hriOno Mind �smth �lorillda �'santracthlo ass ',mmth Horiiida BehaOord Heafth Nemor Inca How many individuals who are homeless or at risk of homelessness were housed? List types of housing resources utilized (i.e., Permanent,transitional,ALF, supportive housing, etc.) If applicable, list training needs: ❑No Changes Acronyms ASAM American Society of Addiction Medicine LOCUS Level of Care Utilization System OAT Online Application Tracking SOAR (SSI/SSDI)Outreach,Access &Recovery CSU Crisis Stabilization Unit(for purposes of this document includes facilities providing inpatient and crisis stabilization services under the Baker Act) Exhibit AC Page 14 of 15 Guidance Care Center, Inc. Contract No. ME225-11-27 0 N O N O n O N N C N O W O O � � L ^ U N xk 7 U � L 3 � O C � ^ ° � u ry Z � 'e^ � i+ •Y F C 'O _ rl 0 ,N xk J� xk ^J JD® •� •� ✓' J bD® � � U C C J L bD� bD C O L L � O U a bA O C -a U � o � ,d % � �+ o +d �•,,d a cG a s a s ® N 0 w s vs s s Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 2 1 2020 Exhibit Al Family Intensive Treatment(FIT) Model Guidelines and Requirements Scope of Work Description:Specific Appropriations 369 provide funding... "to implement the Family Intensive Treatment (FIT)team model that is designed to provide intensive team-based,family focused, comprehensive services to families in the child welfare system with parental substance abuse. Treatment shall be available and provided in accordance with the indicated level of care required and providers shall meet program specifications." The Network Provider shall adhere to the service delivery and reporting requirements described in this Exhibit, the Program Guidance for Contract Deliverables- Incorporated Document 18, Family Intensive Treatment (FIT) Model Guidelines and Requirements, dated July 1, 2019, or the latest revision thereof, which is incorporated by reference, and available at the following link: https://www.myflfa m i l ies.com/service-progra ms/sa m h/ma nagi ng-entities/2019-contract-docs.shtm I A. Goals of the FIT Model 1. Provide intensive treatment interventions targeted to parents with Child Welfare cases determined to be unsafe; 2. Establish a team-based approach to planning and service delivery with Community Based Care Lead Agencies, child welfare Case Management Organizations, Managing Entities, FIT Team Providers and other providers of services. 3. Integrate treatment for substance use disorders, parenting interventions and therapeutic treatment for all family members into one comprehensive treatment approach. This comprehensive approach includes coordinating clinical children's services which are provided outside of the FIT team funding. 4. Provide immediate access to substance abuse and co-occurring mental health treatment services for parents in the child welfare system with early engagement strategies, such as at case initiation or case transfer; 5. Identify family-driven pathways to recovery and promote sustained recovery through involvement in recovery-oriented services and supports; 6. Promote increased engagement and retention in treatment; 7. Facilitate program completion; and 8. In collaboration with Community Based Care Lead Agencies and child welfare Case Management Organizations: a. Promote safety of children in the child welfare system whose parents have a substance use disorder; Exhibit Al Page 1 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7 2020 b. Develop a safe, nurturing and stable living situation for these children as rapidly and responsibly as possible; c. Provide information to inform the safety plan; ongoing Family Functioning Assessments, and any other relevant status updates; d. Reduce the number of out-of-home placements when safe to do so; and e. Reduce rates of re-entry into the child welfare system. B. Client Eligibility The FIT Team Providers shall deliver services to parents who meet all of the following criteria: 1. Are eligible for publiclyfunded substance abuse and mental health services pursuant to s.394.674, F.S.; including persons meeting all other eligibility criteria who are under insured. 2. Meet criteria fora substance use disorder; 3. Have at least one child between the ages of 0 and 10 years old,with priority given to families with a child between the ages of 0 and 8; 4. At the time of referral to FIT: a. A child in the family has been determined to be "Unsafe" and in need of child welfare case management; b. For children in out of home care, the family must have a child welfare case management plan with the permanency goal of reunification, or a concurrent case plan that includes reunification as a permanency goal; and c. The parent(s) are willing to participate in the FIT Program or the parent is court ordered to participate in FIT services. In either case, enhanced efforts to engage and retain the parent(s) in treatment are expected as a critical element of the FIT program. C. Referral Sources The FIT Team Providers shall accept families referred by the child protective investigator, child welfare case manager or Community Based Care Lead Agency, provider of family intervention services, or the dependency court system. D. FIT Process Requirements The FIT Team Providers shall deliver an array of behavioral health services to eligible parents and other adult family members when necessary. Once a referral for an eligible parent(s) is received, the FIT Team Provider shall: 1. Initiate contact with the parent(s) to begin the engagement and enrollment process within two (2) business days of receiving a referral. The FIT Team Provider shall ensure that initial and recurring efforts to contact and engage the referred parent(s) are documented. 2. Document the date of enrollment as the date the parent signs consent for services. Exhibit Al Page 2 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 2020 3. Complete the initial assessments to determine the level of care and severity within fifteen (15) business days of enrollment and include the following assessments, at a minimum: a. American Society of Addiction Medicine(ASAM)to assess level of care; and b. Biopsychosocial Assessment to assess the severity of substance use disorders and other behavioral health needs. a. Any Biopsychosocial Assessment of an eligible parent that is completed within 30 calendar days prior to receiving FIT services may be accepted by the FIT Team Provider. Otherwise, a new Biopsychosocial Assessment shall be completed. b. In instances where an eligible parent is readmitted to the same provider for services within 180 calendar days of discharge, a Biopsychosocial Assessment update shall be conducted, if clinically indicated. Information to be included in the update shall be determined by the qualified professional.A new Biopsychosocial Assessment shall be completed of an eligible parent who is readmitted for FIT services more than 180 calendar days after discharge. c. The Biopsychosocial Assessment shall be updated annually for eligible parents who are in continuous treatment for longer than one year. 4. Provide FIT services within two (2) business days of completing the initial ASAM and Biopsychosocial Assessment. Completion of the treatment plan with the family may be the first service. 5. Document and report the most current and appropriate substance use disorder and mental health disorder diagnosis codes, to the highest level of specificity that supports treatment, on the Monthly Progress Report. 6. Complete the Daily Living Activities (DLA-20) Alcohol-Drug Functional Assessment within thirty (30) calendar days of enrollment. To effectively monitor changes in client functioning over time, the DLA-20 shall be re-administered within sixty (60) calendar days of initial completion, and continue to be administered at 60-day intervals throughout the course of FIT services. A final DLA- 20 shall be administered at discharge 7. Complete additional assessments within thirty (30) calendar days of enrollment, to include the following at a minimum: a. A mental health assessment when indicated; b. Adult Adolescent Parenting Inventory (AAPI-2) to aid in the assessment of parenting capacity and family functioning; and c. Any other assessments as designated by the Department. 8. Complete an initial Adverse Childhood Experience (ACE) Questionnaire within sixty (60) calendar days of enrollment with each parent receiving FIT services and update as needed to consider new information related to trauma that may impact the ACES score. This may be completed sooner if clinically appropriate. 9. Within thirty (30) calendar days of enrollment, ensure the FIT Team's treatment plan and case management plan guide the provision of services. The FIT Team's treatment plan and case management plan is to be developed with the participation of the family receiving services and reviewed or revised with the family to address changes in circumstances impacting treatment.The Exhibit Al Page 3 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/ /2020 case management plan is to be completed with the participation of the family receiving services, other professionals and natural supports chosen by the family and reviewed or revised with the family to address changes in circumstances impacting treatment. The FIT Team's treatment plan or case management plan shall: a. Identify how support services will be provided to the enrolled parent(s); b. Identify how support will be provided to parents to address the child's therapeutic, medical, and educational needs; c. Align with the child welfare case plan by enhancing caregiver protective capacity and/or support conditions for return. If the child welfare case plan has not been developed at the time of the development of the FITTeam's treatment plan or case management plan,they shall be revised upon completion of the child welfare case plan; d. Establish a goal to address the coordination of clinical services received by the child(ren), to align with the parents' clinical services, in the case management plan; and e. Have a mix of formal and community support interventions to address needs identified by the family. 10. If parents are not engaging in services,immediately notify the assigned child welfare case manager to allow for strategies to be developed jointly. Notification and strategy development efforts must be documented in the Florida Safe Families Network(FSFN). 11. The FIT Team Provider will provide updates to the child welfare case manager,to include ongoing assessments of caregiver protective capacities and conditions for return,when indicated.The FIT Team Provider, Managing Entities, and Community Based Care Lead Agency will establish a process to promote concurrent planning throughout the case until it has been determined that: a. The caregivers have enhanced their caregiver protective capacities to the point where there are no longer danger threats within the home and the children are safe, or; b. The children otherwise achieve permanency. 12. Review the family's treatment during a multidisciplinary team (MDT) meeting no later than seven (7) days prior to a family's transition from the FIT program.The review shall include the parent(s) receiving FIT services; other family members or significant others identified by the parent(s); and the child welfare case manager and other providers serving the family. If it is not possible to hold an MDT meeting prior to the family's transition from the FIT program; for example, when treatment is interrupted due to factors such as judicial action or a parent going to jail;the MDT is optional. However, a process should be established to facilitate communication occurs between the FIT provider and the child welfare case manager regarding the status of the family at the time of discharge.The purpose of the MDT meeting is to ensure that: a. The family will receive behavioral health services that address the behavioral health condition and promote relapse prevention and recovery; b. The family has in place the services necessary to address their physical health care including a primary care physician for the parents and children; c. The support services put in place while in FIT; such as housing supports, supportive employment, financial benefits, etc.; can be sustained; Exhibit Al Page 4 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7 2020 d. The FIT Team Provider has identified available community services for the parents and children to provide for their ongoing well-being such as child care, early intervention programs, therapies, and community-based parenting programs; e. The family's natural supports have been engaged to the degree possible; and f. Information about community support programs such as Alcoholics Anonymous, Narcotics Anonymous, a faith-based group or other recovery supports has been provided to the family. 13. A process should be established to ensure communication occurs between the FIT Team Provider and the child welfare case manager regarding the status of the family at the time of discharge. A FIT services Discharge Summary will be completed no later than ten (10) business days after discharge from all FIT services.The summary shall, at minimum, include: a. The reason for the discharge; b. A summary of FIT services and supports provided to the family; c. A summary of resource linkages or referrals made to other services or supports on behalf of the family; and d. A summary of each goal of the FIT Team's treatment plan and case management plan, including the goal of coordinating clinical services to the children. E. FIT Programmatic Requirements As part of a comprehensive array of behavioral health services and supports, FIT team services shall include the following activities, tasks, and provisions: 1. An emergency contact number for parents to reach someone in case of emergency 24 hours a day, 7 days a week; 2. Peer coaching and support services to promote recovery,engagement and retention in treatment, and skill development; 3. Case management services to address the basic support needs of the family and coordinate the therapeutic aspects of services provided to all family members regardless of payer source; 4. Coordination of services and supports with child protective investigators and child welfare case managers; 5. Individualized treatment provided at the level of care that is recommended by standardized placement criteria; 6. Intensive in-home treatment, inclusive of individual and family counseling, related therapeutic interventions, and treatment to address substance use disorders, based on individual and family needs and preferences; 7. Group treatment to address substance use disorders, based on individual and family needs and preferences; 8. During the first phase of treatment,approximately the initial three to four months,clinical services will occur for approximately three hours a week with additional case management and peer services. Exhibit Al Page 5 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/: 202 9. Trauma-informed treatment services for substance use disorders and co-occurring substance abuse and mental health disorders; 10. Therapeutic services and psycho-education in: a. Parenting interventions for child-parenting relationships and parenting skills; b. Natural support development, including the family when appropriate; and c. Relapse prevention skill development and engagement in the recovery community. 11. Care coordination, as reflected in the FIT Team's case management plan, include a multi- disciplinary team to promote access to a variety of services and supports as indicated by the needs and preferences of the family, including but not limited to: a. Domestic violence services; b. Medical and dental health care; c. Basic needs such as supportive housing, housing, food, and transportation; d. Educational and training services; e. Supported employment, employment and vocational services; f. Legal services; and g. Other services identified in the FIT Team's case management plan. 12. The FITTeam Provider will be trained in the use of substance abuse treatment and evidence-based parenting practices found effective for serving families in the child welfare system. 13. The FIT Team Provider may provide Incidental Expense services, as defined in Rule 65E-14.021, F.A.C. All Incidental Expense services must be document in the family's treatment plan. F. Contracting Requirements 1. At minimum, the FIT Team Provider must be licensed for outpatient substance abuse services pursuant to Chapter 65D-30, F.A.C. If additional service components, for which the FIT Team Provider is not licensed, are needed for individualized treatment, the FIT Team Provider must purchase the service from an appropriately licensed provider. 2. FIT Team Providers are responsible for providing or subcontracting for all behavioral health services needed by individuals enrolled in FITthat are not directly provided by the team,including: detoxification; residential; crisis stabilization; medication management; aftercare; and other Covered Services as defined in Rule 65E-14.021, F.A.C., as needed.The FIT provider is responsible for immediate access to these services and for coordinating all services provided or purchased. 3. The FIT funds should not be used to purchase children's services however the FIT team must coordinate clinical services with providers serving children in the family. 4. Services provided by the core FIT team staff and funded by FIT contract dollars cannot be billed to any third-party payers. Services provided outside of the core FIT team staff may be billed to Medicaid or private insurance, to the extent allowable under these programs.The FIT team remains responsible for immediate access to services for enrolled individuals, regardless of payer. G. Administrative Tasks Exhibit Al Page 6 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/: 202 Staffing for FIT teams started prior to July 2016 The FIT Team must include the following general functions: 1. Program Management; 2. Clinical services for Substance Use Disorders and co-occurring mental and substance use disorders; 3. Specialized Care Coordination; and 4. Family Support and Peer Services. H. Staffing for FIT teams started after July 2016 For approximately every 20 families served, programs should have a minimum of: 1. 2 Behavioral Health Clinicians; 2. 1 Case Manager; and 3. 1 Peer Specialist. Programs serving more than 40 families must also have a program manager. Adjustments to staff and management ratios must be approved by the Managing Entity. This ratio is based on enrolled clients. I. Minimum Staffing Qualifications for FIT Teams started after July 2016 1. Program Manager -A Master's degree in Behavioral Health Sciences, such as psychology, mental health counseling, social work, art therapy, or marriage and family therapy; and an active license issued by the Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling; and a minimum of three years working with adults with substance use disorders. 2. Behavioral Health Clinicians - A Master's degree in Behavioral Health Sciences, such as mental health counseling, social work, art therapy, or marriage and family therapy; and a minimum of two years of experience working with adults with substance use disorders. (in smaller teams without a program manager one behavioral health clinician must be licensed). 3. Case Manager-A Bachelor's degree with a major in counseling, social work, psychology, criminal justice, nursing, rehabilitation, special education, health education, or a related field which includes the study of human behavior and development; and a minimum of one year of experience working with adults with behavioral health needs and child welfare involvement; or a Bachelor's degree with a major in another field and a minimum of three years of experience working with adults with substance use disorders. This position does not serve as the Dependency Case Manager and FIT does not fund the Dependency Case Manager. 4. Peer Specialist - A Recovery Peer Specialist certified by the Florida Certification Board; or an individual who has direct personal experience living in recovery from substance abuse and mental health conditions for at least 2 years with a minimum of one year work experience as a peer. If not certified by Florida Certification Board, opportunities should be provided to peers to enhance and develop their skill sets. Peers can maximize their abilities if given opportunities to receive training that will further complement their lived experience. Exhibit Al Page 7 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7 1 2020 J. Required Reports 1. Child Welfare Program Active Cases Weekly Report This report is to be submitted each Monday by Close of Business. It will be emailed to the Child Welfare Integration Coordinator at the ME.The Active Cases Weekly Report is to include the week ending date as the Monday of submission(a week is detailed as Tuesday to Monday).All data included in the Report must be reflective of data up to the date and time of submission. This report must include the current consumers pending intake and currently enrolled consumers assigned to each program. The Network Provider shall use the reporting template provided in Appendix 1 of this Exhibit Al. 2. Monthly Progress Report The Network Provider shall submit FIT data, using Template 17—FIT Reporting Template, by the 151"day of the month following service delivery. Note:Reporting Template 17 is accessible by clicking on the following link: https://www.myflfa m i l ies.com/service-progra ms/sa m h/ma nagi ng-entities/2019-contract-docs.shtm I Note: To access the template click on FY19-20 ME Templates and click on Template 17— FIT Reporting Template. K. Performance Measures for the Acceptance of Deliverables Monthly and yearly service targets should be determined by the Managing Entity, taking into account capacity of the provider, needs of families served, as well as geographical considerations. An estimated cost of $10,000 to $12,500 per family may be used to set targets for number of families to be served during a fiscal year,taking into consideration the above factors.The estimates should assume that families will remain in treatment and after care for several months, in some cases over a year. Managing Entities may consider a higher estimated cost and must discuss this recommendation with the Regional SAMH Director and with the FIT headquarters coordinator. In the event the Provider fails to achieve the minimum performance measures, the Managing Entity may apply appropriate financial consequences. L. Programmatic Performance Measures and Methodologies The Network Provider is responsible for meeting the following performance measures and methodologies: 1. At discharge, 90% percent of parents served will be living in a stable housing environment: 2. 80% percent of parents served will improve their level of functioning, as measured by the Daily Living Activities (DLA-20) Functional Assessment. Exhibit Al Page 8 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 2 2020 a. Measure of improvement is based on change in the average score of the DLA-20. Improvement is based on the change between results from the initial score to the last recorded score. b. The numerator is the sum of the number of parents who completed FIT services during the reporting period with an overall functioning score that is higher than the last recorded score. c. The denominator is the sum of the number of parents who completed the DLA-20 and had more than one score during the reporting period. d. The percentage of parents who improve their level of functioning should be equal to or greater than 80%. 3. 80% percent of parents served will improve their level of functioning, as measured by the Adult Adolescent Parenting Inventory(AAPI-2)Assessment. a. Measure of improvement is based on the change between results in the AAPI-2 Form A (pretest)to Form B (posttest). b. The numerator is the sum of the number of parents discharged during the reporting period with an overall functioning score that is higher on Form B than Form A. c. The denominator is the sum of the total number of parents with assessment results for both Form A and Form B within the reporting period. 4. The FIT Team Provider will complete 85% of the initial level of care assessments (Biopsychosocial Assessment and ASAM)within fifteen (15) days of enrollment into FIT services: a. The numerator is the sum of the number of parents who received initial assessments (Biopsychosocial Assessment and ASAM) within fifteen (15) days of enrollment into FIT services during the reporting period. b. The denominator is the sum of the total number of parents who were enrolled during the reporting period for at least fifteen (15) days. c. The percentage of parents who receive assessments within fifteen(15)days of enrollment during the reporting period should be equal to or greater than 85%. 5. The FITTeam Provider will initiate therapeutic services for 90%of parents within two (2) business days of completing the initial assessments (Biopsychosocial Assessment and ASAM): a. The numerator is the sum of the number of parents who receive therapeutic services within two (2) business days of completing their initial assessments during the reporting period. b. The denominator is the sum of the total number of parents who completed the initial assessments during the reporting period. c. The percentage of parents who receive therapeutic services within two (2) business days of completion of their initial assessments during the reporting period should be equal to or greater than 90%. Exhibit Al Page 9 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/1/2020 APPENDIX I Child Welfare Programs Active Cases Weekly Report REPORTING PERIOD: RA 6 W 'T 4, Q Family Intensive Treatment Team (FITT) Exhibit Al Page 10 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inc.) 2/ /2020 EXHIBIT AJ Community Action Treatment(CAT)Team The Network Provider must operate a Community Action Treatment (CAT) program to provide community-based services to children ages 11 to 21 with a mental health or co-occurring substance abuse diagnosis with any accompanying characteristics such as being at-risk for out-of-home placement as demonstrated by repeated failures at less intensive levels of care; having two or more hospitalizations or repeated failures; involvement with the Department of Juvenile Justice or multiple episodes involving law enforcement;or poor academic performance or suspensions.Children younger than 11 may be candidates if they display two or more of the aforementioned characteristics. The Network Provider must adhere to the service delivery and reporting requirements herein and reporting requirements. Best practice considerations and resources are provided to support continuous improvement of the CAT program; however, these are not contractually required. I. Network Provider Responsibilities 1. The Network Provider must adhere to the service delivery and reporting requirements described in this Exhibit and in DCF Guidance Document 32,dated July 1, 2020 or the latest revision thereof.The DCF Guidance Document 32 can be found at the following link: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml Note: Click on FY20-21 ME Templates and click on Guidance Document 32—Community Action Treatment(CAT) Team 2. Data Submission: The Network Provider must submit data, in accordance with the most recent version of the PAM 155-2, and in compliance with Section C-1.4 of the Managing Entity contract. The Network Provider must submit electronically to the ME by the 4th of each month following the month of service in the Managing Entity's designated data system. 3. The Network Provider must submit Appendix 1 - Persons Served and Performance Measure Report,Appendix 2- Quarterly Supplemental Data Report,and Appendix 3—Monthly CAT Team Invoice,to the individuals identified in Exhibit C, Required Reports, in accordance with the following schedule: o Appendix 1 — Monthly submission to the Managing Entity no later than the 81" of the month following services. o Appendix 2 and Appendix 3 — Quarterly submission to the Managing Entity 101" of the month following the end of each state Fiscal Year Quarter. o Appendix 4 — Monthly submission to the Managing Entity no later than the 81" of the month following services. 4. The Network Provider must participate in all CAT program conference calls, meetings or other oversight events scheduled by the Department and/or the Managing Entity; Revised Exhibit AJ Page 1 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 2/ /2020 5. The Network Provider must submit a quarterly report of actual expenditures, fiscal year-end financial reconciliation of actual allowable expenditures to total payments, and prompt return of any unearned funds or overpayments; 6. The Network Provider must service a minimum service target of thirty-five(35)children per month. o The Managing Entity may request Department approval for an alternative target for a specific Network Service Provider,taking into consideration a Network Service Provider's program-specific staffing capacity, historical funding utilization, estimated community needs, or unique geographic and demographic factors of the service location. 7. The Network Provider must be applied a financial consequence in the event that the Network Service Provider does not meet the monthly minimum service target. Financial consequences must be established at a $2,000 reduction of the monthly invoice amount for each individual served less than the monthly service target. 8. Incidental Expenses: Pursuant to chapter 65E-14.021, F.A.C., temporary expenses may be incurred to facilitate continuing treatment and community stabilization when no other resources are available. Allowable uses of incidental funds include: transportation, childcare, housing assistance, clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals,and other incidentals that can demonstrate support of individual's treatment plan or other allowable uses. 9. Weekly Census:A weekly census of the children enrolled is required to be submitted by 12:00 noon every Monday to the Children System of Care Manager. The weekly census must include the list of names of the current CAT clients and a list with the names of the clients on the waitlist. The census must be submitted in an encrypted and password protected e-mail. 10. Eligible Other Cost Accumulator (OCA) and Covered Services: The OCA for the CAT Team Program is: MHCAT The Covered Services allowed forthe CATTeam program are:Assessment,Case Management,Crisis Support Emergency, In-Home/On-Site, Intervention Individual, Outpatient Individual, Medical Services, Outreach, Supported Employment, Supportive Housing, Incidental Expenses, Information and Referral, Clubhouse Services, CCST-Individual, CCST-Group, Recovery Support — Individual, Recovery Support—Group. II. Program Goals CAT is intended to be a safe and effective alternative to out-of-home placement for children with serious behavioral health conditions. Upon successful completion, the family should have the skills and natural support system needed to maintain improvements made during services. The goals of the CAT program are to: 1. Strengthen the family and support systems for youth and young adults to assist them to live successfully in the community; 2. Improve school related outcomes such as attendance, grades, and graduation rates; 3. Decrease out-of-home placements; 4. Improve family and youth functioning; Revised Exhibit AJ Page 2 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7 2020 5. Decrease substance use and abuse; 6. Decrease psychiatric hospitalizations; 7. Transition into age appropriate services; and 8. Increase health and wellness. III. Eligibility The following participation criteria are established in proviso and must be adhered to by the Network Provider: 1. Otherwise eligible for publicly funded substance abuse and mental health services pursuant to s. 394.674, F.S., and 2. Individuals aged 11 to 21 with a mental health diagnosis or co-occurring substance abuse diagnosis with one or more of the following accompanying characteristics: • The individual is at-risk for out-of-home placement as demonstrated by repeated failures at less intensive levels of care; • The individual has had two or more periods of hospitalization or repeated failures; • The individual has had involvement with the Department of Juvenile Justice or multiple episodes involving law enforcement; or • The individual has poor academic performance or suspensions. 3. Children younger than 11 with a mental health diagnosis or co-occurring substance abuse diagnosis may be candidates if they meet two or more of the aforementioned characteristics. Individuals residing in therapeutic placements such as hospitals, residential treatment centers, therapeutic group homes and therapeutic foster homes; and those receiving day treatment services are not eligible to receive CAT services. IV. CAT Model The CAT model is an integrated service delivery approach that utilizes a team of individuals to comprehensively address the needs of the young person, and their family, to include the following staff: 1. A full-time Team Leader, 2. Mental Health Clinicians, 3. A Psychiatrist or Advanced Registered Nurse Practitioner(part-time), 4. A Registered or Licensed Practical Nurse (part-time), 5. A Case Manager, 6. Therapeutic Mentors, and 7. Support Staff The Network Provider must have these staff as part of the team; however, the number of staff and the functions they perform may vary by team in response to local needs and as approved by the Managing Revised Exhibit AJ Page 3 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inc.) 7/ / 020 Entity.CAT members work collaboratively to deliver the majority of behavioral health services,coordinate with other service providers when necessary, and assist the family in developing or strengthening their natural support system. CAT funds are used to address the therapeutic needs of the eligible youth or young adult receiving services. However, the CAT model is based on a family-centered approach in which the CAT team assists parents or caregivers to obtain services and supports, which may include providing information and education about how to obtain services and supports, and assistance with referrals. The number of sessions and the frequency with which they are provided is set through collaboration rather than service limits. The team is available on nights, weekends, and holidays. In the event that interventions out of the scope of the team's expertise, qualifications, or licensure (i.e., eating disorder treatment, behavior analysis, psychological testing, substance abuse treatment, etc.) are required, referrals are made to specialists, with coordination from the team. This flexibility in service delivery is intended to promote a "whatever it takes" approach to assisting young people and their families to achieve their goals. Best Practice Considerations: Models and Approaches for Working with Young People and Their Families 1. The Transition to Independence Process(TIP) model is an evidence-supported practice based on published studies that demonstrate improvements in real-life outcomes for youth and young adults with emotional/behavioral difficulties (EBD). http://ti gsta rs.orgZHom e.aspx 2. The Research and Training Center for Pathways to Positive Futures (Pathways) aims to improve the lives of youth and young adults with serious mental health conditions through rigorous research and effective training and dissemination. Their work is guided by the perspectives of young people and their families, and based in a positive development framework. httg://www.pathwaysrtc.gdx.ed u/a bout 3. National Wraparound Initiative - Wraparound is an intensive, holistic and individualized care planning and management process that engages and supports individuals with complex needs (most typically children, youth, and their families) to live in the community and realize their hopes and dreams. httgs://nwi.gdx.edu/wraparound-basics 4. Strengthening Family Support for Young People:Tip sheet for strengthening family support. http://www.pathwaysrtc.pdx.edu 5. Positive Youth Development (PYD), Resilience and Recovery: Actively focuses on building strengthens and enhancing healthy development. http://www.pathwaysrtc.pdx.edu 6. Section 394.491, F.S. —Guiding principles for the child and adolescent mental health treatment and support system. Revised Exhibit AJ Page 4 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida 'Contracting as South Florida Behavioral Health Netvvork, Unc.) 7/1/2020 7. Youth M.O.V.E. National 'Youth M.O.V.E is a youth led national organization devoted to improving services and systems that support positive growth and development by uniting the voices of individuals who have lived experience in various systems including mental health, juvenile justice,education, and child welfare.There are chapters in Florida and opportunities for young people to learn leadership and advocacy skills and to get involved with peers. V. Serving Young Adults TheCATpro0ramservesyoun0adu|tsuptothea0eoftvxenty'one (Z1),vxhichindudesyoun0adu|tsa0es eighteen (18) uptotwenty (ZU) vxho are legally considered adults. Network Service Providers serving these young adults must consider their legal rights to make decisions about their treatment, who will be involved,and with whom information will beshared. |n keeping with the focus of the CAT model, Network Service Providers should support the young person to enhance and develop relationships and supports within their family and community, guided by their preferences. VI. Coordination With Other Key Entities It is important for Network Service Providers to address the provision of services and supports from a comprehensive approach, which includes coordination with other key entities providing services and supports to the individual receiving services. In collaboration with and based on the preferences of the individual receiving services and their parent/legal guardian (if applicable). Network Service Providers should identify and coordinate efforts with other key entities as part of their case management function, which include but are not limited to: primary health care, child welfare,juvenile justice, corrections, and special education. If the individual receiving services is a minor served by child welfare, members of their treatment team must include their child welfare Case Manager and guardian ad litem (if assigned). If and how the parent will be included in treatment should be determined in coordination with the dependency case manager, based on individual circumstances. Network Service Providers must document efforts to identify and coordinate with the other key entities in the case notes. VU.Screening and Assessment Within 45 days of an individua|'s admission to services, the Network Service Provider must complete the North Carolina Family Assessment Scale for General Services and ReunificationO (NCFAS'G+R) as the required initial assessment to assist in identifying areas of focus in treatment.The NCFAS'G+R and Plans of Care(initial and Master) must be completed for all individuals served,to include those transferred from another program within the same agency. Network Service Providers are encouraged to use a variety of reliable and valid screening and assessment tools in addition to the NCFAS'G+R as part of the assessment process, with focus on screening for co- occurring mental health and substance use disorders. Additionally, Network Service Providers are encouraged to gather collateral information in coordination with the individual served and their family, to include such things as: school records; mental health and substance abuse evaluations and treatment Revised Exhibit A] Page SoflQ Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inc.) 2/1/2020 history; and level of cognitive functioning to develop a comprehensive understanding of the young person's and their family's circumstances. As with best practice approaches such as Systems of Care and Transition to Independence, the screening and assessment process should focus on identifying competencies and resources to be leveraged as well as needs across multiple life domains, such as education,vocation, mental health, substance use, primary health, and social connections. Best Practice Considerations:Screening and Assessment Resources 1. The California Evidenced-based Clearinghouse for Child Welfare—Assessment ratings and how to determine if an assessment is reliable and valid. http://www.cebc4cw.org/assessment-tools/assessment-ratings/ 2. The REACH Institute offers a listing of mental health screening tools, assessments and tool kits. GLAD-PC Toolkit and T-MAY 3. Screening and assessment resources for co-occurring mental health and substance use disorders. • The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions and offers a compendium of validated screening and assessment instruments and tools for mental and substance use disorders. http://www.i ntegration.sa m hsa.gov/cl i n ica I-practice/screen i ng-tools • SAMHSA Co-occurring Center for Excellence—Integrated Screening and Assessment http://media.samhsa.gov/co-occurring/topics/screening-and- assessment/index.aspx • Alcohol & Drug Abuse Institute - University of Washington: Info Brief: Co-Occurring Disorders in Adolescents. Provides an extensive list of resources related to screening, assessment and integrated treatment. http://adai.uw.edu/pubs/infobriefs/ADAI-IB-2011-01.pdf 4. Casey Life Skills assessment is a free practice tool and framework developed for working with youth in foster care; however, it is beneficial for any young person. It is a self-assessment of independent living skills in eight areas that takes about 30 minutes to complete online and provides instant results. http://I ifesl<i I Is.casey.org/ 5. Youth Efficacy/Empowerment Scale and Youth Participation in Planning Scale-Portland Research and Training Center(Pathways RTC): http://www.pathwaysrtc.pdx.edu Revised Exhibit AJ Page 6 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, lnc.) 2/1/2020 . Strengths, Needs and Culture Discovery Assessment-To explore individual and family strengths, needs, culture, and vision and to use these to develop a document that will serve as the starting point for planning. https://nwi.pdx.edu/ Vill. Treatment Planning Process The treatment planning process serves to identify short-term objectives to build long-term stability, resilience, family unity and to promote wellness and illness management. A comprehensive,team-based approach is increasingly seen as the preferred mechanism for creating and monitoring treatment plans and is consistent with the CAT program. There is evidence that outcomes improve when youth and families participate actively in treatment and their involvement is essential at every phase of the treatment process, including assessment, treatment planning, implementation, and monitoring and outcome evaluation.' Working as a team, the young person,family, natural supports, and professionals can effectively support individualized, strength-based, and culturally competent treatment. Network Service Providers are encouraged to focus on engagement of the young person and their family as a critical first step in the treatment process, as well as the promotion of active participation as equal partners in the treatment planning process. Best Practice Considerations:Treatment Planning for Young People with Behavioral Health Needs 1. Achieve My Plan (AMP) -The AMP study is testing a promising intervention that was developed by researchers at Portland State University, in collaboration with young people who have mental health conditions, service providers and caregivers.Tip sheets for meeting facilitators and young people, the Youth Self-efficacy/Empowerment Scale and Youth Participation in Planning Scale and a video entitled Youth Participation in Planning can be found at: http://www.pathwaysrtc.pdx.edu/prof-3-amp 2. Family and Youth Participation in Clinical Decision Making. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/aacap/Policy State ments/2009/Family and Youth Participation in Cli nical Decision Makin .aspx 3. Individual and Family Team meetings.The Wraparound process promotes Individual and Family team meetings that includes the individual, their family, professionals working with the family and their natural support systems. The initial Wraparound plan is developed during the initial Child and Family Team meetings. Individual and Family team meetings are held every 30 days to See,http://www.aacap.org/aacap/Policy_Statements/2009/Family_and_Youth_Participation_in_Clinical_Decision_Makinq.aspx Revised Exhibit AJ Page 7 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida 'Contracting as South Florida Behavioral Health Netvvork, Unc.) 7/1/2020 monitorthe Wraparound plan to ensure effectiveness and to revise as needed to ensure the plan best matches the individua|'s and fami|y's self-identified needs. |X. Plan mfCare l. Initial Plan of Care Within 30 days of an individua|'s admission to services, the Network Service Provider must complete an Initial Plan of Care to guide the provision of services by the CATteam. Services and supports by the CAT team are established in the Initial Plan of Care, which provides sufficient time to complete the NCFAS'G+R within the first 45 days. Review of the Initial Plan of Care is required to ensure that information gathered during the first 60 days is considered and that a Master Plan of Care is developed to articulate the provision of services and supports longer-term. The Network Service Provider must document that the Initial Plan of Care was reviewed with the individual being served and his or her parent or guardian and request that they sign the plan at the time of review.At a minimum,the Initial Plan of Care must: * Be developed with the participation of the individual receiving services and his or her family, including caregivers and guardians; * Specifythe CAT services and supports to be provided by CATTeam members,to include a focus on engagement, stabilization, and a safety planning if needed; and * Include a brief initial discharge planning discussion, to include the general goals to be accomplished prior to discharge. 2. Master Plan mfCare Within 60 days after admission,the Network Service Provider must review the Initial Plan of Care and update it as needed to include the NCFAS-G+R initial assessment and other information gathered since admission.The Network Service Provider will implement the updated Initial Plan of Care as the Master Plan of Care.The Network Service Provide may adopt an unrevised Initial Plan of Care if it meets the requirements of the Master Plan of Care and includes the initial NCFAS-G+R assessment.At minimum the Master Plan of Care must: * Be strength-based and built on the individua|'s assets and resources; * Be individualized and developmentally appropriate to age and functioning level; * Address needs in various life domains, asappropriate; * Integrate substance abuse and mental health treatment when indicated; * Specify measurable treatment goals and target dates for services and supports; * Specify staff members responsible for completion of each treatment goal; and * Include a discharge plan and identify mechanisms for providing resources and tools for successful transition from services. At minimum, the Network Service Provider must review and revise the Master Plan of Care every three months thereafter until discharge, or more frequently as needed to address changes in circumstances impacting treatment and discharge planning. In each review, the Network Service Revised Exhibit A] Page QoflQ Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inc.) 7/ /2020 Provider must include active participation by the individual receiving services,and his or her family, caregivers, guardians, and other key entities serving the individual as appropriate. Best Practice Considerations: Developing a Plan of Care 1. The Wraparound Approach in Systems of Care http://www.oregon.gov/oha/a m h/wra pa rou nd/flocs/wra ga rou nd-approach-soc.gdf 2. Achieve My Plan (AMP): Youth participation in planning — provides tools, tip sheets for professionals and youth https://www.pathwaysrtc.pdx.edu/p3c-achieve-my-plan 3. Journal of Child and Family Studies (May, 2017): Increasing Youth Participation in Team-Based Treatment Planning:The Achieve My Plan Enhancement for Wraparound: https://www.pathwaysrtc.pdx.edu 4. Community-based Approaches for Supporting Positive Development in Youth and Young Adults: RTC Pathways http:/Zwww.pathwaysrtc.pdx.edu X. Services and Supports The mix of services and supports provided should be dictated by individual needs and strengths, serve to strengthen their family, and provide older adolescents with supports and skills necessary in preparation for coping with life as an adult. ' Services and supports and the manner of service provision should be developmentally appropriate for the individual. For older youth, services and supports may include supported employment and vocation certification, independent living skills training, and peer support services to assist in building social connections and learning new skills. It is important to discuss the roles and responsibilities of the CAT team members with the individual and family to ensure they understand the roles and responsibilities of each.This is especially important to clarify the role of the peer or mentor, as this person may promote social connectedness and assist in the development of a support network of friends outside of the CAT program. Network Service Providers are encouraged to offer an array of formal treatment interventions and informal supports provided in the home or other community locations convenient and beneficial to the individual and family. Network Service Providers are encouraged to assist the individual and family to develop connections to natural supports within their own network of associates, such as friends and neighbors,through connections with community, service and religious organizations, and participation in clubs and other civic activities. Natural supports ease the transition from formal services and provide ongoing support after discharge.' Formal treatment services may include evidenced-based practices appropriate to the circumstances of the young person and their family. Network Service Providers are encouraged to leverage resources and 2Chapter 394.491,F.S.-Guiding principles for the child and adolescent mental health treatment and support system. http://www.leg.state.fl.us/statutes/index.cfm?App mode=Display Statute&Search String=&URL=0300-0399/0394/Sections/0394.491.html 3Transition Youth with Serious Mentallllness:http://www.apa.org/abouYgr/issues/cyf/transition-youth.pdf Revised Exhibit AJ Page 9 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inc.) 7/1/2020 opportunities to implement evidenced-based practices with fidelity, which may include partnering with other CAT teams or organizations in the local system of care. Support services and natural supports are interventions developed on an individualized basis and tailored to address the individual's and family's unique needs, strengths, and preferences. Support services may include but are not limited to: Family Support Specialists; participation in recreational activities; youth development and leadership programs;temporary assistance in meeting and problem-solving basic needs that interfere with attaining treatment goals; and independent living skills training. Best Practice Considerations: 1. Pathways Transition Training Collaborative (PTTC): Community of Practice Training: Provides training and TA materials for serving youth and young adults —Set of competencies; Transition Service Provider Competency Scale; On-line training modules focused on promoting positive pathways to adulthood. https://www.pathwaysrtc.pdx.ed u/pathways-transition-tra i n i ng-collaborative 2. Access to Supports and Services. National Wraparound Initiative: http://www.nwi.pdx.ed u/s u pportsservices.s htm I#1 3. HHS: Office of Adolescent Health: Research, resources and training for providers, fact sheets, grant opportunities: https://www.hhs.gov/ash/oah/adolescent-development/mental-health/mental-health- disorders/index.html 4. RTC Pathways -Youth Peer Support https://www.pathwaysrtc.pdx.edu XI. Discharge As part of the discharge planning process, CAT teams assist in identification of additional resources that help individuals and families maintain progress made in treatment. Throughout treatment, the Network Service Provider should focus on successful transition from services. As the individual moves into the discharge phase of treatment, the CAT Team may determine the need to modify the service array or frequency of services to ease transition to less intensive services and supports. Network Service Providers are encouraged to implement a discharge planning process that: 1. Begins at admission; 2. Includes ongoing discussion as part of the Plan of Care review; 3. Includes active involvement of the individual and family; 4. Includes transition to the adult mental health and other systems, as appropriate; and 5. Includes an aftercare plan submitted to and developed in collaboration with the individual and family that leverages available community services and supports. Revised Exhibit AJ Page 10 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7 2020 Within seven calendar days of an individual's discharge from services, the Provider must complete a Discharge Summary containing the following items, at a minimum: 1. The reason for the discharge; 2. A summary of CAT services and supports provided to the individual; 3. A summary of resource linkages or referrals made to other services or supports on behalf of the individual; and 4. A summary of the individual's progress toward each treatment goal in the Master Plan of Care. XII. Incidental Expenses Pursuant to chapter 65E-14.021, F.A.C., temporary expenses may be incurred to facilitate continuing treatment and community stabilization when no other resources are available. Allowable uses of incidental funds include: transportation, childcare, housing assistance, clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals, and other incidentals that can demonstrate support of individual's treatment plan or other allowable uses. Network Service Providers must follow state purchasing guidelines and any established process for review and approval; however, Network Service Providers are encouraged to be creative in using these funds within the limits of what is allowable and to consult the Managing Entity regarding allowable purchases. XIII.Third-Party Services Services provided by the core CAT Team staff and funded by CAT contract dollars cannot be billed to any third-party payers. Services provided outside of the core CAT Team staff may be billed to Medicaid or private insurance, to the extent allowable under these programs. If there is an imperative need to provide these services or supports sooner than later, the CAT team should use CAT funds to meet this need, while pursuing third-party billing. If and individual requires interventions outside the scope of a team's expertise, qualifications or licensure (i.e.,eating disorder treatment, behavior analysis, psychological testing,substance abuse treatment,etc.), the team may refer to a qualified service provider. The CAT team must work in concert with any referral providers,the individual and the family to integrate referral services into overall treatment and to monitor progress toward treatment goals In accordance with chapter 65D-30.003, F.A.C.,all substance abuse services,as defined in subsection 65D- 30.002(16), F.A.C., must be provided by persons or entities that are licensed by the department pursuant to Section 397.401, F.S., unless otherwise exempt from licensing under Section 397.405, F.S., prior to initiating the provision of services. XIV. Performance Measures The Managing Entity must include the following performance measures in each subcontract for CAT services: 1. School Attendance Revised Exhibit AJ Page 11 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 Individuals receiving services must attend an average of 80% percent of school days, according to the following methodology: b. Calculate the percentage of available school days attended by all individuals served during the reporting period. • Include all individuals served age 15 and younger. • Include only those individuals age 16 and older who are actually enrolled in a school or vocational program. • For individuals in alternative school settings, such as virtual and home school, school attendance may be estimated based on specific requirements applicable to the setting. Examples include the percentage of work completed within a specified time- period;adherence to a schedule as reported by the parent,caregiver or legal guardian or documentation of a reporting mechanism. • Do not include individuals for whom school attendance in an alternative education setting cannot be determined. • Do not include any days an individual is considered medically excused as a result which in a crisis stabilization unit. c. The numerator is the sum of the total number of school days attended for all individuals. d. The denominator is the sum of the total number of school days available for all individuals. 2. Children's Functional Assessment Rating Scales(CFARS)and Functional Assessment Rating Scale (FARS) Effective once the Network Service Provider discharges a minimum of 10 individuals each fiscal year, 80% of individuals receiving services must improve their level of functioning between admission to discharge, as determined by: a. The Children's Functional Assessment Rating Scales(CFARS) if the individual is under 18 years of age; or b. The Functional Assessment Rating Scale(FARS), if the individual is 18 years of age or older. • Measure improvement is based on the change between the admission and discharge assessment scores completed using the CFARS or FARS, as determined by the age of the individual. c. The numerator is the total number of individuals whose discharge score is less than their admission assessment score. Scores are calculated by summing the score for all questions for each person discharged during the current fiscal year-to-date. A decrease in score from the admission score to the discharge score indicates that the level of functioning has improved. d. The denominator is the total number of individuals discharged with an admission and discharge assessment during the current fiscal year-to-date. 3. Living in a Community Setting Individuals served will spend a minimum of 90%of days living in a community setting: a. The numerator is the sum of all days in which all individuals receiving services qualify as living in a community setting. Revised Exhibit AJ Page 12 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 7/ / 020 • "Living in a community setting" excludes any days spent in jail, detention, a crisis stabilization unit, homeless,a short-term residential treatment program,a psychiatric inpatient facility or any other state mental health treatment facility. • Individuals living in foster homes and group homes are considered living in a community setting. • For children under 18 years of age,days spent on runaway status, in a residential level one treatment facility, or in a wilderness camp are not considered living in a community setting. b. The denominator is the sum of all days in the reporting period during which all individuals were enrolled for services. 4. North Carolina Family Assessment Scale for General Services and Reunification (NCFAS-G+R) Effective once the Provider discharges a minimum of 10 individuals each fiscal year, 80% of individuals and families receiving services must demonstrate improved family functioning as demonstrated by an improvement in the Child Well-Being domain between admission and discharge, as determined by the North Carolina Family Assessment Rating Scale for General Services and Reunification(NCFAS-G+R), if the individual is under eighteen (18).The NCFAS-G+R is not required for individuals ages 18 or older. a. Calculate the percentage of individuals who increased their family functioning in the Child Well-Being Domain by at least one point from admission to discharge, as measured by the NCFAS-G+R. b. The numerator is the number of individuals whose score on the Child Well-Being domain at discharge is at least one point higher than their score on the Child Well-Being domain at admission during the current fiscal year-to-date. c. The denominator is the total number of individuals receiving services who were discharged during the current fiscal year-to-date and for whom the NCFAS-G+R was used at admission. Note: If an admission NCFAS assessment has been completed on a child and parent/caregiver and the child moves to a different home with a different caregiver, a NCFAS discharge assessment should be completed at that time to ensure the same parent/caregiver is assessed at admission and discharge. Additional consideration should be given to the following: • If CAT services are continued in the new placement with the new parent/caregiver, an admission and discharge NCFAS assessment should be completed for the new pa rent/caregiver. • If a child changes placements multiple times, the provider and ME should discuss how to report on the NCFAS performance measure for that child, keeping in mind that the NCFAS measures family functioning in the context of services received, so we need to know who received services to determine the level of improvement in functioning. Revised Exhibit AJ Page 13 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 APPENDIX 1 PERSONS SERVED AND PERFORMANCE MEASURE REPORT CAT PROGRAM Provider Name Contract Number Reporting Period From ( To Reporting Requirement Target This Period This Quarter to Year to Date Date DELIVERABLE Number of Persons Served Section D-2 1st Month= 10 Min _ per 2nd Month=20 month 31d Month= 25 Thereafter= 35 o 4: MINIMUM PERFORMANCE MEASURES—Section XV E E E r E a E r L � L Z o a Z o a Z o a School Attendance 80% Improved Level of Functioning, based upon 80% CFARS or FARS Living in a Community Setting 90% Improved Family Functioning, based on Child 65% Well-being Domain, NCFAS-G+R Notes: 1. Performance measures for CFARS/FARS and NCFAS will become effective once the Provider discharges a minimum of 10 individuals. 2. Providers may use the space below to provide performance-related details affecting the delivery of services according to the specified targets. (Optional) ATTESTATION I hereby attest the information provided herein is accurate, reflects services provided in accordance with the terms and conditions of this contract, and is supported by client documentation records maintained by this agency. Authorized Name and Title (please print) Signature Date Revised Exhibit AJ Page 14 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral avioral Health Network, inn. :t iJ APPENDIX 2 QUARTERLY SUPPLEMENTAL DATA REPORT CAT PROGRAM Provider Name Contract # Reporting From To Period Individuals Diverted from Out of Home Placement At admission,number of participants at At admission, risk of out of home placement due to: number of Total Discharge Options Child Residential Juvenile participants not This Total mental at risk of out of Quarter Year to Date Welfare health justice involvement treatment commitment 4 home placement 4 Numberof discharges removed from the home due to child welfare involvement 111111"Nu 11 mberof11 d 11 i 11 s 11 ch 11 ar 11 ge 11 s admitted to a residential mental health treatment center Number of discharges committed to juvenile justice placement Number of discharges living in the community Totals Use the space below to provide any discussion of details affecting the delivery of services and supplemental data. (Optional) Gainful Activity for Individuals Not Enrolled in School or a Vocational Program Required Reporting Total This Quarter Total Year to Date Number of individuals served during the reporting period age 16 and older not included in the school attendance measure. Number of these individuals that engaged in at least one gainful activity during the reporting period. Use the space below to provide examples of the gainful activities these individuals engaged in during the reporting period. ATTESTATION I hereby attest the information provided herein is accurate,reflects services provided in accordance with the terms and conditions of this contract,and is supported by client documentation records maintained by this agency. Authorized Name and Title (please print) Signature Date Revised Exhibit AJ Page 15 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inc.) 0 Appendix 2 Guidance The following guidelines must be used by CAT Network Service Providers and Managing Entities when reporting the required quarterly data using Appendix 2. 1. Discharge placements for individuals identified at admission as at risk of out of home placement A primary CAT program goal is diverting these individuals from placement within the juvenile justice, corrections, residential mental health treatment or child welfare systems, and enabling them to live effectively in the community. The considerations below are non-exhaustive guidelines by which CAT Network Service Providers can determine if an individual is at high risk of out of home placement at the time of admission. a. Residential Mental Health Treatment including therapeutic group homes • Has a recommendation from a psychologistl psych iatrist for placement in residential mental health treatment center? • Has a recommendation from a Qualified Evaluatorfor placement in residential treatment(child welfare)? • Has previously been placed in residential treatment? • Is the parent/legal guardian is requesting placement in a residential mental health treatment center? b. Department of Juvenile Justice(DJJ) Placement • Are there current DJJ charges or is there a long history of charges? • Was there previous DJJ commitment placement? • Does a child aged 12 and under have current or previous DJJ charges? c. Child Welfare Out of Home Placement • Is there an open Child Welfare case or investigation? • Were there previous child welfare cases, investigations or services? • Were there any previous out-of-home Child Welfare placements? 2. Gainful Activity for Individuals Not Enrolled in School or Vocational Program Participation in gainful activities by individuals aged sixteen and older who are not enrolled in school or vocational programs is an indicators of program success in fostering self-sufficiency.These activities should focus on employment, continued education,vocation training and certification,work readiness, career planning,and skill development related to obtaining and keeping a job. These activities are opportunities for a therapeutic mentor to assist individuals in identifying personal goals and developing plans. Examples of enrichment activities include, but are not limited to, employment and supported employment; internships and apprenticeships; linkage to and services from entities such as Vocational Rehabilitation;and activities that support career planning, occupational research and assessment. Revised Exhibit AJ Page 16 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inc.) 7/1/2020 APPENDIX 3 CAT Return on Investment Network Service Provider: Managing Entity: South Florida Behavioral Health Network, Inc. Cumulative Fiscal Year-To-Date Through: Days Involved Number of Clients Actual Costs Per Day Total Costs YTD Clients Served in CAT Clients Discharged from CAT \\\>\�\\\\l3it, �)�\}3{�\;4€i\,\j\i\;�tllit\\k(\\\Ss\Ji\\4\\ilif\i��t�€iil3\114`i�}\1\jt4j}731��\ct'ssttiil}�t3��\tit,'\;\?ttlri\\ Clients Discharged from CAT who Remain in Community The Clients discharged from CAT were diverted from: Cost Per Day Annualized Cost Avoided Diverted from Child Welfare $170 Diverted from Juvenile Justice $223 Diverted from Psychiatric $487.42 Residential(SIPP) Total Cost Avoidance ROI Differential(Total Cost Avoidance less Total Costs YTD) Return on Investment(Total Cost Avoidance divided by Total Costs YTD) Attestation I hereby attest the information provided herein is accurate,reflects services provided in accordance with the terms and conditions of this contract,and is supported by client documentation records maintained by this agency. Authorized Name and Title (Please Print) Signature Date: Revised Exhibit AJ Page 17 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 Appendix 4 CAT TEAM MONTHLY INVOICE PROVIDER NAME CONTRACT NO. FEDERAL ID# VENDOR ID (if different from Federal ID#) ADDRESS INVOICE NUMER INVOICE PERIOD INVOICE AMOUNT TOTAL AMOUNT OF PREVIOUS TOTAL CONTRACT AMOUNT CONTRACT BALANCE AFTER Service Unit Description One month of CAT services provided to a minimum of 35 eligible individuals in accordance with Contract Sections Appendix-1 and Appendix-2 Fixed Fee Amount Requested Supporting Documentation Appendix 1 for the month of: Submitted CERTIFICATION&APPROVAL I certify the above to be accurate and in agreement with this agency's records and with the terms of this agency's contract with the ME. Additionally, I certify that all client demographic and service event data have been submitted to the ME in accordance with the terms and conditions of this contract. Authorized Signature Authorized Name and Title Date Submitted For ME Finance Department use only: Date Invoice Received: Date Goods/Services Received: Date Inspected and Approved: Description Financial Consequences Applied? Reduction Amount Yes No Approved PaymentAmount Approved By: BE: EO: Payment Funding Codes: CAT: OCA: Revised Exhibit AJ Page 18 of 18 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, Mc.) 7/ /2020 EXHIBIT AM Return on Investment for Special Projects funded for FY 2020-2021 I. The Network Provider has been awarded funding to provide the following services: Provider: Guidance/Care Center, Inc. a. Project: Family Intensive Treatment(FIT) Amount: $633,188.00 Designated as follows: Miami-Dade County: $483,871.00 Monroe County: $149,317.00 b. Project: Supported Employment Amount: $75,000.00 II. The Network Provider shall submit the following reports: 1. By July 10, 2020 provides an initial projected estimate of positive return on investment the state may receive by providing the funding, and, 2. No later than 10 days after the completion of each fiscal quarter, provide a report documenting the actual return on investment the state has received as a result of this funded project. The Network Provider shall describe the methodology by which the return of investment was determined. A return on investment can vary and can include increased jobs and revenue to the state; reduced recidivism or involvement in the juvenile justice system; improved health care costs, quality, and access; or improvements to water quality. Actual returns by fiscal year should be included if state funding was previously received, as well as projected positive returns based on current fiscal year funding. 3. Supported Employment Report: No later than the 10 days after the completion of each fiscal year quarter, submit the Supported Employment Tracking Log, herein incorporated by reference and available upon request to the ME's Contract Manager. Exhibit AM Page 1 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/1/2020 The reports must be submitted by the dates and to the individual(s) identified in Exhibit C, Required Reports. Exhibit AM Page 2 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 2/ /2020 EXHIBIT AN Supplemental Security Income/Social Security Disability Insurance(SSI/SSDI)Outreach,Access,and Recovery(SOAR) SOAR is a national project funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) that is designed to increase access to SSI/SSDI for eligible adults and children with mental illnesses or co-occurring disorders who are homeless or at risk of homelessness. Access to SSI/SSDI is a major tool in recovery from mental illnesses, homelessness or co-occurring disorders to engage in treatment, to keep appointments, to maintain housing, and to meet other basic needs. SOAR must be guided by the principles of Recovery Oriented Systems of Care, including community inclusion, person- driven, and team collaboration. SOAR processors should work with the person-served to determine their needs and desires during the application process and, furthermore, allow the process trajectory to be determined to the greatest extent by the person-served. This will include keeping the individual fully informed of the process and the possible results, and including community partners that the individual would like to incorporate into the decision-making process. I. NETWORK PROVIDER RESPONSIBILITIES 1. Designation of a SOAR Processor: The Network Provider must have a designated Case Manager(s)/SOAR Processor(s) trained in the SOAR Process who will process SOAR applications for the target population receiving services under this contract that have been screened and determined to be eligible for SOAR benefits. The required screening tool was developed by the Department and the ME and is found in Appendix 1 of this Exhibit titled"SOAR Applicant Eligibility Criteria Form" dated July 1, 2020, or the latest revision thereof. The Case Manager(s)/SOAR Processor(s) is responsible for their own training in the SOAR Model through the SOAR Online Course developed by Policy Research Associates and SAMHSA available at: https://soarworl<s.prainc.com/content/soar-online-course-catalog A SOAR Processor is identified as a staff that has completed the adult and/or child SOAR Online Course and is submitting applications utilizing the SOAR process. 2. Each Case Manager/SOAR Processor at the Network Provider is responsible for entering their information and data into the SOAR Online Application Tracking (OAT) system. The Network Provider is responsible for notifying the ME about information regarding their Case Manager/SOAR Processor. This includes their name, SOAR Training Completion status, and their registration in OAT. 3. Eligibility Screening: Screening for SOAR eligibility must be conducted during the intake or admissions process. Upon determination that an individual meets SOAR eligibility, the screener must refer the individual to the designated SOAR Trained Processor utilizing the "SOAR Applicant Eligibility Criteria Form". Exhibit AN Page 1 of 4 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/ /2020 4. Timeframes for Completion of Applications: SOAR applications must be completed within a maximum of sixty (60) days of the protective filing date. This may vary depending on the Social Security Administration (SSA) office and the SOAR Liaison at that office. The SOAR Processor is responsible for going to their local SSA office and forming an agreement between themselves and the SSA SOAR Liaison about specific timeframes and what form of communication is best. 5. Reconsiderations/Appeals: If applicable, the SOAR Processor must complete the reconsideration/appeal process for those applications which may be denied upon initial review. 6. Data Requirement (OAT System): The SOAR Processor must register and start entering information into the OAT system once the protective filing date is determined. They should not wait for the application decision to be made before they enter data into the OAT system. The SOAR Processor(s) must input all of the data into the OAT System before the end of the month for processed applications during the reporting period. The SOAR Processor(s) shall be responsible for ensuring that the information in the OAT System is updated regularly as necessary. The OAT program is available at: https://soartracl<.prainc.com/lo in.php 7. Training: New SOAR Processor(s) must be trained within forty-five(45)days of hire or assignment to SOAR cases. The SOAR Processor(s) is responsible for their own training in the SOAR Model through the SOAR Online Course developed by Policy Research Associates and SAMHSA available at: https://soarworl<s.prainc.com/content/soar-online-course-catalog All SOAR Processors must attend a Live SOAR Online Course Review Session once to obtain status as Southern Region certified SOAR Processor, after completion of the SOAR Online Course. These sessions will be held on a quarterly basis and scheduled by the ME. SOAR processors need only attend once to obtain their certification. For those newly trained SOAR Processors through the SOAR Online Course,attendance to the Live SOAR Online Course Review Session should be completed within six(6) months. 8. The Network Provider is responsible for notifying the ME regarding the training status of their Case Manager/SOAR Processor. 9. The SOAR Processor(s) must attend scheduled or specially called meetings when notified by the ME. These include SOAR group technical assistance trainings and SOAR related trainings. 10. The Network Provider must meet with the ME's staff at regularly scheduled or specially called meetings and/or trainings when notified by the ME. Exhibit AN Page 2 of 4 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 7/ /2020 11. Individual Record Reviews: The Network Provider must conduct a sampling of file/record reviews on a quarterly basis to see if individuals paid for by SAMH dollars would be eligible for SOAR. a. The provider will complete five individual record reviews from various programs within their agency. b. The provider will also complete file/record reviews for five indigent individuals identified by the Me Housing Coordinator as receiving transitional vouchers(TRV)during the quarter. Individuals placed in TRV funded shelter beds will be excluded from reviews as will recurring TRV requests. Only new TRV requests as of 7/1/18 will be eligible for review. c. Within fifteen days after each quarter, the network provider is required to submit a report of the sampling results to the ME. The report requires the individual's identifying information (name, DOB, SS#), the date of SOAR eligibility screening, admission date, a copy of the completed screening tool (SOAR Applicant Eligibility Criteria Form version of Identifying SOAR Applicants,July 1,2020), documentation of the referral (if appropriate)to the SOAR Processor, and the completed/submitted SOAR application data entered into OAT. These instructions are on the SOAR Applicant Eligibility Criteria Form version of Identifying SOAR Applicants,July 1,2020 document. 12. Performance Outcomes &Outputs:The Network Provider must meet the standards and required outcomes specified below: a. Maintain a minimum completion rate of 75% of applications completed and submitted within 60 days of the Protective Filing Date. b. At a minimum, the Network Provider must have a sixty-five percent (65%) SOAR application approval rating during each fiscal year. c. Maintain the minimum negotiated quarterly target of 4 for completed applications. d. In addition to the minimum quarterly targets, the Network Provider agrees to an annual target of 16. The Network Provider understands that the annual total may be higher as the expectation is that in some quarters the minimum target will be exceeded. Annual target will be measured at the end of the 4th quarter. e. 13. Children's SOAR a. SOAR processors must be trained within forty-five(45)days of hire or assignment to SOAR cases, and provide certificate copies, within ten (10) business days of completion, to the ME's SOAR Local Lead. The Children's SOAR Online Course is available at: https://soarworl<s.prainc.com/course/soar-child-curriculum b. The Network Provider shall submit to the ME's SOAR Local Lead a quarterly report using the "SOAR Applicant Eligibility Criteria Form" to provide the number of screenings completed for the reporting period and number of eligible SOAR candidates. The report requires the individual's identifying information (name, DOB, SS#), the date of SOAR eligibility screening, admission date, a copy of the completed screening tool (SOAR Applicant Eligibility Criteria Form version of Identifying SOAR Applicants, July 1,2020), documentation of the referral (if appropriate) to the SOAR Processor, and the Exhibit AN Page 3 of 4 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Mc.) 2/ /2020 completed/submitted SOAR application data entered into OAT. These instructions are on the SOAR Applicant Eligibility Criteria Form version of Identifying SOAR Applicants, July 1,2020 document. Network Provider Compliance: Failure to meet the applicable standards established in Sections I and II shall be considered non-performance pursuant to Standard Contract, Paragraph 36. Financial Consequences for Network Provider's Failure to Perform. II. MANAGING ENTITY RESPONSIBILITES 1. The ME must adhere to the requirements identified in the Department's Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR) Guidance Document—Incorporated Document 9. The Department's Incorporated Document 9 can be accessed by visiting the Department's website or by clicking on the link below: https://www.myflfa m i l ies.com/service-progra ms/sa m h/ma nagi ng-entities/i ndex.shtm I Note: To access the form click on FY20-21 ME Templates and click on Guidance 9—Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR). 2. The ME must ensure that the Network Provider implements the SOAR process. 3. The ME must monitor the Network Provider's performance on all tasks identified in this Exhibit and issue corrective actions if deemed necessary. 4. The ME shall provide training and technical assistance when requested by the Network Provider. 5. The ME SOAR Local Lead and the identified System of Care staff will collect and review the sampling of the SOAR screening tools and develop a tracker for success indicator analysis. 6. Reports generated by the ME SOAR Local Lead on the success indicator will be reviewed at each quarterly SOAR Steering Committee meeting. Exhibit AN Page 4 of 4 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 2/ /2020 EXHIBIT AO Peer Services Peer Support Specialists have become an integral part of recovery services nationwide. The state of Florida has committed to delivering behavioral health services in a recovery-oriented and peer involved approach. A Peer Specialist is a person who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings to promote mind-body recovery and resiliency [SAMHSA.gov]. A Peer Support Specialist may go by different names (e.g. life coach, recovery coach, recovery support specialist, peer bridger, etc.) nevertheless they perform similar duties. The primary activities of peer specialists are to provide support and advocacy, role model recovery, and facilitate positive change. Peer support is voluntary, mutual and reciprocal, equally shared power, strengths-focused, transparent, and person driven [National Practice Guidelines for Peer Supporters—International Association of Peer Supporters]. I. NETWORK PROVIDER RESPONSIBILITIES 1. Attain Client Consent: Initiate peer support services after voluntary consent when there is reason to believe such services will help the client/member's recovery, build resilience, or assist the individual to live successfully in their community with greater purpose. 2. Educate Peer Staff Regarding Community Resources: Peer Specialist can greater assist individuals if the specialist is familiarwith appropriate community resources that can advance the individual's recovery. Peer Specialists should be allowed time for attending trainings and seminars that advance the practice of peer support and further their professional development. 3. Document Peer Services Provided: For example,developing a wellness plan,WRAP Plan,the goals of the individual served, progress notes, linkages, etc. These plans should be updated regularly and documented to review progress. 4. Maintain and Update Internal Policies and Procedures for Peer Services: these should include best practices and standards for delivering peer support services and supervision. Each Network Provider must solicit the input and opinions of Peer Specialists they have on staff when drafting or updating Internal Policies and Procedures. The Network Provider also must institute a process for Peer Specialists to provide perspective and input on all Policies and Procedures at any time; this process may include an online form for the Peer Specialist to complete. 5. Weekly Supervision: weekly supervision meetings are required so case issues are addressed quickly, and also to make sure that the peer specialists are receiving clinical oversight for their own well-being. Exhibit AO Page 1 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 2 2020 6. Reporting Requirements: No later than 15 days after the close of each Quarter of the state fiscal year,the Network Provider must submit to the Managing Entity, the following quarterly reports: A. Employment Report a. Name of the Peer b. Role c. Status (full-time vs. part-time) d. Program of each Peer Specialist (Life Coach, Family Peer, Recovery Coach, etc.). B. A Peer Support Quarterly Tracker, which must include the following information: a. Number of Peers funded by the ME with Network Provider, b. Number of vacancies for Peer Specialists jobs, c. Duration of current Peer Specialist vacancies, d. Number of Individuals served by each Peer Specialist employed by provider, e. Number of attempted contacts with Persons Served, and f. Number of attempted contacts where the Person Served did not consent for services and thus terminated the contact before substantial services were provided. The reports must be submitted electronically in a secured, password protected or encrypted format by the dates and to the individuals specified in Exhibit C, Required Reports. Network Provider Compliance: Failure to meet the applicable standards established in Sections I and II shall be considered non-performance pursuant to Standard Contract, Paragraph 8. Financial Consequences for Network Provider's Failure to Perform. II. MANAGING ENTITY RESPONSIBILITES 1. The ME must monitor the Network Provider's performance on all tasks identified in this Exhibit and issue corrective actions if deemed necessary. 2. The ME shall provide training and technical assistance when requested by the Network Provider. Exhibit AO Page 2 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 2 2020 EXHIBIT AP Mental Health Case Management Standards A. Definitions: The definitions below are for the purposes of this Exhibit. Other definitions may exist in care coordination or other authorities. Caseload means those clients which are managed by a designated case manager. Case management services consist of activities that identify the recipient's needs, plan services, link the service system with the person, coordinate the various system components, monitor service delivery, and evaluate the effect of the services received. This covered service shall include clinical supervision provided to a service provider's personnel by a professional qualified by degree, licensure, certification, or specialized training in the implementation of this service. (Ref. Rule 65E-14.021(4)(c)1.) Service Plan is the part of the clinical record which outlines a comprehensive strategy for improving a client's quality of life and ability to function in the community as meaningfully and independently as possible. It identifies goals and objectives and the services and resources necessary to achieve these goals and objectives. The service plan is designed to integrate the efforts and effects of multiple service and resource providers. The case manager and the client develop the service plan in conjunction with family members, service providers and other entities and individuals necessary to its implementation. Treatment Plan is an individual document or identifiable section of the service plan developed by treatment staff and the client which depicts goals or objectives for the provision of services within specific treatment environments. Examples of treatment environments include, but are not limited to, day treatment,vocational, residential, outpatient and activities of daily living programs. B. Overall Goal of Case Management. The primary goal of care management is to optimize the functioning of individuals who have complex needs by coordinating the provision of quality treatment and support services in the most efficient and effective manner. The desired outcomes for persons using the service system are self-sufficiency and satisfaction in the living, learning, work and social environments of their choice. Case managers shall have at a minimum a bachelor's degree with major course work in a human services field or equivalent training and experience on a year for year basis in a related field. (1) Case management responsibilities include, but are not limited to, the following activities: (a) Development and implementation of a case management assessment: 1. A case management assessment is a holistic review of a client's living situation which includes a determination of the client's strengths and weaknesses, the client's needs and resources, and the strengths and weaknesses of the client's support system. The case Exhibit AP Page 1 of 6 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 manager shall be responsible for the overall completion of the assessment, but shall work with the client and consult with relevant professionals where specific expertise is needed. 2. The case management assessment shall consider information from the following sources: a. Client's assessment of his or her personal situation; b. Input from the family, friends or significant others. Such input shall be sought with the consent of the client; c. Collateral information which may include records dealing with previous psychiatric hospitalizations, outpatient treatment and evaluations, summaries and progress notes from other involved human service individuals or agencies. If collateral information is not available, this shall be documented in the case record; d. Information from the referral source; e. Pertinent service agencies with whom the client is involved and an evaluation of the impact these services have on the client's life. 3. The case management assessment shall consider the following: a. The presenting problem; b. Client's current and potential strengths and deficits; c. The family's current and potential strengths and deficits; d. Client's relationship with family members and significant others; e. The impact of the currently provided services on the client's life; f. Client's involvement or need for involvement in client support groups or ancillary social support systems; g. Need for training in community living skills, medications, or activities of daily living; h. Need for education, vocational training or job-seeking skills; i. Need for housing,food, clothing, and transportation; j. Need for mental health, alcohol and drug abuse services; k. Need for medical and dental services, including current medications; I. Need for legal services; m. Need for backup support and consultation to family, friends, landlords, employers, community agencies and community members who come in contact with the client; and n. Need for and the establishment of financial resources such as Social Security, Supplemental Security Income,Veterans Administration or trust funds. 4. The case management assessment is to consist of a single identifiable, dated document, included in the clinical record. 5. The initial case management assessment must be completed within 30 days of the referral of the client for case management services. Exhibit AP Page 2 of 6 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 6. A home visit is to be made prior to the completion of the Assessment, unless the case manager's supervisor deems such a visit unsafe to the case manager or such a visit is denied by the client. In such instances where a home visit does not occur: a. The reasons for the failure to make such a visit will be documented in the case record and signed by the case manager and the case manager supervisor. b. Subsequent visitations and the suitability of the housing shall be considerations addressed in the service plan. 7. Subsequent written case management assessments shall be completed and an updated Service Plan developed at a minimum of every 6 months, or when the client changes residence, enters or is discharged from a state treatment facility or at other times when the client's situation changes significantly. (b) Service Planning 1. Service planning is the process of developing a general strategy to utilize strengths and address weaknesses identified through case monitoring and through assessments. The case manager, in conjunction with the client, shall be responsible for the development of the service plan. However, service planning is a collaborative effort which also involves family members, service providers, or others significant to the implementation of the resultant plan.The results of the service planning process shall be a service plan. 2. The Service Plan must be on a single identifiable and dated document, developed within 15 days of a completed Assessment and signed by the client, case manager, the case manager's supervisor, and other appropriate participants involved in the service plan development. The service plan is an individualized document which meets the comprehensive needs of the client. All service plans shall be included in the client's record. 3. In cases where immediate services are needed, service delivery shall not be delayed pending completion of either the assessment or service plan. 4. The Service Plan shall contain a description of the long-term desired outcome for the case. 5. The Service Plan shall contain measurable goals and objectives derived from the assessment of client's strengths, deficits and resource needs. a. Each objective must have an identified time frame for achievement and must be stated in terms of observable and measurable outcomes. b. Each objective shall state the name of the individual or agency responsible for the action to be achieved. Exhibit AP Page 3 of 6 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 6. The client shall be provided a copy of the Service Plan, and this shall be documented in the record. With the approval of the client, others involved in its development or implementation shall be provided with a copy of the service plan. (c) Linkage and Brokerage The case manager shall ensure that the Service Plan is implemented through a variety of linkage and brokerage activities designed to procure specified services,treatment and resources for the client. 1. Such activities include verbal or written referrals, telephone calls, meetings, assistance with making appointments and completing applications, assistance at interviews and hearings, transportation and supportive counseling. 2. The case manager shall convene a case staffing at major decision points during the client's involvement with the alcohol, drug abuse and mental health system. Such decision points shall include movements to a lesser or more restrictive environment in the community or transfers to and from state hospitals. Such conferences shall be attended, as appropriate, by the client, family members, service providers and significant others. (d) Monitoring Case Managers shall ensure that Service Plan goals and objectives are consistently pursued, assess the functioning level of the client, and assess progress toward the achievement of goals and objectives through a range of monitoring activities including telephone calls, home visits, case and treatment reviews, interviews and site visits. 1. Where monitoring reveals that minor adjustments are necessary in order to better accomplish the goals and objectives of the service plan,the case manager shall update these portions of the plan and take action to implement these adjustments. 2. Where monitoring reveals that conditions have changed to the extent that the service plan is no longer valid,the case manager shall make a reassessment and ensure the development of a new service plan. (e) Advocacy 1. Case managers shall function in the best interest of the client and shall intercede on behalf of the client to assure that service and resource needs are met. 2. The case manager shall identify service and resource gaps and barriers which limit a client's access to existing services and resources to client managers. (2) The case manager shall make a minimum of a monthly face-to-face contact with all clients residing in the community. Exhibit AP Page 4 of 6 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 (3) Case managers may utilize contingency funds provided by the department in accordance with circuit procedures.These shall be used to provide for unmet resource needs of clients when other resources are not available or in combination with other resources. (4) For clients residing in the community, the case manager shall make a home visit or field visit within the client's natural environment at a minimum of every other month, unless the case manager's supervisor deems such visits unsafe to the case manager or the client declines such visitation during the planning process. In such instances where home visits are not to occur: (a) The reason for the failure to make such a visit will be documented in the case record signed by the case manager and case manager supervisor, (b) Subsequent visitations and the suitability of the housing shall be considerations in the service plan. (5) When a client misses an appointment related to the service plan or is absent from a treatment program without notification, the case manager shall attempt to contact the client either by telephone or face-to-face meeting within twenty-four hours. If initial attempts to contact the client are unsuccessful, the case manager shall make additional efforts by telephone, face-to-face meetings, or correspondence. Upon contacting the client, the case manager shall explore the reasons for the absence or the missed appointment and shall work with the client to resolve any issues inhibiting the effective implementation of the plan. Such efforts and their results shall be documented in the case record. (6) Case Management Record. 1. An individualized case record for each client shall be maintained. 2. A clearly identifiable portion of the agency's record shall be devoted to case management. This portion shall contain the demographic information and items specified in subsection 65E-4.014(3)b., F.A.C. 3. The case record shall be maintained in accordance with Rule 65E-4.014, F.A.C. 4. In addition to items specified in Rule 65E-4.014, F.A.C., the record shall contain: (a) The name of the current assigned case manager. (b) Any copies of a consent to give information relevant to the case. (c) Assessment information as stated above. (d) Service Plan as stated above. (e) Progress Notes, documenting all of the case manager's activities, contacts and communications on behalf of the client, including the following: 1. Date 2. Type of contact; for example, home visit, telephone, office visit 3. Contacting person 4. Person or agency contacted 5. Brief account of contact 6. Relevance to the Service Plan Exhibit AP Page 5 of 6 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 7. Documentation of missed appointments, follow-up, and an explanation of why the appointments were missed 8. Documentation for the need and lack of availability of any goods or services for which contingency funds are requested (f) Advocacy efforts as specified above. (7) Case load. The mental health case manager's caseload shall not exceed 40 consumers at any given time. (8) Case managers shall at a minimum of a bachelor's degree with major course work in a human services field or equivalent training and experience on a year for year basis in a related field. Exhibit AP Page 6 of 6 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 EXHIBIT AS Monroe County Centralized Receiving Facility I. OVERVIEW Guidance/Care Center, Inc. ("Network Provider") is the designated centralized receiving facility ("CRF") that serves as the coordinated system of entry in the central region of Monroe County for individuals with mental health or substance use disorders, or co-occurring disorders. The designation as the CRF and the services to be provided are established in accordance with Florida Statute 394, Florida Mental Health Act, Florida Statute 397, Hal S. Marchman Alcohol and Other Drug Services Act, and in accordance with the Monroe County Designated Receiving System Plan,dated 2017-2020,(MC-Plan,or latest revision thereof), herein incorporated by reference. The CRF is responsible for assessment and evaluation, both voluntary and involuntary, and treatment or triage and/or stabilization of persons with mental health or substance use disorder, or co-occurring disorders. The CRF must function as a no-wrong-door model that responds to individual needs and integrates services among various providers. The Network Provider must participate in a coordinated system that is linked by a method to share data, formal referral agreements, and cooperative arrangements for care coordination. The Network Provider must provide or arrange for necessary services following an initial assessment or screening and evaluation. II. PROVISION OF THE PRIME CONTRACTS The CRF is funded with Department of Children and Families and Monroe County funding. All provisions, terms and conditions, or amendments, addendum, changes or revisions applicable to the Network Provider made subsequent to the initial execution of the Prime Contract, (the contract entered into between the Department of Children and Families and the ME, not in conflict with this Contract, must be binding upon the Network Provider and the Network Provider agrees to comply with same. The Prime Contract is incorporated by reference in this Contract. III. MONROE COUNTY DESIGNATED RECEIVING SYSTEM PLAN The Network Provider agrees to adhere to and implement the CRF in Monroe County as described in the Monroe County Designated Receiving System Plan, dated 2017-2020 (or the latest revision thereof), herein incorporated by reference. IV. OBJECTIVES The primary objectives of the CRF are to: 1. Provide a central receiving system serving the target populations; Exhibit AS Page 1 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 2. Provide initial screenings, assessments for consumers that meet criteria for acute care services, triage, care coordination, and related services and linkage to appropriate level of care; 3. Provide opportunities for jail diversion, offering a more suitable and less costly alternative to incarceration; 4. Reduce the inappropriate utilization of emergency rooms; 5. Increase the quality and quantity of services through coordination of care and recovery support services; 6. Implement standardized screening tools and procedures for services; and, 7. Improve access and reduce processing time for law enforcement officials transporting individuals needing behavioral health services. V. SCOPE OF THE ACTIVITIES AND SERVICES A. Target Population 1. Individuals needing evaluation or stabilization under s. 394.463, F.S., the Baker Act; 2. Individuals needing evaluation or stabilization under s. 397.675, F.S., the Marchman Act; and, 3. Individuals needing crisis services as defined in ss. 394.67(17)-(18), F.S. 4. Individuals needing screening for non-acute mental health and/or substance abuse treatment services and that meet the target population descriptions contained in s. 394.674, F.S. and described in the DCF Pamphlet 155-2. B. Client Services 1. The Network Provider must provide crisis stabilization, substance abuse detoxification services,crisis support emergency services,screenings,assessments for consumers that meet criteria for acute care services,and Medication Assisted Treatment, and care coordination for clients referred to other providers. 2. Screening services for individuals needing acute and non-acute mental health and/or substance abuse treatment services must be available through the CRF twenty-four hours seven days per week, 365 days per year. 3. Screening Tools:The Network Provider must utilize screening tool(s) agreed to between the ME and the Network Provider. 4. The Network Provider must have a protocol to screen and triage all individuals to determine an individual's immediacy of needs and establish a plan for further assessment and treatment. The screening must at a minimum include: • Reason for referral Exhibit AS Page 2 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 7/ / 020 • Medical needs • Current medications • Current substance use, and • Risk of harm to self and others C. The Network Provider's ability to accept consumers under the CRF system is to be executed according to its capabilities and limitations as described in the table below and as described in the Monroe County Transportation Plan for Involuntary Examinations (Baker Act) and Involuntary Admissions (Marchman Act), herein incorporated by reference. CRF Service Capabilities/Limitations Voluntary Assessment and Evaluation Crisis Stabilization Unit(Adults Only), Detoxification (Adults Only), Screening and Assessment Involuntary Assessment and Evaluation Crisis Stabilization Unit(Adults Only), Detoxification (Adults Only), Screening and Assessment Triage for Mental Health Services Crisis Stabilization Unit(Adults Only), Screening and Assessment Triage for Substance Use Disorder Services Detoxification (Adults Only), Screening and Assessment Involuntary Treatment for Mental Health Crisis Stabilization Unit(Adults Only) Disorders Involuntary Treatment for Substance Use Detoxification (Adults Only) Disorders D. PERFORMANCE MEASURES 1. 100% of persons who walk into the CRF requesting screening (non-acute) services must be screened on the same day. 2. 100% of persons brought in involuntarily by law enforcement under Baker Act will be admitted for evaluation.Appropriate transfer to other CSU's/Inpatient will be secured by the Network Provider staff upon evaluation and determination that continued admission is medically required. Transportation to the referral facility will be arranged by the Network Provider. Exhibit AS Page 3 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 7 2020 3. 100% of persons determined by the screening process to need outpatient services must be linked to an appropriate provider. The CRF will secure an outpatient appointment within ten (10) business days of the date of the initial screening. 4. 85% of persons referred to outpatient services will receive a follow-up within seventy- two (72) hours of scheduled appointment to determine linkage. 5. 85% of persons determined not to have a successful linkage will receive an alternate referral for outpatient services within ten (10) business days. 6. No more than 14.81% CSU readmissions within thirty (30) calendar days for consumers referred internally for post-CSU discharge services. 7. No more than TBD% Detoxification readmissions within thirty (30) calendar days for consumers referred internally for post-detoxification discharge services. E. SERVICE SITE ADDRESS AND TELEPHONE NUMBER 3000 41't Street Ocean Marathon, FL 33050 (305)434-7660 F. FUNDING: The Network Provider's allocation to operate the CRF is found in Exhibit H, Funding Detail. G. METHOD OF PAYMENT: The CRF must be paid on a fee-for-service (Unit Rate) method of payment, in accordance with the payment methodology provided for in Rule 65E-14.019 (2), F.A.C. for the covered services listed in Exhibit G,Covered Service by OCA. H. COLLABORATIONS AND PARTNERSHIPS 1. ME's Care Coordination Department: The Network Provider must work with the ME's Care Coordination Department if an individual entering the CRF is identified as needing care coordination services. Refer to Attachment I, Section B. 1. a. (25), Care Coordination and Reporting Requirements, for a more detailed description of Care Coordination services. 2. The Network Provider, in collaboration with the ME and Monroe County, must review and update, as necessary, the designated receiving system at least once every three (3) years, or earlier if deemed necessary. 3. The Network Provider is expected to develop partnerships and agreements with community partners (i.e., other SFBHN contracted Network Providers, managed care organizations, criminal and juvenile justice systems,community based care organizations, housing providers, federally qualified health centers, etc.) for the coordination of care to individuals referred from the CRF, to leverage resources and share data as allowed by federal and state laws. Exhibit AS Page 4 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 7/ /2020 I. REPORTING REQUIRMENTS 1. Service Data: Service Data into KIS or any data system designated by the ME and must be submitted per the requirements described in Attachment I, Section B. 4. Deliverables, and in Attachment I, Section D. 3., Acute Care Service Utilization Reporting for Public Receiving Facilities, Detoxification and Addiction Receiving Facilities. 2. Performance Measures Report: By the 301"of every month following the reporting month for the measures listed above in Section VI., paragraph D., Performance Measures. 3. Ad Hoc Reports:The Network Provider agrees to submit any ad-hoc and/or additional reports as determined necessary by the ME, Department of Children and Families. J. STAFFING: Any changes in staffing plan greater than 25% of either the total FTE or total salary costs, as per the approved budget, is subject to ME approval. K. MEETINGS/TRAININGS 1. The Network Provider will ensure that its staff is properly trained on CRF model, goals and objectives, evidence based practices and Screening and Level of Care Placement Tools. 2. The Network Provider must meet with the ME's staff at regularly scheduled or specially called meetings and/or trainings when notified by the ME. Exhibit AS Page 5 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 EXHIBIT AV TRANSITIONAL VOUCHER PROGRAM I. ELIGIBILITY Persons eligible for services under this component must be currently receiving Department-funded SAMH services pursuant to chs. 394 and 397, F.S., and must meet one the following alternative characteristics: 1) Experiencing homelessness; meaning an individual who lacks housing, including: a. An individual whose primary overnight residence is a temporary accommodation provided by a supervised public or private facility, or b. An individual who resides in transitional housing 2) At Risk of homelessness;for example:an individual whose only housing option is shelter due to lack of affordable housing opportunities 3) Vouchers may also be utilized to assist eligible individuals maintain their current level of care by achieving residential stability. 4) Participating in a FACT team and ready to transition to a lower level of care. 5) Receiving Care Coordination services pursuant to the Department's Guidance Document 4. To access the Department's FY 20-21 Guidance Document 4, click on the link below: htt s: www.m flf�milies.com servico- ro rims s�mh m�n� in -entitios index.shtml Note: Click on FY20-21 ME Templates and click on Guidance Document 4, Care Coordination II. REQUEST PROCESS A. The Care Coordinator or Case Manager at the provider will ensure that services and/or supports requested cannot or are not funded through any other source.The Network Provider must exhaust all other funding alternatives before submitting a funding request to the ME. Steps taken with alternative sources must be documented in the individual's file/chart. B. A Funds Request Form and Treatment/Service Plan should be submitted to the ME's Housing Coordinator or designee to the following email address: housing@sfbhn.org. All supports and Exhibit AV Page 1 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/: 2 20 services requested and authorized must directly address specific need to achieve goals on the current service plan or treatment plan when applicable. 1) If requesting assistance for individuals exiting a state treatment facility the State Hospital Transitional Voucher Funds Request Form must be used, attached herein as Appendix 1. 2) For all other requests, the Transitional Voucher Funds Request Form must be used, attached herein as Appendix 2 C. If requesting assistance with payments for an ALF, the following is required: 1) A copy of the AHCA Facility Finder ALF page indicating active LMH License. If ALF does not have an LMHL please include justification for other specialty license(s). 2) Description of actions that will be taken in order to sustain funding, including a plan of self-sustainability with an estimated end date. i.e. SSA Benefits pending (include application date), SSA Benefits suspended (date will be taken to SSA for reinstatement), Being assessed for SOAR process (date of assessment), etc. D. The ME's Housing Coordinator or designee will review funding requests and make a determination of approval or denial of funding within 3 business days of receipt of the request. If necessary, the ME Housing Coordinator will contact the referral source to staff a case prior to approval or denial. E. The ME Housing Coordinator or designee shall notify the Care Coordinator or Case Manager of the decision to approve or deny funding via email. III. ALLOWABLE EXPENSES A. Transitional Voucher services may be authorized only to the extent that they are reasonable, allowable and necessary as determined through the assessment process; are clearly identified in the individual's service plan or treatment plan when applicable; and only when no other funds are available to meet the expense. 1) Transitional Vouchers will be approved for no more than a three (3) month period. 2) All fund requests must be submitted to the ME for prior approval. B. The person served is the primary decision maker as to the services and supports to be purchase and from what vendor those services are procured. C. Allowable expenses include the following Covered Services as defined by ch. 65E-14.021, F.A.C.: Exhibit AV Page 2 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 1) Aftercare; 2) Assessment; 3) Case Management; 4) Day Care; 5) Day Treatment; 6) Incidental Expenses; 7) In-Home and On-Site; 8) Intensive Case Management; 9) Intervention; 10) Medical Services; 11) Medication-Assisted Treatment; 12) Outpatient; 13) Recovery Support; 14) Respite Services; 15) Substance Abuse Outpatient Detoxification; 16) Supported Employment 17) Supportive Housing/Living D. Allowable Incidental Expenses include time limited transportation, childcare, housing assistance, clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals and other incidentals as approved by the Managing Entity in compliance with Rule 65E-14.021, F.A.C. E. Network Service Providers adhere to: 1) State purchasing guidelines for allowable expenses as promulgated by the Department and the Department of Financial Services 2) The requirements of Chapter 65E-14, F.A.C., and 3) Managing Entity protocols regarding allowable purchases. IV. ME RESPONSIBILITIES A. For all voucher requests: 1) The ME will review the completed transitional voucher request form along with all supporting documents (i.e. service plan, treatment plan, lease agreement, etc.) for authorization. 2) The ME Housing Coordinator will provide authorization or denial to the Care Coordinator/Case Manager requesting the funds within three (3) business days via email. In case of a denial, an email will be sent with reason(s) for denial. Should the ME Housing Exhibit AV Page 3 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florid (Contracting as South Florida Behavioral Health Network, inn.) 7/: 2 20 Coordinator not be available, the ME Housing Peer or Care Coordinator Lead will provide authorization or denial for transitional vouchers within three (3) business days. 3) The ME will conduct service data validation using FASAMS service data. Service data for each invoice must be equal or less to the ME Voucher approved amount. Invoice not matching approved amount, or without service data, will not be approved for payment.The ME will inform the provider of the denial and reason for denial. B. For all voucher reporting: 1) The ME Housing Coordinator,or designee,will keep track of the voucher requests and funding approvals. 2) The ME Housing Coordinator or monitoring team may periodically request individual files for auditing purposes. 3) Upon completion of the monthly review, the Network Provider will be notified of any discrepancies and the invoice will be adjusted accordingly. 4) The ME shall adhere to the requirements identified in the Department's Transitional Voucher Guidance Document 29. To access the Department's FY 20-21 Guidance Document 29, click on the link below: hops:JJwww.myflf�mili s.com�s rvic -pro r�msJs�mhJm�n� in - ntiti sJind x.shtml Note: Click on FY20-21 ME Templates and click on Guidance Document 29, Transitional Voucher V. NETWORK SERVICE PROVIDERS RESPONSIBILITIES A. The Care Coordinator or Case Manager will verify that the funds requested directly address specific needs to achieve goals on the individual's current Service Plan. B. The Care Coordinator or Case Manager will ensure Transitional Voucher funds are used only for services and supports that cannot be paid for by another funding source; specifically: a) Network Providers and participants are responsible for locating other non-SAMH payor sources for services or supports prior to using Transitional Voucher funds. b) In collaboration with the participant, Network Providers must certify no other payer source is available and due diligence was exercised in searching for alternative funding prior to the use of Transitional Voucher funds. Network Providers must submit a signed certification for each use of Transitional Voucher funds with the monthly invoice. Exhibit AV Page 4 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 C. The Care Coordinator or Case Manager must maintain in the individuals' file a record of all individual expenses charged against the funds. D. The Care Coordinator or Case Manager will provide the following documents in a timely manner: a) Transitional Voucher request form with the individual's service plan or treatment plan. All supports and services requested must directly address specific needs to achieve goals on the current service plan or treatment plan. b) Documents with attempts made to use alternative sources of funding. E. All Transitional Vouchers must be coded with the appropriate modifier: a. For Substance Abuse use modifier: DS b. For Mental Health use modifier: DM F. All invoices and supporting documentation must be submitted to the ME by the 81"of the month.Any voucher that has not been invoiced to the ME within 45 days from the approval date will be voided, and the approved amount will return to available transitional voucher funds. The Network Provider must ensure the service data is entered in FASAMS during the service month and coded with the appropriate modifier. The service data must be less or equal to the approved voucher amount. Any discrepancies in service data will delay payment of the invoice. It is the responsibility of the Network Provider to update service data and resubmit invoice for reimbursement. Exhibit AV Page 5 of 5 Guidance Care Center, Inc. Contract No. ME225-11-27 �.40 0 . -I- HRINrINO M 1 N O SOUTH FLORIDA A network of exceptional mental health ,and substance riso provi(Jeps3, Appendix 1 State Hospital Transitional Voucher (TV) Funds Request Form Date of TV Submission: Date of Expected Discharge: Agency/ Provider: Funds requested by/Title: Phone number: Fax number: Email address: Individual's Name: Date of Birth: Sex: SSN: Recommended Discharge Environment: Description of goods or services being requested, plan for self-sustainability: Required Additional Documentation Choose One that Applies: ❑ Attached copy of AHCA Facility Finder ALF page ❑ SSA Application Date: indicating LMH License (if applying for ALF ❑ SSA Appointment Date for Benefits funding) Reinstatement: ❑ Attached signed consent form ❑ SOAR Screening Date: _ ❑ Copy of the Transition/Discharge Plan ❑ Other: ❑ Completed Care Coordination Enrollment Form Amount requested: One time request: ❑Yes ❑ No, Estimated end date: Funding source: ❑ Mental Health ❑Substance Abuse Appendix 1 of Exhibit AV Page 1 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 �.40 0 . -I- HRINrINO M 1 N O SOUTH FLORIDA A network of exceptional mental health ,and substance riso provi(Jeps3, CERTIFICATION: I here certify that the information above is accurate and that this request is for appropriate therapeutic reasons which have been documented in the consumers' service and treatment plans. In collaboration with the above named participant, I certify that no other payer source is available and due diligence was exercised in searching for alternative funding prior to the use of the Transitional Voucher funds. Form completed by: _ Title: Signature: _ _ Date: AUTHORIZATION OF SERVICES: (SFBHN USE ONLY) Approved by: _ _ Date: Signature: _ _ _ Title: Authorization number: _ DCF Approval Date: OCA: ❑ Mental Health MHTRV ❑Substance Abuse MSTRV Not approved by: _ Date: Reason not approved: Signature: _ _ _ _ Title: Appendix 1 of Exhibit AV Page 2 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 m THRIVING MIND SOUTH FLORIDA A n two'k at x .ag?t+t �in:ntsl Appendix 2 Transitional Voucher Funds Request Form Date: Agency/ Provider: Funds requested by/Title: Phone number: Fax number: Email address: Individual's Name: Date of Birth: Sex: SSN: Does the consumer fall under any of the following categories? ❑Care Coordination ❑ Homeless/or at risk ❑ FACT Team Description of goods or services being requested: Appendix 2 of Exhibit AV Page 1 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 m THRIVING MIND SOUTH FLORIDA A n two'k at x .ag?t+t �in:ntsl The assistance requested is for (please check one): ❑Housing Assistance ❑Childcare El Clothing El Transportation (Bus passes, bicycles, airfares) ❑Educational Services ❑Vocational Services ❑Medical Care (Medication, doctor visits) ❑Housing Subsidies (Utility bills, furniture, toiletries) El Other Incidentals Amount requested: One time request: ❑Yes ❑ No Funding source: ❑ Mental Health ❑Substance Abuse CERTIFICATION: I here certify that the information above is accurate and that this request is for appropriate therapeutic reasons which have been documented in the consumers' service and treatment plans. In collaboration with the above named participant, I certify that no other payer source is available and due diligence was exercised in searching for alternative funding prior to the use of the Transitional Voucher funds. Form completed by: _ Title: Signature: _ _ Date: AUTHORIZATION OF SERVICES: (SFBHN USE ONLY) Approved by: _ Date: Signature: _ _ Title: Authorization number: OCA: ❑ Mental Health MHTRV ❑Substance Abuse MHTRV Not approved by: _ Date: Reason not approved: Signature: _ _ _ _ Title: Appendix 2 of Exhibit AV Page 2 of 2 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 Exhibit AY Mobile Response Team for Monroe County I. OVERVIEW Guidance/Care Center ("Network Provider") is funded to operate a Mobile Response Team for Monroe in compliance with the Florida Department of Children and Families Substance Abuse & Mental Health Mobile Reponse Team Framwork("DCF MRT Framework"),dated 8/29/2018 or the latest revision thereof, incorporated herein by reference. II. GOALS The primary goals of the MRTs is to lessen trauma, divert from emergency departments or juvenile/criminal justice, and prevent unnecessary psychiatric hospitalizations. MRTs must be designed to be accessible in the community at any time. If inpatient services are needed, MRTs facilitate that connection. MRTs must be effective in connecting people with the community mental health system who had not accessed treatment and services before. III. TARGET POPULATION The target population of focus for the MRT per the DCF MRT Framework are children, youth, and young adults ages twenty-five(25) and under, however, the team must serve others experiencing a behavioral or mental health crisis.The target population will also include any child, adolescent or young adult under the age of twenty-five(25)who are being served by the child welfare system and are experiencing or are at high risk of placement instability. IV. SERVICE ARRAY MRTs provide on-demand crisis intervention services in any setting in which a behavioral health crisis is occurring, including homes, schools and emergency rooms. MRTs are multi-disciplinary teams of behavioral health professionals and paraprofessionals with specialized crisis intervention and operations training. Mobile response services are available 24/7 with the ability to respond within 60 minutes to new requests. MRT staff are expected to triage calls in order to determine the level of severity and prioritize calls that meet the clinical threshold required for an in-person response. MRTs must include access to a board-certified or board-eligible psychiatrist or psychiatric nurse practitioner. Best practice suggests these professionals play a vital role to stabilize the crisis until the individual is connected to a behavioral health services provider for ongoing services, if necessary. For example, these professionals can provide: Phone consultation to the team within 15 minutes or shortly after a request from an MRT, and Exhibit AY Page 1 of 3 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 Face-to-face or telehealth appointments with the individual within 48 hours of a request if the individual has no existing behavioral health services provider. Services include evaluation and assessment,development of safety or crisis plans, providing or facilitating stabilization services, supportive crisis counseling, education, development of coping skills, linkage to appropriate resources and connecting those individuals who need more intensive mental health and substance abuse services.They facilitate "warm handoffs"to community services, and other supports. Once this occurs, it is expected that either the crisis has resolved naturally,the individual is connected to a community-based provider who will engage the individual in services,or the individual was assisted with admission to a designated receiving facility. MRTs will need to establish protocols for working with existing care coordination teams for individuals who are not already connected to behavioral health services, for those that are eligible. To meet community needs, MEs and their partners will develop the delivery system and process for MRT response. MRTs are designed to provide immediate intervention to attempt to stabilize the individual's condition safely in situations that do not require an immediate public safety response, prevent unnecessary hospitalizations, manage appropriate levels of risk and provide timely access to assessment and evaluation in a wide array of settings. Intervention is warranted when a crisis significantly interferes with the ability to function and is severe enough to place the individual at a risk of disruption of services or living environment. The clinical threshold for crisis may include aggressive behaviors; suicide attempts/ideation; drug and alcohol overdose or abuse; or disruptive symptoms related to thought, mood and anxiety disorders (e.g., panic, hopelessness, anger, depression), escalating behavior(s) and,without immediate intervention,the individual is likely to require a higher intensity of services. It may also present as an overt change in functioning or be prompted by traumatic life events. Mobile Response Teams must coordinate in-person services with law enforcement to provide additional safety, when appropriate and necessary. The MRT provider will need to be well connected to the local behavioral health system of care. This includes being familiar with the community resources, services, and supports available to the individuals they serve. When the crisis assessment indicates a need for additional services, MRTs need to be positioned to facilitate a warm handoff to the right service at the right time. This can range from case management to Community Action Treatment teams and anything in between. MRT providers will need to be connected to local multi-disciplinary/family service planning teams as they are able to assist in identifying supports and service planning for the family. Telehealth is an important asset for increasing the capacity of MRTs especially in rural areas, geographically large counties, or urban areas where congested traffic patterns make meeting the 60- minute response time a challenge. Telehealth can be used to provide direct services to individuals via video-teleconferencing systems, mobile phones, and remote monitoring. It can also be used to provide assessments and follow-up consultation as well as initial triage to determine if an in-person visit is needed to respond to the crisis call. At minimum, the Mobile Response Team must be available for administrative business Monday through Friday between 9:00 a.m. and 5:00 p.m., local time, and available 24 hours per day, 7 days per week for referral response. On-call services must be available nightly between 10PM and 7AM. Exhibit AY Page 2 of 3 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 7/ /2020 A 24 hour per day, 7 days per week Crisis Hotline staffed by a trained and qualified specialist, must be available as the primary referral portal for Mobile Response Team services. Mobile Response Team services may be provided up to a 72-hour period after the initial contact, during which the mobile response team providers deliver immediate and direct clinical intervention, either in person or telephonically. Mobile Response Team services may include ongoing coordination during the 72-hour period following the crisis assessment and stabilization intervention to facilitate "warm hand- offs"to community services, and other follow-up supports. V. SERVICE DATA Service Data: Service Data must be submitted monthly by the 41"of every month following the month of service into the ME's designated data system and must comply with the requirements of the Department of Children & Families, Pamphlet 155-2 - Mental Health and Substance Abuse Measurement and Data, version 13.0, or the latest revised edition thereof. VI. REPORTING REQUIREMENTS 1. Monthly MRT Tracker:The Network Provider must submit MRT Monthly Tracker using template provided by the ME by the 101" of every month for data from the previous month. The Network Provider will submit the monthly tracker to the individuals listed in Exhibit C, Required Reports. 2. Outreach Activities Log: -The Network Provider must submit a quarterly log of formal outreach activities (such as trainings, education and networking) to increase community awareness about MRT and behavioral health needs. This log will include at a minimum the date, time, duration, # of individuals trained and#of staff that participated.The Outreach Log must be submitted by the dates and to the individuals specified in Exhibit C,Required Reports. 3. Ad Hoc Reports:The Network Provider agrees to submit any ad-hoc and/or additional reports as determined necessary by the ME, Department of Children and Families and/or Monroe County. VII. MEETINGS/TRAININGS 1. The Network Provider will ensure that its staff is properly trained on MRT model, goals and objectives, evidence-based practices and screenings. 2. The Network Provider shall meet with the ME's staff at regularly scheduled or specially called meetings and/or trainings when notified by the ME. Exhibit AY Page 3 of 3 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, inn.) 7/ /2020 EXHIBIT BB State Opioid Response Discretionary Grant Services Medication Assisted Treatment Services OCAS: MSSM2 and/or MSSM3 A. OVERVIEW The Network Provider is contracted to provide Medication-assisted treatment (MAT) services for the treatment of opioid use disorder associated with the State Opioid Response (SOR) Grant awarded by the Substance Abuse and Mental Health Services Administration. B. CLIENT ELIGIBILITY Eligibility includes individuals who are indigent, uninsured, or underinsured and misuse opioids, have an opioid use disorder, or experience an opioid overdose. The following individuals should be given preference in admissions in the following order: 1. Pregnant women; 2. Injection drug users; 3. Caretakers involved with child welfare; 4. Caretakers of children ages 0-5; and 5. Individuals re-entering the community from incarceration. C. ALLOWABLE COVERED SERVICES The following covered services described in Ch.65E-14.021, F.A.C.,are allowable uses of these funds when provided to individuals in conjunction with methadone, buprenorphine, or oral naltrexone maintenance. These funds may also be used to support individuals receiving VIVITROL, except for Assessment, Medical Services and Medication-Assisted Treatment, as this will be paid through the Florida Alcohol and Drug Abuse Association. Aftercare Assessment Case Management Crisis Support/Emergency Day Care Day Treatment Incidental Expenses Outreach (to identify and Medication-Assisted (excluding direct payments link individuals with Treatment(only to participants) opioid use disorders to methadone, MAT providers) buprenorphine, or oral naltrexone maintenance) Medical Services Outpatient In-Home and On-Site Recovery Support Supported Employment Supportive Housing/Living Inpatient Detoxification Residential Levels I and II Outpatient Detoxification Inpatient and outpatient detoxification must be accompanied by injectable extended-release naltrexone (Vivitrol). Residential services may only be used to stabilize and treat eligible individuals during transition to medication-assisted treatment.When determining level of care, individuals must be assessed using the ASAM dimension spectrum criteria to determine appropriate care level followed by documentation justifying placement. Level of care should be reevaluated at least every 5 days for inpatient detoxification placements and every 14 days for residential treatment placements. Exhibit BB Page 1 of 3 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/ /2020 D. LICENSES For licensable services to be provided with the SOR funds, the Network Provider shall have and maintain correct and current Department of Children and Families, as required by Rule 65D-30, F.A.C., Licensure Standards for Substance Abuse Services, and only bill for services under those licenses. In the event any of the Network Provider's license(s) is suspended, revoked, expired or terminated, the ME shall suspend payment for services delivered by the Network Provider under such license(s) until said license(s) is reinstated. E. SERVICE DATA REPORTING REQUIREMENTS Service data shall be submitted monthly into the ME's designated data system and shall comply with the requirements of the FASAMS DCF Pamphlet 155-2. F. PROGRAMMATIC DATA COLLECTION AND REPORTING REQUIREMENTS 1. The Network Provider will be required to collect data via face-to-face interviews at five data collection points (intake, , 6 months post-intake, discharge, 3-months post-discharge, and 6- months post-discharge) using the Government Performance and Results Modernization Act (GPRA) data collection tools, herein incorporated by reference. Follow up interviews MUST be completed within four(4)weeks of the follow-up date. EX: If a 6-month follow up is due on 5/15, the interview MUST take place between 4/17 and 6/12 Network Providers are expected to achieve a 3-month follow-up rate of 80% and a 6-month follow-up rate of 80%. The Department is currently working with a vendor to provide the tools online; however, there may be paper collection until the electronic record system is available. Training on the electronic record system will be provided by the Department. Note: If an individual is terminated from treatment (non-completion discharge from treatment episode) and the individual then returns to re-enroll in a new SOR funded treatment episode, a new GPRA timeline must be started. EX: An individual is terminated "Left on own against staff advice with satisfactory progress"at 4 months post intake with a GPRA at Intake and 3-month post intake follow- up having been completed. Individual re-enrolls 2 months later. A new GPRA at intake MUST be completed and continued on a new GPRA timeline. HOSPITAL DATA: Separate data collection will be required for Emergency Department Bridge programs.The following data elements must be sent to the SOR epidemiology team on the 301n of each month: • #of individuals screened • #of individuals induced with buprenorphine in the ED/hospital prior to discharge Exhibit BB Page 2 of 3 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, inn.) 7/1/2020 • #of individuals referred to treatment providers • #of individuals linked to treatment providers 2. The Network Provider will maintain all required data on paper and upon availability of an electronic record system will enter all data collected to date and any new data collected as instructed by the ME. 3. The Network Provider shall provide additional reporting pertaining to the services and activities rendered should the Department or ME determine this to be necessary. G. RESTRICTIONS Funds may not be used by any Network Provider that denies any eligible individual access to their program because of their use of FDA-approved medications for the treatment of substance use disorders, namely methadone and buprenorphine. In all cases, MAT must be permitted to be continued for as long as the prescriber determines that the medication is clinically beneficial. Network Providers must assure that individuals will not be compelled to no longer use MAT as part of the conditions of any programming if stopping is inconsistent with a licensed prescriber's recommendation or valid prescription. In addition, State Opioid Response funds may not be used for the following purposes: 1. Make direct payments to individuals to enter treatment or continue to participate in prevention or treatment services. 2. To pay for construction or purchase of structures. 3. To pay the salary of an individual at a rate in excess of$189,600. 4. To supplant(or replace) current funding of existing services. H. MONTHLY SOR DATA COLLECTION REPORT The Network Provider shall submit a monthly SOR Data Collection report in the template provided by the ME. The template may be requested from the ME's Contract Manager. The report shall be submitted to the ME's Contract Manager by the 15r" of each month with the preceding months services information.The report must be submitted electronically encrypted and password protected. I. QUARTERLY AND ANNUAL EXPENDITURE REPORT For services reimbursed based on a case rate, the Network Provider shall submit a quarterly expenditure report by the dates and to the individuals identified in Exhibit C,Required Reports,in a template provided by the ME. Any funds paid to the Network Provider in excess of the amount to which the Network Provider is entitled under the terms and conditions of this Contract must be refunded to the ME. Exhibit BB Page 3 of 3 Guidance Care Center, Inc. Contract No. ME225-11-27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 ATTACHMENT 11 Financial and Audit Compliance The administration of resources awarded by the Department of Children & Families, through the Managing Entity, to the provider may be subject to audits as described in this attachment. MONITORING In addition to reviews of audits conducted in accordance with Z Code of Federal Regulations (CFR) §§ 200'500'200.521 and § 215.97, F.S, as revised, the Department may monitor or conduct oversight reviews to evaluate compliance with contract, management and programmatic requirements. Such monitoring or other oversight procedures may include, but not be limited to, on-site visits by Department staff, agreed-upon procedures engagements as described in Z CFR y 200.425 or other procedures. By entering into this agreement, the recipient agrees to comply and cooperate with any monitoring procedures deemed appropriate by the Department. In the event the Department determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by the Department regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Department's inspector general, the state's Chief Financial Officer or the Auditor General. AUDITS PART|: FEDERAL REQUIREMENTS This part is applicable if the recipient is a State or local government or a non-profit organization as defined in ZCFR yy 200'500'200.521. In the event the recipient expends $750,000or more in Federal awards during its fiscal year, the recipient must have a single or program-specific audit conducted in accordance with the provisions ofZCFR §§ 200.500'200.521. The recipient agrees to provide copy of the single audit to the Department's Single Audit Unit and its contract manager. In the event the recipient expends less than $750,000 in Federal awards during its fiscal year, the recipient agrees to provide certification to the Department's Single Audit Unit and its contract manager that single audit was not required. In determining the Federal awards expended during its fiscal year, the recipient shall consider all sources of Federal awards, including Federal resources received from the Department ofChildren & Families, Federal government (direct), other state agencies, and other non state entities. The determination of amounts of Federal awards expended should be in accordance with guidelines established by Z CFR §§ 200'500'200.521. An audit of the recipient conducted by the Auditor General in accordance with the provisions of Z CFR Part ZUU §§ 200'500'200.521 will meet the requirements ofthis part. In connection with the above audit requirements, the recipient shall fulfill the requirements relative toauditee responsibilities as provided in ZCFR §ZUU.SUO. Attachment || Page lof3 Guidance Care Center, Inc. Contract No. mE225'11'27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 The schedule of expenditures should disclose the expenditures by contract number for each contract with the Department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the Department shall be fully disclosed in the audit report package with reference to the specific contract number. PART III:STATE REQUIREMENTS This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2), Florida Statutes. In the event the recipient expends $500,000 or more ($750,000 or more for fiscal years beginning on or after July 1, 2016) in state financial assistance during its fiscal year, the recipient must have a State single or project-specific audit conducted in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. The recipient agrees to provide a copy ofthe single audit to the Department's Single Audit Unit and its contract manager. In the event the recipient expends less than $500,000 (less than $7SU,UUU for fiscal years beginning on or after July 1, 2016) in State financial assistance during its fiscal year, the recipient agrees to provide certification to the Department's Single Audit Unit and its contract manager that a single audit was not required. In determining the state financial assistance expended during its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Department of Children & Families, other state agencies, and other nonstate entities. State financial assistance does not include Federal director pass-through awards and resources received by a nonstate entity for Federal program matching requirements. In connection with the audit requirements addressed in the preceding paragraph, the recipient shall ensure that the audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 1U.SSUor1U.6SU, Rules of the Auditor General. The schedule of expenditures should disclose the expenditures by contract number for each contract with the Department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the Department shall be fully disclosed in the audit report package with reference to the specific contract number. PART III: REPORT SUBMISSION Any reports, management letters, or other information required to be submitted to the Department pursuant to this agreement shall be submitted within 180 days after the end of the provider's fiscal year or within 30 (federal) or4S (State) days of the recipient's receipt of the audit report, whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes: A.Contract manager for this contract (1copy) Attachment || Page 2of3 Guidance Care Center, Inc. Contract No. mE225'11'27 Thriving Mind South Florida (�ontractingasSouth Florida Behavioral Health Network, Inc.) 7/1/2020 B. Department of Children & Families ( I electronic copy and management letter, if issued Office of the Inspector General Single Audit Unit Building S, Room Z37 1317VVinevxoodBoulevard Tallahassee, FL3Z399'U7UU Email address: C. Reporting packages for audits conducted in accordance with Z CFR PartZUU yyZUU.SUU'ZUU.SZ1, and required by Part | of this agreement shall be submitted, when required by § 200.512 (d) by or on behalf of the recipient directly to the Federal Audit Clearinghouse using the Federal Audit Clearinghouse's Internet Data Entry System at: and other Federal agencies and pass-through entities in accordance with 2 CIFIR § 200.512. O. Copies of reporting packages required by Part || of this agreement shall be submitted by or on behalf of the recipient directly to the following address: Auditor General Local Government Audits/34Z Claude Pepper Building, Room 4U1 III West Madison Street Tallahassee, Florida 3Z399'14SU Email address: Providers, when submitting audit report packages to the Department for audits done in accordance with 2 CIFIR §§ 200.500-200.521, or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit or for- profitor0anizationd, Ru|esoftheAuditorGenera|, shou|dindude, vxhenavai|ab|e, correspondencefnonn the auditor indicating the date the audit report package was delivered to them. When such correspondence is not available, the date that the audit report package was delivered by the auditor to the provider must be indicated in correspondence submitted to the Department in accordance with Chapter 1U.SSO(3) or Chapter 1U.6S7(Z), Rules of the Auditor General. PART IV: RECORD RETENTION The recipient shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued and shall allow the Department or its designee, Chief Financial Officer or Auditor General access to such records upon request. The recipient shall ensure that audit working papers are made available tothe Department or its designee, Chief Financial Officer or Auditor General upon request for a period of three years from the date the audit report is issued, unless extended in writing by the Department. Attachment || Page 3of3 "da Nrivi ng M I lo South F .rI as(Contract' q ffi Florida Behavioral Health Netwolrk, Inc.) 07/01/2020 Ung ATTACHMENT III CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. C. L,,*'-100 6/30/2020 Signature Date Maureen Dunleavy, VP Frank C. Rabbito, COO ME225-11-27 Name of Authorized Individual Application or Contract Number Guidance/Care Center, Inc. Name of Organization Address of Organization CIF 1123, PDF 03/96 Attachment III Page I of I Guidance Care Center, Inc. Contract No. ME225-11-27 NX THRIVING MIND SOUTH FIOHICA" SCOPE OF WORK ATTACHMENT IV NAME OF PROVIDER: Guidance Care Center NAME OF PREVENTION PROGRAM: Power of Prevention AMOUNT OF CONTRACT AWARD: $199,063.00 "Regular" Prevention Prevention Partnership TYPE OF FUNDING: Services Grant (PPG) XX COST ALLOCATED TO: (check both Children's Substance Adult Substance Abuse if approved for both covered services) Abuse XX Section I. DESCRIPTION OF SERVICES AND STRATEGIES FOR SERVICE DELIVERY DESCRIPTION OF SERVICES SUMMARY (include overall intention/purpose of program and service flow, brief description of program activities, target population to be served by the program services and how it was selected, how the services address cultural competency, the name (s)of the EBP (s) and how it (they) will be implemented, describe comprehensive programming, and the partners and coordination efforts): The Guidance/Care Center's Prevention program, POP (Power of Prevention) consists of (5) evidence-based practices: An Apple A Day©(K-4), Project SUCCESS Prevention Education Series (PES) (Middle School), and Teen Intervene (Middle School). These programs are facilitated in person at the schools or community sites. Due to Covid-19, we have teamed up with Monroe County Coalition to provide (2) additional online EBP Programs, AlcoholEdu and Prescription Drug Safety, which allows us to provide services while the traditional sites (schools & community) are closed. These programs address the specific long-term outcomes identified in the CCAP for Monroe County. The overall intention of implementing these practices is to build self-esteem, develop resiliency skills, and enable children to become caring, responsible adults. These practices also address common goals and outcomes listed in the Monroe County CCAP 2017-2022, while integrating linkages to primary care for those participants currently lacking resources to maintain overall health and wellness. Services will build upon identified protective factors while considering identified risk factors to align with SAMHSA's CSAP Strategic Prevention Framework, the National Drug Control Strategy, and the National Underage Drinking Prevention Strategy. Using the Strategic Prevention Strategy's 5 steps, POP staff will ASSESS the needs of youth; build participant's capacity considering risk and protective factors; plan the best Prevention approaches with participants using EBP's; implement sessions based on these EBP's; and work closely with the SFBHN and Behavioral Science Research Institute (BSRI) evaluation entity to conduct evaluation of the program's outcomes and effectiveness. The Mental Health First Aid strategy will support the processes. These five steps assist youth while considering sustainability of the program and a framework of cultural competency always. The POP program staff will seek to coordinate all prevention activities with referrals from other agencies to collaborate and maximize resources when indicated and possible. Page 1 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 The Guidance/Care Center's Prevention program, POP (Power of Prevention) consists of (5) evidence-based practices: An Apple A Day©(K-4), Project SUCCESS Prevention Education Series (PES) (Middle School), and Teen Intervene (Middle School). These programs are facilitated in person at the schools or community sites. Due to Covid-19, we have teamed up with Monroe County Coalition to provide (2) additional online EBP Programs, AlcoholEdu and Prescription Drug Safety, which allows us to provide services while the traditional sites (schools & community) are closed. These programs address the specific long-term outcomes identified in the CCAP for Monroe County. The overall intention of implementing these practices is to build self-esteem, develop resiliency skills, and enable children to become caring, responsible adults. These practices also address common goals and outcomes listed in the Monroe County CCAP 2017-2022, while integrating linkages to primary care for those participants currently lacking resources to maintain overall health and wellness. Services will build upon identified protective factors while considering identified risk factors to align with SAMHSA's CSAP Strategic Prevention Framework, the National Drug Control Strategy, and the National Underage Drinking Prevention Strategy. Using the Strategic Prevention Strategy's 5 steps, POP staff will ASSESS the needs of youth; build participant's capacity considering risk and protective factors; plan the best Prevention approaches with participants using EBP's; implement sessions based on these EBP's; and work closely with the SFBHN and Behavioral Science Research Institute (BSRI) evaluation entity to conduct evaluation of the program's outcomes and effectiveness. The Mental Health First Aid strategy will support the processes. These five steps assist youth while considering sustainability of the program and a framework of cultural competency always. The POP program staff will seek to coordinate all prevention activities with referrals from other agencies to collaborate and maximize resources when indicated and possible. 10M Specific Category primary Activity/Program - (Universal prevention Number of include whether Indirect programs, Unduplicated Brief Description practices in Participants the strategy is an Universal each of the six (if duplicated EBP Direct, prevention note) Selective,Indicated) strategies CSAP AlcoholEdu EBP & Online interactive education Selective Education 100 Middle & Prescription Drug courses ATOD pre/post High School Safety EBP completion Youth Community Face to Face anti-ATOD Universal Information 600 Youth & Activities, Fairs, messages through school Direct Dissemination Adults Drives, and based anti-ATOD assemblies, Workshops workshops, health fairs, community events or meetings for youth. An Apple A Day© Classroom education Selective Education 200 (AAAD) Elementary teaching inner strength EBP protective & risk factors and resilience to resist ATOD. Page 2 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 An Apple A Day© School and summer camp Selective Alternative 25 (AAAD) EBP & participants will participate in Project SUCCESS alternative activities ATOD to EBP (Summer) reinforce skills as well as risks & protective factors. Project SUCCESS Classroom education Selective Education 100 Middle School EBP addressing challenges of adolescence, risk of ATOD, relationships & refusal skills. Teen Intervene Early intervention for youth Indicated Education 10 Middle School EBP deemed high risk for or reporting alcohol/drug use referred by school counselor, coach, or as self-referred. An Apple A Day© Support to youth and families Selective Problem 15* (AAAD) EBP, who need additional services. Identification and Project SUCCESS Referral EBP & Teen Intervene EBP Community Community Norms, Prosocial Universal Information 75 Capacity Building — Activities, Opportunities for Direct Dissemination Adults Prosocial Involvement Section II. TARGET POPULATION — RISK AND PROTECTIVE FACTORS TARGET POPULATION OR PARTICIPANTS (Include numbers in tables and a narrative description of participant characteristics below): Description of participants to be served (describe criteria for program enrollment eligibility, geographic areas/ Neighborhoods (list zip codes), risk factors of the neighborhoods, description of the sites (school, church, park, etc.), as well as any other significant demographic information), specific cultural characteristics, and describe according to the Comprehensive Community Action Plan priorities: Youth alcohol use—Abuse by "legal" age individuals, Youth/Adult marijuana use, Prescription drug misuse/abuse, over the counter drugs misuse/abuse, other illicit drug use. Participants to be served include male and female at-risk youth serving elementary, middle school and high school ages residing in Monroe County, FI. Services will be provided county-wide (110 miles) to include all middle schools, elementary schools, high schools and youth residing at the Florida Keys Children's Shelter, Treasure Village Montessori, May Sands Montessori School, Ocean Studies Charter, online virtual programs and courses, youth attending various community programs as well as youth involved in the Juvenile Justice System. Educational priorities in accordance with the Monroe County CCAP are Youth Alcohol Use/Abuse, Youth Drug Use/Abuse. Participants to be served include Health Fairs, School Lunch Family Relief Programs and Food Banks Family Relief Programs throughout Monroe County. Including handing out community needed relief items, materials concerning the prevention programs, information about substance use —wellness, and resources and meeting with participants face to face. Universal Indirect will be used for meetings and strategizing with the Monroe County Coalition. RISK AND PROTECTIVE FACTORS TARGETED, AND PREVENTION SYSTEM OF CARE Page 3 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 COMPREHENSIVE COMMUNITY ACTION PLAN (CCAP) GOALS Prevention Program/Strategy and Related System of Target Population Risk/Protective Factors Targeted Care/CCAP Goal Addressed Education - Favorable Attitudes Towards ATOD, Peer Norms, 1, 2, 3 AlcoholEdu EBP, Prescription Peer Perceptions, Perceptions of Harm, Increased Drug Safety EBP, An Apple A Day Knowledge and Awareness, Boundaries, Family EBP, Project SUCCESS EBP, & Management &Adult Role Models. Teen Intervene EBP Community Activities, Fairs, Community Norms, Pro-social Activities, 3 Drives, and Workshops & Opportunities for Pro-social Involvement. Community Capacity Building Problem Identification & Referral - Truancy, Misconduct, Neglect, Basic Needs With 1 An Apple A Day© (AAAD) EBP, Linkage to Community Resources, Family Project SUCCESS EBP &Teen Management. Intervene EBP Community Capacity Building — Community Norms, Pro-social Activities, 3 Adults Opportunities for Pro-social Involvement Section III. SITE LOCATIONS AND INFORMATION* Target Participants Site Name (Check all that apply) Zip Child Note whether school Street Address City Code / or community Yout Parents Other h Community Partner Monroe 33040 X X Sites 33050 33037 Key Largo Middle 104801 Overseas Hwy Key Largo 33037 X School Plantation Key Middle 100 Lake Rd Tavernier 33070 X School Ocean Studies 92295 Overseas Hwy Tavernier 33070 X Charter School Treasure Village 86731 Overseas Hwy Islamorad 33036 X Montessori School a Stanley Switlik Middle 3400 Overseas Hwy Marathon 33050 X School Sugarloaf School 255 Crane Blvd Sugarloaf 33042 X Gerald Adams 855 W College Rd Key West 33040 X Elementary School Page 4 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 Poinciana Elementary 1407 Kennedy Dr. Key West 33040 X School Sigsbee Charter 939 Felton Rd Key West 33040 X School Horace O'Bryant 1105 Leon Street Key West 33040 X School May Sands Montessori 1400 United Street Key West 33040 X School Marathon Middle 350 Sombrero Rd Key West 33040 X School TOTAL NUMBER TO BE SERVED 1,125 *Changes in sites/locations of services must adhere to contractual requirement procedures. Section IV. MAJOR REFERRAL SOURCES List the major referral sources for the services provided: Monroe County Schools Teachers, Principals and School Counselors Department of Juvenile Justice Self-Referral Social Service Agencies Community Section V. EVALUATION AND PERFORMANCE/OUTCOME MEASURES Describe how the program will evaluate the effectiveness of all prevention services to be implemented consistent with 65D-30.013(2), F.A.C., in collaboration with the Evaluation Team identified by SFBHN each year. The SFB'HN Evaluation Team shall review the results of providers' program evaluation and all technical materials used by providers annually to ensure consistency with current research in the `prevention field. Evaluation of the effectiveness of all Prevention services described shall take place with BSRI. GCC/POP will do the following: Address the underage drinking goal from the Monroe County CCAP and common outcomes related to substance and other alcohol use and will measure them using the Monroe County FYSAS, and Alcohol Time Line Follow Back. POP will use results from previous years' FYSAS as the baseline and utilize more results by 2017 during course of this project to define meaningful improvement and gauge POP participant outcomes as they relate to the overall goals of the CCAP. Adhere to the Fidelity requirements of each program. Any problem areas in the classrooms or in the groups, will be discussed and addressed at weekly Supervision meetings. The effectiveness of all programs will be evaluated through the pre and post surveys and client satisfaction surveys. Random observations will be done by Prevention Coordinator and Research Assistant. All activities for Prevention will be consistent with the agency's Quality Assurance/Quality Improvement Plan. Activity Logs will be maintained for all Prevention activities and client charts will be maintained for Indicated Prevention Activities. Coordinate with the Evaluation Team regularly, attend meetings, and submit the required documentation. Page 5 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 Section VI. QUANTITY AND QUALITY PERFORMANCE MEASURES AND TASK LIST Include all TMSF Prevention required performance assessment tools (e.g. information forms, pre- post surveys, satisfaction surveys, fidelity measures, onsite observation reports) and other required information pertaining to quality. Number Program Activity- EBP and %to Meet this Type of EBP Activities/Service Name and Description Ty Outcome Observat (Include frequency, intensity, &duration of Particip Recomme and ion' sessions, as well as the number of cycles/cohorts ants - nded Annual Sessions Meaningful Visits by expected to be offered and tentative Improvement Evalua schedule/timing) Pre-Post Goal or Hours tion Number served Activity Title: Education-An Apple A Day© 200 (8-10) 100% will receive 2 on site Activity Description: EBP Anti-ATOD Curriculum youth sessions services and or virtual • Recruit sites/locations 85% of program visits • Create Memorandums of Understanding K-4th completers will /Affiliation agreements for each site. grade show decreased • Meet with staff for curriculum scheduling of favorable educational sessions in the site. attitudes, and • Curriculum preparation- print learning increased materials, prepare PowerPoint perceptions of presentations. harm, and • Youth registration- create participant data increased record sheet at initiation of first session. prosocial skills. • Complete registration, pre/posttest, satisfaction • Enter all outcome data in the BSRI D.O.E.S system. • Update participant information in database. • Conduct weekly curriculum sessions. • Update weekly attendance • Enter participant or event data in PBPS data collection system • Provide follow up information as needed Frequency: Education 1 x weekly (or 2x - 3x depending on site/cohort schedule) Intensity: 30 Min to 1 hour depending on grade. Duration: 8-10 sessions (includes registration, pre/posttest, plus satisfaction, participant orientation), year- round but primarily during school year and during the summer Meaningful Improvement Satisfaction: 90% of program completers demonstrate satisfaction with Page 6 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 program services Activity Title: Education Project SUCCESS PES 100 (6-8) 100% will Activity Description: EBP Anti-ATOD Curriculum youth Sess receive services • Recruit sites/locations ions and • Create Memorandums of Understanding 6th-8th 85% of program /Affiliation agreements for each site. grade completers will • Meet with staff for curriculum scheduling of show educational sessions in the site. decreased • Curriculum preparation- print learning favorable materials, prepare PowerPoint attitudes, and presentations. increased • Youth registration- create participant data perceptions of record sheet at initiation of first session. harm, and • Complete registration, pre/posttest, satisfaction increased Enter all outcome data in the BSRI D.O.E.S prosocial skills. system. • Update participant information in database. • Conduct weekly curriculum sessions. • Update weekly attendance • Enter participant or event data in PBPS data collection system • Provide follow up information as needed Frequency: Education 1 x weekly (or 2x - 3x depending on site/cohort schedule) Intensity: 1 hour Duration: 6-8 sessions (includes registration, pre/posttest, plus satisfaction, participant orientation), year- round but primarily during school year and during the summer Meaningful Improvement Satisfaction: 90% of program completers demonstrate satisfaction with program services Activity Title: Education Teen Intervene 10 (3-5) 100% will NA Activity Description: EBP Anti-ATOD youth session receive services Curriculum s and • Recruit sites/locations 6th-8th 85% of program • Create Memorandums of Understanding grade completers will /Affiliation agreements for each site. show • Meet with staff for curriculum scheduling of decreased educational sessions in the site. favorable • Curriculum preparation- print learning attitudes, and materials, prepare PowerPoint increased presentations. perceptions of • Youth registration- create participant data harm, and record sheet at initiation of first session. increased • Complete registration, pre/posttest, satisfaction prosocial skills. • Enter all outcome data in the BSRI D.O.E.S system. • Update participant information in database. • Conduct weekly curriculum sessions. Page 7 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 • Update weekly attendance • Enter participant or event data in PBPS data collection system • Provide follow up information as needed Frequency: Education Weekly or Schedule Allows Intensity: 1 hour Duration: 3-5 sessions (includes registration, pre/posttest, plus satisfaction, participant orientation), year- round but primarily during school year and during the summer Meaningful Improvement Satisfaction: 90% of program completers demonstrate satisfaction with program services. Activity Title: AlcoholEdu EBP & Prescription 100 As 100% will NA Drug Safety EBP youth needed receive Activity Description Online interactive services ATOD education courses. 6th_12th and • Recruit sites/locations grade 85% of program • Get Parent approval completers will • Meet with staff for curriculum scheduling of show decreased educational sessions in the site. favorable • Curriculum preparation- print learning attitudes, and materials, prepare PowerPoint increased presentations. perceptions of • Youth registration- create participant data harm, and record sheet at initiation of first session. increased • Complete registration, pre/posttest, satisfaction prosocial skills. • Enter all outcome data in the BSRI D.O.E.S system. • Update participant information in database. • Enter participant or event data in PBPS data collection system • Provide follow up information as needed Frequencv: Education as needed to complete course. Intensity: 1 or 3 hours depending on course. Duration: As needed to complete course. Activity Title: Capacity Building /ATOD 75 As 100% of NA Presentations adults needed individuals Activity Description: ATOD prevention receive presentations to adults in both school and All materials and/or non-traditional settings. As well as for site ages information. personnel, other community key stakeholders including parents, teachers, and coaches. Frequencv: One-time presentation Intensity: As needed Duration: Year-Round and scheduled with school faculty/administration and community partners. Activity Title: Community Activities, Fairs, 600 As 100% of NA Drives, and Workshops/ATOD youth & needed individuals Page 8 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 Activity Description: Face to Face anti- adult receive ATOD messages and providing materials materials and/or through school based anti-ATOD All information. assemblies, workshops, health fairs, ages community events or meetings for youth. Frequency:As needed and/or scheduled & available. Intensity. As needed Duration: Year-Round and scheduled with school faculty/administration and community partners. Section VII. CAPACITY BUILDING AND COORDINATION List other funding sources your agency/organization has for prevention/youth development programming. Describe how the program will coordinate with other programs and services provided by funded agency/organization. Describe other programs funded that align with prevention goals. GCC currently receives support from the PPG Grant for school based youth development programs. They are in all (3) high schools full-time using the EBP Project SUCCESS. GCC will coordinate with PPG staff so that youth who are in need of additional prevention services are identified via problem ID and referral strategies and are referred into Teen Intervene program. This will be noted in DOES system. List other prevention programming and providers in sites mentioned in Section III of this document. Describe how the program will coordinate with other funded organizations' programs and services to avoid duplication of services. GCC also knows that The Florida Keys Children's Shelter has programs in the sites we are in; they provide the EBP All Stars. GCC will begin scheduling meetings to build capacity and cross-learn more about their programs to best develop a coordination plan documented in PBPS. List the coalition(s)within the target service areas in which prevention services will be provided under this Scope. Describe how the program will coordinate with the coalition and share data/contribute to the ongoing Strategic Prevention Framework with the identified coalition(s). Monroe County Coalition (MCC) covers all our area. GCC works with MCC on two EBP's (AlcoholEdu and Prescription Drug Safety). GCC and the MCC partnered in implementing these two programs as they serve our shared prevention goals and each entity having roles in the start-up, implementation and evaluation processes. We attend the Monthly Coalition Meetings where attendees share information and data on their programs, community events, rules, laws, and community ATOD activities from our local sheriff's office and nationwide. Attendance is strong with representation from Local, State&County Community Leaders, Prevention Providers, and Law Enforcement. All share the same prevention framework goals and we review and strategize for maximum coverage with positive outcomes. Section Vill. ADDITIONAL PREVENTION REQUIREMENTS Page 9 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 1. Site Schedule A final site schedule, on the Site Schedule form, with dates, times, and location of services shall be submitted no later than August 31 of the fiscal year or when requested by the Contract Manager. Sites schedules must be approved by SFBHN, in writing, and will be based on county need and distribution of services to avoid duplication in any geographical area or school to maximize SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity in writing and submitted to the Contract Manager for review and approval by the Prevention Director.The Contract Manager will reply with approval. The site schedules shall be submitted on the SFBHN Prevention Site Schedule format. 2. Memorandum of Understanding (MOU)With the Community Coalition To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition shall execute and /or maintain a memorandum of understanding (MOU)delineating the specific responsibilities of each. This MOU will be consistent with the strategies of the State of Florida Department of Children and Families' and the Managing Entity's (ME's) prevention strategy.The provider shall submit an executed copy of the MOU to the ME's Contract Manager within 30 days of the effective date of the contract (for newly executed MOUs)or within thirty(30)calendar days for renewed MOUs. 3. Memorandum of Understanding (MOU)With Sites To facilitate the coordination and delivery of services, all providers shall have executed Memoranda of Understanding (MOU) with the sites where services are being provided. All MOUs with the sites shall be current and up to date, outlining the terms of the agreement. 4. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work. 5. Meetings All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, BSRI, at regularly scheduled or specially called meetings when notified by the ME. The ME will make every attempt possible to schedule meetings with advanced notice; however, there may be meetings that may be called on short notice. These include, but are not limited to, Prevention provider meetings, meetings with Behavioral Science Research Institute, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, and other meetings as noticed by SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 6. Reports/Assignments and Special Reports/Assignments Providers are expected to submit reports as outlined in the contract. Prevention Partnership Grant (PPG) reporting is specifically described in the contract with dates for submission. Other reports will be requested by SFBHN. Page 10 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 Special reports and assignments are requested from time to time to meet State/Local Department of Children and Families, State Block Grant,SFBHN, and other requirements and needs. Prevention providers are required to submit the reports in the format requested and by the timeline requested. These reports may be requested from different sources for different reasons. Requests generally come from SFBHN staff, including the Prevention Director, and may be requested verbally or in writing. There may be times when other collaborative partners request information and SFBHN will support these requests. 7. Training The Scope of Work outlines the requirements for training to support the State Block Grant reporting requirements for workforce development as well as for strengthening the Prevention workforce. All providers shall attend scheduled training as required by the ME, meet the ME and the evaluation team, BSRI, for technical assistance and/or training, at regularly scheduled or specially called meetings when notified by the ME. 8. Report Cards Providers are required to comply with the measures on the Prevention Report Card. Grading for the measures will be according to compliance or lack thereof. 9. Data All providers are required to submit the program data monthly in the Performance Based Prevention System (PBPS)as required by the contract. The provider shall also: ■ Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract and consistent with the Scope of Work in the contract; ■ Ensure that all data submitted to PBPS is consistent with the data maintained in the provider's file and consistent with the Scope of Work in the contract; ■ Review the data submitted with the evaluation team, Behavioral Science Research Institute(BSRI), monthly to determine any discrepancies in the numbers related the evaluation and the Scope of Work and make corrections prior to submission for approval by the SFBHN Prevention Director; ■ Submit an email to the SFBHN Prevention Director and the designated SFBHN Data Analyst verifying that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. There shall be a designated individual and one back up individual at the provider organization responsible for verifying the data and submitting the email. This will imply that the data has been reviewed and is ready for submission. o The email subject line shall read: PBPS Data Submission Verification o The body of the email shall read: (name of organization) is submitting the PPG Prevention data for the month of (name of the month) in PBPS and we assure that the data is complete and correct. Our organization's data may be used to report to the State for the Block Grant report. Our organization's data may be used to reconcile with the payments for this month. ■ Failure to submit any data, or correct any errors in the data which results in a rejection rate of ten percent (10%) or higher of the monthly data submitted, will require the provider to submit a Page 11 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 corrective action plan describing how and when the missing data will be submitted or how and when the rejected will be corrected and resubmitted; and ■ In accordance with the provisions of s. 402.73(1), F. S., and Rule 65-29.001 F.A.C., corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 10. Evaluation Prevention providers shall work in collaboration with the evaluation team, Behavioral Science Research Institute (BSRI) by participating in meetings, training, and providing service data and other necessary identified data vital to the completion of the system-wide evaluation of the prevention services within the Strategic Prevention Framework. Data will be provided to BSRI in the BSRI data system, DOES, and in any other requested format. The data includes the numbers for outcome data and process data required that contributes to the evaluation of the Prevention System of Care. Prevention providers are required to participate in fidelity checks, meetings, training, and other fidelity activities related to the outcomes in the Scope of Work and for the larger Prevention System of Care evaluation. BSRI will report compliance and collaboration to SFBHN per the BSRI Scope of Work requirements Page 12 of 12 Scope of Work Guidance Care Center, Inc. Contract No. ME225-11-27 NX THRIVING MIND SOUTH FIOHICA" Attachment V SCOPE OF WORK NAME OF PROVIDER: Guidance/Care Center NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: $22437.00 State Opioid Response Prevention Partnership TYPE OF FUNDING: Prevention Services Grant (PPG) x COST ALLOCATED TO: (check both Children's Substance Adult Substance Abuse if approved for both covered services) Abuse x Section I. DESCRIPTION OF SERVICES AND STRATEGIES FOR SERVICE DELIVERY DESCRIPTION OF SERVICES 'SUMMARY (include overall intention/purpose of program and service flow, brief description of program activities, target population to be served by the program services and how it was selected, how the services address cultural competency, the name (s)of the EBP (s)and how it (they) will be implemented, describe comprehensive programming, and the partners and coordination efforts): The Guidance/Care Center's (GCC) will provide the Project SUCCESS program using the Substance Abuse and Mental Health and Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) Project SUCCESS program recognized in the National Registry of Evidence-based Programs and Practices (NREPP). The program will be available and accessible to high risk youth ages 11 to 13 who have experimented with alcohol, are showing early danger signs and multiple risk factors for substance abuse and who attend Horace O'Bryant Middle School. Project SUCCESS relies primarily on Education as a strategy. Services include school wide activities targeting the entire school population and are designed to increase awareness of mental health and substance abuse issues, small groups targeting youth identified as being at risk, prevention education groups targeting all 91h graders, and individual counseling to those in need of additional supportive counseling. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20-year olds by 10% by meeting the following objectives: reducing alcohol use, increasing the perception of harm and risk in youth and enhancing positive, pro-social protective factors. Goal 2: Increase capacity by providing level 2 prevention programming for those at high risk; thereby eliminating service gaps for these students by providing the funding and resources necessary to ensure successful program implementation, continuity of care and partnership capacity countywide. GCC partners with the Monroe County School District and the Monroe County Coalition for the provision of these services Scope of Work Page 1 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 IOM Specific Category primary Number of Activity/Program - (Universal prevention Unduplicate include whether Indirect, programs, d the strategy is an Brief Description Universal practices in Participants EBP Direct, each of the six (if duplicated Selective prevention note) Indicated) strategies (CSAP) School wide School wide Activities is a Universal Information and 75 activities Universal Direct prevention Dissemination strategy. 9 months out of the school year Project SUCCESS staff will conduct activities designed to inform and increase awareness of varying targets of prevention services (suicide awareness, mental health and substance use awareness for example). 7th grade PES 7th grade Prevention Education Selective Education 50 Series is a Selective prevention strategy which consists of 4 topics taught in 4 to 8 sessions to all 7th graders enrolled in the school Small groups Small groups is a Selective Selective Education 20 prevention strategy which consists of small group activities organized around various themes used to serve youth who are identified as being at risk. Student Assistance Student Assistance is a Selective Selective Problem I D and 100 prevention strategy in which referral students who are identified as needing a services are provided that service by Project SUCCESS staff or referred elsewhere for the needed service. One on One One on One is an Indicated Indicated Education 8 prevention strategy in which a student can receive up to 3 individual prevention sessions as need. Section 11. TARGET POPULATION — RISK AND PROTECTIVE FACTORS TARGET POPULATION OR PARTICIPANTS (include numbers in tables and a narrative description of participant characteristics below): Description of participants to be served (describe criteria for program enrollment eligibility, geographic areas/ Neighborhoods (list zip codes), risk factors of the neighborhoods, description of the sites (school, church, park, etc.), as well as any other significant demographic information), specific cultural characteristics, and describe according to the Comprehensive Community Action Plan priorities: Youth alcohol use—Abuse by "legal" age individuals, Youth/Adult marijuana use, Prescription drug misuse/abuse, over the counter drugs misuse/abuse, other illicit drug use. Scope of Work Page 2 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Participants will be students at Horace O'Bryant Middle School students in Key West. School wide activities are universal in nature while PES, small groups and individual counseling are targeted at youth identified as at risk. At risk students might be identified by parents, teachers, and other community agencies or by themselves. Project SUCCESS is designed to be implemented in school settings. Each counselor has been provided with adequate space and access to student populations to fully implement the program as designed. GCC has made changes to its Prevention programming for the coming year in that most all grade levels will be covered. Apple a Day will cover K through grade 4, Alcohol Literacy and Teen Intervene will cover middle schools and Project SUCCESS will be in the high schools. The comparison of percentage of Monroe County youth and Florida Statewide youth who reported having used a list of 14 various drugs in their lifetimes reveals that percentages for Monroe County youth exceed those for the state in every category (FYSAS 2010). A significantly greater percentage of Monroe County High School students (40.9%) than statewide students (33.6%) witnessed gang members selling drugs. The ethnicity of these children breaks down as follows: 52.9% White, 33.8% Hispanic, 10.10% Black, 1.45% Asian and 2.88% Other. Risk factors: Favorable attitudes towards ATOD Perceptions of harm Community Norms Self-regulation Protective factors: Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values RISK AND PROTECTIVE FACTORS TARGETED, AND PREVENTION SYSTEM OF CARE COMPREHENSIVE COMMUNITY ACTION PLAN (CCAP) GOALS Prevention Program/Strategy and Related System of Target Population Risk/Protective Factors Targeted Care/CCAP Goal Addressed School wide activities Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Prosocial opportunities/activities Positive peer influence, Healthy behaviors Increased knowledge/awareness 71h Grade Prevention Education Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Scope of Work Page 3 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Skill/competency Healthy behaviors Increased knowledge/awareness Small groups Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Student Assistance Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values One on one Indicated Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Section III. SITE LOCATIONS AND INFORMATION* Site Name Street Address City Zip Target Participants Code (Check all that apply) Scope of Work Page 4 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Note whether school or Child/ Parents Others community Youth Horace O'Bryant Middle 1105 Leon St, Key Key West 33040 x School TOTAL NUMBER TO BE SERVED 253 *Changes in sites/locations of services must adhere to contractual requirement procedures. Section IV. MAJOR REFERRAL SOURCES List the major referral sources for the services provided: Monroe County Public Schools Parents Self-referral Other Community Agencies Section V. EVALUATION AND PERFORMANCE/OUTCOME MEASURES Describe how the program will evaluate the effectiveness of all prevention services to be implemented consistent with 65D-30.013(2), F.A.C., in collaboration with the Evaluation Team identified by SFBHN each year. The SFBHN Evaluation Team shall review the results of providers' program evaluation and all technical materials used by providers annually to ensure consistency with current research in the prevention field. Evaluation of the effectiveness of all Prevention services described shall take place with BSRI. GCC will do the following: Address the underage drinking goal from the Monroe County CCAP and common outcomes related to substance and other alcohol use and will measure them using the Monroe County FYSAS, and Alcohol Time Line Follow Back. GCC will use results from previous years' FYSAS as the baseline and utilize more results by 2017 during course of this project to define meaningful improvement and gauge GCC participant outcomes as they relate to the overall goals of the CCAP. Adhere to the Fidelity requirements of each program. Any problem areas in the classrooms or in the groups, will be discussed and addressed at weekly Supervision meetings. The effectiveness of all programs will be evaluated through the pre and post surveys and client satisfaction surveys. Random observations will be done by Prevention Coordinator and Research Assistant. All activities for Prevention will be consistent with the agency's Quality Assurance/Quality Improvement Plan. Activity Logs will be maintained for all Prevention activities and client charts will be maintained for Indicated Prevention Activities. Coordinate with the Evaluation Team regularly, attend meetings, and submit the required documentation. GCC will coordinate with the Evaluation Team, Behavioral Science Research Institute (BSRI), for process and outcome data as required. The Data will support any processes from the Westcare Team Scope of Work Page 5 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Section VI. QUANTITY AND QUALITY PERFORMANCE MEASURES AND TASK LIST Include all TIVISF Prevention required performance assessment tools (e.g. information forms, pre- post surveys, satisfaction surveys, fidelity measures, onsite observation reports) and other required information pertaining to quality. Number Program Activity— EBP and %to Meet this Obsery Activities/Service Name and Description Type of EBP Outcome ation (include frequency, intensity, &duration of Particip Recomm and Visits sessions, as well as the number of cycles/cohorts ants - ended Meaningful by expected to be offered and tentative Annual Sessions Improvement Evalua schedule/timing) Goal or Hours Pre-Post tion Number served Activity Title: Recruitment/Screening 100 N/A 85% NA Activity Description:. All students referred or presenting for service will receive an initial screening of risk and protective factors Frequency, One time upon program entry Intensity, one session Duration:. 15 mins. Activity Title: Intake/Assessment 8 45 - 60 85% NIA Activity Description: Participants who become mins. enrolled in the program will complete a detailed intake of service needs Frequency: Once, upon enrollment in the program Intensity. One session Duration: 60 mins. Activity Title: Project SUCCESS Prevention 50 85% of 85% 2 Education Series Curriculum schedule 0 Activity Description:. 7 th graders will participate d n in a 4 topic Prevention Education Curriculum sessions sit Frequency: one time per week (6 - 8) e Intensity. 6—8 sessions, based on class time For or restrictions 45 Vir Duration: 45 to 50 mins. to al 60 Vi min sit S. S Activity Title: Pre- and Post-testing 70 45 to 85 % N Activity Description:. All large and small group 60 A participants will be pre and post tested for the min. knowledge, beliefs, attitudes and use of sessi substances ons Frequency: Twice Intensity. once before first session, once at completion of last session Duration: 45 to 50 mins. Scope of Work Page 6 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Activity Title: Small group activities 20 45 to 60 85% 2 onsite Activity Description:. At risk students will min. or virtual participate in small group sessions designed to session visits mitigate risk factors and enhance protective s per factors quarter Frequency: One session per week Intensity. 4-8 sessions depending on the group subject and with the exception of New Comers groups which only meet 3 times. Duration: 45 to 50 minsDuration: Meaningful Improvement Satisfaction: 90% of program completers demonstrate satisfaction with program services Section VII. CAPACITY BUILDING AND COORDINATION List other funding sources your agency/organization has for prevention/youth development programming. Describe how the program will coordinate with other programs and services provided by funded agency/organization. Describe other programs funded that align with prevention goals. GCC currently receives funding from SFBHN Regular Prevention which supports An Apple A Day serving K through 41h grade, and Teen Intervene in the High Schools. Since Project SUCCESS focuses on HOB middle school students there is no overlap. Prevention staff participate in clinical staff meetings in each location and can make referrals for higher levels of care as needed. List other prevention programming and providers in sites mentioned in Section III of this document. Describe how the program will coordinate with other funded organizations' programs and services to avoid duplication of services. GCC is aware that the Florida Keys Children's Shelter operates Prevention services using the EBP All Stars. GCC and FKCS hold conversations to ensure awareness of each other's Prevention Activities and to avoid duplication List the coalition(s)within the target service areas in which prevention services will be provided under this Scope. Describe how the program will coordinate with the coalition and share data/contribute to the ongoing Strategic Prevention Framework with the identified coalition(s). GCC works with the Monroe County Coalition by attending all meetings and coordinating activities county wide. MCC has been particularly helpful in supporting Project SUCCESS school wide activities by providing student hand-outs and incentives. GCC will coordinate and participate in MCC community events such as "Know the Law" campaign Section Vill. ADDITIONAL PREVENTION REQUIREMENTS Scope of Work Page 7 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 1. Site Schedule A final site schedule, on the Site Schedule form, with dates, times, and location of services shall be submitted no later than August 31 of the fiscal year or when requested by the Contract Manager. Sites schedules must be approved by SFBHN, in writing, and will be based on county need and distribution of services to avoid duplication in any geographical area or school to maximize SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity in writing and submitted to the Contract Manager for review and approval by the Prevention Director.The Contract Manager will reply with approval. The site schedules shall be submitted on the SFBHN Prevention Site Schedule format. 2. Memorandum of Understanding (MOU)With the Community Coalition To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition shall execute and /or maintain a memorandum of understanding (MOU)delineating the specific responsibilities of each. This MOU will be consistent with the strategies of the State of Florida Department of Children and Families' and the Managing Entity's (ME's) prevention strategy.The provider shall submit an executed copy of the MOU to the ME's Contract Manager within 30 days of the effective date of the contract (for newly executed MOUs)or within thirty(30)calendar days for renewed MOUs. 3. Memorandum of Understanding (MOU)With Sites To facilitate the coordination and delivery of services, all providers shall have executed Memoranda of Understanding (MOU) with the sites where services are being provided. All MOUs with the sites shall be current and up to date, outlining the terms of the agreement. 4. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work. 5. Meetings All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, BSRI, at regularly scheduled or specially called meetings when notified by the ME. The ME will make every attempt possible to schedule meetings with advanced notice; however, there may be meetings that may be called on short notice. These include, but are not limited to, Prevention provider meetings, meetings with Behavioral Science Research Institute, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, and other meetings as noticed by SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 6. Reports/Assignments and Special Reports/Assignments Providers are expected to submit reports as outlined in the contract. Prevention Partnership Grant (PPG) reporting is specifically described in the contract with dates for submission. Other reports will be requested by SFBHN. Scope of Work Page 8 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 Special reports and assignments are requested from time to time to meet State/Local Department of Children and Families, State Block Grant,SFBHN, and other requirements and needs. Prevention providers are required to submit the reports in the format requested and by the timeline requested. These reports may be requested from different sources for different reasons. Requests generally come from SFBHN staff, including the Prevention Director, and may be requested verbally or in writing. There may be times when other collaborative partners request information and SFBHN will support these requests. 7. Training The Scope of Work outlines the requirements for training to support the State Block Grant reporting requirements for workforce development as well as for strengthening the Prevention workforce. All providers shall attend scheduled training as required by the ME, meet the ME and the evaluation team, BSRI, for technical assistance and/or training, at regularly scheduled or specially called meetings when notified by the ME. 8. Report Cards Providers are required to comply with the measures on the Prevention Report Card. Grading for the measures will be according to compliance or lack thereof. 9. Data All providers are required to submit the program data monthly in the Performance Based Prevention System (PBPS)as required by the contract. The provider shall also: ■ Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract and consistent with the Scope of Work in the contract; ■ Ensure that all data submitted to PBPS is consistent with the data maintained in the provider's file and consistent with the Scope of Work in the contract; ■ Review the data submitted with the evaluation team, Behavioral Science Research Institute(BSRI), monthly to determine any discrepancies in the numbers related the evaluation and the Scope of Work and make corrections prior to submission for approval by the SFBHN Prevention Director; ■ Submit an email to the SFBHN Prevention Director and the designated SFBHN Data Analyst verifying that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. There shall be a designated individual and one back up individual at the provider organization responsible for verifying the data and submitting the email. This will imply that the data has been reviewed and is ready for submission. o The email subject line shall read: PBPS Data Submission Verification o The body of the email shall read: (name of organization) is submitting the PPG Prevention data for the month of (name of the month) in PBPS and we assure that the data is complete and correct. Our organization's data may be used to report to the State for the Block Grant report. Our organization's data may be used to reconcile with the payments for this month. ■ Failure to submit any data, or correct any errors in the data which results in a rejection rate of ten percent (10%) or higher of the monthly data submitted, will require the provider to submit a Scope of Work Page 9 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 corrective action plan describing how and when the missing data will be submitted or how and when the rejected will be corrected and resubmitted; and ■ In accordance with the provisions of s. 402.73(1), F. S., and Rule 65-29.001 F.A.C., corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 10. Evaluation Prevention providers shall work in collaboration with the evaluation team, Behavioral Science Research Institute (BSRI) by participating in meetings, training, and providing service data and other necessary identified data vital to the completion of the system-wide evaluation of the prevention services within the Strategic Prevention Framework. Data will be provided to BSRI in the BSRI data system, DOES, and in any other requested format. The data includes the numbers for outcome data and process data required that contributes to the evaluation of the Prevention System of Care. Prevention providers are required to participate in fidelity checks, meetings, training, and other fidelity activities related to the outcomes in the Scope of Work and for the larger Prevention System of Care evaluation. BSRI will report compliance and collaboration to SFBHN per the BSRI Scope of Work requirements Scope of Work Page 10 of 10 Guidance Care Center, Inc. Contract No. ME225-11-27 ATTACHMENT D (Continued) Contractual Agreements P-4 Guidance/Care Center and South Florida Behavioral Health Network, Inc. South Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 CFDA No(s). See Post Award Notice Client Services 0 Non-Client Services ❑ CSFA No (s). See Post Award Notice Subrecipient 0 Vendor ❑ Federal Funds © State Funds ❑ STANDARD CONTRACT THIS CONTRACT is entered into between the South Florida Behavioral Health Network, Inc., (SFBHN) hereinafter referred to as the "Managing Entity"(ME)and Guidance/Care Center,Inc., hereinafter referred to as the "Network Provider." 1. Contract Document The Network provider shall provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits,and documents incorporated by reference which constitute the contract document. 2. Requirements of Section 287.058, Florida Statutes(F.S.) The Network Provider shall provide units of deliverables,including reports,findings,and drafts,as specified in this contract.These deliverables must be received and accepted by the ME contract manager and/or designee, in writing prior to payment.The Network Provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for proper pre-audit and post-audit;where itemized payment for travel expenses are permitted in this contract,submit bills for any travel expenses in accordance with section 112.061, F.S.,or at such lower rates as may be provided in this contract. To allow public access to all documents, papers, letters, or other public records as defined in subsection 119.011(12), F.S.and as prescribed by subsection 119.07(1)F.S., made or received by the Network Provider in conj unction with this contract except that public records which are made confidential by law must be protected from disclosure. It is expressly understood that the Network Provider's failure to comply with this provision shall constitute an immediate breach of contract for which the ME may unilaterally terminate the contract. 3. Provisions of the Prime Contract All provisions,terms and conditions,or amendments,addendum,changes or revisions applicable to the Network Provider made s ubsequent to the initial execution of the Prime Contract, i.e.,the Contract entered into between the DCF and SFBHN (ME), not in conflict with this Contract, shall be binding upon the Network Provider and the Network Provider agrees to comply with same. The Prime Contract is incorporated by reference in this Contract. In case of conflict with the provisions,terms and conditions of The Prime Contract and this Contract,the provisions, terms and conditions of this Contract will prevail. In the event of a conflict between the provisions of the documents of this contract, the documents shall be interpreted in the order of precedence listed in Paragraph 51.,of this Standard Contract. 4. Effective and Ending Dates This contract shall begin on July 1, 2018. It shall end at midnight, local time in Miami-Dade County, Florida on June 30, 2021, subject to the survival of terms of Section 49. 5. State of Florida Law This contract is executed and entered into in the State of Florida,and shall be construed, performed and enforced in all respects in accordance with Florida law, without regard to Florida provisions for conflict of laws. Courts of competent jurisdiction in Florida shal I have exclusive jurisdiction in any action regarding this contract and venue shall be the appropriate State court in Miami-Dade County, Florida. 6. Federal Law If this contract contains federal funds and it is determined by the ME that the Network Provider is a subrecipient, the Network Provider must adhere to the terms below: a. The Network Provider shall comply with the provisions of Federal law and regulations including, but not limited to, 2 CFR, Part 200, and other applicable regulations. b. If this Contract contains $10,000 or more of Federal Funds, the Network Provider shall comply with Executive Order 11246, Equal Employment Opportunity,as amended by Executive Order 11375 and others,and as supplemented in Department of Labor regulation 41 CFR, Part 60 if applicable. c. If this Contract contains over $150,000 of Federal Funds, the Network Provider shall comply with all applicable standards, orders, or regulations issued under section 306 of the Clean Air Act, as amended (42 U.S.C. § 7401 et seq.), section 508 of the Federal Water Pollution Control Act, as amended (33 U.S.C. § 1251 et seq.), Executive Order 11738, as amended and where applicable, and Environmental Protection Agency regulations(2 CFR, Part 1500).The Network Provider shall report any violations of the above to the ME and the Department. d. No Federal Funds received in connection with this Contract may be used by the Network Provider,or agent acting for the Ne twork Provider, or subcontractor to influence legislation or appropriations pending before the Congress or any State legislature.If this Contract contains Federal funding in excess of$100,000, the Network Provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment III. All disclosure forms as required by the Certification Regarding Lobbying from must be completed and returned to the ME Standard Contract Guidance/Care Center, Inc. Page 1 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 Contract Manager, prior to payment under this Contract. e. If this Contract provides services to children up to age 18,the Network Provider shall comply with the Pro-Children Act of 1994(20 U.S.C.§ 6081).Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to$1,000 for each violation or the imposition of an administrative compliance order on the responsible entity,or both. f. If the Network Provider is a federal subrecipient or pass through entity, the Network Provider and its subcontractors who are federal subrecipients or pass-through entities are subject to the following:A contract award (see 2 CFR§ 180.220) must not be made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines in 2 CFR, Part 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended,or otherwise excluded by agencies,as well as parties declared ineligible under statutory or regulatory authority other than Executive Order12549. 7. Audits, Inspections, Investigations,Records and Retention a.The Network Provider shall establish and maintain books,records and documents(including electronic storage media)sufficient to reflect all income and expenditures of funds (to include funds used to meet the local match requirements per 65-E-14 F.A.C., if applicable, provided by the ME under this contract. The Network provider shall establish and maintain books, records and documents (including electronic storage media) sufficient to reflect that the Department is the payer of last resort for substance abuse and mental health services. b. Retention of all client records,financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract shall be maintained by the Network Provider for a period of seven (7)years after completion of the contract or longer when required by law. In the event an audit is required by this contract, records shall be retained for a minimum period of seven (7) years after the audit report is issued or until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the ME. c. Upon demand,at no additional cost to the ME,the Network Provider will facilitate the duplication and transfer of any records or documents during the required retention period in Section 7.b. d. These records shall be made available at all reasonable times for inspection, review,copying,or audit by Federal, State,or other personnel duly authorized by the ME. e. At all reasonable times for as long as records are maintained, persons duly authorized by the ME,State, and Federal auditors, pursuant to 45 CFR,section 92.36(i)(10),shall be allowed full access to and the right to examine any of the Network Provider's contracts and related records and documents, regardless of the form in which kept. f. A financial and compliance audit shall be provided to the ME as specified in this contract and in Attachment II, Financial and Compliance Audit. g. The Network Provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by The Office of the Inspector General (section 20.055, F.S.). h.The Network Provider shall include the aforementioned audit,inspections,investigations and record keeping requirements i n all subcontracts and assignments. 8. Inspections and Corrective Action The Network Provider shall permit all persons who are duly authorized by the ME and the Department to inspect and copy any records, papers, documents, facilities, goods and services of the Network Provider which are relevant to this contract, the scope of review being conducted, and to interview any clients,employees and subcontractor employees of the Network Provider to assure the ME of the satisfactory performance of the terms and conditions of this contract. Following such review,the ME will deliver to the Network Provider a written report of its findings, and may direct the development, by the Network Provider,of a corrective action plan where appropriate.The Network Provider hereby agrees to timely correct all deficiencies identified in the corrective action plan.This provision will not limit the ME's termination rights under Section 40. Failure to implement corrective action plans to the satisfaction of the ME, after receiving due notice, shall be grounds for contract termination. 9. Indemnification a. The Network Provider shall be fully liable for the actions of its agents, employees, partners, or subcontractors and shall fully indemnify, defend, and hold harmless the ME, State and the Florida Department of Children and Families (DCF), and its officers,agents, and employees, from suits, actions, damages, and costs of every name and description, including attorneys'fees, arising from or relating to any alleged act or omission by the Network Provider, its agents,employees, partners,or subcontractors, provided, however,that the Network Provider sha II not indemnify for that portion of any loss or damages caused by the negligent act or omission of the ME. b.The Network Provider shall fully indemnify,defend and hold harmless the ME,the State and the DCF,from any suits,actions,damages, and Standard Contract Guidance/Care Center, Inc. Page 2 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 costs of every name and description, including attorneys'fees, arising from or relating to violation of infringement of a trademark, copyright, patent, trade secret or intellectual property right, provided, however, that the foregoing obligation shall not apply to the ME's misuse or modification of Network Provider's products or a ME's operation or use of Network Provider's products in a manner not contemplated by the contract or the purchase order. If any product is the subject of an infringement suit or in the Network Provider's opinion is likely to become the subject of such a suit,the Network Provider may at its sole expense procure for the ME the right to continue using the product or modify it to become non-infringing. If the Network Provider is not reasonably able to modify or otherwise secure the ME the use,the ME shall not be liable for any royalties.The Network Provider's indemnification for violation or infringement of a trademark,copyright, patent,trade secret or intellectual property right shall encompass all such items used or accessed by the Network Provider, its officers, agents or subcontractors in the performance of this contract or delivered to the ME for the use of the ME, its employees,agents or contractors. c. The Network Provider shall protect, defend, and indemnify, including attorney's fees and cost, the ME for any and all claims and litigation (including litigation initiated by the ME) arising from or relating to Network Provider's claim that a document contains proprietary or trade secret information that is exempt from disclosure or the scope of the Network Provider's redaction, as provided for under Section 32. d.The ME shall not be liable for any cost, expense,or compromise incurred or made by the Network Provider in any legal action.The Network Provider's inability to evaluate liability or its evaluation of liability shall not excuse its duty to defend and indemnify after receipt of notice. Only an adjudication or judgment after the highest appeal is exhausted finding the ME negligent shall excuse the Network Provider of performance under this provision, in which case the ME shall have no obligation to reimburse the Network Provider for costs of its defense. If the Network Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the ME shall be to the extent permitted by section 768.28, F.S.or other applicable law, and without waiving the limits of sovereign immunity. 10. Insurance a. Continuous adequate liability insurance coverage shall be maintained by the Network Provider during the existence of this contract and any renewal(s)and extension(s)thereof and in accordance with the requirements in Attachment I. By execution of this contract, unless it is a State agency or subdivision as defined by subsection 768.28(2), F.S.,the Network Provider accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Network Provider and the clients to be served under this contract.The limits of coverage under each policy maintained by the Network Provider do not limit the N etwork Provider's liability and obligations under this contract. Upon the execution of this contract,the Network Provider shall furnish the ME written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida.The ME reserves the right to require additional insurance as specified in this contract.The network provider shall notify the ME's Contract Manager within thirty(30) calendar days if there is a modification to the terms of insurance,to include but not limited to,cancellation or modification to policy limits. b. To the fullest extent permitted by law, and not withstanding any other provision of this Contract, the Network Provider by signing this contract acknowledges the value of obtaining Cyber Liability insurance, has considered all of the risks,and assumes all of the risks and liability associated with not obtaining such insurance.The Network Provider will indemnify,defend,and hold the ME harmless from any and all claims, losses, liabilities, damages,judgments, fees, expenses, awards, civil monetary penalties, and costs(including reasonable attorneys' and court fees and expenses) arising out of or related to any Breach or alleged Breach of Unsecured PHI created, received, maintained, transmitted, or otherwise used by the Network Provider and arising from the Network Provider's breach, or failure to perform pursuant to this Contract (collectively, a "Claim") up to and including the Appellate Court level and until the case is resolved. If the Network Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the ME shall be to the extent permitted by section 768.28, F.S. or other applicable law,and without waving the limits of sovereign immunity. 11. Confidential Client and Other Information Except as provided by this Contract,the Network Provider shall not disclose but shall protect and maintain the confidentiality of any client information and any other information made confidential by Florida Laws or regulations that is obtained or accessed by the Network Provider or its subcontractors incidental to performance under this contract. State laws providing for confidentiality of client and other information include but are not limited to sections 39.0132, 39.00145, 39.202, 39.809, 39.908,63.162,.63.165,383.412,394.4615,397.501,409.821,409.175,410.037,410.605,414.295,415.107,741.3165 and 916.107,F.S. Federal laws and regulations to the same effect include section 471(a)(8) of the Social Security Act, section 106(b)(2)(A)(viii) of the Child Abuse Prevention and Treatment Act,7 U.S.C.§2020(e)(8),42 U.S.C.§602 and 2 CFR§200.303 and 2 CFR§200.337,7 CFR§272.1(c),42 CFR§§2.1-2.3, 42 CFR§§431.300-306,45 CFR§205. A summary of Florida Statutes providing for confidentiality of this and other information are found in Part II of the Attorney General's Government in the Sunshine Manual,as revised from time-to-time. b. The Network Provider shall not use or disclose any information concerning a recipient of services under this contract for any purpose Standard Contract Guidance/Care Center, Inc. Page 3 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 prohibited by State or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 12. Assignments and Subcontracts a.The Network Provider shall not assign the responsibility for this contract to another party without prior written approval of the ME, upon the ME's sole determination that such assignment will not adversely affect the public interest; however, in no event may the Network Provider assign or enter into any transaction having the effect of assigning or transferring any right to receive payment under this contract which right is not conditioned on full and faithful performance of Network Provider's duties hereunder.Any sublicense,assignment,or transfer otherwise occurring without prior approval of the ME shall be null and void.The Network Provider shall not subcontract for any of the work contemplated under this contract without prior written approval of the ME,which shall not be unreasonably withheld. b. The Network Provider shall ensure that all subcontract agreements,at any tier,for work contemplated under this contract,adhere to all of the requirements of the ME's Prime Contract with the department and all the requirements of this contract. A copy of the Prime Contract can be found at the ME's website.www.sfbhn.org. c.To the extent permitted by Florida Law,and in compliance with Section 9.of this Standard Contract,the Network Provider is responsible for all work performed and for all commodities produced pursuant to this contract whether actually furnished by the Network Provider or its subcontractors. Any subcontracts shall be evidenced by a written document. The Network Provider further agrees that the ME shall not be liable to the subcontractor in any way or for any reason.The Network Provider,at its expense, will defend the ME against such claims. d. The Network Provider shall make payments to any subcontractor within seven(7)working days after receipt of full or partial payments from the ME in accordance with section 287.0585, F.S., unless otherwise Stated in the contract between the Network Provider and subcontractor. Failure to pay within seven (7)working days will result in a penalty that shall be charged against the Network Provider and paid by the Network Provider to the subcontractor in the amount of one-half of one percent (.005) of the amount due per day from the expiration of the period allowed for payment.Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15%) percent of the outstanding balance due. e. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under its contract with the ME to another governmental agency in the State of Florida or to a provider of the Department's selection, upon giving prior written notice to the ME. In the event the State of Florida approves transfer of the ME's obligations,the Network Provider remains responsible for all work performed and all expenses incurred in connection with the contract.This contract shall remain binding upon the successors in interest of the Network Provider, the ME and the Department. f. The Network Provider shall include, or cause to be included, in all subcontracts (at any tier) the substance of all clauses contained in this Standard Contract that mention or describe subcontract compliance. 13. Return of Funds a. The Network Provider shall return to the ME any overpayments due to unearned funds or funds disallowed that were disbursed to the Network Provider by the ME and any interest attributable to such funds.Should repayment not be made promptly upon discovery by the Network Provider or its auditor or upon written notice by the ME,the Network Provider will be charged interest at the lawful rate of interest on the outstanding balance until returned.Payments made for services subsequently determined by the ME to not be in full compliance with contract requirements shall be deemed overpayments. The ME shall have the right at any time to offset or deduct from any payment due under this or any other contract or agreement any amount due to the ME fro m the Network Provider under this or any other contract or agreement.If this contract involves federal or state financial assistance,the following applies:The Grantee shall return to the ME any unused funds; any accrued interest earned; and any unmatched grant funds, as detailed in the Final Financial Report, no later than 60 days following the ending date of this Contract. b. The funds paid to the Network Provider are continually subject to Review,Revision and Adjustment after evaluation of Utilization and measures monitored by ME. 14. Client Risk Prevention and Incident Reporting a. If services to clients are to be provided under this contract,the Network Provider and any subcontractors shall,in accordance with the client risk prevention system, report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6 or circuit or region operating procedures.The Network Provider shall immediately report any knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the Statewide toll-free telephone number (1-800-96ABUSE). As required by Chapters 39 and 415, F.S.,this provision is binding upon both the Network Provider and its employees. b. The ME monitors timely submissions of incident reports and may impose financial penalties as described in Section 39. Financial Penalties for Failure to Comply with Requirement for Corrective Action of this Standard Contract, paragraphs b.,c.,and d. Standard Contract Guidance/Care Center, Inc. Page 4 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 15. Civil Rights Requirements In accordance with Title VII of the Civil Rights Act of 1964,the Americans with Disabilities Act of 1990,or the Florida Civ it Rights Act of 1992,as applicable the Network Provider shall not discriminate against any employee(or applicant for employment) in the performance of this contract because of race, color, religion, sex, national origin, disability, age, or marital status. Further, the Network Provider shall not to discriminate against any applicant, client, or employee in service delivery or benefits in connection with any of its programs and activities in accordance with 45 CFR 80,83,84, 90, and 91,Title VI of the Civil Rights Act of 1964,or the Florida Civil Rights Act of 1992,as app licable and CFOP 60-16. These requirements shall apply to all contractors,subcontractors,sub-grantees or others with whom it arranges to provide services or benefits to clients or employees in connection with its programs and activities.The Network Provider shall complete the Civil Rights Certificate,CF Form 707 and the Civil Rights Compliance Checklist,CF Form 946 in accordance with CFOP 60-16 and 45 CFR 80. 16. Independent Capacity of the Contractor a.In performing its obligations under this contract,the Network Provider shall at all times be acting in the capacity of an independent contractor and not as an officer, employee, or agent of the ME or the State of Florida, except where the Network Provider is a State agency. Network Provider nor its agents, employees, subcontractors or assignees shall represent to others that it has the authority to bind the ME or the Department unless specifically authorized in writing to do so.This contract does not create any right to State retirement, leave benefits or any other benefits of State employees as a result of performing the duties or obligations of this contract. b.The Network Provider shall take such actions as may be necessary to ensure that each subcontractor of the Network Provider will be deemed to be an independent contractor and will not be considered or permitted to be an agent, servant,joint venture, or partner of the ME or the State of Florida.The ME will not furnish services of support(e.g.,office space,office supplies,telephone service,secretarial or clerical support) to the Network Provider,or its subcontractor or assignee, unless specifically agreed to by the ME in this contract. c. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Network Provider, the Network Provider's officers, employees, agents, subcontractors, or assignees shall be the sole responsibility of the Network Provider. 17. Sponsorship As required by section 286.25, F.S., if the Network Provider is a non-governmental organization which sponsors a program financed wholly or in part by State funds, including any funds obtained through this Contract, it shall, in publicizing,advertising,or describing the sponsorship of the program State: "Sponsored by (Network Provider's Name), Inc., South Florida Behavioral Health Network, and the State of Florida, Department of Children and Families". If the sponsorship reference is in written material,the words"South Florida Behavioral Health Network " and "State of Florida, Department of Children and Families" shall appear in at least the same size letters or type as the name of the organization. 18. Publicity Without limitation, the Network Provider and its employees, agents, and representatives will not, without the ME's prior written consent in each instance, use in advertising, publicity or any other promotional endeavor any ME or State mark,the name of the ME's or State mark,the name of the ME,the State, or any ME or State affiliate or any officer or employee of the ME or the State, or represent, directly or indirectly, that any product or service provided by the Network Provider has been approved or endorsed by the ME, or refer to the existence of this Contract in press releases,advertising or materials distributed to the Network Provider's prospective customers. 19. Final Invoice The final invoice for payment shall be submitted to the ME no more than twenty (20) days, per the requirements stipulated in the Method of Payment section of this Contract, after the contract ends or is terminated. If the Network Provider fails to do so, all rights to payment are forfeited and the ME will not honor any requests submitted after the aforesaid time period.Any payment due under the terms of this contract may be withheld until all reports due from the Network Provider and necessary adjustments thereto, have been approved by the ME. 20. Use of Funds for Lobbying Prohibited The Network Provider shall comply with the provisions of sections 11.062 and 216.347, F.S.,which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature,judicial branch,or a State agency. 21. Public Entity Crime Pursuant to section 287.133,F.S.,the following restrictions are placed on the ability of persons on the convicted vendor li st orthe discriminatory vendor list.When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime,or an entity or affiliate has been placed on the discriminatory vendor list, such person, entity or affiliate may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a publ is entity for the construction or the repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; Standard Contract Guidance/Care Center, Inc. Page 5 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 and may not transact business with any public entity in excess of the threshold amount provided in section 287.017, F.S.,for CATEGORY TWO for a period of thirty-six(36) months from the date of being placed on the convicted vendor list. This provision applies to the Network Provider and all their subcontractors. 22. Gratuities The Network Provider agrees that it will not offer to give or give any gift to any ME or Department employee.As part of the consideration for this contract,the parties intend that this provision will survive the contract for a period of two years.In addition to any other remedies available to the ME and the Department, any violation of this provision will result in referral of the Network Provider's name and description of the violation of this term to the Department of Management Services for the potential inclusion of the Network Provider's name on the suspended vendors list for an appropriate period.The Network Provider will ensure that its subcontractors, if any,comply with these p rovisions. 23. Intellectual Property a. It is agreed that all intellectual property, inventions,written or electronically created materials, including manuals, presentations,films,or other copyrightable materials, arising in relation to Network Provider's performance under this contract, and the performance of all of its officers, agents and subcontractors in relation to this contract, are works for hire for the benefit of the Department,fully compensated for by the contract amount, and that neither the Network Provider nor any of its officers, agents nor subcontractors may claim a ny interest in any intellectual property rights accruing under or in connection with the performance of this contract.It is specifically agreed that the Department shall have exclusive rights to all data processing software falling within the terms of section 119.084, F.S., which arises or is developed in the course of or as a result of work or services performed under this contract, or in any way connected herewith. Notwithstanding the foregoing provision,if the Network Provider is a university and a member of the State University System of Florida,then section 1004.23,F.S.,shall apply. b. If the Network Provider uses or delivers to the Department for its use or the use of its employees,agents or contractors,any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the compensation paid pursuant to this contract includes all royalties or costs arising from the use of such design, device,or materials in any way involved in the work contemplated by this contract. For the purposes of this provision,the term "use"shall include use by the Network Provider during the term of this contract and use by the ME,agents,or contractors and the Department during the term of this contract and perpetually thereafter. c.All applicable subcontracts shall include a provision that the Federal awarding agency reserves all patent rights with respect to any discovery or invention that arises or is developed in the course of or under the subcontract. Notwithstanding the foregoing provision, if the Network Provider or one of its subcontractors is a university and a member of the State University of Florida,then section 1004.23, F.S.,shall apply, but the Department shall retain a perpetual, fully-paid, non-exclusive license for its use and the use of its contractors of any resulting patented, copyrighted or trademarked work products. 24. Real Property Any State funds provided for the purchase of or improvements to real property are contingent upon the Network Provider granting to the State a security interest in the property at least to the amount of the State funds provided for at least five(5)years from the date of purchase or the completion of the improvements or as further required by law.As a condition of receipt of State funding for this purpose,the Network Provider agrees that, if it disposes of the property before the Department's interest is vacated, the Network Provider will refund the proportionate share of the State's initial investment,as adjusted by depreciation. 25. Information Security Obligations a. An appropriately skilled individual shall be identified by the Network Provider to function as its Data Security Officer. The Data Security Officer shall act as the liaison to the ME's security staff and will maintain an appropriate level of data security for the information the Network Provider is collecting or using in the performance of this contract.An appropriate level of security includes approving and tracking all Network Provider employees that request or have access to any ME or DCF data system or information. b.The Data Security Officer will ensure that user access to the data system or information has been removed from all terminated Network Provider employees immediately upon termination of employment. c.The Network Provider shall provide the latest DCF HIPAA and Security Awareness Training to its staff and subcontractors who have access to ME and DCF data system, information and/or who have access to Protected Health Information regardless of format (e.g. electronic,written, audio, video or still image recording) or function. Security and HIPAA requirements extend to non-clinical or non-administrative personnel if such persons can access Protected Health Information.The Network Provider shall ensure that proof of training is maintained in each employee file. d. All Network Provider employees who have access to ME or DCF data system or information, including but not limited to access to KIS, or any data system designated by the ME, Substance Abuse and Mental Health Information System (SAMHIS), Incident Reporting and Analysis System (IRAS),Temporary Assistance for Needy Family(TANF), shall comply with, and be provided a copy of CFOP 50-2, and shall sign the DCF Security Agreement form CF 0114 annually or immediately upon hire and annually thereafter. The Network Provider shall maintain a copy of Standard Contract Guidance/Care Center, Inc. Page 6 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 the signed DCF Security Agreement form CF 0114 in the personnel file. The Network Provider agrees to submit copies of each signed DCF Security Agreement form CF 0114 to the ME's Contract Manager and the ME's Director of Information Technology upon request.A copy of CF 0114 may be obtained from the contract manager. e. The Network Provider shall make every effort to protect and avoid unauthorized release of any personal or confidential information by ensuring both data and storage devices are encrypted as prescribed in CFOP 50-2. If encryption of these devices is not possible, then the Network Provider shall assure that unencrypted personal and confidential ME or DCF data will not be stored on unencrypted sto rage devices. The Network Provider shall require the same of all subcontractors. f. The Network Provider agrees to notify the contract manager as soon as possible, but no later than four (4) business days following the determination of any breach or potential breach of personal and confidential ME or DCF data.The Network Provider shall require the same notification requirements of all subcontractors. g. The Network Provider shall provide notice to affected parties no later than thirty (30) days following the determination of any potential breach of personal or confidential ME or DCF data provided in section 501.171(4),F.S.The Network Provider shall require the same notification requirements of all subcontractors. The Network Provider shall also at its own cost implement measures deemed appropriate by the ME to avoid or mitigate potential injury to any person due to a breach of personal and confidential ME and/or DCF data. 26. Accreditation The ME is committed to ensuring provision of the highest quality services to the persons we serve.Accordingly,the ME has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service, the majority of the ME's Network Providers will take appropriate steps to maintain its accreditation or become fully accredited by June 30,2019. 27. DEO and Workforce Florida a. The Network Provider understands the DCF, the Department of Economic Opportunity, and Worksource Florida, Inc., have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment.The ME encourages Network Provider participation with the Department of Economic Opportunity and Workforce Florida, Inc. b. Transitioning Young Adults:The Network Provider understands DCF's interest in assisting young adults aging out of the dependency system. The ME encourages Network Provider participation with the local Community-Based Care Lead Agency Independent Living Program to offer gainful employment to youth in foster care and young adults transitioning from the foster care system. 28. Health Insurance Portability and Accountability Act In compliance with 45 CFR § 164.504 (e) , the Network Provider shall comply with the provisions of the Business Associate Agreement, incorporated herein by reference, governing the safeguarding, use and disclosure of Protected Health Information created, received, maintained,or transmitted by the Network Provider or its subcontracts incidental to the Network Provider's performance of this Contract. 29. Emergency Preparedness a. If the tasks to be performed pursuant to this contract include the physical care or supervision of clients,the Network Provider shall,within thirty(30)days of the execution of this contract,submit to the contract manager an emergency preparedness plan which shall include provisions for records protection, alternative accommodations for clients in substitute care, alternate facilities for the 24 hour facilities in case those facilities are incapacitated by the disaster and the expectation for returning exceeds emergency sheltering capabilities and time allowances supplies, and a recovery plan that will allow the Network Provider to continue functioning in compliance with the executed contract in the event of an actual emergency. For the purpose of disaster planning,the term supervision includes the responsibility of the M E,or its contracted agents to ensure the safety, permanency and well-being of a child who is under the jurisdiction of a dependency court.Children may remain in their homes, be placed in a non-licensed relative/non-relative home,or be placed in a licensed foster care setting. b. The ME agrees to respond in writing within thirty(30) days of receipt of the plan accepting, rejecting, or requesting modifications. In the event of an emergency, the ME may exercise oversight authority over such Network Provider in order to assure implementation of agreed emergency relief provisions. c. An updated emergency preparedness plan shall be submitted by the Network Provider no later than 12 months following the acceptance of an original plan or acceptance of an updated plan.The ME agrees to respond in writing within 30 days of receipt of the updated plan,accepting, rejecting,or requesting modification to the plan. 30. Notification of Legal Action The Network Provider shall notify the ME of legal actions taken against them or potential actions such as lawsuits, related to services provided through this contract or that may impact the Network Provider's ability to deliver the contractual services, or adversely impact the ME.The ME's contract manager will be notified within ten (10) days of Network Provider becoming aware of such actions or from the day of the legal Standard Contract Guidance/Care Center, Inc. Page 7 of 13 Contract No. P-4 Seth Florida Qi-A, Behavioral Health Network,Inc. rev.07/19/2018 filing,whichever comes first. 31. State and Federal Whistleblower Act Requirements a. In accordance with subsection 112.3187, F.S., the Network Provider and its subcontractors shall not retaliate against an employee for reporting violations of law, rule, or regulation that creates substantial and specific danger to the public's health, safety, or welfare to an appropriate agency. Furthermore,agencies or independent contractors shall not retaliate against any person who discloses information to an appropriate agency alleging improper use of governmental office,gross waste of funds,or any other abuse or gross neglect of duty on the part of an agency, public officer,or employee.The Network Provider and any subcontractor shall inform its employees that they and other persons may file a complaint with the Office of Chief Inspector General,Agency Inspector General,the Florida Commission on Human Relations or the Whistle-blower's Hotline number at 1-800-543-5353. b. Pursuant to Section 11(c) of the OSH Act of 1970 and the subsequent federal laws expanding the act, the Network Provider is prohibited from discriminating against employees for exercising their rights under OSH Act. Details of the OSH Act can be found at this website: https://www.whistleblowers.gov/ 32. Proprietary or Trade Secret Information a. Unless exempted by law,all public records are subject to public inspection and copying under Florida's Public Records Law,Chapter 119,F.S. Any claim by Network Provider of proprietary or trade secret confidentiality for any information contained in Network Provider's documents (reports, deliverables or work papers, etc., in paper or electronic form) submitted in connection with this contract will be waived, unless the claimed confidential information is submitted in accordance with Section 32. b. below. b. The Network Provider must clearly label any portion of the documents, data or records submitted that it considers exempt from public inspection or disclosure pursuant to Florida's Public Records Law as proprietary or trade secret. The labeling will include a justification citing specific statutes and facts that authorize exemption of the information from public disclosure. If different exemptions are claimed to be applicable to different portions of the protected information, the Network Provider shall include information correlating the nature of the claims to the particular protected information. c. The ME,when required to comply with a public records request including documents submitted by the Network Provider, may require the Network Provider to expeditiously submit redacted copies of documents marked as confidential or trade secret in accordance with Section 32. b.above.Accompanying the submission shall be an updated version of the justification under Section 32. b.,correlated sped fically to redacted information,either confirming that the statutory and factual basis originally asserted remain unchanged or indicating any changes affecting the basis from the asserted exemption from public inspection or disclosure.The redacted copy must exclude or obliterate only tho se exact portions that are claimed to be proprietary or trade secret. If the Network Provider fails to promptly submit a redacted copy,the ME is authorized to produce the records sought without any redaction of proprietary or trade secret information. d. The Network Provider shall be responsible for defending its claim that each and every portion of the redactions of proprietary or trade secret information are exempt from inspection and copying under Florida's Public Records Law. 33. Support to the Deaf or Hard-of-Hearing a.The Network Provider and its subcontractors,where direct services are provided, shall comply with section 504 of the Rehabilitation Act of 1973, 29 U.S.C.794, as implemented by 45 C.F.R. Part 84(hereinafter referred to as Section 504),the Americans with Disabilities Act of 1990, 42 U.S.C. 12131, as implemented by 28 C.F.R. Part 35 (hereinafter referred to as ADA), and the Children and Families Operating Instruction (CFOP)60-10,Chapter 4,entitled "Auxiliary Aids and Services for the Deaf or Hard-of-Hearing. b. If the Network Provider or any of its subcontractors employs fifteen (15)or more employees,the Network Provider shall designate a Single- Point-of-Contact to ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504, the ADA, and CFOP 60-10,Chapter 4. c. The Network Provider shall, within 30 days of the effective date of this requirement, contractually require that its subcontractors comply with section 504,the ADA,and CFOP 60-10,Chapter 4.The Network Provider's Single Point of Contact and that of its subcontractors will process the compliance data into the Department of Children and Families HHS Compliance reporting database at https://fs16.formsite.com/DCFTrainingZMonthly-Sum mary-Report/form login.html by the 41h working day of the month,covering the previous month's reporting, and forward the confirmation of submission to the ME's Contract Manager. The name and contact information for the Network Provider's Single Point of Contact shall be furnished to the ME's Contract Manager within fourteen(14)calendar days of the effective date of this requirement. d.The network provider shall contractually require that its subcontractors comply with Section 504, the ADA, and CFOP 60-10, Chapter 4. A Single-Point-of-Contact shall be required for each subcontractor that employs fifteen(15)or more employees.This Single-Point-of-Contact will Standard Contract Guidance/Care Center, Inc. Page 8 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the Network Provider's Single-Point-of-Contact. e. The Single-Point-of-Contact shall ensure that employees are aware of the requirements, roles & responsibilities, and contact points associated with compliance with Section 504, the ADA, and CFOP 60-10, Chapter 4. Further, employees of Network Providers and its subcontractors with 15 or more employees shall attest in writing that they are familiar with the requirements of Section 504, the ADA, and CFOP 60-10,Chapter 4.This attestation shall be maintained in the employee's personnel file. f. The Network Provider's Single-Point-of-Contact will ensure that conspicuous Notices which provide information about the availability of appropriate auxiliary aids and services at no-cost to the deaf or hard-of-hearing customers or companions are posted near where people enter or are admitted within the agent locations.Such Notices must be posted immediately by Network Providers and subcontractors.The approved Notice can be downloaded through the Internet at: http://www.myflfamilies.com/service-programs/deaf-and-hard-hearing/providers g. The Network Provider and its subcontractors shall document the customer's or companion's preferred method of communication and any requested auxiliary aids/services provided in the customer's record. Documentation, with supporting justification, must also be made if any request was not honored.The Network Provider shall distribute Customer Feedback forms to customers or companions,and submission to the Department of Children and Families Office of Civil Rights. h. If customers or companions are referred to other agencies, the Network Provider must ensure that the receiving agency is notified of the customer's or companion's preferred method of communication and any auxiliary aids/service needs. i. The network provider's and its subcontractors' direct service employees shall complete the online training annually:Serving our Customers who are Deaf or Hard of Hearing, (as requested of all Department of Children and Families and ME employees) and sign the Attestation of Understanding annually or immediately upon hire and annually thereafter. Direct service employees will also print their certificate of completion,attach it to their Attestation of Understanding,and maintain them in their personnel file. 34. Contract Amount The ME shall pay for contracted services according to the terms and conditions of this Contract in an amount not to exceed $450,000.00, subject to the availability of funds and satisfactory performance of all terms by the Network Provider. Of the total Contract amount, the ME will be required to pay $450,000.00, subject to the delivery and billing for services. The remaining amount of 0.00 represents "Uncompensated Units Reimbursement Funds", which the ME, at its sole discretion and subject to the availability of funds, may pay to the Network Provider, in whole or in part, or not at all, for Exemplary Performance by the Network Provider. Exemplary Performance will be determined by the Network Provider delivering and billing for services in excess of those units of service the ME will be required to pay.Should the network provider receive any funding from the "Uncompensated Units Reimbursement Funds", then the amount of Local Match as it appears on Exhibit B, Method of Payment and in Exhibit H, Funding Detail,will automatically change, utilizing the formula prescribed in the Method of Payment section of this contract. The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the DCF. Any costs or services eligible to be paid for under any other contract or from any other source are not eligible for payment under this Contract. 35. Contract Payment a. The network provider shall request payment monthly through submission of a properly completed invoice, per the requirements of this Contract,within eight(8)calendar days following the end of the month for which payment is being requested. b. If no services are due to be invoiced from the preceding month,the network provider shall submit a written document to the M E indicating this information within eight(8)calendar days following the end of the month.Should the network provider fail to submit an invoice or written documentation (should no services be due to be invoiced from the preceding month),within thirty(30)calendar days following the end of the month,then the ME at its sole discretion will consider these funds as lapse and may reallocate these funds within the network of providers. If the Network Provider fails to submit an invoice or written documentation for two (2) consecutive months within a twelve (12) month period, the ME at its sole discretion can terminate the contract or whole or in part. c. The ME has ten (10) working days, subject to the availability of funds, to inspect, and approve for goods and services, unless the bid specifications,purchase order,or this Contract specify otherwise.The MEs failure to pay the Network Provider within the ten(10)working days will result in penalties as referenced in the Prime Contract. Invoices returned to a Network Provider due to preparation errors will result in a non-interest bearing payment delay. Interest penalties less than one(1) dollar will not be paid unless the Network Provider requests payment. Payment shall be made only upon written acceptance by the ME and shall remain subject to the subsequent audit or review to co nfirm contract compliance. 36. Financial Consequences for Network Provider's Failure to Perform If the Network Provider fails to meet the minimum level of service or performance identified in this contract, or that is customary for the Standard Contract Guidance/Care Center, Inc. Page 9 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 industry, then the ME will apply financial consequences commensurate with the deficiency. Financial consequences may include but are not limited to refusing payment, withholding payments until deficiency is cured, tendering only partial payments, imposition of penalties per Section 39.,and termination of contract in whole or in part and requisition of services form an alternate source. Any payment made in reliance on the Network Provider's evidence of performance which evidence is subsequently determined to be erroneous,will be immediately due as an overpayment in accordance with Section 13.above,entitled "Return of Funds"to the extent of such error. 37. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Financial Services.The duties of this office are found in s ection 215.422, F.S.,which include disseminating information relative to prompt payment and assisting vendors in receiving their payments in a timely manner from a State agency.The Vendor Ombudsman may be contacted at(850)413-5516. 38. Notice Any notice that is required under this contract shall be in writing,and sent by U.S.Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery. Said notice shall be sent to the representative of the Network Provider responsible for administration of the program,to the designated address contained in this contract. 39. Financial Penalties for Failure to Take Corrective Action In accordance with the provisions of section 402.73(1), F.S., and Rule 65-29.001, F.A.C., should the ME require a corrective action to address noncompliance under this Contract, incremental penalties listed in section 39.a.through section 39. b.shall be imposed for Network Provider failure to achieve the corrective action. These penalties are cumulative and may be assessed upon each separate failure to comply with instructions from the ME to complete corrective action, but shall not exceed ten (10%) of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made.These penalties do not limit or restrict the ME's application of any other remedy available to it under law or this Contract. a. The increments of penalty imposition that shall apply, unless the ME determines that extenuating circumstances exist,shall be based upon the severity of the noncompliance, nonperformance, or unacceptable performance that generated the need for corrective action plan, in accordance with the following standards. b.Noncompliance that is determined by the ME to have a direct effect on client health and safety shall result in the imposition of a ten percent (10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. c. Noncompliance involving the provision of service not having a direct effect on client health and safety sh all result in the imposition of a five percent(5%) penalty. d. Noncompliance as a result of unacceptable performance of administrative tasks shall result in the imposition of a two percent(2%) penalty. The deadline for payment shall be as stated in the Order imposing the financial penalties. In the event of nonpayment the ME may deduct the amount of the penalty from invoices submitted by the Network Provider. 40. Termination a. This contract may be terminated by either party without cause upon no less than thirty(30) calendar days' notice in writi ng to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the contract manager or the representative of the Network Provider responsible for administration of the program. This provision shall not limit the ME's ability to terminate this Contract for cause according to other provisions herein. b.In the event funds for payment pursuant to this Contract become unavailable,the ME may terminate this Contract upon no less than twenty- four(24) hour notice in writing to the Network Provider.Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery.The ME shall be the final authority as to the availability and adequacy of funds. In the event of termination of this contract,the Network Provider will be compensated for any work satisfactorily completed through the date of termination. c. In the event the Network Provider fails to fully comply with the terms and conditions of this contract, the ME may terminate upon no less than twenty-four (24) hours, excluding Saturday, Sunday, and Holidays, notice in writing to the Network Provider after Network Provider's failure to fully cure such noncompliance within the time specified in a written notice of noncompliance issued by the ME specifying the nature of the noncompliance and the actions required to terminate the contract. The ME's failure to demand performance of any provision of this Contract shall not be deemed a waiver of performance. The ME's waiver of any one breach of any provision of this Contract shall not be deemed to be a waiver of any other breach and neither event shall be construed to be a modification of the terms and conditions of t his contract. The provisions herein do not limit the ME's right to remedies at law or in equity. Standard Contract Guidance/Care Center, Inc. Page 10 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 d. Failure to have performed any contractual obligations with the ME in a manner satisfactory to the ME will be a sufficient cause for termination.To be terminated as a Network Provider under this provision, the Network Provider must have: (1) previously failed to satisfactorily perform in a contract with the ME, been notified by the ME of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of the ME; or(2) had a contract terminated by the ME for cause.Termination shall be upon no less than twenty-four(24) hour notice in writing. e.Should the termination of the contract be inevitable, the Network Provider shall work in collaboration with the ME to develop a transition plan, in accordance with the Network Service Provider Contract Non-Renewal/Termination/Record Transition Plan, incorporated herein by reference, and timeline to ensure the uninterrupted continuum of services to individuals served under this contract, to include but not be limited to the transfer of client records. A copy of the Network Service Provider Contract Non-Renewal/Termination/Record Transition Plan may be obtained from the ME's Contract Manager. f.If this Contract is for an amount of$1Million or more,the ME may terminate this Contract at any time the Network Provider is found to have submitted a false certification under section 287.135, F.S. or has been placed on the Scrutinized Companies that Boycott Israel List, or the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or found be engaged in business operations in Cuba or Syria. 41. Renegotiations or Modifications Modifications of provisions of this contract shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment when these have been established through the appropriations process and subsequently included in the ME's prime contract with the DCF. 42. Dispute Resolution a. The parties agree to cooperate in resolving any differences in interpreting the contract, including but not limited to,client eligibility and/or placement into the appropriate level of care, a general dispute arising out of, or relating to this contract, or contesting a financial penalty for failure to comply with requirements of a corrective action plan.Within five (5)working days of the execution of this contract, each party shall designate a Dispute Resolution Officer with the requisite authority to act as its representative for dispute resolution purposes,and provide that information to the other party. b. Within five (5)working days from delivery to the Dispute Resolution Officer of the other party of a written request for dispute resolution, the representatives will conduct a face-to-face meeting to resolve the disagreement amicably. If the parties are not able to meet within the five (5) working days due to scheduling difficulties, the meeting shall occur as mutually agreed to by the parties, but no later than ten (10) working days from the date of receipt of the written request for dispute resolution. If the representatives are unable to reach a mutually satisfactory resolution at the face-to-face meeting,the dispute resolution process in Section 42.c. shall be followed. In the event of a dispute regarding client eligibility and/or placement into the appropriate level of care, the dispute shall not preclude the Network Provider from providing the provision of services to eligible individuals until the dispute is resolved. c. If the representatives are unable to reach a mutually satisfactory resolution, either representative may request referral of the issue to the President/Chief Executive Officer of the respective parties. Upon referral to this next step,the President/Chief Executive Officer of the parties shall confer in an attempt to amicably resolve the issue. If the President/Chief Executive Officer of the parties cannot resolve the issue, the issue shall be presented at the discretion of the ME either to the Board of Directors Executive Committee and/or the ME's Board of Directors. Should the dispute not be resolved at the Board of Directors Executive Committee and/or the ME's full Board of Directors leve I,the decision of the ME shall prevail subject to any legal rights that the Network Provider may have and/or wish to exercise.Venue for any court action will be in Miami-Dade County, Florida.This provision shall not limit the parties' rights of termination under Section 40. 43. Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (For Contracts Valued at$1,000,000.00(total contract value),or more,awarded, extended,or renewed on or after July 1,2011). The Network Provider agrees to refrain from any of the prohibited business activities with the Governments of Sudan and Iran as described in s.215.473,F.S. Pursuant to section s.287.135(5),F.S.,the ME shall immediately terminate this contract for cause if the Network Provider is found to have submitted a false certification or if the Network Provider is placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List during the term of the contract. 44. Unauthorized Aliens and Employment Eligibility Verification (E-Verify) Unauthorized aliens shall not be employed. Employment of unauthorized aliens shall be cause for unilateral cancellation of this Contract by the ME for violation of section 274A(e) of the Immigration and Nationality Act (8 U.S.C. § 1324 a) and section 101 of the Immigration Reform and Control Act of 1986. The Network Provider and subcontracts, if applicable, will enroll in and use the E-Verify system established by the U.S. Standard Contract Guidance/Care Center, Inc. Page 11 of 13 Contract No. P-4 Seth Florida Qi_A, Behavioral Health Network,Inc. rev.07/19/2018 Department of Homeland Security to verify the employment eligibility of its employees and its subcontractors' employees performing under this contract. Employee assigned to the contract means all persons employed or assigned (including subcontractors) by the Network Provider during the contract term to perform work pursuant to this contract within the United States and its territories. 45. Employment Screening: The Network Provider shall ensure that all staff utilized by the Network Provider and its subcontractors (hereinafter, "Contracted Staff")that are required by Florida law and by CFOP 60-25,Chapter 2,which is hereby incorporated by reference to be screened in accordance with chapter 435, F.S., are of good moral character and meet the Level 2 Employment Screening standards specified by sections 435.04, 110.1127, and subsection 39.001(2),F.S.,as a condition of initial and continued employment that shall include but not be limited to: a. Employment history checks; b. Fingerprinting for all criminal record checks; C. Statewide criminal and juvenile delinquency records checks through the Florida Department of Law Enforcement(FDLE); d. Federal criminal records checks from the Federal Bureau of Investigation via the Florida Department of Law Enforcement;and e. Security background investigation,which may include local criminal record checks through local law enforcement agencies. f. Attestation by each employee,subject to penalty of perjury,to meeting the requirements for qualifying for employment pursuant to chapter 435 and agreeing to inform the employer immediately if arrested for any of the disqualifying offenses while employed by the employer 46. Employment Screening Affidavit:The Network Provider shall sign the Florida Department of Children and Families Employment Screening Affidavit each State fiscal year(no two such affidavits shall be signed more than 13 months apart)for the term of the Contract stating that all required staff have been screened or the Provider is awaiting the results of screening. 47. The Department requires,as applicable,the use of the Officer of Inspector General's Request for Reference Check form(CF 774),which states:"As part of the screening of an applicant being considered for appointment to a career service,selected exempt service,senior management,or OPS position with the Department of Children and Families or a Contract or sub-contract provider,a check with the Office of Inspector General(IG)is required to determine if the individual is or has been a subject of an investigation with the IG's Office.The request will only be made on the individual that is being recommended to be hired for the position if that individual has previously worked for the Contract or sub-contract provider,or if that individual is being promoted,transferred or demoted within the Contract or sub-contract provider." 48. Human Subject Research:The Network Provider shall comply with the requirements of CFOP 215-8 for any activity under this contract involving human subject research within the scope of 45 CFR,Part 46,and 42 U.S.C.section 289,et seq.,and may not commence such activity until review and approval by the Department of Children and Families Human Protections Review Committee and a duly constituted Institutional Review Board. 49. Survival of Terms: The parties agree that,unless a provision of this Contract,its Exhibits,Attachments,or incorporated documents expressly states otherwise as to itself or a named provision,all provisions of this Contract concerning obligations of the Network Provider and remedies available to the ME and/or the Department are intended to survive the ending date or an earlier termination of this Contract. The Network Provider's performance pursuant to such surviving provisions shall be without further payment,as the contract payments received during the term of this Contract are consideration for such performance. 50. Official Payee and Representatives(Names,Addresses,Telephone Numbers and E-Mail Addresses) a. The Network Provider name,as shown on page 1 of this Contract,and b. The name,address, and telephone of the Contract Manager for the mailing address of the official payee to whom the payment shall be ME for this contract is: made is: Guidance/Care Center,Inc. Elba Taveras 3000 41st Street Ocean South Florida Behavioral Health Network,Inc. Marathon,FL 33050 7205 Corporate Center Drive,Suite 200 Miami,FL 33126 Tel.(786)507-7462 E-Mail: Etaveras@sfbhn.org c. The name of the contact person and street address where the d. The name,address,and telephone number of the representative of the Network Provider's financial and administrative records are Network Provider responsible for the administration of the program under maintained is: this contract is: Kristen Chaffee,Regional Controller Sharon Crippen,Sr.Vice President 100 2nd Avenue South#901 169 E.Flagler Street,Suite 1300 St.Petersburg,FL 30100 Miami,FL 33131 Office number:727-490-6767 x 30111 Office number: (305)573-3784 Mobile number:727-465-6083 Mobile number:(305)815-3702 Fax number:727-825-0573 Fax number: (305)381-7733 E-Mail: kristen.chaffee@westcare.com E-Mail:sharon.crippen@westcare.com Standard Contract Guidance/Care Center, Inc. Page 12 of 13 Contract No. P-4 South Florida Behavioral Health Network,Inc rev.07/19/2018 Upon change of representatives(names,addresses,telephone numbers and e-mail addresses)by either party,notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 51. All Terms and Conditions Included This contract and it attachments,I,__II. III_, &IV and any exhibits referenced in said attachments,together with any documents incorporated by reference,including the ME prime contract(which can be found at http://www.sfbhn.org),contain all the terms and conditions agreed upon by the parties. There are no provisions,terms,conditions,or obligations other than those contained herein, and this contract shall supersede all previous communications,representations,or agreements,either verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable,the remainder of the contract shalt remain in full force and effect and such term or provision shall be stricken. In the event of a conflict between the provisions of the documents,the documents shall be interpreted in the following order of precedence: a.Attachment I,Exhibits,the Business Associate Agreement,and other attachments,if any; b.Any documents incorporated into any Exhibit or Attachment by reference; c.The Standard Contract; d.Any documents incorporated herein by reference BY SIGNING THIS CONTRACT,THE PARTIES AGREE THAT THEY HAVE READ AND AGREE TO THE ENTIRE CONTRACT,AS DESCRIBED IN SECTION 51. ABOVE. IN WITNESS THEREOF,the parties have caused this contract,attachments,exhibits,and any documents referenced herein,to be executed by their undersigned officials as duly authorized. NETWORK PROVIDER:Guidance/Care Center,Inc. SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK,INC. SIG. p SIGNf BY(f ri° `, BY - NAME:Sharon Crippen NAME: Stephen Zuckerman TITLE:Sr.Vice President TITLE:Interim `f0 .q f DATE:— ' € _ DATE: '' Federal Tax ID#(or SSN)59-1458324 Network Provider Fiscal Year Ending Date 6 30 Standard Contract Guidance/Care Center,Inc. Page 13 of 13 Contract No.P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. ATTACHMENT I A. Service to be Provided 1. Program/Service Specific Terms (1) "Behavioral Health Services" are mental health services and substance abuse prevention and treatment services as defined by s. 394.9082(2)(a), F.S., and in Chapter 397. F.S. (2) "Block Grants":The Community Mental Health Block Grant(CMHBG), pursuant to 42 U.S.C. s. 300x, et. seq.,and the Substance Abuse Prevention and Treatment Block Grant(SAPTBG), pursuant to 42 U.S.C. s. 300x-21, et. seq. (3) "Care Coordination" means the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure service linkage. Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures. The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations. (4) Collaborative Planning Group Systems, Inc. is the entity contracted with the Department of Children and Families that maintains the database called Performance Based Prevention System (PBPS) that Network Providers contracted to provide substance abuse prevention services must utilize to upload substance abuse prevention data required by this contract. (5) "Comprehensive Continuous Integrated System of Care (CCISC) model" is a system design and implementation model for organizing services for individuals and families with co- occurring disorders that is designed to improve services capability on a statewide or regional basis to achieve: system level change; efficient use of resources; use of evidence- based and consensus based practices; and integrated mental health and substance abuse services throughout the system, by organizing a process in which every program improves their provision of co-occurring disorder services, and every clinical staff person improves their level of co-occurring disorder service competency based on their job and level of training. (6) "Continuous Quality Improvement" is an ongoing, systematic process of internal and external improvements in service provision and administrative functions, taking into account both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. (7) "Contract Manager" is the ME employee who is responsible for enforcing the compliance with administrative and programmatic terms and conditions of a contract. The Contract Attachment I HCO2 (f) Page 1 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. Manager is the primary point of contact through which all contracting information flows between the ME and the Network Provider. All actions related to the contract shall be initiated by or coordinated with the Contract Manager. (8) "Co-occurring Disorder" is any combination of mental health and substance abuse in any individual, whether or not they have been already diagnosed. (9) "Co-occurring Disorder Service Capability" is the ability of any program to organize every aspect of its program infrastructure (policies, procedures, practices, documentation, and staff competencies), within its existing resources, to provide appropriately matched, integrated services to the individuals and families with co-occurring disorders that are routinely presenting for care in that program. Should services not be available at the Network Provider then then the consumer must be linked to an agency with the capability to meet the consumer's needs. (10)"Coordinated System of Care", as described in section 394.4573, F.S.is the array of behavioral health and related services in a region or community offered by all service providers, whether participating under a contract with a Managing Entity or by another method of community partnership or mutual agreement. The essential elements of a coordinated system of care include but are not limited to: Community interventions such as prevention, primary care for behavioral health needs, therapeutic and supportive services, crisis response services, and diversion programs. and early intervention; Services provided within the System of Care must be accessible and responsive to the needs of individuals, their families, and community stakeholders. (11)"Cost Analysis" is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. (12)"Cultural and Linguistic Competence" is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professional that enable effective work in cross-cultural situations that provides services that are respectful and/or responsive to cultural and linguistic needs. (13) "DCF PAM 155-2" is the Department of Children & Families, Pamphlet 155-2 - Mental Health and Substance Abuse Measurement and Data, effective July 2016, version 11.1.3 , or the latest revised edition thereof, means a document promulgated by the department that contains required data-reporting elements for substance abuse and mental health services, and which can be found at: http://www.myflfamilies.com/service- programs/substance-abuse/pamphlet-155-2-v11, and is incorporated herein by reference. (14) "Department" means the State of Florida Department of Children and Families. Attachment I HCO2 (f) Page 2 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. (15) "Electronic Health Record (EHR)" is defined in s. 408.051(2)(a), F.S. (16) "Evidenced-Based Practices (EBP) are programs, practices or strategies that are supported by research. EBP's are programs that have demonstrated effectiveness with established genera lizability (replicated in different settings and with different populations over time) through research. Option#1: The program or strategy is recognized by a national registry of evidence-based programs and strategies as one that is appropriate for the identified outcome. It is important to note that inclusion within a registry does not reflect a program's effectiveness. Programs need to be reviewed for the intended target population,demographics,setting,and the research results for each program outcome. Additionally, the rating provided to the program by the registry must be considered prior to selection. Programs deemed not effective or inconclusive should not be selected. For a list of registries that provide information and research outcomes for evidence-based programs and strategies please refer to the Department's Guidance Document 1, Evidence Based Guidelines available at the following link: http://www.myflfa m i I ies.com/service-programs/substance-abuse/managing-entities/2018- contract-does Or Option#2: The program or strategy is reported in peer-reviewed journals or has documented effectiveness which is supported by other sources of information and the consensus judgment of informed experts. When claiming this option, a provider must include: • A description of the theory of change and a logic model; and • A discussion of how the content and structure of this proposed program or strategy is similar to programs or strategies that appear in approved registry or in the peer- reviewed literature, or how it is based on sound scientific principles of community prevention or public health; and • Documentation that the program or strategy was effectively implemented in the past, with results that show a consistent pattern of credible and positive effects, including: ■ the number of times it was implemented, ■ the fidelity with which it was implemented, and ■ the results of any outcome evaluations; and • Documentation of a review by, and consent of, a Panel of Informed Experts indicating that the implementation of this proposed program or strategy is appropriate for the Attachment I HCO2 (f) Page 3 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. community and likely to have a positive effect on the identified outcome and what evidence their decision was based upon. • Following the selection of an option, sufficient documentation to support the decision must be maintained by the Network Provider. • The ME does not fund Prevention services for this category. (17) "Forensic Mental Health Services" are services provided to individuals with mental illness pursuant to Chapter 916, Florida Statutes. (18) "HIPAA" is the acronym for Health Insurance Portability and Accountability Act and shall mean the Privacy,Security, Breach Notification,and Enforcement Rules at 42 U.S.C. §1320d, and 45 C.F.R. Parts 160, 162, and 164. (19) "Individual(s)Served" (synonymous with Consumer,Consumer, Participant) is an individual who receives substance abuse or mental health services, the cost of which is paid, either in part or whole, by Department appropriated funds or local match (matching). (20) "Knight Information Software (KIS)", (synonymous with Care Coordination, Utilization Management and Financial Reporting System) is the ME's online data system which Network Providers are required to use to collect and report data and performance outcomes on consumers served whose services are paid for, in part or in whole, by the ME's Substance Abuse and Mental Health (SAMH) contract, Medicaid, local match, Temporary Assistance for Needy Families (TANF), Purchase of Therapeutic Services (PTS) and Title 21 . The KIS,or other system designated by the ME, shall be utilized to upload consumer-related data as required by this contract. (21) "Local Match"are funds received from governing bodies of local government, including city commissions, county commissions, district school boards, special tax districts, private hospital funds, private gifts both individual and corporate, bequests and funds received from community drives or any other sources. Matching requirements may be satisfied by any or all of the following: (a) Allowable costs supported by non-State or Federal grants incurred by the service provider during the effective funding period; (b) The value of third-party funds and in-kind contributions applicable to the matching requirement period; and, (c) Costs supported by fees and program income. See § 394.67, F.S. F.S. and 65E-14.005, F.A.C. (22) "Managing Entity(ME)" as defined in section 394.9082(2)(e), F.S., is a corporation selected by and under contract with the Department to manage the daily operational delivery of behavioral health services through a coordinated system of care. Attachment I HCO2 (f) Page 4 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. (23) "Mental Health Services" is defined pursuant to Chapter 394, F.S. (24)"Motivational Support Program" are services designed to reduce the incidence of child abuse and neglect resulting from parents' or caregivers' behavioral health and to improve outcomes for families in the child welfare system and/or community based care. (25) "Network Provider" is an entity that contracts with the ME and receives funding to provide services to consumers; in this contract the Network Provider is synonymous with provider or subcontractor. (26) "Our Kids of Miami-Dade/Monroe" is the Community Based Care provider under contract with the State of Florida Department of Children and Families for the child welfare system. (27)"Outcome for Individual Service Recipient" is a measure of the quantified result, impact, or benefit of services on the individual service recipient. (28) "Payer class" Medicare, Medicare HMO, Medicaid, Medicaid HMO, private-pay health insurance, private-pay health maintenance organization, private preferred provider organization,the Department of Children and Family Services,other government programs, self-pay patients, charity care and any other payer class other than the Department. (29) "Payer of last resort" is a standard that is applied by the Network Provider to ensure that all options to collect payment for services rendered under this contract from "First Party Payer" (individual receiving services), "Second Party Payer or Responsible Party", and/or "Third Party Payer", as defined in Rule 65E-14, F.A.C. are pursued prior to billing the ME. The ME is always the payer of last resort. Refer to Rule 65E-14, F.A.C. and Exhibit B, Method of Payment. (30) "PBPS" is the Department's Performance Based Prevention System that collects data related to community assessments and plans and substance abuse prevention programs and activities. (31) "Performance Measures" are quantitative indicators, outcomes and outputs that are used by the Department to objectively measure performance and are used by the ME and Network Providers to improve services. (32)"Prevention" refers to the proactive approach to preclude, forestall, or impede the development of substance abuse or mental health related problems.These strategies focus on increasing public awareness and education, community-based processes, and incorporating evidence-based practices. Additional guidance regarding prevention services can be found in the Department's Guidance Document 10, Prevention Services and is available at the following link: Attachment I HCO2 (f) Page 5 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida ����� Behavioral Health Network,Inc. Effective:7/O1/2D1O Programs designed to prevent the development of mental, emotional, and behavioral disorders are commonly categorized in the following manner: (a) Universal Direct Prevention Directly serve an identifiable group of participants who have not been identified on the basis of individual risk. This includes interventions involving interpersonal and ongoing or repeated contact such as curricula, programs, and classes. These services shall address the following specific prevention strategies, as defined in Ru|e6SD'3U.U13, F.A.C.: information dissemination, education, alternatives orproblem identification and referral services. (b) Universal Indirect Prevention Universal indirect services support popu|ation-based programs and policies implemented by coalitions.These services can also include meetings and events related to the design and implementation of components of the strategic prevention framework, including needs assessments, logic models and comprehensive community action plans. The services shall address the following specific prevention strategies, as defined in Ru|e6SD'3U.U13, F.A.C.: information dissemination, community-based processes and environmental strategies. (c) Selective Prevention Preventive interventions that are targeted to individuals or to a subgroup of the population whose risk ofdeveloping mental, emotional, or behavioral disorders is significantly higher than average. The risk may be imminent or it may be a lifetime risk. Risk groups may be identified on the basis of biological, psychological, or social risk factors that are known to be associated with the onset of disorder. Examples include programs offered to children exposed to risk factors, such as parental divorce, parental mental illness, death of dose relative, or abuse, to reduce risk for adverse mental, emotional, and behavioral outcomes. (d) Indicated Prevention Preventive interventions that are targeted to high-risk individuals who are identified as having minimal but detectable signs or symptoms that foreshadow mental, emotional, or behavioral disorders, as well as biological markers that indicate a predisposition in a person for such a disorder but who does not meet diagnostic criteria at the time of the intervention. (33) "Prevention Partnership Grant" is a program created by o. 397.99, F.S. designed to encourage school and community substance abuse prevention partnerships. The PPG program is funded through the federal Substance Abuse and Treatment Block Grant, administered by the Florida Department of Children and Families and managed by the ME. (34)"PrimeContract" is the contract between the Department ofChildren and Families and the ME. Attachment|H02N Page 6of52 Guidance/Care Center, Inc. Contract No. P'4 South Florida Behavioral Health Network,Inc. (35) "Program Description" is the document the Network Provider prepares and submits to the ME for approval prior to the start of the contract period, which provides a detailed description of the services to be provided under the contract pursuant to Rule 65E-14, F.A.C. It includes but is not limited to the Network Provider's organizational profile, the service activity description, a detailed description of each program and covered service funded in the contract, the geographic service area, service capacity, staffing information, and consumer and target population to be served. (36) "Projects for Assistance in Transition from Homelessness (PATH)" is a federal grant to support homeless individuals with mental illnesses, who may also have co-occurring substance abuse and mental health treatment needs. (37) "Protected Health Information" (PHI) relates to any information whether oral or recorded in any form or medium that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and 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. (38) "Provider Network" (subcontractor or Network Provider) refers to the group of direct service providers, facilities, and organizations under contract with a ME to provide a comprehensive array of emergency, acute care, residential, outpatient, recovery support, and consumer support services including prevention services and any other services purchased by this contract. See section 394.9082, F.S. (39) "Quality Assurance" is a process that measures performance in achieving pre-determined standards,validates internal practice,and uses sound principles of evaluation to ensure that data are collected accurately, analyzed appropriately, reported correctly and acted upon in a timely manner. The process may employ peer review, outcomes assessment, and utilization management techniques to assess quality of care. (40) "Quality Improvement/Continuous Quality Improvement" is a management technique to assess and improve internal operations and network services. It focuses on organizational systems rather than individual performance and seeks to continuously improve quality.The process involves setting goals implementing systematic changes, measuring outcomes, and making subsequent appropriate improvements. Quality improvement activities will assess compliance with contract requirements, state and Federal law and associated administrative rules, regulations, and operating procedures and validate quality improvement systems and findings. (41) "Recovery-Oriented System of Care" is defined as a coordinated network of community- based services and supports that are person-centered and build on the strengths and resilience of individuals, families and communities to achieve abstinence, and improved Attachment I HCO2 (f) Page 7 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. health and the quality of life for individuals, families, and communities.' (42)"Representative Payee" refers to an entity/individual that is legally authorized to receive Supplemental Security Income, Social Security Income, Veterans Administration benefits, or other federal benefits on behalf of an individual served. (43)Request for Application#101-117GN1:The Department's most recent Prevention Partnership Grant Request for Application for Fiscal Years 2018-2021. (44)"SAMH" stands for the Substance Abuse and Mental Health Programs within the Department. (45) "SAVE/VIS Program" is the U.S. Department of Homeland Security (DHS) administers the Systematic Alien Verification for Entitlements (SAVE) program. This program verifies immigration status and eligibility of alien applicants for federal benefits. The alien status verification system under SAVE is entitled the Alien Status Verification Index (ASVI), as described at 60 Federal Register 52694, 52697 (1995) administered by the Computer Sciences Corporation (CSC) as the Verification Information System (VIS). The SAVE/VIS Program can and may provide assistance in verifying eligibility in cases where a consumer does not possess sufficient documentation. (46) "SOAR" stands for Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access and Recovery and is a Substance Abuse and Mental Health Services Administration (SAMHSA) technical assistance initiative designed to help individuals increase earlier access to SSI and SSDI through improved approval rates on initial Social Security applications by providing training, technical assistance, and strategic planning to Network Service Providers. (47) "Stakeholder(s)" are individuals/groups with an interest in the provision of treatment services for substance abuse, mental health services, and/or co-occurring disorders in the circuits outlined in Section A.2.c.(2), of this Contract. This includes, but is not limited to,the key community constituents included in section 394.9082, F.S. (48) "Statewide Inpatient Psychiatric Programs (SIPP)" are residential inpatient facilities under contract with the Agency for Health Care Administration (AHCA) under the Medicaid Institutes for Mental Disease (IMD) 1915B waiver for children under age 18 to provide diagnostic and active treatment services in a secure setting. (49) "Substance abuse" is s a pattern of chronic or harmful use of alcohol, illicit or prescribed drugs that result in adverse physical, psychological, or social consequences. Substance abuse prevention and treatment services, pursuant to Chapter 397, F.S.,which are provided ' See https://www.samlisa.gov/sites/default/files/rosc_resource de_book.pdf accessed May,2018. Attachment I HCO2 (f) Page 8 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. using state or federal funding. (50) "Substance Abuse and Mental Health Information System (SAMHIS)" is the Department's web-based data system for reporting substance abuse and mental health services, including the Substance Abuse and Mental Health Information System (SAMHIS) or any replacement system identified by the Department for the reporting of data by the Managing Entity and all Network Service Providers in accordance with this contract. (51) "TANF Participant" is a person or family member of that person defined in 45 C.F.R. Part 260.30 and section 414.1585 and subsection 414.0252(9), F.S. (52) "Temporary Assistance to Needy Families(TANF)"are cash assistance forfamilies,including any family receiving cash assistance payments or TANF diversion services from any state program as defined in under 42 U.S.C. ss. 601, et. seq., and ch. 414, F.S. (53)"Unit Measurement" synonymous with "measurement standard" is used in billing the ME for services.The definition of each unit of measure can be found in Rule 65E-14, F.A.C. (54) "Utilization Management" is a system to ensure maximum, cost-effective, and clinically appropriate utilization of behavioral health services. The goal of the program is to eliminate waitlists and maximize utilization as well as diverting individuals served to more clinically appropriate services when applicable. (55) "Verifiable Service" is a service provision that is documented in compliance with the requirements contained in Rule 65E-14, F.A.C. (56)"Wait List" is a master list for the Network, maintained by a Managing Entity that shows: (a) The number of individuals waiting for access to the recommended service or program; (b) The length of time each individual has been on the waiting list; and (c) The interim services provided to the individual. 2. General Description a. General Statement The Prevention Partnership Grants (PPG) program created by s. 397.99, F.S., is designed to encourage school and community substance abuse prevention partnerships. The PPG program is funded through the federal Substance Abuse Prevention and Treatment Block Grant (Block Grant), administered by the Florida Department of Children and Families and managed by the ME. The services provided under this contract are to fund rigorous, effective, evidence-based, substance abuse prevention programs and strategies intended to prevent or reduce Florida Attachment I HCO2 (f) Page 9 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. substance use and abuse rates at the community level. The strategies, activities, and services must be consistent with the local community ME- approved local Needs Assessment Logic Model (HALM), the Comprehensive Community Action Plan (CCAP) and with the Network Provider's Application filed with the Department in response to the Request for Applications# 10H17GN1, herein incorporated by reference and made part of this contract. The Network Provider shall work in collaboration with the funded ME Evaluation Entity, by participating in meetings and providing service data vital for the completion of a system-wide evaluation of the prevention services within the Strategic Prevention Framework. The evaluation of the prevention system is expected to be the systematic collection and analysis of information about program activities, characteristics, and outcomes to reduce uncertainty, improve effectiveness, and assist in decision-making. The information gathered from the evaluation process will help the ME,the State and communities become more skillful and exact in describing what they plan to do, monitor what they are doing, and improve the prevention system of care. Evaluation results can and should be used to determine what efforts should be sustained and to assist in sustainability planning efforts. The ME will provide substantial input, in collaboration with the Network Provider and the Evaluation Entity, both in planning and implementation of the evaluation process and activities, and will make recommendations regarding the continuance of the activities. b. Authority Section 394.9082, F.S., the Prime Contract, and the Request for Applications # 10H17GN1, provides the ME with the authority to contract for these services. c. Scope of Service The following scope of service applies to the contract period and any renewal or extension. (1) The Network Provider is responsible for the administration and provision of services to the target population(s) indicated in Exhibit A, Consumers/Participants to be Served, and in accordance with the tasks outlined in Section B.1.a., of this contract, and the Scope of Work found in Attachment IV. Services shall also be delivered at the locations specified in, and in accordance with the Program Description, as required by Rule 65E-14.021, F.A.C. which is herein incorporated by reference, and maintained in the ME's Contract Manager's file. (2) Services are to be delivered in the following county(ies): Miami-Dade County X Monroe County Attachment I HCO2 (f) Page 10 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. d. Major Program Goals The overall scope of the grant activities for the PPG program are to: (1) Develop effective substance abuse prevention and early intervention strategies for the target populations; and, (2) Conduct prevention activities serving students who are not involved in substance abuse, intervention activities serving students who are experimenting with substance use, or both prevention and intervention activities, if a comprehensive approach is indicated as a result of a needs assessment. (3) PPG activities must relate to the local community department-approved local Needs Assessment Logic Model (HALM)to show target population and subpopulation problems to be addressed.The goals and objectives of the Comprehensive Community Action Plan (CCAP) will call for evidence-based prevention program activities or strategies for which there is a demonstrated need. The CCAP guides the selection of evidence-based prevention program activities or strategies for which there is limited or no current local capacity. The principles of cultural competency must be incorporated into their needs assessment logic model and the CCAP. Each community must also include a written sustainability plan in their response which details their plan to sustain activities after funding has ended. e. Minimum Programmatic Requirements The Network Provider shall maintain the following minimum programmatic requirements: (1) System of Care The consumer-centered and family-focused system of care will: (a) Be driven by the needs and choices of the customers; (b) Promote family and personal self-determination and choice; (c) Be ethically,socially,and culturally responsive;and (d) Be dedicated to excellence and quality results. (2) Guiding Principles Guiding principles specify that services are as follows: (a) Inclusive - involve and engage families and consumers as full partners to participate in the planning and delivery of services; Attachment I HCO2 (f) Page 11 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. (b) Comprehensive - incorporating a broad array of service and supports (e.g. physical, emotional,clinical, social,educational and spiritual); (c) Individualized- meeting the individual's exceptional needs and strengths; (d) Community-based- provided in the least restrictive,clinically appropriate setting; (e) Coordinated-both at the system and service delivery levels to ensure that multiple services are provided and change as seamlessly as possible when warranted; (f) Cultural and linguistic competence (g) Gender responsive, and (h) Sexual orientation 3. Consumers to be Served See Exhibit A,Consumers/Participants to be Served B. MANNER OF SERVICE PROVISION 1. Service Tasks The following tasks must be completed for each fiscal year covered in the contract period. a. Task List (1) Based on consumer needs, the Network Provider shall adhere to services as outlined in the approved Prevention Program Description, incorporated herein by reference and as set forth in in addition to providing services from the list of approved covered services listed in Exhibit G, Covered Service Funding by OCA.Any change in the array of services shall be justified in writing and submitted to the ME's Contract Manager for review and approval. (2) The Network Provider shall ensure that all staff is properly trained as required by the substance abuse licensing Rule 65D-30, F.A.C. (3) The Network Provider shall serve the number of persons indicated in Exhibit D, Substance Abuse and Mental Health Required Outcomes/Outputs within the covered services listed in Exhibit G,Covered Service Funding by OCA. (4) The Network Provider shall ensure the fidelity of each EBP the agency is utilizing. Attachment I HCO2 (f) Page 12 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. (5) The Network Provider shall develop and implement policies so that all applicable providers' employees abide by the terms and conditions of Paragraph 25., Information Security Obligations, of the Standard Contract. The Network Provider shall submit to the Managing Entities Contract Manager, by 8 01 2018,verification that all Network Provider employees and subcontractors who have access to ME and Department information systems have completed the Security Agreement form as identified in Paragraph 25. Information Security Obligations, of the Standard Contract. (6) For licensable services purchased by this Contract, such as substance abuse prevention services, the Network Provider shall have and maintain correct and current Department of Children and Families and Agency for Health Care Administration (AHCA) licenses and only bill for services under those licenses. In the event any of the Network Provider's license(s) are suspended, revoked, expired or terminated, the ME shall suspend payment for services delivered by the Network Provider under such license(s) until said license(s) are reinstated. (7) By 08/01/2018, the Network Provider shall submit to the ME's Contract Manager grievance procedures,which include an appeal process with the ME,should the grievance not be resolved at the Network Provider level, which applicants for, and recipients of, services being provided under this contract, may use to present grievances to the Network Provider, or to the ME about contracted services. (8) By 08/01/2018,the Network Provider shall submit to the ME's Contract Manager a disaster plan consistent with Paragraph 29., Emergency Preparedness, of the Standard Contract. (9) Should the ME conduct a mock emergency drill, the Network Provider shall participate by activating their emergency/disaster plan and reporting on preparedness activities, response activities, and post-recovery activities. (10) By 08/01/2018,the Network Provider shall submit to the ME's Contract Manager a completed Civil Rights Compliance Questionnaire. (11) The Network Provider shall execute or maintain if executed, a Memorandum of Understanding (MOU) or contract with the appropriate Federally Qualified Health Center or other medical facility. The MOU provides for the integration of behavioral health services and primary health care services for all participants and consumers in care. Referral and linkage processes will be necessary for all participants/consumers who do not have a primary care provider at entry into the services in the system of care. Follow up and coordination of services are essential to meeting participant/consumer health and behavioral health needs which result in: Attachment I HCO2 (f) Page 13 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. • Improved access to primary care services; • Improved prevention, early identification, and intervention to reduce the incidence of serious physical illnesses, including chronic disease; • Increased availability of integrated, holistic care for physical and behavioral disorders; and • Improved overall health status of consumers The relationships should be cooperative and reciprocal; that is, the partnership adds value to the program strategies and outcomes and achieves a level of systems improvement beyond the current standards. Programs and coalitions are required, based on the Strategic Prevention Framework(SPF)and all of the Prevention philosophy,to worktogetherto achieve larger system outcomes based on the planning process and following the principles of integrated care. In addition, all funded providers will be contractually required to work comprehensively with the funded Evaluation entity. The MOU shall be submitted within ninety(90) days of the effective date of this contract to the ME's Contract Manager on or before the due date(s) as specified in Exhibit C-1, Required Reports.The Network Provider shall submit copies of any amendment to the MOU,to the ME's Contract Manager, within thirty (30) calendar days of execution. Federally Qualified Health Centers are required to submit policies and procedures that explain the access to primary care services to the medically underserved behavioral health consumer. (12) The Network Provider shall implement a "no wrong door" model as defined in s. 394.4573, F.S, by developing a process for assessing, referring and/or treating consumers with co-occurring disorders, to increase access of persons identified as co-occurring, to provide services for both disorders regardless of the entry point to the behavioral health system. (13) By 08/01/2018, the Network Provider shall submit to the ME's Contract Manager a Quality Assurance Plan that details how the Network Provider will ensure and document that quality services are being provided to the consumers served,which is herein incorporated by reference. The Network Provider shall submit updates as amended of the Quality Assurance Plan within thirty(30)days of adoption. The Quality Assurance Plan should address the minimum guidelines for the Network Provider's continuous quality improvement program, including, but not limited to: (a) Individual care and services standards to include transfers and referrals, co-occurring supportive services, trauma informed services, and cultural and linguistic competence. (b) Individual records maintenance and compliance. (c) Staff development standards. Attachment I HCO2 (f) Page 14 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'Pi-A, Behavioral Health Network,Inc. (d) Service-environment safety and infection control standards. (e) Peer review and utilization management review procedures. (f) Incident reporting policies and procedures that include verification of corrective action and a provision that specifies that a person who files an incident report, in good faith, may not be subjected to any civil action by virtue of that incident report. (g) Fraud, waste, abuse and other potential wrongdoing auditing, monitoring, and remediation procedures. (h) Evidence-based practices (EBPs) utilized by the agency and how these EBPs are monitored to ensure fidelity to the model. (i) The Continuous Quality Improvement Initiatives identified in Section B.1.a.(18) below. (14) Linkage and Referral Process (a) The Network Providers policies and procedures must address the referral and linkage process of consumers to local community providers for services not offered by the Network Provider. Such services include, but are not limited to, linkages with community programs such as housing, employment and parenting supports, and primary health care. The Network Provider is responsible for tracking and ensuring that the proper linkages are made and documented in accordance with the requirements in the Coordination Care Plan & Utilization Management Manual. Network Providers are required to submit all required documentation for the initiated referral. (b) The Network Provider may only refer a consumer to a provider that offers the service for which the Network Provider created the referral. (c) If the Network Provider is a receiving provider then the Network Provider must inform the referring provider that the consumer was admitted/not admitted within seven (7) calendar days, unless otherwise required by applicable state, federal rules and/or statues. (d) If the Network Provider is the receiving provider, the Network Provider will have seventy- two (72) hours to respond to a new referral, unless otherwise required by applicable state, federal rules and/or statues. (e) If the Network Provider is the receiving provider, and if upon assessing a referred consumer on in-take, determines that the consumer requires a service that is different from the service for which the consumer has been referred, the Network Provider will admit the Attachment I HCO2 (f) Page 15 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. consumer for the service that the consumer needs if the Network Provider offers the service and has availability to offer the service. In the event the Network Provider does not offer the service nor has availability to offer the service, the Network Provider will create a referral for the consumer to receive the service at a different provider. (15) By 10/01/2018,the Network Provider shall submit an attestation signed by the CEO/Executive Director indicating that all applicable staff funded by this Contract have received a copy of this fully executed contract and will receive copies of any amendments made to this Contract. (16) Continuous Quality Improvement Programs (a) The Network Provider must maintain a continuous quality improvement program and report on the continuous quality improvement activities. The program is the responsibility of the Director and is subject to review and approval by the governing board of the service Network Provider. Each director shall designate a Quality Assurance Officer/Compliance Officer who will be responsible for the continuous quality improvement program. The continuous quality Improvement program should objectively and systematically monitor and evaluate the appropriateness and quality of care to ensure that services are rendered consistent with prevailing professional standards,and identify and resolve problems. (b) The quality improvement program must include at minimum: i. Activities to ensure that fraud, waste and abuse do not occur. ii. Composition of quality assurance review committees and subcommittees, purpose,scope,and objectives of the continuous quality assurance committee and each subcommittee, frequency of meetings, minutes of meetings, and documentation of meetings. iii. A framework for evaluating outcomes, including: 1. Output measures, such as capacities, technologies, and infrastructure that make up the system of care. 2. Process measures, such as administrative and components of the services. 3. Outcome measures pertaining to the outcomes of services; Attachment I HCO2 (f) Page 16 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. iv. A system of analyzing those factors which have an effect on performance; V. A system of reporting the results of continuous quality improvement reviews; and, vi. Best practice models for use in improving performance in those areas which are deficient. vii. Establishment of a Seclusion and Restraint Oversight Committee per Chapter 65E- 5.180, F.A.C. for agencies utilizing seclusion and/or restraint. (17) Continuous Quality Improvement Initiatives - Providers must comply with all of the provisions for the initiatives outlined below: (a) Integration of Behavioral Health Services and Primary Health Care It is the goal of the ME to ensure the integration of behavioral health services and primary care services to all the consumers in care. The integration will be ensured through linkage of the behavioral health provider with the primary health care provider of the consumer through an electronic health record or other means of contact(phone, in person, etc). Referral and linkage processes will be necessary for all consumers who do not have a primary health care provider at entry into the system of care. Follow up and coordination of services are essential to meeting consumer health and behavioral health needs. Many individuals with behavioral health issues have chronic health conditions and may have neglected their primary health needs for some time. The ME and the Southern Region are committed to developing an integrated system of care that incorporates comprehensive screening and monitoring tools that identify those affected by chronic health conditions and a system of care that meets their needs. Network Providers will be implementing Integrated Primary and Behavioral Health techniques and initiatives to meet this need. This initiative will be addressed through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the Health Integration Initiative. As part of the plan or component of the plan must include the following: L Identification of the Federally Qualified Health Center or other medical facility where consumers who have been identified as needing primary health care services are referred to or the process established by the Network Provider to coordinate services with consumers' private primary health care provider should such exist. Attachment I HCO2 (f) Page 17 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. ii. A process to track and report outcomes of successful referrals and linkages of consumers of behavioral health services to primary health care services. In addition to tracking and reporting outcomes of consumers referred for behavioral health services by a primary health care provider to the Network Provider. The outcomes must be reported in the semi-annual Continuous Quality Improvement Updates. iii. Identification of at least two Integrated Healthcare Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. iv. By 08/31/2018, unless otherwise directed by the ME, the Network Provider shall submit an action plan on the template provided by the ME.The action plan must be developed based on the results of the most recently completed Site Self-Assessment Evaluation Tool for the Maine Health Access Foundation Integration Initiative (MeHAF).The action plan will outline tasks and objectives that the Network Provider must address during the fiscal year that were identified in the self-assessment as needing improvement. V. Participation in the regional Healthcare Integration Committee meetings to develop the processes and training germane to this initiative. vi. Attendance of appropriate staff at the regional trainings regarding Integrated Healthcare, as requested by the ME staff. Participation in the trainings will be documented in the Continuous Quality Improvement Updates. vii. By 03/01/2019, unless otherwise directed by the ME, the Network Provider shall complete an annual agency-wide self-assessment using the Site Self- Assessment Evaluation Tool for the Maine Health Access Foundation Integration Initiative (MeHAF). (b) Trauma Informed Care Many individuals with behavioral health issues have experienced trauma that affects their development and adjustment.The ME and the Southern Region are committed to developing a system of care that incorporates comprehensive assessment tools that identify those affected by trauma and a system of care that meets their needs. Network Providers will be implementing the Trauma Informed Care (TIC) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the TIC initiative.As part of the plan or component of the plan must include the following: Attachment I HCO2 (f) Page 18 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. i. Identification of at least two TIC Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. ii. By 08/31/2018, unless otherwise directed by the ME,the Network Provider shall submit an action plan on the template provided by the ME. The action plan must be developed based on the results of the most recently completed Fallot Tool. The action plan will outline tasks and objectives that the Network Provider must address during the fiscal year that were identified in the self-assessment as needing improvement. The ME will monitor the Network Provider on its execution of the tasks and objectives identified in the action plan. iii. Participation in the regional TIC meetings to develop the process for identifying and responding to those affected by trauma. iv. Attendance at the regional trainings regarding TIC as applicable. Applicable trainings will be documented in the Continuous Quality Improvement Updates. V. Participation in all TIC related activities to ensure staff and agency become competent in all areas of trauma informed care. (c) Cultural and Linguistic Competence It is the goal of the ME to become a culturally and linguistically proficient network, through the full implementation of The National Standards for Cultural and Linguistically Appropriate Services (the National CLAS Standards). The National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and behavioral health care. In order to accomplish this task the Network Provider: i. Identification of at least two CLC Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. ii. Participation in the regional CLC meetings. iii. By 08/31/2018, unless otherwise directed by the ME,the Network Provider shall submit an action plan on the template provided by the ME. The action plan must be developed based on the results of the most recently completed Cultural and Linguistic Competence survey.The action plan will outline tasks and objectives that the Network Provider must address during the fiscal year that were identified in the self-assessment as needing improvement. iv. Collaborate with the ME to identify and utilize the Network Provider's data to (1) Attachment I HCO2 (f) Page 19 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. identify sub-populations (i.e., racial, ethnic, Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, or Two-Spirited (LGBTQI-2S), minority groups) vulnerable to disparities and (2) implement strategies to decrease the differences in access, service use, and outcomes among sub-populations. These strategies should include the use of the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care; V. Agrees to implement effective language access services to meet the needs of their limited-English-proficient consumers, and/or deaf and hard-of-hearing consumers, and increase their access to behavioral health care by providing sign language, translation, and interpretive services required to meet the communication needs of consumers, including English, Spanish and Creole. Services will meet the cultural needs and preferences of the populations served. (d) Integration of Behavioral Health and the Child Welfare System i. The Network Provider will ensure that behavioral health services are available to consumers referred by the Community Based Care Organizations (CBC) or by the Department's Child Protective Investigators in cases where behavioral health indicators are present during the initial child abuse/neglect investigation or at any point during child protective supervision or out-of-home care. Priority will be given to cases where a child is at risk for immediate removal or has been removed from the family, with a goal of reunification in the family safety plan. Services may also be provided for the enrolled parent(s)'/caregiver(s)'family members, household residents, or significant others in need of behavioral health prevention or treatment services,as well as children in relative placements. For a detailed description of the consumer eligibility criteria please refer to the approved Motivational Support Program Protocols and Family Intensive Treatment Team Protocols, herein incorporated by reference and available upon request to the MEs Contract Manager. ii. The coordination of efforts between the CBC,the ME and Network Providers is essential to the efficient service delivery for child-welfare involved families in behavioral health treatment. The ME and the Southern Region are committed to developing an integrated system of care that meets the needs of children and their families as there is significant overlap between consumers. Network Providers will be implementing the Child Welfare Integration (CWI) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the CWI initiative. As part of the plan or component of the plan must include the following: 1. Identification of at least two CWI Champions and submit the names of the Attachment I HCO2 (f) Page 20 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. individuals when requested by ME staff. 2. Participation in the CWI meetings to develop the process for identifying and responding to child-welfare involved families. 3. Attendance at trainings regarding CWI when notified by the ME. Attendance applicable trainings will be documented in the Continuous Quality Improvement Updates. 4. Participation in all CWI related activities to ensure staff and agency become knowledgeable of the Child Welfare system. (e) Mandatory Accreditation Accreditation by an accrediting organization recognized by the Department, as discussed in 65D-30.0031, F.A.C., is a requirement for licensure of clinical substance abuse treatment services. The licensable substance abuse treatment components are listed in subsection 65D- 30.002 (17), F.A.C. Network Provider applicants for licensure and licensed network providers must meet the most current best practice standards related to the licensable service components of the accrediting organization. For a list of accrediting organizations recognized by the Department visit the following website: http://www.myflfamilies.com/service-programs/substance-abuse/licensure-regulation The Network Provider shall take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2019, as required by this section, in order to promote best practices and the highest quality of care. The Network Provider shall provide the ME with their full accreditation and licensing reports upon request. Failure to meet the accreditation requirements will be considered by the ME to be a breach of this Contract and this contract may be subject to termination. (18) By 8 31 2018 the Network Provider shall submit a single agency action plan which outlines all of the components/activities identified in agency's annual self-assessments for each initiative. For example, the Integrated Healthcare Initiative (Behavioral Health and Primary Health Care) action plan should be developed based on the results of the most recently completed self- assessment, the Trauma Informed Care action plan shall be developed based on the results of the most recently completed Fallot Tool,and the Cultural and Linguistic Competence action plan shall be based on the results of the Cultural and Linguistic Competence survey. Attachment I HCO2 (f) Page 21 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. (19) Continuous Quality Improvement Updates The Network Provider shall submit semi-annual updates, by the dates specified in Exhibit C-1, Required Reports, on the implementation and progress of the following activities: (a) Integration of Behavioral Health Services and Primary Care as described in the agency's action plan; (b) Trauma Informed Care, as described in the agency's action plan; (c) Cultural and Linguistic Competence initiative, as described in the agency's action plan; (d) Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; (e) Mandatory Accreditation Requirements: Monitoring processes to ensure that all licensable substance abuse treatment components funded by this Contract meet the most current best practice standards related to the licensable service components of the accrediting organization,as required by Rule 65D-30.003(2), F.A.C., Department Licensing and Regulatory Standards; (f) Evidence of the implementation of the integration of behavioral health services and primary health care, evidence of tracking and ensuring the successful referrals and linkages of consumers of behavioral health services to primary health care services and consumers referred from the primary health care provider to the Network Provider for behavioral health services, and include progress on the implementation as described in the Network Provider's action plan to include the following: • The number of behavioral health consumers identified as needing primary care. • Number of successful linkages to primary care. (20) Care Coordination and Reporting Requirements If requested by the ME, the Network Provider shall participate and comply with Care Coordination activities as defined in section 394.4573(1)(a), F.S. (21) Program Status Report The Network Provider shall submit an annual detailed report of the services and activities performed and the progress of the Program in meeting the performance measures, goals, objectives and tasks as described in Attachment IV, Scope of Work. The report shall be submitted by the due date specified in Exhibit C-1, Required Reports. Attachment I HCO2 (f) Page 22 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. (22) PPG Specific Financial Report The Network Providers shall submit a quarterly detailed financial report of Program Expenses which are used to track all expenses associated with this Contract and reconcile these expenditures with the payments made to the Network Provider by the dates specified in Exhibit C-1, Required Reports. The financial reports track both grant award-funded and match funded expenses and encourages expenditure planning and projection. Pursuant to Rule 65E- 14.021, F.A.C., the Network Provider shall use the Department's form CF-MH 1037. The form CF-MH 1037 and the corresponding instructions are available at the following website: https://eds.myflfamilies.com/DCFFormslnternet/Search/DCFFormSearch.aspx (23) Financial Audit Reports (a) The Network Provider shall submit quarterly financial statements consisting of Balance Sheet and Statement of Activity (income statement) per the schedule and to the individual(s) identified in the Exhibit C-1, Required Reports. The Network Provider agrees to provide the ME with any requests for additional financial statements/documentation. (b) Network Providers who withhold income taxes, social security tax, or Medicare tax from employee's paychecks or who must pay the employer's portion of social security or Medicare tax must use Form 941, Employer's Quarterly Federal Tax Return, to report those taxes. On a quarterly basis, and by the dates specified in Exhibit C-1, Required Reports, the Network Provider, shall submit an attestation that the 941 has been filed timely and any taxes due have been paid timely to IRS. (c) The Network Provider shall complete and submit the Department-approved Local Match Calculation Form, per the schedule and to the individual(s) identified in the Exhibit C-1, Required Reports. The Department-approved Local Match Calculation Form, Template 9— Local Match Calculation Form is available at the following website: http://www.myflfa m i I ies.com/service-programs/substance-abuse/ma nagi ng- entities/2018-contract-does (24) The Network Provider shall implement and maintain fiscal operational procedures.These shall contain but, not be limited to procedures relating to overpayments,charge-backs that directly apply to subcontractors and documentation of cost sharing(match) that comply with state and federal rules, regulations and/or ME policies and procedures and shall comply with the requirements in Section 7., Audits, Inspections, Investigations, Records, and Retention. (25) The Network Provider shall maintain in one place for easy accessibility and review by ME and/or Attachment I HCO2 (f) Page 23 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. Department staff all policies,procedures,tools,and plans adopted by the Network Provider. The Network Provider's policies, procedures,and plans, must conform to state and federal laws,the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/requirements contained in applicable Department of Children and Families and ME operating procedures. (26)The Network Provider shall maintain a mechanism for monitoring, updating, and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations, and the ME's policies and procedures. (27) The Network Provider shall make available upon request all plans, policies, procedures, and manuals to ME staff, Department staff, Network Provider staff, and to consumers/stakeholders if applicable and appropriate. (28) The Network Provider shall comply with Children and Families Operating Procedure 215-8, OVERSIGHT OF HUMAN SUBJECT RESEARCH AND INSTITUTIONAL REVIEW BOARD DESIGNATION. The policy and guidance can be found at: http://www.dcf.state.fl.us/admin/publications/policies/215-8.pdf Approval from the Department through the ME is mandatory for all research conducted by any employee, contracted organization or individual, or any public or private vendor, even if the aforementioned has their own Institutional Review Board which has granted approval. (29) The Network Provider shall participate in the State's Peer Review process,when implemented, to assess the quality, appropriateness, and efficacy of services provided to individuals pursuant to 45 CFR 96.136. (30) The Network Provider shall attend required trainings and/or meetings as required by the ME, meet with the ME's staff at regularly scheduled or specially called meetings when notified by the ME. (31) Develop and Disseminate Consumer Manual The Network Providers shall assist the ME in developing and maintaining a manual for service recipients which includes information about access procedures, recipient rights and responsibilities(including grievance and appeal procedures). This information will be available for use by the consumers within each subcontractor location. (32) Work and Social Opportunities for Peer Specialists Nationwide, health systems have accepted peers as a valuable part of the workforce. A shift to Attachment I HCO2 (f) Page 24 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. a more person-centered approach, a focus on integrated health, and a demand for more workers have increased the role peer specialists play in Florida's mental health and substance abuse systems. In keeping with Florida's goal of increasing the number of peer specialists, The Network Provider shall will provide employment and social opportunities to individuals who have lived experience of mental health and/or substance use condition and/or lived experience of trauma. (33) Assist Stakeholder Involvement in Planning,Evaluation,and Service Delivery (a) At the ME's request, the Network Provider will assist the ME in engaging local stakeholders, per section 394.9082 F.S., in its support activities for the Department's local plans. (b) The Network Provider shall work with the ME to provide performance, utilization, and other information for the Department's Substance Abuse and Mental Health Services Plan, and annual updates thereof, and to provide appropriate information for the Department's Long Range Program Plan and its Annual Business Plan. (34) Develop,Maintain and Improve Reporting The Network Provider shall submit reports included in Exhibit C-1, Required Reports. The Network Provider agrees to submit ad hoc and additional reports as determined by the ME and/or the Department. In all cases, the delivery of reports, ad hoc or scheduled, shall not be construed to mean acceptance of those reports. Acceptance, in writing, of required reports shall constitute a separate act and shall be approved by the ME's Contract Manager. The ME reserves the right to reject reports as incomplete, inadequate or unacceptable. (35) Consumer Satisfaction Survey The Network Provider shall conduct satisfaction surveys of individuals served pursuant to DCF PAM 155-2. The Network Provider shall utilize a Department-approved satisfaction survey instrument. Failing to provide the required number of satisfaction surveys and/or utilizing a survey instrument other than that approved by the Department will result in a corrective action and an imposed financial penalty. (36) If requested by the ME, the Network Provider agrees to assist in the development and implementation of the Care Coordination and Utilization Management (UM) System and shall maintain the capacity to perform the following functions including, but not limited to: (a) ME-approved automated, standardized, and screening and assessment instruments to improve proper evaluation and placement of individuals; Attachment I HCO2 (f) Page 25 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. (b) Automated referral and electronic consent for release of confidential information with the ME and other Network Providers, to the extent permitted by law; (c) Integrated processes for intake, admission, discharge and follow-up; (d) Encounter and progress notes to support all services provided under this contract and that automatically generate state and Medicaid billing and payment in the event Medicaid compensable services are provided to individuals eligible for Medicaid; (e) Utilization management, including but not limited to Wait Lists and capacity management; (f) Determination of financial and clinical eligibility of Individuals Served; (g) Processes to ensure the Department is the payer of last resort; (h) Electronic capability for billing, invoice payment and claims adjudication, and/or Medicaid billing and payment (HIPAA 837 and 835 Transactions); (i) Automated processes for state and federal data analysis and reporting; and (j) Full compliance with federal and state laws, rules and regulations pertaining to security and privacy of protected health information. b. Task Limits The Network Provider shall perform services in accordance with applicable, rules, statutes, licensing standards and policies and procedures. The Network Provider agrees to abide by the approved Program Description, and is not authorized by the ME to perform any tasks related to the project other than those described in the approved Program Description and in this contract, without the express written consent of the ME. The Network Provider shall ensure that services are performed in accordance with applicable rules, statutes, and licensing standards. 2. Staffing Requirements a. Staffing Levels (1) The Network Provider shall maintain staffing levels in compliance with applicable rules, statutes, licensing standards and policies and procedures. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations. Attachment I HCO2 (f) Page 26 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. (2) The Network Provider shall engage in recruitment efforts to maintain as much as possible staff with the ethnic and racial composition of the consumers served. The ME, at its sole discretion may request documentation evidencing recruitment efforts. b. Professional Qualifications (1) The Network Provider shall comply with applicable rules, statutes, requirements, and standards with regard to professional qualifications. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules, and Regulations and the requirements specified in Section 45. of the Standard Contract. (2) The Network Provider shall provide employment screening for all mental health personnel and all chief executive officers, owners, directors, and chief financial officers of service Network Providers using the standards for Level II screening set forth in Chapter 435, and s. 408.809 F.S., except as otherwise specified in s. 394.4572(1)(b)-(d), F.S. For the purposes of this contract, "Mental health personnel" includes all program directors, professional clinicians,staff members, and volunteers working in public or private mental health programs and facilities who have direct contact with individuals held for examination or admitted for mental health treatment. (3) Additionally, the Network Provider shall provide employment screening for substance abuse personnel using the standards set forth in Chapter 397.451, F.S., Background Checks for Service Provider Personnel. "All owners, directors, and chief financial officers of service providers are subject to level 2 background screening as provided under chapter 435. All service provider personnel who have direct contact with children receiving services or with adults who are developmentally disabled receiving services are subject to level 2 background screening as provided under chapter 435. A volunteer who assists on an intermittent basis for fewer than 40 hours per month and is under direct and constant supervision by persons who meet all personnel requirements of this chapter is exemptfrom fingerprinting and background check requirements." (4) Network Providers who have programs for children are required to meet the requirements of s. 39.001(2), (a) and (b) F.S which states the following: (a) A Network Provider that contracts for any program for children, all personnel, including owners, operators, employees, and volunteers, in the facility must be of good moral character. A volunteer who assists on an intermittent basis for less than 10 hours per month need not be screened if a person who meets the screening requirement of this section is always present and has the volunteer within his or her line of sight. (b) Employment screening and rescreening no less frequently than once every 5 years, pursuant to chapter 435, using the level 2 standards set forth in that chapter for personnel in programs for children or youths. Attachment I HCO2 (f) Page 27 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. c. Staffing Changes The Network Provider shall notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding the positions of Chief Executive Officer, Chief Financial Officer, Medical Director, and Clinical Director, IT Director, Dispute Resolution Officer, Data Security Officer, Single Point of Contact in accordance with Section 504 of the Rehabilitation Act of 1973 as required by Paragraph 33. of the Standard Contract, or any individuals with similar functions. Additionally, the Network Provider will notify the ME's Contract Manager in writing, of changes in the Executive Director or any senior management position. d. Subcontractors (1) This contract allows the Network Provider to subcontract for the provision of services related to the performance required under this Contract, subject to the provisions relating to Assignments and Subcontracts in the Standard Contract and referenced therein. Written requests by the Network Provider to subcontract for the provision of services under this contract will be routed through the ME's Contract Manager for approval.The ME is not obligated, nor will it pay for any services delivered prior to its written approval of the act of subcontracting. The act of subcontracting shall not in any way relieve the Network Provider of any responsibility for the contractual obligations of this contract.The pre-approval process applies to Subcontractors and not Independent Contractors as defined below. (2) The ME has adopted the following definitions for vendors, subcontractors and/or independent contractors who are contracted by the Network Provider to do work contemplated under this contract: (a) Vendor: A person or company offering something for sale. (b) Subcontractor: A business to business relationship; contracting a business or person outside of one's own company to do work as part of a larger project. (c) Independent Contractor: a person who is in an independent trade, business, or profession in which they offer their services and/or expert advice to an individual or organization. The general rule is that an individual is an independent contractor if the payer has the right to control or direct only the result of the work and not what will be done and how it will be done. The earnings of a person who is working as an independent contractor are subject to Self-Employment Tax. (3) The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds"To provide financial assistance to any entity other than a public or non- Attachment I HCO2 (f) Page 28 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. While the above-referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916 (a)(5), and 45 CFR, Part 96.135(a)(5)]. (4) Any vendor, subcontractor, or independent contractor the Network Provider contracts to do work contemplated under this contract, and who meets the definition of a Business Associate as defined in 45 CFR 160.103, must sign a legally binding document with the Network Provider that contains the same restrictions and conditions of the Business Associate Agreement between the Network Provider with the ME. The binding document must meet the requirements of 45 CFR s.164.504(e), Standard: Business Associate Contracts, the Privacy Rule, the Security Rule, the Breach Notification Rule, the Health Information Technology for Economic and Clinical Health ("HITECH") Act, the provisions included in the Network Provider's Business Associate Agreement with the ME, the ME's contractual requirements, and other laws and regulations pertaining to access, use, disclosure, and management of Protected Health Information ("PHI") without limitation, PHI in an electronic format (EPHI) created, received, maintained, or transmitted by the Network Provider or its subcontractors incidental to Network Provider's performance of this Contract. (5) All agreements, for services contemplated under this contract, shall adopt the applicable terms and conditions of the Network Provider's contract with the ME, including but not limited to, any Federal block grant requirements. In addition, all subcontract agreement's shall contain the applicable terms and conditions, and any amendments thereto, found in the ME's contract with the Department (Prime Contract), which is incorporated herein by reference. Subcontract agreements shall include a detailed scope of work; term of the agreement, method of payment, clear and specific deliverables; and performance standards. (6) The Network Provider shall maintain individual subcontractor files for each subcontractor and provide a copy of all subcontracts agreements prior to the execution of those subcontracts and any amendments to the ME's Contract Manager. (7) All independent contractor agreements, and subcontractor agreement, vendor agreements, and business associate agreements, or other legally binding agreements, for work contemplated under this contract shall be available upon request by ME staff and at the time of monitoring. (8) The Network Provider shall implement and maintain procedures for subcontract procurement, development, performance, and management that comply with state and federal rules, regulation, and/or ME policies and procedures, in addition to identifying the ME's pre-approval process for approving the Network Providers act of subcontracting. Attachment I HCO2 (f) Page 29 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. (9) The Network Provider shall not subcontract for substance abuse/mental health services with any person, entity,vendor, purchase orders or any like purchasing arrangements that: (a) is barred, suspended, or otherwise prohibited from doing business with any government entity, or has been barred, suspended, or otherwise prohibited from doing business with any government entity within the last 5 years; (b) is under investigation or indictment for criminal conduct, or has been convicted of any crime which would adversely reflect on their ability to provide services, or which adversely reflects their ability to properly handle public funds; (c) is currently involved, or has been involved within the last 5 years, with any litigation, regardless of whether as a plaintiff or defendant, which might pose a conflict of interest to the department, the state or its subdivisions, or a federal entity providing funds to the department; (d) had a contract terminated by the department or ME for failure to satisfactorily perform or for cause; or, (e) failed to implement a corrective action plan approved to the satisfaction of the ME, the department, and other governmental entities, after having received due notice. (10) Unless the Department agrees to an alternative payment method as authorized in section 394.9082, F.S., and prior to entering into any subcontract, or an amendment which modifies the previously negotiated unit cost rate or adds additional Covered Services, the Network Provider shall conduct a cost analysis for said subcontract, in accordance with Rule 65E-14. F.A.C. A cost analysis is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. Subcontractors will be required to comply with Rule 65E-14, F.A.C., Unit Cost Method of Payment, including but not limited to, Covered Services, unit measurements, descriptions, program areas, data elements, maximum unit cost rates, required fiscal reports, program description, setting unit cost rates, payment for services including allowable and unallowable units and requests for payments. (11) The Network Provider shall monitor the performance of all subcontractors, and perform follow up actions as necessary. The Network Provider shall notify the ME immediately upon discovery hours of conditions related to subcontractor performance that could impair continued service delivery. 3. Service Location and Equipment a. Service Delivery Location Attachment I HCO2 (f) Page 30 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. The location of services will be as specified in the approved Program Description required by Rule 65E-14, F.A.C. b. Service Times (1) A continuum of services shall be provided on the days and times as specified in the approved Program Description Attachment IV,Scope of Work. (2) The Network Provider shall notify the M E's Contract Manager, in writing, at least ten (10) calendar days prior to any changes in days and times where services are being provided pursuant to Rule 65E-14, F.A.C. c. Changes in Location The Network Provider shall notify the M E's Contract Manager, in writing, at least ten(10)calendar days prior to any changes in location where services are being provided pursuant to Rule 65E-14, F.A.C. d. Equipment The Network Provider shall furnish all appropriate equipment necessary for the effective delivery of the services purchased. In the event that the Network Provider is allowed to purchase any non-expendable property with funds under this contract, the Network Provider will ensure compliance with the Tangible Property Requirements, Department operating Policies and Procedures as outlined in CFOP 40-5, CFOP 80-2, Rule 65E-14, F.A.C., which are incorporated herein by reference and may be obtained from the ME's Contract Manager. The provider shall submit an inventory report, as specified in the Network Provider Inventory List, incorporated herein by reference, and by the date(s) listed in Exhibit C-1, Required Reports. The Network Provider Inventory List form may be requested from ME Contract Manager. 4. Deliverables a. Services The Network Provider shall deliver the services specified in and described in the Program Description submitted by the Network Provider and as set forth in Exhibit G,Covered Service Funding by OCA and in Attachment IV,Scope of Work. b. Records and Documentation The Network Provider shall protect confidential records from disclosure and protect consumer confidentiality in accordance with ss. 397.501(7), 394.455(6), 394.4615, and 414.295, F.S., and also the Health Insurance Portability and Accountability Act(HIPAA),42 CFR Part 2,and any other applicable State, and Federal laws, rules, and regulations. c. Reports Attachment I HCO2 (f) Page 31 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. Where this contract requires the delivery of reports to the ME, mere receipt by the ME shall not be construed to mean or imply acceptance of those reports. It is specifically intended by the parties that acceptance of required reports shall require a separate act in writing. The ME reserves the right to reject reports as incomplete, inadequate, or unacceptable according to the parameters set forth in the resulting contract. The ME, at its sole option, may allow additional time within which the Network Provider may remedy the objections noted by the ME or the ME may, after having given the Network Provider a reasonable opportunity to comply with the report requirements,declare this agreement to be in default. (1) The Network Provider shall submit to the M E financial and programmatic reports specified in Exhibit C-1,Required Reports, by the dates specified or as requested by ME staff. (2) Upon request, the network provider shall submit to the ME and the Department information regarding the amount and number of services paid for by the Substance Abuse Prevention and Treatment Block Grant. (3) The Network Provider shall provide performance information or reports other than those required by this agreement at the request of the ME, the Southern Region's SAMH Regional Director, or their designee. For requests that are complex and difficult to address, all parties will develop and implement a mutually viable work plan. (4) The Network Provider shall ensure that its audit report will include the standard schedules that are outlined in Rule 65E-14, F.A.C. and submitted within the timeframes specified in Exhibit C-1, Required Reports. (5) The Network Provider shall submit prevention services data to PBPS,and/or any other data reporting mechanism as directed by the ME. The data shall be submitted electronically no later than the 4th of each month following the month of service. The Network Provider shall also: (a) Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract. (b) Ensure that one-hundred percent (100%) of all data submitted to PBPS and/or any other data reporting mechanism as directed by the ME is consistent with the data maintained in the Network Providers service documentation and or/consumer files. (c) The Network Provider will accurately report the performance measures specified in Attachment IV, Scope of Work. (d) Resubmit corrected records no later than the next monthly submission deadline. The failure to submit any data set or the Network Provider's total monthly submission per data set,which results in a rejection rate of 5% or higher of the number of monthly records submitted will require the Attachment I HCO2 (f) Page 32 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. Network Provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected records will be corrected and resubmitted; and (e) Upon submission of the monthly data,the Network Provider's Director of Prevention/Supervisor, shall send an e-mail to the ME's Director of Prevention Services attesting that the data submitted has been reviewed and approved. (f) In accordance with the provisions of section 402.73(1), F.S.,and Rule 65-29.001, F.A.C.,corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties maybe imposed for failures to implementor to make acceptable progress on such corrective action plans. Failure to implement corrective action plans to the satisfaction of the ME and after receiving due notice, shall be grounds for contract termination. (6) Upon request, the Network Provider shall submit to the ME and/or the Department, information regarding the amount and number of services paid for by Substance Abuse Prevention and Treatment Block Grant. 5. Performance Specifications a. Performance Measures (1) The Network Provider shall meet the performance standards and required outcomes as specified in Exhibit D,Substance Abuse and Mental Health Required Performance Outcomes/Outputs and as outlined in Attachment IV, Scope of Work. (2) The Network Provider agrees that the PBPS, KIS, SAMHIS, or other data reporting system designated by the ME, will be the source for all data used to determine compliance with performance standards and outcomes in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. PBPS maintained by Collaborative Planning Group Systems, Inc. Any conflicts will be clarified by the ME and the Network Provider shall adhere to the ME's resolution. The Network Provider shall submit all service related data for consumers funded in whole or in part by SAMH funds, local match, or Medicaid. b. Performance Measurement Terms DCF PAM 155-2 provides the definitions of the data elements used for various performance measures which are quantitative indicators, outcomes, and outputs used by the ME to objectively measure a Network Provider's performance and contains policies and procedures for submitting the required data. c. Performance Evaluation Methodology (1) The Network Provider shall collect information and submit performance data and individual Attachment I HCO2 (f) Page 33 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. consumer outcomes, to the ME data system in compliance with DCF PAM 155-2 requirements. The specific methodologies for each performance measure may be found at the following website: http://www.myflfa m i I ies.com/service-programs/substance-abuse/pa m ph let-155-2-v11, (2) The Network Provider is expected to have the capability to engage in organized performance improvement activities, and to be able to participate in partnership with the department and ME in performance improvement projects that are related to system wide transformation and improvement of services for individuals and families. (3) By execution of this contract the Network Provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth in this contract. If the Network Provider fails to meet these standards, the ME, at its exclusive option, may allow a reasonable period, not to exceed six (6) months, for the Network Provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the ME within the prescribed time and if no extenuating circumstances can be documented by the Network Provider to the ME's satisfaction,the ME must terminate the contract. The ME has the sole authority to determine whether there are extenuating or mitigating circumstances. (4) The ME will monitor the standards and outcomes specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs,the standards and outcomes and in Attachment IV, Scope of Work., during the contract period, to determine if the Network Provider is achieving the levels that are specified. (5) Substance abuse prevention data information may be found on the Exhibit D Report which is transmitted to the ME Director of Prevention Services, as requested. 6. Network Provider Responsibilities a. Network Provider Unique Activities (1) The Network Provider shall adhere to the deliverables as set forth in (1) In the event of a dispute as to the ME's determination regarding consumer eligibility and/or placement into the appropriate level of care,the ME's dispute resolution process, as described in the Standard Contract shall be followed. An eligibility dispute shall not preclude the provision of services to Individuals Served, unless the dispute resolution process reverses the ME's determination. (2) The Network Provider is responsible for the satisfactory performance of the tasks referenced in this contract. By executing this contract, the Network Provider recognizes its responsibility for the tasks, activities, and deliverables described herein and warrants that it has fully informed itself of all relevant factors affecting the accomplishment of the tasks, activities and deliverables and agrees to be fully accountable for the performance thereof whether performed by the Network Provider or its subcontractors. Attachment I HCO2 (f) Page 34 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. (3) The Network Provider agrees that services other than those set out in this contract will be provided only upon receipt of a written authorization from the ME's Contract Manager or an authorized ME staff member. The department through the ME has final authority to make any and all determinations that affect the health safety and well-being of the residents of the State of Florida. (4) The Network Provider shall be responsible for the fiscal integrity of all funds under this contract, and for demonstrating that a comprehensive audit and tracking system exists to account for funding by consumer, and have the ability to provide an audit trail. The Network Provider's financial management and accounting system must have the capability to generate financial reports on individual service recipient utilization, cost, claims, billing, and collections for the ME. The Network Provider must maximize all potential sources of revenue to increase services, and institute efficiencies that will consolidate infrastructure and management functions in order to maximize funding. (5) The Network Provider shall ensure that the invoices submitted to the ME reconcile with the amount of funding and services specified in this contract, as well as the Network Provider's agency audit report and consumer information system and reconciled with KIS, PBPS,or other data reporting system designated by the ME. (6) The Network Provider shall make available source documentation of units billed by Network Provider upon request from the ME staff. The Network Provider shall track all units billed to the ME by program and by Other Cost Accumulator(OCA). (7) A Network Provider that receives federal block grant funds from the Substance Abuse Prevention and Treatment or Community Mental Health Block Grants agrees to comply with Subparts I and II of Part B of Title XIX of the Public Health Service Act,s.42 U.S.C.300x-21 et seq. (as approved September 22, 2000) and the Health and Human Services (HHS) Block Grant regulations (45 C.F.R. Part 96). (8) A Network Provider that receives funding from the SAPTBG certifies compliance with all of the requirements of the Substance Abuse and Mental Health Services Administration (SAMHSA) Charitable Choice provisions and the implementing regulations of 42 C.F.R. s. 54a. (9) A Network Provider that receives block grant funding shall monitor its compliance with block grant requirements and activities. (10) A Network Provider that receives block grant funding shall comply with state or federal requests for information related to block grant. (11) A Network Provider that receives CMH block grant funding and has been designated as a prevention provider for the purposes of H.R. Res. 3547, 113th Cong. (2014) (enacted), compliance with federal requirements. (12) None of the funds provided under the following grants may be used to pay the salary of an individual at a rate in excess of Level 11 of the Executive Schedule: Block Grants for Community Mental Health Services, Substance Abuse Prevention and Treatment Block Grant, Projects for Assistance in Attachment I HCO2 (f) Page 35 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. Transition from Homelessness, Project Launch, Florida Youth Transition to Adulthood; and Florida Children's Mental Health System of Care Expansion Implementation Project. (13) Any compensation paid for an expenditure subsequently disallowed as a result of the Managing Entity's or any Network Service Providers' non-compliance with state or federal funding regulations shall be repaid to the Department upon discovery. (14) The Network Provider shall make available to the ME and the Department all records pertaining to service delivery. These records shall be made available at all reasonable times for inspection, review, copying, or audit. Service delivery records include but are not limited to, invoicing, fiscal management, data management, incident reporting, consumer records, and such documents determined to assure accountability of service provision and/or the expenditure of state and federal funds. (15) The Network Provider shall assist the ME and the Department in developing legislative budget requests based upon identified needs of the community. (16) The Network Provider shall provide to the ME, copies of, including but not limited to, evaluations, assessments, surveys, monitoring reports that pertain to licensure, accreditation, or other administrative or programmatic review, when those reports identify deficiencies that require corrective action.The Network Provider shall submit to the ME all of the applicable reports, including copies of the corrective action plan(s)within ten(10)calendar days of receipt by the Network Provider from the reviewing entity. (17) The Network Provider shall cooperate with the ME and the Department when investigations are conducted regarding a regulatory complaint of the Network Provider. When additional information or documentation is requested by the ME, the Network Provider will submit the information within twenty-four(24) hours of the request unless otherwise specified in the ME's request. (18) The Network Provider shall maintain human resource policies and procedures that provide safeguards to ensure compliance with laws, rules and regulations. Integrate current and/or new state/federal requirements and policy initiatives into its operations upon provision by the Department and/or ME of the same. (19) The Network Provider shall maintain in one place for easy accessibility and review by ME and/or Department staff all policies, procedures, tools, and plans adopted by the Network Provider. The Network Provider's policies,procedures,and plans,must conform to state and federal laws,the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/ requirements contained in applicable Department of Children and Families and ME operating procedures. (20) The Network Provider shall maintain a mechanism for monitoring, updating, and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations, and the ME's policies and procedures. (21) Pursuant to s. 394.74(3)(e), F.S., the Network Provider shall maintain data on the performance Attachment I HCO2 (f) Page 36 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. standards specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes and Outputs,for the types of services provided under this contract. (22) The Network Provider shall comply with all other applicable federal laws, state statutes and associated administrative rules as may be promulgated or amended. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations, and ME policies and procedures. (23) Records relating solely to actions taken in carrying out the requirements of this contract and records obtained by the ME and/or the Department to determine a Network Provider's compliance with this section are confidential and exempt from s. 119.07(1) and s. 24(a), Access to Public Records and Meetings, Article. I, Constitution of the State of Florida. Such records are not admissible in any civil or administrative action except in disciplinary proceedings by the Department of Health or the appropriate regulatory board, and are not part of the record of investigation and prosecution in disciplinary proceedings made available to the public by the Department of Health or the appropriate regulatory board. Meetings or portions of meetings of continuous quality improvement program committees that relate solely to actions taken pursuant to this section are exempt from s.286.011.F.S. b. Coordination with other Providers/Entities (1) The Network Provider shall develop, maintain,and improve coordination and integrated care systems as follows: (i) Partnerships and collaborations with other community organizations/entities is expected to add value to the programs, services, strategies and community activities funded under this Contract. (ii) The Network Provider agrees to fulfill their designated role in implementing and/or maintaining a system of care in support of the Southern Region's SAMH Program Office's approved working agreement with the Department's contracted Community Based Care (CBC) providers. The intent of the working agreement is to establish a formal linkage of partnerships with a shared vision for improving outcomes for families involved in the child welfare system by providing integrated community support and services. (iii) The Network Provider may be required to enter into agreements with other external stakeholders (2) The failure of other providers or entities does not relieve the network provider of any accountability for tasks or services that the Network Provider is obligated to perform pursuant to this contract. c. State and Federal Laws, Rules, and Regulations See Exhibit F,SAMH Programmatic State and Federal Laws, Rules, and Regulations Attachment I HCO2 (f) Page 37 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. 7. Managing Entity Responsibilities a. Managing Entity Obligations (a)The ME shall only subcontract with entities that are fiscally sound, and that can adequately ensure the accountability of public funds. (b)The ME shall assess the Network Provider's financial stability, using a risk assessment approach; the risk assessment approach will examine the impact of programmatic requirements on the Network Provider's financial stability. Any issues identified as a result of the financial risk assessment shall be reported to the Department during the quarterly/monthly reconciliation and performance review identified in the Prime Contract. (c)The ME will provide administrative and programmatic oversight to ensure that the Network Provider comply with all consumer-related services and other requirements of this contract. (d)The ME is solely responsible for the oversight of the Network Provider and enforcement of all terms and conditions of this contract. Any and all inquiries and/or issues arising under this contract are to be brought solely and directly to the ME for consideration and resolution between the Network Provider and the ME. In any event, the ME's decision on all issues is final and solely subject to the ME's appeal process and legal rights of the Network Provider. (e)The ME reserves the right terminate this contract in whole or in part,for non-performance as determined by the ME and to procure the services purchased through this contract to another entity and/or Network Provider. (f) The ME is responsible for the administration, management, and oversight, and through subcontracts, the provision of behavioral health services in Miami Dade and Monroe Counties. (g)The ME shall monitor and take action when necessary so that services which meet the standards defined herein will be provided throughout the contract period. (h)lf applicable, the ME will ensure that the Network Provider utilizes the approved consumer assessment and placement tool designated by the ME. Standardized tools and assessments approved by the ME must be used to determine placement and level of care. (i) The ME shall work with the Department to redirect administrative cost savings into improved access to quality care, promotion of service continuity, required implementation of EBPs, the expansion of the services array, and necessary infrastructure development. It acknowledges the benefits to be realized, include improved access to quality care, promotion of service continuity, implementation of EBPs, improved performance and outcomes, Attachment I HCO2 (f) Page 38 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. expansion of the service array, and necessary infrastructure development. b. Monitoring Requirements (1) The ME will monitor the Network Provider in accordance with this contract and the ME's Contract Accountability Policies and Procedures which can be obtained from the designated ME Contract Manager, and is incorporated herein by reference. The Network Provider shall comply with any coordination or documentation required by the ME's monitor(s) to successfully evaluate the programs, and shall provide complete access to all budget and financial information related to services provided under this contract, regardless of the source of funds. (2) Network Providers with electronic health record (EHR)or electronic medical record systems (EMR)shall provide access to ME funded service and consumer data contained in these systems to the ME's monitoring team and provide sufficient resources to facilitate the monitoring process of services provided under this contract. Resources is defined but is not limited to, personnel, terminals, guest read-only accounts, privileges for monitors to access consumer records, and/or remote access into the systems by the monitors. (3) The ME will monitor the Network Provider on its performance of all tasks and special provisions of the contract. (4) The ME will provide a written report to the Network Provider within thirty (30) calendar days of the conclusion of the monitoring. If the report indicates corrective action is necessary, the Network Provider shall have ten (10) calendar days from receipt of the monitoring report to respond in writing to the request. In the sole discretion of the ME, if there is a threat to health, life, safety or well-being of consumers,the ME may require immediate corrective action or take such other action as the ME deems appropriate. Failure to implement corrective action plans to the satisfaction of the ME and after receiving due notice, shall be grounds for contract termination in whole or in part. c. Training and Technical Assistance (1) The ME's contact manager, or designee, will provide training and technical assistance concerning the terms and conditions of this contract and may maintain a documentation trail demonstrating any training and/or technical assistance efforts. (2)The ME will provide technical assistance and support to the Network Provider to ensure the continued integration of services and support for consumers, to include but not limited to, quality improvement activities to implement evidenced-based practice treatment protocols,the application of process improvement methods to improve the coordination of access and services that are culturally and linguistically appropriate. (3) The ME will provide technical assistance and support to the Network Provider for the maintenance and reporting of data on the performance standards that are specified in Exhibit Attachment I HCO2 (f) Page 39 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. In addition, the ME may convene cross-organizational training and assistance to help non- accredited Network Providers become accredited. (4)The ME implements a training program for its staff and the Network Provider staff. The trainings assure that staff receives externally mandated and internal training. The ME may coordinate training or directly provide training to Network Provider staff. d. Managing Entity Determinations The ME has exclusive authority to make the following determination(s) and to set the procedures that the Network Provider shall follow in obtaining the required determination(s): (1) Whether the Network Provider is meeting the terms and conditions of this contract, to include the Standard Contract, Attachment I, any documents incorporated into any attachment by reference, Program Description,and any documents incorporated by herein by reference. (2) The ME reserves the exclusive right to make certain determinations in these specifications.The absence of the ME setting forth a specific reservation of rights does not mean that all other areas of this contract are subject to mutual agreement.The ME reserves the right to make exclusively any and all determinations that it deems are necessary to protect the best interests of the State of Florida and the health, safety, and welfare of the consumers who are served by the ME either directly or through any one of its contracted Network Providers. (3) In the event of any disputes regarding the eligibility of individuals served, the determination made by the ME is final and binding on all parties. C. Method of Payment Exhibit B, Method of Payment Exhibit E, Monthly Payment Request (Incorporated herein by reference and available from the ME's Contract Manager Exhibit G,Covered Service Funding by OCA Exhibit H, Funding Detail and Local Match D. Special Provisions 1. The Network Provider is expected to maintain its administration cost to 10.00%or less for Fiscal Year 2018-2019 for SAMH services purchased under this contract. The cost savings shall be reallocated to support the increase of direct services, improved access to quality care, promotion of service continuity, and the implementation and/or expansion in the use of evidence-based practices.The Network Provider's Attachment I HCO2 (f) Page 40 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. Projected Covered Service Operating and Capital Budget shall evidence the reduction and redistribution of the cost savings. 2. Intern Registration Requirements pursuant to section 491.0045, F.S. (a) The Network Provider shall monitor and ensure that an individual who has not satisfied the postgraduate or post-master's level experience requirements, as specified in s. 491.005(1)(c), (3)(c),or(4)(c), F.S., register as an intern in the profession for which he or she is seeking licensure before commencing the post-master's experience requirement or for an individual who intends to satisfy part of the required graduate-level practicum, internship, or field experience, outside the academic arena for any profession, the network provide must monitor and ensure that the individual registers as an intern in the profession for which he or she is seeking licensure before commencing the practicum, internship, or field experience. (b) An intern registration is valid for five (5)years. (c) A registration issued on or before March 31, 2017, expires March 31, 2022, and may not be renewed or reissued. Any registration issued after March 31, 2017, expires 60 months after the date it is issued. A subsequent intern registration may not be issued unless the candidate has passed the theory and practice examination described in s.491.005(1)(d), (3)(d), and (4)(d), F.S. (d) An individual who has held a provisional license issued by the board may not apply for an intern registration in the same profession. 3. Real-time Data Entry: When required by the Prime Contract, state and/or federal rules, regulations, or policies, the Network Provider shall submit to the ME real-time data in KIS Express, or other similar data structure, for services purchased by this contract. The Network Provider agrees to implement the new data reporting system when notified and as directed by the ME. 4. Incident Reports a. The Network Provider shall submit incident reports into the Incident Reporting and Analysis System (IRAS)on all reportable incidents per CFOP 215-6,within 24 hours of receiving notification of a reportable incident. In the event an incident has an immediate impact on the health or safety of a consumer, has potential media impact, or involves employee-related incidents of criminal activity, the Network Provider must notify the ME Risk and Compliance Coordinator immediately upon discovery. Certain incidents may warrant additional follow-up by the ME. Follow-up may include on-site investigations or requests for additional information or documentation. When additional information or documentation is requested, the Network Provider will submit the information Attachment I HCO2 (f) Page 41 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. requested by the ME within 24 hours unless otherwise specified in the request. It is the responsibility of the Network Provider to maintain a monthly log listing all incidents occurring at the agency, including those submitted to the Office of the Inspector General and those not reportable in IRAS, with the following information: Consumer's initials, incident report tracking number from IRAS(if applicable), incident report category, date and time of incident,and follow-up action taken. b. All Network Providers (inpatient and outpatient) will report seclusion and restraint events in SAMHIS and in accordance with Rule 65E-5.180(7)(g), F.A.C. 5. Mandatory Reporting Requirements a. The Network Provider and any subcontractor must comply with and inform its employees of the following mandatory reporting requirements. Each employee of the Network Provider, and of any subcontractor, providing services in connection with this contract who has any knowledge of a reportable incident shall report such incident as follows: 1) Reportable incidents that may involve an immediate or impending impact on the health or safety of a consumer shall be immediately reported to the Contract Manager; and 2) Other reportable incidents shall be reported to the ME and Department's Office of Inspector General by completing a Notification/Investigation Request (form CF 1934) and emailing the request to the Office of Inspector General at ig_complaints@dcf.state.fl.us. The Network Provider and subcontractor may also mail the completed form to the Office of Inspector General, 1317 Winewood Boulevard, Building 5, 2nd Floor,Tallahassee, Florida,32399-0700;or via fax at(850)488-1428. A reportable incident is defined in Children and Families Operating Procedures CFOP 180-4 (CFOP 180-4) Mandatory Reporting Requirements to The Office of The Inspector General, which can be obtained from the Contract Manager. b. In the event of a breach or potential breach of Protected Health Information, the Network Provider is directed to the reporting requirements delineated in the executed Business Associate Agreement, incorporated herein by reference. 6. Service Provision Requirements for Substance Abuse Prevention and Treatment Block Grants a. As applicable, the Network Provider shall comply with the requirements set forth in 45 C.F.R. Subpart L—Substance Abuse Prevention and Treatment Block Grant and with the requirements of 42 C.F.R. Part 2. b. In accordance with 45 C.F.R. s. 96.131(b), the Network Provider that receive Block Grant funds and that serve injection drug users shall publicize the following notice: "This program receives federal Substance Abuse Prevention and Treatment Block Grant funds and serves people who inject drugs. This program is therefore federally required to give preference in admitting people into treatment as follows: 1. Pregnant injecting drug users; 2. Pregnant drug users; 3. People who inject drugs; and 4. All others." Attachment I HCO2 (f) Page 42 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. c. A Network Provider that receives SAPT block grant funding for the purpose of primary prevention, shall comply with 45 C.F.R. s. 96.125. d. Behavioral health services shall be provided to persons pursuant to s. 394.674, F.S., including those individuals who have been identified as requiring priority by state or federal law. The identified priority populations are found in Exhibit A, Consumer/Participants to be Served, however persons in categories (1) and (2) below are specifically identified as persons to be given immediate priority over those in any other categories. These individuals may not be placed on a wait list without receiving interim services within the required timeframes. (i) Pursuant to 45 C.F.R. s. 96.131, priority admission to pregnant women and women with dependent children by Network Service Providers receiving SAPT Block Grant funding. If the clinically appropriate services cannot be provided for the pregnant woman, interim services, not later than forty (48) hours after the woman seeks treatment services, shall be provided pursuant to 45 C.F.R. s. 96.123; (ii) Pursuant to 45 C.F.R. s. 96.126 (b), (1) and (2), adherence with the requirement to provide interim services for injection drug users by Network Service Providers receiving SAPT Block Grant funding and until the clinically appropriate level of treatment can be provided to the individual as follows: 45 C.F.R. s. 96.126(b), (1)-(2)Capacity of treatment for intravenous substance abusers and any other requirement. (1) 14 days after making the request for admission to such a program;or (2) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services, including referral for prenatal care, are made available to the individual not later than 48 hours after such request. e. Outreach Services to Injection Drug Users:The Network Provider shall carry out outreach activities to encourage injection drug users in need of treatment to undergo such treatment pursuant to the requirements in 45 C.F.R. s. 96.126(e).,The Network Provider shall document the services to demonstrate the provision of these services per the documentation requirements for Outreach services specified in Rule 65E-14, FAC. f. As required by 45 C.F.R.ss.96.17,the Network Provider may be requested to provide information to the ME for the purposes of reporting on SAPTBG activities to the Department g. The Network Provider shall ensure compliance with 45 C.F.R. Subpart C—Financial Management. h. The Network Provider agrees to comply with the data submission requirements outlined in DCF PAM 155-2 and by the dates specified in Exhibit C, Required Reports. i. In addition to the modifiers to procedure codes that are currently required to be utilized as per Attachment I HCO2 (f) Page 43 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. DCF PAM 155-2,Appendix 2,the Network Provider is directed to utilize the modifiers required for Block Grant funds, where applicable. The Network Provider also agrees to report to the ME and/or the Department, information regarding the amount and number of services paid for by the Community Mental Health Services Block Grant and/or the Substance Abuse Prevention and Treatment Block Grant. j. Only if such services are purchased through this contract is the Network Provider responsible for complying with the reporting requirements outlined in Exhibit AB, Substance Abuse Prevention and Treatment Block Grant (SAPTBG) Early Intervention Funded Services for Human Immunodeficiency Virus (HIV) by the dates and to the individual(s) listed in Exhibit C, Required Reports. Subject to other applicable state and/or federal requirements, the ME may require additional reports from the Network Provider. k. Only if such services are purchased through this contract is the Network Provider responsible for complying with the for SAPTBG set-aside funded services for pregnant women and women with dependent children services, SAPTBG set-aside funded services for HIV Early Intervention Programs and the SAPTBG set-aside funds for Evidenced-based Outreach Services to Injection Drug Users as outlined in Exhibit C, Required Reports. I. The Network Provider shall make available, either directly or by arrangement with others, tuberculosis services to include counseling, testing, and referral for evaluation and treatment pursuant to 45 C.F.R. s.96.17 and in compliance with Ch. 65D-30.004(9). F.A.C. m. The Network Provider shall use SAPTBG funds provided under this contract to support both substance abuse treatment services and appropriate co-occurring disorder treatment services for individuals with a co-occurring mental disorder only if the funds allocated are used to support substance abuse prevention and treatment services and are tracked to the specific substance abuse activity as listed in Exhibit G,Covered Service Funding by OCA. n. The Network Provider is required to participate in the peer-based fidelity assessment process to assess the quality, appropriateness, and efficacy of treatment services provided to individuals under this contract pursuant to 45 C.F.R. 96.136. o. The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non-profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. While the above- referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916(a)(5), and 45 C.F.R., Part 96.135(a)(5)]. Attachment I HCO2 (f) Page 44 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. 7. The Network Provider agrees to maximize the use of state residents,state products,and other Florida- based businesses in fulfilling their contractual duties under this contract. 8. Option for Increased Services The Network Provider acknowledges and agrees that the contract may be amended to include additional, negotiated, services as deemed necessary by the ME. Additional services can only be increased if the Network Provider demonstrates competence in the provision of contractual services and meets whatever criteria are established by the ME from time to time. The ME in its sole discretion shall determine at what time and to which Network Provider and what amounts are to be given to Network Providers for additional services. 9. Sliding Fee Scale Prevention services are exempt from the Sliding Fee Scale requirements per Rule 65E-14.018, F.A.C. 10. Transportation Disadvantaged The Network Provider agrees to comply with the provisions of chapter 427, F.S., Part I, Transportation Services, and Chapter 41-2, F.A.C., Commission for the Transportation Disadvantaged, if public funds provided under this contract will be used to transport consumers. The Network Provider agrees to comply with the provisions of Children and Families Operating Procedures 40-50 (CFOP 40-5) Acquisition of Vehicles For Transporting Disadvantaged Consumers if public funds provided under this contract will be used to purchase vehicles which will be used to transport consumers. 11. Medicaid Enrollment,if applicable Those Network Providers with SAMH contracts that meet Medicaid provider criteria and with funding in excess of $500,000 annually shall enroll as a Medicaid provider. This process shall be initiated within ninety (90) days of contract execution. A waiver of the ninety (90) day requirement may be granted, in writing, by the Department's Director of Substance Abuse and Mental Health Program Office,through the ME. 12. National Provider Identifier(NPI) (a) All network providers shall obtain and use an NPI, a HIPAA standard unique health identifier for health care providers. (b) An application for an NPI may be submitted online at https://nppes.cros.hhs.gov/NPPES/StaticForward.do?forward=static.npistart . (c) Additional information can be obtained from one of the following websites: Attachment I HCO2 (f) Page 45 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Hea|thNetwork,|nc. Effective:7/O1/2D1O (1) The Florida Medicaid HIPAA located at: h11p://wwvv.fdhc.s1a1eƒ|.us/hipaa/index.sh1m| (2) The National Plan and Provider Enumeration System (NPPES) located at: h11ps://nppeszms.hhs.Kov/NPPES/VVe|come.do (3) h11p://wvvvvzms.hhs.0ov/Na1iona|Prov|den1S1and/ 13. Ethical Conduct The Network Provider understands that performance under this contract involves the expenditure of public funds from both the state and federal governments, and that the acceptance of such funds obligates the Network Provider to perform its services in accordance with the very highest standards of ethical conduct. No employee, director, officer, agent of the Network Provider shall engage in any business, financial or legal relationships that undermine the public trust, whether the conduct is unethical,or lends itself to the appearance of ethical impropriety. Network Providers' directors, officers or employees shall not participate in any matter that would inure to their special gain, and shall recuse themselves accordingly. Public funds may not be used for purposes of lobbying, or for political contributions, or for any expense related to such activities, pursuant to Paragraph ZU. of the Standard Contract of this contract. The Network Provider understands that the ME contracts with the department, and as a subcontractor, recognizes that the department is a public agency which is mandated to conduct business in the sunshine, pursuant to section 286.011, F.S, and chapter 119, Florida Law, and that all issues relating to the business of the department, the ME and the Network Provider are public record and subject to full disclosure. The Network Provider understands that attempting to exercise undue influence on the ME, the department and its employees to a||ovx deviation or variance from the terms of this contract other than a negotiated, publicly disclosed amendment, is prohibited by the State of Florida, pursuant to sectionZO6.U11, F.S. The Network Provider's conduct is subject to all state and federal laws governing the conduct of entities engaged in the business of providing services togovernment. 14. Information Technology Resources If applicable,the Network Providers must receive written approval from the ME prior to purchasing any Information Technology Resource (|TR)with contract funds. The Contract Manager is responsible for serving as the liaison between the Network Provider and the ME during the completion of the process as instructed by the Contract Manager. The Network Provider will not be reimbursed for any |TR purchases made prior to obtaining the ME's written approval. lS. Programmatic,Fiscal&k Contractual Contract File References All of the documentation submitted by the Network Provider which may include, but not be limited to the Network Provider's original proposal, Program Description, Projected Covered Service Operating and Capital Budget, Agency Capacity Report and Personnel Detail Record, are herein incorporated by reference for programmatic, contractual and fiscal assurances of service provision These referenced contractual documents will be part of the Contract Manager's file. Documents Attachment|H02N Page 46of52 Guidance/Care Center, Inc. Contract No. P'4 South Florida Q'pi_A, Behavioral Health Network,Inc. incorporated by reference in this contract are available in the ME Contract Manager's file. 16. Employee Loans Funds provided by the ME to the Network Provider under this contract shall not be used by the Network Provider to make loans to their employees, officers, directors and/or subcontractors. Violation of this provision shall be considered a breach of contract and the termination of this contract shall be in accordance with the Paragraph 40. of the Standard Contract. A loan is defined as any advancement of money for which the repayment period extends beyond the next scheduled pay period. 17. Travel The Network Provider's internal procedures will assure that: travel voucher Form DFS-AA-15, State of Florida Voucher for Reimbursement of Traveling Expenses, incorporated herein by reference, be utilized completed and maintained on file by the Network Provider. Original receipts for expenses incurred during officially authorized travel, items such as car rental and air transportation, parking and lodging, tolls and fares, must be maintained on file by the Network Provider. Section 287.058 (1) (b) F.S., requires that bills for any travel expense shall be maintained in accordance with Section 112.061, F.S. governing payments for traveling expenses. CFOP 40-1 (Official Travel of State Employees and Non-Employees) provides further explanation, clarification, and instruction regarding the reimbursement of traveling expenses necessarily incurred during the performance of business. The Network Provider must retain on file documentation of all travel expenses to include the following data elements: name of the traveler, dates of travel, travel destination, purpose of travel, hours of departure and return, per diem or meals allowance, map mileage, incidental expenses, signature of payee and payee's supervisor. 18. Property and Title to Vehicles a. Property (1) Nonexpendable property is defined as tangible personal property of a non-consumable nature that has an acquisition value or cost of $1,000 or more per unit and an expected useful life of at least one year, and hardback covered bound books that are not circulated to students or the general public, the value or cost of which is $250 or more. Hardback books with a value or cost of$100 or more should be classified as nonexpendable property only if they are circulated to students or to the general public. All computers, including all desktop and laptop computers, regardless of the acquisition cost or value are classified as nonexpendable property. Motor vehicles include any automobile, truck, airplane, boat or other mobile equipment used for transporting persons or cargo. (2) When state property will be assigned to a provider for use in performance of a contract, the title for that property or vehicle shall be immediately transferred to the provider where it shall remain until this contract is terminated or until other disposition instructions are furnished Attachment I HCO2 (f) Page 47 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. by the ME's Contract Manager. When property is transferred to the provider, the department shall pay for the title transfer. The provider's responsibility starts when the fully accounted for property or vehicle is assigned to and accepted by the provider. Business arrangements made between the provider and its subcontractors shall not permit the transfer of title of state property to subcontractors. While such business arrangements may provide for subcontractor participation in the use and maintenance of the property under their control, the ME shall hold the provider solely responsible for the use and condition of said property. Provider inventories shall be conducted in accordance with CFOP 80-2. (3) If any property is purchased by the provider with funds provided by this contract, the provider shall inventory all nonexpendable property including all computers. A copy of which shall be submitted to the along with the expenditure report for the period in which it was purchased. At least annually, the provider shall submit a complete inventory of all such property to the ME whether new purchases have been made or not. (4) The Network Provider Inventory List, incorporated herein by reference, and available from the designated ME Contract Manager upon request, shall include, at a minimum,the identification number; year and/or model, a description of the property, its use and condition, current location, the name of the property custodian, class code (use state standard codes for capital assets), if a group, record the number and description of the components making up the group, name, make, or manufacturer, serial number(s), if any, and if an automobile, the VIN and certificate number; acquisition date, original acquisition cost, funding source, information needed to calculate the federal and/or state share of its cost. (5) The ME's Contract Manager must provide disposition instructions to the provider prior to the end of the contract period. The provider cannot dispose of any property that reverts to the ME or department without the Contract Manager's approval. The provider shall furnish a Closeout Inventory Form no later than 30 days before the completion or termination of this contract. The Closeout Inventory Form shall include all nonexpendable property including all computers purchased by the provider. The Closeout Inventory Form shall contain, at a minimum,the same information required by the annual inventory. (6) The provider hereby agrees that all inventories required by this contract shall be current and accurate and reflect the date of the inventory. If the original acquisition cost of a property item is not available at the time of inventory,an estimated value shall be agreed upon by both the provider and the ME and shall be used in place of the original acquisition cost. (7) Title (ownership) to and possession of all property purchased by the provider pursuant to this contract shall be vested in the ME upon completion or termination of this contract. During the term of this contract, the provider is responsible for insuring all property purchased by or transferred to the provider is in good working order. The provider hereby agrees to pay the cost of transferring title to and possession of any property for which ownership is evidenced by a certificate of title. The provider shall be responsible for repaying to the ME the replacement cost of any property inventoried and not transferred to the ME upon completion or termination of this contract. When property transfers from the provider to the ME, the provider shall be responsible for paying for the title transfer. Attachment I HCO2 (f) Page 48 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. (8) If the provider replaces or disposes of property purchased by the provider pursuant to this contract, the provider is required to provide accurate and complete information pertaining to replacement or disposition of the property as required on the provider's annual inventory. (9)The provider hereby agrees to indemnifythe ME and the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. (10) A formal contract amendment is required prior to the purchase of any property item not specifically listed in the approved contract budget. b.Title to Vehicles (1) Title (ownership) to, and possession of, all vehicles acquired with funds from this contract shall be vested in the ME upon completion or termination of the contract. The provider will retain custody and control during the contract period, including extensions and renewals. (2) During the term of this contract, title to vehicles furnished by the state or acquired at the direction of the state (using state or federal funds) shall not be vested in the provider. Subcontractors shall not be assigned or transferred title to these vehicles. The provider hereby agrees to indemnifythe ME or the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. 19. Health Insurance Portability and Accountability Act(HIPAA) a. In compliance with 45 CFR s.164.504(e),the Network Provider shall comply with the provisions of the Business Associate Agreement, incorporated herein by reference to this Contract, governing the safeguarding, use and disclosure of Protected Health Information created, received, maintained, or transmitted by the Network Provider or its subcontractors incidental to Network Provider's performance of this Contract. b. A violation or breach of any of the assurances as stipulated in the Business Associate Agreement shall constitute a material breach of this contract. 20. National Voter Registration Act(NVRA) of 1993 a. The Network Provider shall comply with the National Voter Registration Act (NVRA) of 1993, Pub. L. 103-31 (1993), section 97.025, F.S. b. As a Voter Registration Agency, the Network Providers shall designate a Voting Registration Activities Coordinator and provide the contact information of the Coordinator by the date and to the individual(s) identified in Exhibit C-1, Required Reports. The Network Provider shall notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding this position. Attachment I HCO2 (f) Page 49 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. c. As a Voter Registration Agency, the Network Provider shall provide individuals seeking services and/or individuals served with an opportunity at admission or when they change an address, to either register or update their voter registration.The National Voter Registration Act Preference Form/Application are DS-DE77-ENG and DS-DE77-SPN, are available at the link provided in paragraph f., below d. The Network Provider shall submit a NVRA Voter Registration Agencies Quarterly Activities Report Form, DS-DE131, by the dates and to the individual(s) identified in Exhibit C-1, Required Reports. The Quarterly Activity Report Form is available at the link provided in paragraph f., below. e. Any person aggrieved by a violation of either the National Voter Registration Act or a voter registration or removal procedure under the Florida Election Code may file a written complaint with the Department of State by completing and submitting the NVRA Complaint Form (DS-DE 18). f. The Department of State has published all form referenced herein, along with online training and additional guidance to implement NVRA at: http://dos.myflorida.com/elections/for-voters/voter-registration/nationa I-voter-registration- act 21. Special Insurance Provisions a. The Network Provider shall notify the ME Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance including but not limited to, cancellation or modification to policy limits. b. The Network Provider acknowledges that, as an independent contractor,the Network Providers, and its subcontractors, at all tiers are not covered by the State of Florida Risk Management Trust Fund for liability created by s. 284.30, F.S. c. The Network Provide shall obtain and provide proof to the ME's Contract Manager of comprehensive general liability insurance coverage (broad form coverage), specifically including premises,fire and legal liability to cover managing the Network Provider and all of its employees. The limits of Network Provider's coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. d. The Managing Entity shall cause all Network Service Providers, at all tiers, who the Managing Entity reasonably determines to present a risk of significant loss to the Managing Entity or the Department, to obtain and provide proof to Managing Entity and the Department of comprehensive general liability insurance coverage (broad form coverage), specifically including Attachment I HCO2 (f) Page 50 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. premises, fire and legal liability covering the Network Service Provider and all of its employees. The limits of coverage for the Managing Entity's Network Service Providers, at all tiers, shall be in such amounts as the Managing Entity reasonably determines to be sufficient to cover the risk of loss. e. If any officer, employee, or agent of the Managing Entity operates a motor vehicle in the course of the performance of its duties under this contract,the Managing Entity shall obtain and provide proof to the Department of comprehensive automobile liability insurance coverage.The limits of the Managing Entity's coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. f. If any officer, employee, or agent of any Network Service Provider, at all tiers, operates a motor vehicle in the course of the performance of the duties of the Network Service Provider, the Managing Entity shall cause the Network Service Provider to obtain and provide proof to the Managing Entity and the Department of comprehensive automobile liability insurance coverage with the same limits. g. The Managing Entity shall obtain and provide proof to the Department of professional liability insurance coverage, including errors and omissions coverage, to cover the Managing Entity and all of its employees. If any officer, employee, or agent of the Managing Entity administers any prescription drug or medication or controlled substance in the course of the performance of the duties of the Managing Entity under this contract,the professional liability coverage shall include medical malpractice liability and errors and omissions coverage,to cover the Managing Entity and all of its employees.The limits of the coverage shall be no less than$300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. h. If any officer, employee, or agent of the Network Service Provider, at all tiers, provides any professional services or provides or administers any prescription drug or medication or controlled substance in the course of the performance of the duties of the Network Service Provider, the Managing Entity shall cause the Network Service Provider, at all tiers,to obtain and provide proof to the Managing Entity and the Department of professional liability insurance coverage, including medical malpractice liability and errors and omissions coverage, to cover all Network Service Provider employees with the same limits. L The ME and the Department shall be exempt from, and in no way liable for, any sums of money that may represent a deductible or self-insured retention under any such insurance.The payment of any deductible on any policy shall be the sole responsibility of the Network Provider purchasing the insurance. j. All such insurance policies of the Network Providers, and its subcontractors at all tiers, shall be provided by insurers licensed or eligible to do and that are doing business in the State of Florida. Each insurer must have a minimum rating of"A" by A. M. Best or an equivalent rating by a similar insurance rating firm, and shall name the ME and the Department as an additional insured under Attachment I HCO2 (f) Page 51 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. the policy(ies). The Network Provider shall use its best good faith efforts to cause the insurers issuing all such general, automobile, and professional liability insurance to use a policy form with additional insured provisions naming the ME and the Department as an additional insured or a form of additional insured endorsement that is acceptable to the ME and the Department in the reasonable exercise of its judgment. k. All such insurance proposed by the Managing Entity shall be submitted to and confirmed by the Contract Manager annually by March 31. I. The requirements of this section shall be in addition to, and not in replacement of, the requirements of Section 10, of the Standard Contract to which this Attachment I is attached, but in the event of any inconsistency between the requirements of this section and the requirements of the Standard Contract, the provisions of this section shall prevail and control. E. List of Exhibits The Network Provider agrees to comply with the exhibits listed below. The following exhibits,or the latest revisions thereof,are incorporated in and made a part of the contract. 1. Exhibit A,Clients/Participants to be Served 2. Exhibit B, Method of Payment 3. Exhibit C-1, Required Reports for Prevention Providers 4. Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes and Outputs 5. Exhibit E, Monthly Payment Request 6. Exhibit F, State and Federal Laws, Rules and Regulations 7. Exhibit G,Covered Service Funding by OCA 8. Exhibit H, Funding Detail &Local Match Plan Attachment I HCO2 (f) Page 52 of 52 Guidance/Care Center, Inc. Contract No. P-4 'South Rloriiida eha� ilor ill t:te�flitli Nen ork.f (a EXHIBIT A Consumers/Participants to be Served A. GENERAL DESCRIPTION The Network Provider shall furnish services funded by this contract to the target population(s) checked below: Non-Prevention Prevention ❑ Adult Mental Health-Severe &Persistent Mental Illness ❑ Adult Substance Abuse ❑ Adult Mental Health-Serious&Acute Episodes of Mental ® Children's Substance Abuse Illness ❑ Adult Mental Health-Mental Health Problems ❑ Substance Abuse Community Coalition ❑ Adult Mental Health-Forensic Involvement ❑ Children's Mental Health-Serious Emotional Disturbances ❑ Children's Mental Health-Emotional Disturbances ❑ Children's Mental Health-At Risk of Emotional Disturbances ❑ Adult Substance Abuse ❑ Children's Substance Abuse B. CONSUMER/PARTICIPANT ELIGIBILITY 1. The Network Provider agrees that all persons meeting the target population descriptions in the table above are eligible for services based on the availability of resources. A detailed description of each target population is contained in s. 394.674, Florida Statutes and as described in the Department of Children and Families Pamphlet 155-2 (PAM 155-2), based on the availability of resources. Pamphlet 155-2 is available on the Department's website (www.myflfamilies.com/service-programs/substance-abuse/publications) and is incorporated herein by reference. 2. Behavioral Health services shall be provided to persons pursuant to s. 394.674, F.S., including those individuals who have been identified as requiring priority by state or federal law. These identified priorities include, but are not limited to, the categories in sections (a) through (j), below. Persons in categories (a) and (b) are specifically identified as persons to be given immediate priority over those in any other categories. a. Pursuant to 45 C.F.R. s. 96.131, priority admission to pregnant women and women with dependent children by Network Providers receiving SAPT Block Grant funding; b. Pursuant to 45 C.F.R. s. 96.126, compliance with interim services, for injection drug users, by Network Providers receiving SAPT Block Grant funding and treating injection drug users; c. Priority for services to families with children that have been determined to require substance abuse and mental health services by child protective investigators and also meet the target populations in subsections (a) or (b), above. Such priority shall be limited to individuals that are not enrolled in Medicaid or another insurance program, or require services that are not paid by another payor source: Exhibit A Guidance/Care Center, Inc. Page 1 of 3 Contract No. P-4 South Horiiida eha� ilor ill t:fe�dfll Neat ork.ln(% (1) Parents or caregivers in need of adult mental health services pursuant to s. 394.674(1)(a)2., F.S., based upon the emotional crisis experienced from the potential removal of children; and (2) Parents or caregivers in need of adult substance abuse services pursuant to s. 394.674(1)(c)3., F.S., based on the risk to the children due to a substance use disorder. d. Individuals who reside in civil and forensic state Mental Health Treatment Facilities and individuals who are at risk of being admitted into a civil or forensic state Mental Health Treatment Facility pursuant to s. 394.4573, F.S., Rules 65E- 15.031 and 65E-15.071, F.A.C.; e. Individuals who are voluntarily admitted, involuntarily examined, or placed under Part I, Chapter 394, F.S.; f. Individuals who are involuntarily admitted under Part V, Chapter 397, F.S.; g. Residents of assisted living facilities as required in s. 394.4574 and 429.075, F.S.; h. Children referred for residential placement in compliance with Ch. 65E-9.008(4), F.A.C.; and i. Inmates approaching the End of Sentence pursuant to Children and Families Operating Procedure (CFOP) 155-47. j. In the event of a Presidential Major Disaster Declaration, Crisis Counseling Program (CCP) services shall be contracted for according to the terms and conditions of any CCP grant award approved by representatives of the Federal Emergency Management Agency (FEMA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). 3. Mental health crisis intervention and crisis stabilization facility services, and substance abuse detoxification and addiction receiving facility services, shall be provided to all persons meeting the criteria for admission, subject to the availability of beds and/or funds. C. CONSUMER/PARTICIPANTS DETERMINATION 1. Determination of consumer eligibility is the responsibility of the Network Provider. The Network Provider shall adhere to the eligibility requirements as specified in Exhibit F, SAMH Programmatic State and Federal Laws, Rules, and Regulations. The ME reserves the right to review the Network Provider's determination of consumer eligibility and override the determination of the Network Provider. When this occurs the Network Provider will immediately provide services to the consumer until such time the consumer completes his/her treatment, voluntarily leaves the program, or the ME's decision is overturned as a result of the dispute resolution. 2. In no circumstances shall an individual's county of residence be a factor that denies access to service. Authorized services shall only be provided within the serviced area(s) outlined in Attachment 1, Section A.2.c.(2), subject to the availability of funds. 3. In the event of a dispute regarding consumer eligibility and/or placement into the appropriate level of care, the dispute shall not preclude the Network Provider from providing the provision of services to eligible individuals until the dispute is resolved. The dispute resolution process is described in Paragraph 42. of the Standard Contract. Exhibit A Guidance/Care Center, Inc. Page 2 of 3 Contract No. P-4 South Horiiida eha� ilor ill t:fe�dfll Nen ork.f (a 4. Participant eligibility (Direct Prevention) and target population eligibility (Community Prevention) shall also be based upon the community action plan or on the relevant epidemiology data. D. CONTRACT LIMITS 1. The Network Provider is not authorized to bill the ME for more units than can be purchased with the amount of funds specified in Exhibit G, Covered Service Funding by OCA, subject to the availability of funds. An exception is granted at the end of the contract term, when the ME at it sole discretion may pay, subject to the availability of funds, the Network Provider for "Uncompensated Units Reimbursement Funds", in whole or in part, or not at all, for Exemplary Performance by the Network Provider. Exemplary Performance will be determined by the Network Provider delivering and billing for services in excess of those units of service the ME will be required to pay. The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the DCF. 2. The Network Provider agrees that funds provided in this contract will not be used to serve persons outside the target population(s) specified in the paragraph above. NOTE: Prevention funds allocated to underage drinking programs and activities targeting eighteen (18) to twenty (20)year old individuals may be taken from Adult Substance Abuse Prevention funds. 3. The provision of services required under this contract are limited to eligible residents, children and adults receiving authorized services within the counties outlined in Attachment I, Section A. 2. c. (2) and limited by the availability of funds. 4. The Network Provider may not authorize or incur indebtedness on behalf of the ME or the Department. Exhibit A Guidance/Care Center, Inc. Page 3 of 3 Contract No. P-4 South Horiiida eha� ilor ill Health Nem ork. (% EXHIBIT B Method of Payment 1. PAYMENT CLAUSES a. This is a fixed price (unit cost) contract. The unit prices are listed on Exhibit G, Covered Service Funding by OCA. The ME shall pay the Network Provider for the delivery of service units provided in accordance with the terms and conditions of this contract for a total dollar amount not to exceed $450,000.00 ($150,000.00 per fiscal year of this contract), subject to the availability of funds and satisfactory performance of all terms by the Network Provider. Of the total Contract amount, the ME will be required to pay $450,000.00($150,000.00 per fiscal year of this contract), subject to the delivery and billing for services. The remaining amount of$0.00 represents "Uncompensated Units Reimbursement Funds",which the ME, at its sole discretion and subject to the availability of funds, may pay to the Network Provider, in whole or in part, or not at all, for Exemplary Performance by the Network Provider. Exemplary Performance will be determined by the Network Provider delivering and billing for services in excess of those units of service the ME will be required to pay. The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the DCF. Any costs or services eligible to be paid for under any other contract or from any other source are not eligible for payment under this Contract. b. Fixed Price (Unit Cost) for contracts with a hybrid method of payment: The ME shall pay the Network Provider for the delivery of service units provided in accordance with the terms and conditions of this contract for a total dollar amount not to exceed 0.00 subject to the availability of funds. The unit prices are listed on Exhibit G, Covered Services Funding by OCA. c. Cost Reimbursement for contracts with a hybrid method of payment: The ME shall reimburse the Network Provider for allowable expenditures incurred pursuant to the terms of this contract and the terms in Exhibit M-1, Services to be Provided, for a total dollar amount not to exceed 0.00 , subject to the availability of funds and Exhibit M-2, Line Item Operating Budget. d. Aftercare, Intervention, Outpatient, and Recovery Support Services (Substance Abuse) are eligible for special group rates. Group services shall be billed based on a direct staff hour, at 25%of the contract's established rate for the individual services for the same covered service. Excluding Outpatient, total hourly reimbursement for group services shall not exceed the charges for fifteen individuals per group. Group size limitations outlined in the current Medicaid Handbook apply to Outpatient group services funded under this contract. e. Pursuant to s. 394.76(3), Florida Statutes (F.S.), the Network Provider agrees to provide local matching funds in the amount of$112,500.00 as indicated in Exhibit H, Funding Detail and Local Match Plan. Should the Network Provider receive any funding from the "Uncompensated Units Exhibit B Page 1 of 6 Guidance/Care Center, Inc. Contract No. P-4 South Horiiida eha� ilor ill Health Nem Ork. (% Reimbursement Funds", then the amount of Local Match Plan as it appears on Exhibit H, Funding Detail, will automatically change, utilizing the following formula: The additional match required on the uncompensated units= Uncompensated Substance Abuse Services X 16.67%+Uncompensated Mental Health Services that is not exempt from local match requirements X 33.33%. * *The following MH services are exempt from the local match requirement i. Deinstitutionalization Projects Case Management Intensive Case Management Residential Services I-IV Supported Housing/Living Short Term Residential Treatment(not exempt if funded by Baker Act funds or operated by a public receiving facility) FACT Teams ii. CMH Programs (100435 Category & 102780 (PRTS) Category) that are not grant funded. f. In accordance with the provisions of s. 402.73(1), F.S., and Rule 65-29.001, Florida Administrative Code (F.A. C.), corrective action plans may be required for noncompliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed, to include contract termination in whole or in part, for failures to implement or to make acceptable progress on such corrective action plans. g. The ME shall reduce or withhold funds pursuant to Rule 65-29.001, F.A.C., if the Network Provider fails to comply with the terms of the contract and/or fails to submit client reports and/or data as required in DCF PAM 155-2, Rule 65E-14, F.A.C. and by the due dates listed on Exhibit C, Required Reports. h. The ME's decision to reduce or withhold funds will be submitted to the Network Provider in writing. The written notice will specify the manner in which the Network Provider has failed to comply with the terms of the contract.When, and if, compliance is achieved, the withheld funds will be disbursed to the Network Provider. L If the Network Provider closes or suspends the provision of services funded by this contract, the Network Provider agrees to notify the ME in writing thirty(30)calendar days prior to their intent to close, suspend or end service(s). If the Network Provider fails to notify the ME, the Network Provider hereby agrees not to request payment for services provided in prior months if the actual number of services in the month for which payment is being requested is less than twenty-five percent(25%)of the prorated amount of services by covered service as given on Exhibit G, Covered Service Funding by OCA, or twenty-five percent (25%) of the prorated share of the amount of funding as specified on Exhibit G, Covered Service Funding by OCA. j. The ME in its sole discretion and subject to funding availability, may purchase from any Network Provider prior to the end of the contract period any service units provided at any Exhibit B Page 2 of 6 Guidance/Care Center, Inc. Contract No. P-4 South Horiiida eha� ilor ill Health Nem ork. (% time during the term of the contract. 2. ADDITIONAL RELEASE OF FUNDS At its sole discretion,the ME may approve the release of more than the monthly prorated amount when the Network Provider submits a written request justifying the release of additional funds, if funds are available and services have been provided. 3. THIRD PARTY BILLING a. The Department is always the payer of last resort. The ME and the Network Provider specifically agree that the Department, through the ME, is never a liable third party. The Network Provider shall not bill the ME for services provided to: L Individuals who have third party insurance coverage when the services provided are covered under the insurance plan; or ii. Medicaid enrollees or recipients of another publically funded health benefits assistance program,when the services provided are covered by said program. b. The Network Provider may bill the ME if services are provided to: i. Individuals who have lost coverage through Medicaid, or any another publically funded health benefits assistance program coverage for any reason during the period of non-coverage subject to the sliding fee scale requirements in Rule 65E- 14.018, F.A.C; or ii. Individuals who have a net family income at or above 150 percent of the Federal Poverty Income Guidelines, subject to the sliding fee scale requirements in Rule 65E-14.018 F.A.C. iii. The Network Provider shall ensure that Medicaid funds are accounted for separately from funds for this contract. c. In no event shall Medicaid, any health insurance, another publically funded health benefits assistance program, or the ME be billed for the same service provided to the same individual on the same day. d. Medicaid earnings cannot be used as local match. e. The Network Provider shall ensure that Medicaid payments are accounted for in compliance with federal regulations. f. The Network Provider operating a residential treatment facility licensed as a crisis stabilization unit, detoxification facility, short-term residential treatment facility, residential treatment facility Levels 1 or 2,or therapeutic group home that is greater than 16 beds is not permitted to bill or knowingly access Medicaid Fee For-Service programs for any services for individuals eligible for Medicaid while in these facilities. g. The Network Provider operating a children's residential treatment center of greater than 16 beds are not permitted to bill or knowingly access Medicaid Fee-For Service programs for any services for individuals meeting the eligibility criteria for Medicaid in these facilities except as permitted under the Medicaid State Inpatient Psychiatric Program Waiver. Exhibit B Page 3 of 6 Guidance/Care Center, Inc. Contract No. P-4 South Horiiida eha� ilor ill Health Nem ork. (% h. The Network Provider shall assist individuals receiving services who need assistance and who meet the eligibility criteria for Medicaid to make application including assistance with medical documentation required in the disability determination process. L The Network Provider agrees to assist individuals eligible for Medicaid covered by a Medicaid capitated entity who need and request assistance to obtain covered mental health services that the treating Network Provider considers to be medically necessary. This assistance shall include assisting clients in appealing a denial of services. 4. PAYMENT FROM MEDICAID HEALTH MAITENANCE ORGRANIZATIOINS, PREPAID MENTAL HEALTH PLAN, OR PROVIDER SERVICE NETWORKS Unless waived in Section D (Special Provisions) of this contract, the Network Provider agrees that payments from a health maintenance organization, prepaid mental health plan, or provider services network will be "third party payer" contractual fees as defined in Rule 65E-14.001, F.A.C. Services which are covered by the sub-capitated contracts and provided to persons covered by these contracts must not be billed to the Department. 5. TEMPORARY ASSISTANCE TO NEEDY FAMILIES(TANF) BILLING a. The Network Provider's attention is directed to its obligations under applicable parts of Part A or Title IV of the Social Security Act and the Network Provider agrees that TANF funds shall be expended for TANF participants in accordance with Chapters 414, and 445, F.S. and the Department's State Plan for Temporary Assistance for Needy Families, renewal October 1, 2011 — September 30, 2014, or the latest revision thereof. Department's State Plan for Temporary Assistance for Needy Families can be obtained from the contract manager, or can be found at the following web site: http://www.dcf.state.fl.us/programs/access/flocs/TAN F-P la n.pdf b. The contract shall specify the unit cost rate for each covered service contracted for TANF funding, which shall be the same rate as for non-TANF funding, but the contract shall not specify the number of TANF units or the amount of TANF funding for individual covered services. 6. INVOICE REQUIREMENTS a. The rates negotiated with any Network Provider may not exceed the rate as specified in in Exhibit G, Covered Service Funding by OCA and or the amounts listed in Exhibit M-2, Line Item Operating Budget, if applicable. b. Network Providers are required to comply with Rule 65E-14.021, F.A.C., Schedule of Covered Services, including but not limited to, covered services, methods of payments, descriptions, program areas, data elements, required fiscal reports, program description, rate setting process, payment for services including allowable and unallowable units and requests for payments. c. The Network Provider shall request payment monthly through submission of a properly completed invoice, within eight (8) days following the end of the month for which payment is being requested for the delivery of service. Payment to the Network Provider by the ME is subject to the availability of funds and payments received from the Exhibit B Page 4 of 6 Guidance/Care Center, Inc. Contract No. P-4 South Horiiida eha� ilor ill Health Nem ork. (% Department.The invoice Exhibit E,Monthly Payment Request, is incorporated herein by reference and available upon request from the ME's Contract Manager. d. If no services are due to be invoiced from the preceding month, the Network Provider shall submit a written document to the ME indicating this information within eight (8) calendar days following the end of the month. The Network Provider shall request payment monthly through submission of a properly completed invoice, per the requirements of this contract, within eight (8) calendar days following the end of the month for which payment is being requested. e. If no services are due to be invoiced from the preceding month, the Network Provider shall submit a written document to the ME indicating this information within eight (8) calendar days following the end of the month. Should the Network Provider fail to submit an invoice or written documentation if no services are due to be invoiced from the preceding month, within thirty (30) calendar days following the end of the month, then the ME at sole discretion can reallocate funds. If the Network Provider fails to submit an invoice or written documentation for two (2) consecutive months within a twelve (12) month period, the ME at sole discretion can terminate the contract. f. The Network Provider's final invoice must reconcile actual service units provided during the contract period with the amount paid by the ME.The Network Provider shall submit their fiscal year final invoice to the ME within twenty(20)days after the end of each state fiscal year in the contract period. g. The Network Provider shall ensure that the year-to-date number of units of service reported on a request for payment or any associated worksheet shall reconcile with the total number of units reported and accepted in KIS or other data system designated by the ME. h. Pursuant to 65E-14.021(7)(a)2., F.A.C., the Network Provider shall not invoice for any Covered Services paid for under any other contract or from any other source. The Network Provider must subtract all units which are billable to Medicaid, and all units for SAMH client services paid from other sources, including Social Security, Medicare payments, Food Stamps, and funds eligible for local matching which include patient fees from first, second, and third-party payers, from each monthly request for payment. For services provided based on bed-day availability, the Network Provider must report any payments received from all other sources on the"Schedule of Bed-Day Availability" at the end of the fiscal year and refund any overpayment. i. Invoices shall be submitted in detail sufficient for a proper pre-audit and post-audit. 7. SUPPORTING DOCUMENTAITON a. The Network Provider agrees to maintain and submit to the ME, if applicable, service documentation for each service billed to the ME pursuant to this contract. The Network Provider shall track all units billed to the ME by program and by Other Cost Accumulator (OCA). Proper service documentation for each SAMH covered service is outlined in Rule 65E-14.021, F.A.C., Exhibit Y, TANF SAMH Guidelines and TANF SAMH Incidental Expenditures for Housing Assistance, if applicable. Exhibit B Page 5 of 6 Guidance/Care Center, Inc. Contract No. P-4 South Horiiida eha� ilor ill Health Nem ork. (% b. The Network Provider shall maintain documentation to support all units billed to the ME and units subtracted for SAMH client services on each monthly request for payment. c. The Network Provider shall ensure that all services provided are entered into KIS, PBPS, or other data system designated by the ME. d. The ME, Department and the State's Chief Financial Officer, reserve the right to request supporting documentation at any time after actual units have been delivered. 8. The Network Provider's attention is directed to the Department of Financial Services Reference Guide for State Expenditures for guidance regarding the requirements applicable to the disbursement of funds from the State Treasury, regardless of payment methods. The Reference Guide for State Expenditures can be obtained at the following website: http://www.myfloridacfo.com/aadir/reference guide/Reference Guide For State Expenditu res. df 9. FUNDING SWEEPS The Network Provider agrees that at the sole discretion of the ME and at such time and upon terms, conditions or criteria set by the ME, a review of the funding utilization rate or pattern of the Network Provider may be conducted by the ME. Based upon such review, if it is determined that the rate of utilization may result in a lapse of funds, then in that event the ME may amend the Network Provider's total amount of funding by reducing same to prevent the potential lapse. Additionally, the Network Provider's funding may be reduced and reallocated within the system of care,as determined by the ME and its sole discretion,to meet the changing needs of the system of care.The ME will notify the Network Provider in writing of the reduction prior to amending the total amount of funding. The ME's Lapse Policy is incorporated herein by reference. Exhibit B Page 6 of 6 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. Exhibit C-1 Required Reports �i"ii n mi iu�ii{il llll i7 � i «as �II[� i�illllll.l 1. ME Contract Manager Response to Monitoring Reports and Within 10 calendar days from the day the 1 (Electronic Submission via Corrective Action Plans report is received E-mail) 2. SFBHN staff member issuing CAP External Quality Assurance Reviews, Within 10 calendar days from the day the 1.ME Contract Manager Monitoring Reports,Surveys and Corrective report is received,or as requested by the 1 (Electronic Submission via Actions,as applicable Contract Manager E-mail) 2.Director of Contract Accountability Memorandum of Understanding(MOU)with a Within 90 calendar days of the effective Federally Qualified Health Center(FQHC) date of the contract(for newly executed or MOU's); 1 (Electronic Submission via Federally Qualified Health Centers are required Within 30 calendar days for renewed E-mail) ME Contract Manager to submit policies and procedures that explain MOU's;Updates to P&P for FQHC's shall the access to primary care services to the be submitted within 30 calendar days of medically underserved behavioral health client adoption Sliding Fee Scale[reflecting the uniform 1 (Electronic Submission via schedule of discounts referenced in 65E- Prior to contract execution E-mail) ME Contract Manager 14.018(4)] Final FY 2018-2019 (1)Projected Cost Center Operating and Submitted annually prior to contract Capital execution. Submit updates within 30 1.ME Contract Manager Budget, 1 (Electronic Submission via calendar days of execution of an (2)Budget Narrative, amendment to the contract affecting the E-mail) 2,VP of Finance (3)Network Providers Agency Service Capacity Report, budget. (4)Cost Center Personnel Detail Report Program Description Annually,prior to contract execution. 1 (Electronic Submission via 1.ME Contract Manager (1)Organizational Profile Submit updates within 30 calendar days of E-mail) (2)Service Activity Description amendment 2.VP of Behavioral Health Grievance Procedures Annually,prior to contract execution. 1 (Electronic Submission via 1.ME Contract Manager a)Clients(applicants or recipient of services) Submit updates within 30 calendar days of E-mail) b)Agency Staff implementation 2.VP of CQI Affidavit Regarding Debarment Annually prior to contract execution,or as 1 ME Contract Manager requested by the Contract Manager Submit updates within 30 calendar days of amendment or 1. ME Contract Manager "No Wrong Door"Policy and Procedures as requested by 1 the contract manager and/or the QA/QI 2.QA/QI Risk&Compliance Risk&Compliance Manager Manager Exhibit C-1 Guidance/Care Center, Inc. Page 1 of 7 Contract No. P-4 South Florida Behavioral Health Network,Inc. Within 24 hours of occurrence,in accordance with CFOP 215-6 and Incident Report reportable incidents defined CFOP 180-4 Submission through IRAS Submission through IRAS Mandatory Reporting Requirements to the Office of the Inspector General ADA Client Communication Assessment https/fs16.formsite con DCFrrain inp{IVI onthly-Summary- Report 1 (Electronic Submission via Auxiliary Aid Service Record Monthly Summary By the 4th business day following the Re ort form to in.html (Applicable to agency's that employ fifteen(15) reporting month E-mail) or more employees) Confirmation E-mail to the ME Contract Manager By July 20 of each fiscal year and/or 20 ME Final Invoice days 1 Sr.Accountant(Fiscal De after contract end date Department) Designation of Dispute Resolution Officer Within 5 working days of contract 1 (Electronic Submission via ME Contact Manager execution E-mail) Inventory Report 8/1/2018 1 (Electronic Submission via ME Contract Manager E-mail) Attestation of Network Provider's Verification that all applicable employees and subcontractors with access to ME and/or DCF 8/1/2018 1 (Electronic Submission via ME Contract Manager information systems have signed a DCF E-mail) Security Agreement form CF 0114,per the Attachment I and Standard Contract 1. ME Contract Manager Emergency Preparedness Plan 8/1/2018 1 (Electronic Submission via E-mail) 2.QA/QI Risk&Compliance Manager Civil Rights Compliance Checklist(CF0946) 8/1/2018 1 (Electronic Submission via ME Contract Manager E-mail) Civil Rights Certificate(CF707) 8/1/2018 1 (Electronic Submission via ME Contract Manager E-mail) 1.ME Contract Manager Quality Assurance/Quality Improvement Plan 8/1/2018 1 (Electronic Submission via E-mail) 2.QA/QI Risk&Compliance Manager Signed Florida Department of Children and Families Employment Screening Affidavit that 1 (Electronic Submission via all required staff have been screened or 8/1/2018 ME Contract Manager Network Provider is awaiting the results of E-mail) screening Exhibit C-1 Guidance/Care Center, Inc. Page 2 of 7 Contract No. P-4 South Florida Behavioral Health Network,Inc. 1.ME Contract Manager Action Plan(Integration of Behavioral Health 8/31/2018 1 (Electronic Submission via Services and Primary Care,TIC,CLC) E-mail) 2.QA/QI Risk&Compliance Manager Attestation singed by the CEO/Executive Director indicating that all applicable staff 1 (Electronic Submission via funded by this Contract have received a copy 10/1/2018 E-mail) ME Contract Manager of this fully executed Contract and will receive any amendments made to this Contract. July 5,2018 (Period:04/01/18-06/30/18) October 5,2018 NVRA Voter Registration Agencies Quarterly (Period:07/01/18-09/30/18) 1.ME Voter Registration Activities Report Form (DS-DE131;effective January 5,2019 1 (Electronic Submission via Activities Coordinator 01/2012 or latest revision thereof,if applicable (Period:10/01/18-12/31/18) E-mail) 2,ME Contract Manager April 5,2019 (Period:01/01/19-03/31/19) July 5,2019 (Period:04/01/19-06/30/19) October 31,2018 (Period:07/01/18-09/30/18) January 31,2019 Quarterly Financial Statements(Balance Sheet (Period:10/01/18-12/31/18) 1 (Electronic Submission via 1.ME VP of Finance and Statement of Activity) April 30,2019 E-mail) (Period:01/01/19-03/31/19) 2.ME Contract Manager July 31,2019 (Period:04/01/19-06/30/19) October 31,2018 (Period:07/01/18-09/30/18) January 31,2019 Attestation indicating the filing of Form 941 and (Period:10/01/18-12/31/18) 1 (Electronic Submission via payment of any taxes due to the IRS have April 30,2019 E-mail) ME Contract Manager been paid. (Period:01/01/19-03/31/19) July 31,2019 (Period:04/01/19-06/30/19) January 30,2019 1.ME Contract Manager Continuous Quality Improvement Updates (Period:07/01/18-12/31/18) 1 (Electronic Submission via July 30,2019 E-mail) 2.QA/QI Risk&Compliance (Period:01/01/19-06/30/19) Manager Completion of the annual self-assessment for the following initiative: 1.ME Contract Manager 1.Integration of Behavioral Health and Primary 3/1/2019 1 2.QA/QI Risk&Compliance Care(MeHAF) Manager Year-End Financial Reports for Network Provider's Not Requiring Audits Per Attachment II Exhibit C-1 Guidance/Care Center, Inc. Page 3 of 7 Contract No. P-4 South Florida Behavioral Health Network,Inc. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, Certification indicating that recipient expended whichever occurs first,directly to each of 1 (Electronic Submission via 1. ME Contract Manager less than$750,000 in Federal Awards or in the following unless otherwise required by E-mail) State Awards during the fiscal year Florida Statutes The schedule shall be 2.VP of Finance based on revenues and expenditures recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of the following unless otherwise required by Schedule of State Earnings Florida Statutes The schedule shall be 1 (Electronic Submission via 1. ME Contract Manager based on revenues and expenditures E-mail) 2.VP of Finance recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, Projected Cost Center Operating and Capital whichever occurs first,directly to each of Budget the following unless otherwise required by 1 (Electronic Submission via 1. ME Contract Manager Actual Expenses&Revenues Schedule Florida Statutes The schedule shall be E-mail) based on revenues and expenditures 2.VP of Finance recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of Local Match Calculation Form-Template 9- the recipient's receipt of the audit report, Department of Children and Families form, whichever occurs first,directly to each of available at the following website: the following unless otherwise required by 1. ME Contract Manager Florida Statutes The schedule shall be 1 (Electronic Submission via http://www.myflfamilies.com/service- based on revenues and expenditures E-mail) 2,VP of Finance programs/substance-abuse/managing- recorded during the state's fiscal year. e n ti ties/2018-con tract-d ocs Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of the following unless otherwise required by 1. ME Contract Manager Schedule of Bed-Day Availability Payments Florida Statutes The schedule shall be 1 (Electronic Submission via based on revenues and expenditures E-mail) 2,VP of Finance recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of 1. ME Contract Manager Agency Prepared Financial Statements the following unless otherwise required by 1 (Electronic Submission via (Balance Sheet and Statement of Activity Florida Statutes The schedule shall be E-mail) 2,VP of Finance based on revenues and expenditures recorded during the state's fiscal year. Year-End Financial Reports for Network Provider's Requiring Audits Per Attachment II Exhibit C-1 Guidance/Care Center, Inc. Page 4 of 7 Contract No. P-4 South Florida Behavioral Health Network,Inc. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of Correspondence from the Auditor showing the following unless otherwise required by 1. ME Contract Manager proof of submission of the Audit Report and Florida Statutes The schedule shall be 1 (Electronic Submission via Mangement Letter to the Network Provider. based on revenues and expenditures E-mail) 2,VP of Finance recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, 1. ME Contract Manager Management letter addressed to the Network whichever occurs first,directly to each of 1 (Electronic Submission via Provider issued by the Auditor the following unless otherwise required by E-mail) 2.VP of Finance Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of 1. ME Contract Manager Financial&Compliance Audit to include the the following unless otherwise required by 1 (Electronic Submission via necessary schedules per Attachment II Florida Statutes The schedule shall be E-mail) 2,VP of Finance based on revenues and expenditures recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of Schedule of State Earnings the following unless otherwise required by 1 (Electronic Submission via 1. ME Contract Manager Florida Statutes The schedule shall be E-mail) 2.VP of Finance based on revenues and expenditures recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, Schedule of Related Party Transaction whichever occurs first,directly to each of 1 (Electronic Submission via 1. ME Contract Manager Adjustments the following unless otherwise required by E-mail) Florida Statutes The schedule shall be 2.VP of Finance based on revenues and expenditures recorded during the state's fiscal year. Local Match Calculation Form-Template 9- Due 180 days after the end of the Network Department of Children and Families form, Provider's fiscal year or within 30 days of available at the following website: the recipient's receipt of the audit report, 1. ME Contract Manager whichever occurs first,directly to each of 1 (Electronic Submission via http://www.myflfamilies.com/service- the following unless otherwise required by E-mail) programs/substance-abuse/managing- Florida Statutes The schedule shall be 2.VP of Finance entities/2018-contract-docs based on revenues and expenditures recorded during the state's fiscal year. Exhibit C-1 Guidance/Care Center, Inc. Page 5 of 7 Contract No. P-4 South Florida Behavioral Health Network,Inc. Year-End Financial Reports for Network Provider's Requiring Audits Per Attachment II-Continued Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, Projected Cost Center Operating and Capital whichever occurs first,directly to each of Budget the following unless otherwise required by 1 (Electronic Submission via 1. ME Contract Manager Actual Expenses&Revenues Schedule Florida Statutes The schedule shall be E-mail) based on revenues and expenditures 2.VP of Finance recorded during the state's fiscal year. Due 180 days after the end of the Network Provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first,directly to each of 1. ME Contract Manager Schedule of Bed-Day Availability Payments the following unless otherwise required by 1 (Electronic Submission via Florida Statutes The schedule shall be E-mail) based on revenues and expenditures 2.VP of Finance recorded during the state's fiscal year. Additional Reports Required for Substance Abuse Prevention Services Providers Prevention service data shall be submitted PBPS,or other data system Monthly Data Required by DCF PAM 155-2 electronically to PBPS no later than the Electronically designated by the ME or the 4th of each month following the month of Department service Monthly Data to the ME's contracted evaluation Monthly,by the 4th calendar day after the Electronically DOES or any other format entity-BSRI month of service requested by BSRI Monthly Service Invoice Monthly,by the eighth(8th) calendar day 1 ME Sr.Accountant(Fiscal after the month of service Department) Invoice Review Supporting Documentation- Submitted with the monthly invoice 1 ME Sr.Accountant(Fiscal from PBPS in a jpeg format Department) Exhibit C-1 Guidance/Care Center, Inc. Page 6 of 7 Contract No. P-4 South Florida Behavioral Health Network,Inc. Additional Reports Required for Substance Abuse Prevention Services Providers-Continued Monthly E-Mail Notification to the ME Prevention Services Director and ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete 1. ME Director or Prevention and may be used for Block Grant reporting and Monthly,by the 4th calendar day after the 1 (Electronic Submission via Services payment. month of service E-mail) 2.ME Data Analyst Refer+u 3cei e c'Work Avacwnew lc r1 e r;tract r'cr S1,eer rus 1 (Electronic Submission via 1.ME Contract Manager Final Annual Site Schedule 8/31/2018 E-mail) 2 ME Director of Prevention Services Within 30 calendar days of the effective Memorandum of Understanding(MOU)with a date of the contract(for newly executed 1. ME Contract Manager Community Coalition MOU's) 1 (Electronic Submission via OR E-mail) 2. ME Director or Prevention Within 30 calendar days for renewed Services MOU's 1. ME Contract Manager Submission of Participant Satisfaction Survey- Refer to Scope of Work Attachment to the 1 (Electronic Submission via Contract for specifics E-mail) 2. ME Director or Prevention Services Additional Reports Required for Prevention Partnership Grant(PPG)Services Providers 1. ME Contract Manager Program Status Report 7/15/2019 1 (Electronic Submission via (Period:07/01/18-06/30/19) E-mail) 2. ME Director or Prevention Services October 31,2018 (Period:07/01/18-09/30/18) January 31,2019 1. ME Contract Manager (Period:10/01/18-12/31/18) 1 (Electronic Submission via 2. ME Director or Prevention Financial Report April 30,2019 (Period:01/01/19-03/31/19) E-mail) Services July 31,2019 3.ME VP for Finance (Period:04/01/19-06/30/19) Note:When a regular due date for a required report falls on a weekend or a legal holiday,the due date is extended to the next business day immediately following the weekend or holiday. Exhibit C-1 Guidance/Care Center, Inc. Page 7 of 7 Contract No. P-4 South Florkla Befun tonfl lleflth N'em,orL Inc, Ro,, 7,,L,2018 EXHIBIT D Substance Abuse & Mental Health Required Performance Outcomes & Outputs Provider Name: Guidance/Care Center,Inc. Contract P-04 Date: 7/1/2018 Revision ............... ..................... 110 11", AN 1 10 4o,W " VA, k1- U i A I I Q I',, ............... .......... rk, 6'd M,V it Adults Community Mental Health MH003 a. Average annual days worked for pay for adults with severe and persistent mental 40 illness MH703 b. Percent of adults with serious mental illness who are competitively employed 24% MH742 c. Percent of adults with severe and persistent mental illnesses who live in stable 90% housing environment MH743 d. Percent of adults in forensic involvement who live in stable housing environment 67% MH744 e. Percent of adults in mental health crisis who live in stable housing environment 86% Adult Substance Abuse SAA73 a. Percentage change in clients who are employed from admission to discharge 10% SA754 b. Percent change in the number of adults arrested 30 days prior to admission versus 15% 30 days prior to discharge SA755 c. Percent of adults who successfully complete substance abuse treatment services 51% SA756 d. Percent of adults with substance abuse who live in a stable housing environment 94% at the time of discharge Children's Mental Health MH012 a. Percent of school days seriously emotionally disturbed (SED) children attended 86% MH377 b. Percent of children with emotional disturbances (ED)who improve their level of 64% functioning MH378 c. Percent of children with serious emotional disturbances (SED)who improve their 65% level of functioning MH778 d. Percent of children with emotional disturbance (ED)who live in a stable housing I 95% environment MH779 e. Percent of children with serious emotional disturbance (SED)who live in a stable 93% housing environment MH780 f. Percent of children at risk of emotional disturbance (ED)who live in a stable 96% housing environment Children's Substance Abuse SA725 a. Percent of children who successfully complete substance abuse treatment services 48% SA751 b. Percent change in the number of children arrested 30 days prior to admission 20% versus 30 days prior to discharge SA752 c. Percent of children with substance abuse who live in a stable housing 93% environment at the time of discharge Exhibit D Guidance/Care Center, Inc. Page 1 of 2 Contract No. P-4 South Flue:kla Bthau iuu:utl teakh Netwoi,L Inc, Rm 7 I,20I8 Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Year FY18-19 Service Category FY Target Residential Care N/A Outpatient Care N/A �a Crisis Care N/A 4173 � State Hospital Discharges N/A Q Peer Support Services N/A Residential Care N/A a., a, Outpatient Care N/A _ M -a -_ Crisis Care N/A c.� a, Residential Care N/A Q Outpatient Care N/A a, U = Detoxification N/A 4a Women's Specific Services N/A +� Injecting Drug Users N/A Q Peer Support Services Residential Care N/A _ f0 Outpatient Care N/A M Detoxification N/A � ._ **Refer to Attachment IV,Scope of Prevention Work for the numbers served.** s U Network Provider Compliance: Failure to meet the applicable standards established in Tables 1 and 2 shall be considered nonperformance pursuant to Standard Contract, Paragraph 36. Financial Consequences for Network Provider's Failure to Perform. Exhibit D Guidance/Care Center, Inc. Page 2 of 2 Contract No. P-4 ',mmth Horii€€a Behar ilor€ill Health Nem€ rk.Inc ;i /20 EXHIBIT E Monthly Payment Request 1. Exhibit E, Monthly Payment Request This exhibit is incorporated by reference and available upon request to the ME's Contract Manager Exhibit E Guidance/Care Center, Inc. 1 of 1 Contract No. P-4 Exhibit F SAMH PROGRAMMATIC STATE AND FEDERAL LAWS, RULES, AND REGULATIONS The Network Provider and its subcontractors shall comply with all applicable state and federal laws, rules and regulations,as amended from time to time, that affect the subject areas of the contract. Authorities include but are not limited to the following: F-1 Federal Authority F-1.1 Block Grants Regarding Mental Health and Substance Abuse B-1.1.1 Block Grants for Community Mental Health Services 42 U.S.C. ss. 300x, et seq. B-1.1.2 Block Grants for Prevention and Treatment of Substance Abuse 42 U.S.C. ss. 300x-21 et seq. 45 C.F.R. Part 96, Subpart L F-1.2 Department of Health And Human Services,General Administration, Block Grants 45 C.F.R. Part. 96 F-1.3 Charitable Choice Regulations Applicable to Substance Abuse Block Grant and PATH Grant 42 C.F.R. Part 54 F-1.4 Confidentiality Of Substance Use Disorder Patient Records 42 C.F.R. Part 2 F-1.5 Security and Privacy 45 C.F.R. Part 164 F-1.6 Supplemental Security Income for the Aged, Blind and Disabled 20 C.F.R. Part 416 F-1.7 Temporary Assistance to Needy Families(TANF) 42 U.S.C. ss. 601 -619 45 C.F.R., Part 260 F-1.8 Projects for Assistance in Transition from Homelessness(PATH) 42 U.S.C. ss. 290cc-21 —290cc-35 F-1.9 Equal Opportunity for Individuals with Disabilities (Americans with Disabilities Act of 1990) 42 U.S.C. ss. 12101 -12213 F-1.10 Prevention of Trafficking(Trafficking Victims Protection Act of 2000) 22 U.S.C. s. 7104 2 C.F.R. Part 175 F-2 Florida Statutes F-2.1 Child Welfare and Community Based Care Ch. 39, F.S. Proceedings Relating to Children Exhibit F Page 1 of 4 Guidance/Care Center, Inc. Contract No. P-4 Ch. 402, F.S. Health and Human Services: Miscellaneous Provisions F-2.2 Substance Abuse and Mental Health Services Ch. 381, F.S. Public Health: General Provisions Ch. 386, F.S. Particular Conditions Affecting Public Health Ch. 394, F.S. Mental Health Ch. 395, F.S. Hospital Licensing and Regulation Ch. 397, F.S. Substance Abuse Services Ch. 400, F.S. Nursing Home and Related Health Care Facilities Ch. 414, F.S. Family Self-Sufficiency Ch. 458, F.S. Medical Practice Ch. 464, F.S. Nursing Ch. 465, F.S. Pharmacy Ch. 490, F.S. Psychological Services Ch. 491, F.S. Clinical, Counseling, and Psychotherapy Services Ch. 499, F.S. Florida Drug and Cosmetic Act Ch. 553, F.S. Building Construction Standards Ch. 893, F.S. Drug Abuse Prevention and Control S. 409.906(8), F.S. Optional Medicaid Services—Community Mental Health Services F-2.3 Developmental Disabilities Ch. 393, F.S. Developmental Disabilities F-2.4 Adult Protective Services Ch. 415, F.S. Adult Protective Services F-2.5 Forensics Ch. 916, F.S. Mentally Deficient and Mentally III Defendants Ch. 985, F.S. Juvenile Justice; Interstate Compact on Juveniles S. 985.19, F.S. Incompetency in Juvenile Delinquency Cases S. 985.24, F.S. Interstate Compact on Juveniles; Use of detention; prohibitions F-2.6 State Administrative Procedures and Services Ch. 119, F.S. Public Records Ch. 120, F.S. Administrative Procedures Act Ch. 287, F.S. Procurement of Personal Property and Services Ch. 435, F.S. Employment Screening Ch. 815, F.S. Computer-Related Crimes Ch. 817, F.S. Fraudulent Practices Exhibit F Page 2 of 4 Guidance/Care Center, Inc. Contract No. P-4 S. 112.061, F.S. Per diem and travel expenses of public officers, employees,and authorized persons S. 112.3185, F.S. Additional standards for state agency employees S. 215.422, F.S. Payments,warrants, and invoices; processing time limits; dispute resolution; agency or judicial branch compliance S. 216.181(16)(b), F.S. Advanced funds for program startup or contracted services F-3 Florida Administrative Code F-3.1 Child Welfare and Community Based Care Ch. 65C-13, F.A.C. Foster Care Licensing Ch. 65C-14, F.A.C. Child-Caring Agency Licensing Ch. 65C-15, F.A.C. Child-Placing Agencies F-3.2 Substance Abuse and Mental Health Services Ch. 65D-30, F.A.C. Substance Abuse Services Office Ch. 65E-4, F.A.C. Community Mental Health Regulation Ch. 65E-5, F.A.C. Mental Health Act Regulation Ch. 65E-10, F.A.C. Psychotic and Emotionally Disturbed Children -Purchase of Residential Services Rules Ch. 65E-11, F.A.C. Behavioral Health Services Ch. 65E-12, F.A.C. Public Mental Health Crisis Stabilization Units and Short Term Residential Treatment Programs Ch. 65E-14, F.A.C. Community Substance Abuse and Mental Health Services-Financial Rules Ch. 65E-20, F.A.C. Forensic Client Services Act Regulation Ch. 65E-26, F.A.C. Substance Abuse and Mental Health Priority Populations and Services F-3.3 Financial Penalties Ch. 65-29, F.A.C. Penalties on Service Providers F-4 MISCELLANEOUS F-4.1 Department of Children and Families Operating Procedures CFOP 155-10/175-40 Services for Children with Mental Health and Any Co-Occurring Substance Abuse or Developmental Disability Treatment Needs in Out- of-Home Care Placements CFOP 155-11 Title XXI Behavioral Health Network CFOP 155-47 Processing Referrals From The Department Of Corrections CFOP 215-6 Incident Reporting and Analysis System (IRAS) F-4.2 Standards applicable to Cost Principles,Audits, Financial Assistance and Administrative Requirements S. 215.97, F.S. Florida Single Audit Act Exhibit F Page 3 of 4 Guidance/Care Center, Inc. Contract No. P-4 S. 215.971, F.S. Agreements funded with federal or state assistance Comptroller's Memorandum No. 03(1999-2000) Florida Single Audit Act Implementation CFO's Memorandum No. 03 (2014-2015) Compliance Requirements for Agreements 2 C.F.R., Part 200 Office of Management and Budget Guidance-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, available at https://federalregister.gov/a/2013-30465 2 C.F.R., Part 300 Department of Health and Human Services-Office of Management and Budget Guidance-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Adoption of 2 C.F.R. Part 200 45 C.F.R., Part 75 Uniform Administration Requirements, Cost Principles,and Audit Requirements for HHS Awards F-4.3 Data Collection and Reporting Requirements S. 394.74(3)(e), F.S. Data Submission S. 394.9082, F.S. Behavioral health managing entities S. 394.77, F.S. Uniform management information, accounting,and reporting systems for providers S. 397.321(3)(c), F.S. Data collection and dissemination system DCF PAM 155-2 Mental Health and Substance Abuse Measurement and Data <<< The remainder of this page is intentionally left blank. >>> Exhibit F Page 4 of 4 Guidance/Care Center, Inc. Contract No. P-4 v a 0 z U C U 0 N Q1 O V 41 z A w w � w o A O C7 oa x w M w M 0 0 0 O . . . . . . . . . . . . . . . . . . . . . . . . . . . N N N N O W7 R Vi Vi Vi O 7 z A O u Z Q U C w � a� > > > o o O O aAA cG cGcGv v E a aw CG CG CGv UUUCGCGwww wv y� � rn v a 0 z U C O U . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N a, p, O V � z A w w w o p, W 'O H3 V � F yQ�ya W � w M w M 0 0 0 O . . . . . . . . . . . . . . . . . . . . . . . . . . . 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N N N N O W7 R Vi Vi Vi O 7 z A d. d, d, - d, d, d, - d, d, - d, d, d, d. d, d, d} d, d, d1 d, d, d, d} d, d, d1 - -fig fig fig fig- O u Z Q U C w � a� > > > W u o O > > > a>i o o a o o o. o o ; o U U '�. '� � a�' C .a 1 .a .a� W x '� � o 0 oCGci� d aaj IA IA a a a a o w o 0 0 0 u O O w ro ¢� UUU �I aaa CG cG cGcGv v E a aw CG CG CGv UUUCGCGwww 72 w 'A y� � rn C7 0. v v v v July 1,2018-June 30,2019 EXHIBIT H-FUNDING DETAIL July 2018 Provider: Guidance/Care Center,Inc. Contract#: P-04 Amendment# ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NETS'OCA AMOUNT OCA DESCRIPTION NETS'OCA AMOUNT ���... Residential Services MH001 �$ Residential Services MH001 � $ �� Non-Residential Services MH009 $��� Non-Residential Services MH009 �$��� Crisis and Baker Act Services 1\414018 $ Crisis and Baker Act Services 1\414018 � Community Forensic Program MH072 �$ Special Appropriation-ICFH MHOBN �$��� FACT Team 1\41-1073 $ Purchased Residential Treatment(PRTS) 1\414071 � -$---Indigent Drug Program 1\414076 �$ Community Action Treatment(CAT)Team MHCAT Proviso Allocation-Citrus 1\414094 �$�� �$�� --- PATH Grant MHOPG -- TANF Services MHOTB --- Early Intervention-Psychotic Disorders 1\41-1026 �$��� �$ - Forensic Hospital Multidisciplinary Team MHOF�II � �$� --- For Profit Sub-Recipeint-Key West HMA MHSFP �$��� �$ Supported Employment Services MHEMP $ $ Miami-Dade County Homeless Trust 1\414010 �$�� �$�� - IOS Pilot Project MH021 �$�� �$� ------------ MDC-Central Receiving Facility MDCRF �$ $ - - Care Coordination MHOCN $ Care Coordination MHOCN �$� Carry Forward MHOCI $ Carry Forward MHOCF $ TOTAL ADULT MENTAL HEALTH= $ TOTAL CHILDREN MENTAL HEALTH= $ ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NETS'OCA AMOUNT OCA DESCRIPTION NETS'OCA AMOUNT Residential Services IAS003 �$ Residential Services MS003 Non-Residential Services MS011 �$ Non-Residential Services MS011 �$��� Detox Services 4S021 $ Detox Services MS021 HIV Services MS023 �$�� �$��� HIV Services MS023 �$��� Prevention Services MS025 $ Prevention Services MS025 �$�� Women's Services MS027 �$ Prevention Partnership Grant MSOPP �$������150 000 Pregnant Women Project MS081 $ TANF Services MSOTB --- Proviso Allocation-GCC MS091 �$ Proviso Allocation-Here's Help MS903 -------------- �$ TANF Services MSOTB $ Here's Help Opioid Training MS913 $ Proviso Allocation-New Hope CORPS MS908 -------------- �$�� �$�� Targeted Response-Opioid Crisis MSOPH $ $ Opioid Crisis MAT MSOPM ---------------- �$�� �$�� Here's Help Opioid Training MS913 $ $ ------------ -------------- MDC-Central Receiving Facility MDCRF �$�����������-�� �$�����������-�� Care Coordination MSOCN �$ Care Coordination MSOCN Carry Forward MSOCF $ Carry Forward MSOCF ------------- $ TOTAL ADULT SUBSTANCE ABUSE_ $ TOTAL CHILDREN SUBSTANCE ABUSE_ $ 150,000 FUNDS NOT REQUIRING MATCH: Drug Abuse Services $ TOTAL ALL PROGRAMS= $ 150,000 Prevention $ UNCOMPENSATED UNITS= Deinstitutionalization Project $ - TOTAL— $ 150,000 CMH Program $ MH Block Grant TOTAL FUNDS REQUIRING MATCH= $ 150,000 TOTAL FUNDS NOT REQUIRING MATCH $ LOCAL MATCH REQUIRED= $ 37,500 NOTES #N/A Guidance/Care Center, Inc. Exhibit Contract No. P-4 Page 1 of 1 July 1,2019-June 30,2020 EXHIBIT H-FUNDING DETAIL July 2019 Provider: Guidance/Care Center,Inc. Contract#: P-04 Amendment# ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NETS'OCA AMOUNT OCA DESCRIPTION NETS'OCA AMOUNT ���... Residential Services MH001 �$ Residential Services MH001 � $ �� Non-Residential Services MH009 $��� Non-Residential Services MH009 �$��� Crisis and Baker Act Services 1\414018 $ Crisis and Baker Act Services 1\414018 $�� Community Forensic Program MH072 �$ Special Appropriation-ICFH MHOBN �$��� FACT Team 1\41-1073 $ Purchased Residential Treatment(PRTS) 1\414071 � -$---Indigent Drug Program 1\414076 �$ Community Action Treatment(CAT)Team MHCAT Proviso Allocation-Citrus 1\414094 �$�� �$�� --- PATH Grant MHOPG -- TANF Services MHOTB --- Early Intervention-Psychotic Disorders 1\41-1026 �$��� �$ - Forensic Hospital Multidisciplinary Team MHOF�II � �$� --- For Profit Sub-Recipeint-Key West HMA MHSFP �$��� �$ Supported Employment Services MHEMP $ $ Miami-Dade County Homeless Trust 1\414010 �$�� �$�� - IOS Pilot Project MH021 �$�� �$� ------------ MDC-Central Receiving Facility MDCRF �$ $ - - Care Coordination MHOCN $ Care Coordination MHOCN �$� Carry Forward MHOCI $ Carry Forward MHOCF $ TOTAL ADULT MENTAL HEALTH= $ TOTAL CHILDREN MENTAL HEALTH= $ ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NETS'OCA AMOUNT OCA DESCRIPTION NETS'OCA AMOUNT Residential Services IAS003 �$ Residential Services MS003 Non-Residential Services MS011 �$ Non-Residential Services MS011 �$��� Detox Services 4S021 $ Detox Services MS021 HIV Services MS023 �$�� �$��� HIV Services MS023 �$��� Prevention Services MS025 $ Prevention Services MS025 �$�� Women's Services MS027 �$ Prevention Partnership Grant MSOPP �$������150 000 Pregnant Women Project MS081 $ TANF Services MSOTB --- Proviso Allocation-GCC MS091 �$ Proviso Allocation-Here's Help MS903 -------------- �$ TANF Services MSOTB $ Here's Help Opioid Training MS913 $ Proviso Allocation-New Hope CORPS MS90$ -------------- �$�� �$�� Targeted Response-Opioid Crisis MSOPH $ $ Opioid Crisis MAT MSOPM ---------------- �$�� �$�� Here's Help Opioid Training MS913 $ $ ------------ -------------- MDC-Central Receiving Facility MDCRF �$�����������-�� �$�����������-�� Care Coordination MSOCN �$ Care Coordination MSOCN Carry Forward MSOCF $ Carry Forward MSOCF ------------- $ TOTAL ADULT SUBSTANCE ABUSE_ $ TOTAL CHILDREN SUBSTANCE ABUSE_ $ 150,000 FUNDS NOT REQUIRING MATCH: Drug Abuse Services $ TOTAL ALL PROGRAMS= $ 150,000 Prevention $ UNCOMPENSATED UNITS= Deinstitutionalization Project $ - TOTAL— $ 150,000 CMH Program $ MH Block Grant TOTAL FUNDS REQUIRING MATCH= $ 150,000 TOTAL FUNDS NOT REQUIRING MATCH $ LOCAL MATCH REQUIRED= $ 37,500 NOTES #N/A Guidance/Care Center, Inc. Exhibit Contract No. P-4 Page 1 of 1 July 1,2020-June 30,2021 EXHIBIT H-FUNDING DETAIL July 2020 Provider: Guidance/Care Center,Inc. Contract#: P-04 Amendment# ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NETS'OCA AMOUNT OCA DESCRIPTION NETS'OCA AMOUNT ���... Residential Services MH001 �$ Residential Services MH001 � $ �� Non-Residential Services MH009 $��� Non-Residential Services MH009 �$��� Crisis and Baker Act Services 1\414018 $ Crisis and Baker Act Services 1\414018 $�� Community Forensic Program MH072 �$ Special Appropriation-ICFH MHOBN �$��� FACT Team 1\41-1073 $ Purchased Residential Treatment(PRTS) 1\414071 � -$---Indigent Drug Program 1\414076 �$ Community Action Treatment(CAT)Team MHCAT Proviso Allocation-Citrus 1\414094 �$�� �$�� --- PATH Grant MHOPG -- TANF Services MHOTB --- Early Intervention-Psychotic Disorders 1\41-1026 �$��� �$ - Forensic Hospital Multidisciplinary Team MHOF�II � �$� --- For Profit Sub-Recipeint-Key West HMA MHSFP �$��� �$ Supported Employment Services MHEMP $ $ Miami-Dade County Homeless Trust 1\414010 �$�� �$�� - IOS Pilot Project MH021 �$�� �$� ------------ MDC-Central Receiving Facility MDCRF �$ $ - - Care Coordination MHOCN $ Care Coordination MHOCN �$� Carry Forward MHOCI $ Carry Forward MHOCF $ TOTAL ADULT MENTAL HEALTH= $ TOTAL CHILDREN MENTAL HEALTH= $ ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NETS'OCA AMOUNT OCA DESCRIPTION NETS'OCA AMOUNT Residential Services IAS003 �$ Residential Services MS003 Non-Residential Services MS011 �$ Non-Residential Services MS011 �$��� Detox Services 4S021 $ Detox Services MS021 HIV Services MS023 �$�� �$��� HIV Services MS023 �$��� Prevention Services MS025 $ Prevention Services MS025 �$�� Women's Services MS027 �$ Prevention Partnership Grant MSOPP �$������150 000 Pregnant Women Project MS081 $ TANF Services MSOTB --- Proviso Allocation-GCC MS091 �$ Proviso Allocation-Here's Help MS903 -------------- �$ TANF Services MSOTB $ Here's Help Opioid Training MS913 $ Proviso Allocation-New Hope CORPS MS90$ -------------- �$�� �$�� Targeted Response-Opioid Crisis MSOPH $ $ Opioid Crisis MAT MSOPM ---------------- �$�� �$�� Here's Help Opioid Training MS913 $ $ ------------ -------------- MDC-Central Receiving Facility MDCRF �$�����������-�� �$�����������-�� Care Coordination MSOCN �$ Care Coordination MSOCN Carry Forward MSOCF $ Carry Forward MSOCF ------------- $ TOTAL ADULT SUBSTANCE ABUSE_ $ TOTAL CHILDREN SUBSTANCE ABUSE_ $ 150,000 FUNDS NOT REQUIRING MATCH: Drug Abuse Services $ TOTAL ALL PROGRAMS= $ 150,000 Prevention $ UNCOMPENSATED UNITS= Deinstitutionalization Project $ - TOTAL— $ 150,000 CMH Program $ MH Block Grant TOTAL FUNDS REQUIRING MATCH= $ 150,000 TOTAL FUNDS NOT REQUIRING MATCH $ LOCAL MATCH REQUIRED= $ 37,500 NOTES #N/A Guidance/Care Center, Inc. Exhibit Contract No. P-4 Page 1 of 1 LO 0 N ti U � F d d' o � z 69 U O l� 69 V F 69 F V F 69 a H � Z � U � w I y 0 H U F O a V O a 59 F O M O O O O O W N N N N Z O krl krl krl bR 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 bR bR bR bR V b19 cz O V Ct —Cto —Ct � � y i i O O O Y Y o v v o .c .ct a cz 7� 7� 7� O O p 0 M O N N Y Y Y 'm 'm 'm CZ o 0 0 i i i i O O O O O O O ti rt' ti ti ti M ti ti ti N N N N N N N N rt' M M M M M M rt' rt' rt' rt' rt' � � 00 O N !, z 0 N ti U � F d d' o � z 69 U O l� 69 U F 69 F U F 69 a H � Z � � y O rt � U F O a U a 59 F O M O O O O O W N N N N Z O krl krl krl bR 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 bR bR bR bR U bR cz U Ct —CtO —Ctct � y i i N U �--• O O O O N �--• �--• cd cd cd cd O O cd O V� V� L1 L1 L1 L1 o o a o 0 0 0 N V� V� O O o cz 7� 7� 7� O O p 0 M O N N Y Y Y 'm 'm 'm CZ o 0 0 i i i i O O O O O O O ti rt' ti ti ti M ti ti ti N N N N N N N N rt' M M M M M M rt' rt' rt' rt' rt' � � 6� O N !, 0 N 0 N ti U � F d d' o � z 69 U O l� 69 U F 69 F U F 69 a H � Z � � y O rt � U F O a U a 59 F O M O O O O O W N N N N Z O krl krl krl bR 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 bR bR bR bR U bR cz U Ct —CtO —Ctct � y i i N U �--• O O O O N �--• �--• cd cd cd cd O O cd O V� V� L1 L1 L1 L1 O o a o 0 0 0 N V� V� O O ocz cz 7� 7� 7� O O p 0 M O N N Y Y Y 'm 'm 'm CZ o 0 0 i i i i O O O O O O O ti rt' ti ti ti M ti ti ti N N N N N N N N rt' M M M M M M rt' rt' rt' rt' rt' � � O N O N !, South Florida Q'pi_A, Behavioral Health Network,Inc. ATTACHMENT II Financial and Audit Compliance The administration of resources awarded by the Department of Children & Families, through the Managing Entity, to the provider may be subject to audits as described in this attachment. MONITORING In addition to reviews of audits conducted in accordance with 2 Code of Federal Regulations (CFR) §§ 200.500-200.521 and § 215.97, F.S., as revised, the Department may monitor or conduct oversight reviews to evaluate compliance with contract, management and programmatic requirements. Such monitoring or other oversight procedures may include, but not be limited to, on-site visits by Department staff, agreed-upon procedures engagements as described in 2 CFR § 200.425 or other procedures. By entering into this agreement, the recipient agrees to comply and cooperate with any monitoring procedures deemed appropriate by the Department. In the event the Department determines that a limited scope audit of the recipient is appropriate,the recipient agrees to comply with any additional instructions provided by the Department regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Department's inspector general, the state's Chief Financial Officer or the Auditor General. AUDITS PART I: FEDERAL REQUIREMENTS This part is applicable if the recipient is a State or local government or a non-profit organization as defined in 2 CFR §§ 200.500-200.521. In the event the recipient expends $750,000 or more in Federal awards during its fiscal year, the recipient must have a single or program-specific audit conducted in accordance with the provisions of 2 CFR §§ 200.500-200.521. The recipient agrees to provide a copy of the single audit to the Department's Single Audit Unit and its contract manager. In the event the recipient expends less than $750,000 in Federal awards during its fiscal year, the recipient agrees to provide certification to the Department's Single Audit Unit and its contract manager that a single audit was not required. In determining the Federal awards expended during its fiscal year, the recipient shall consider all sources of Federal awards, including Federal resources received from the Department of Children & Families, Federal government (direct), other state agencies, and other non- state entities. The determination of amounts of Federal awards expended should be in accordance with guidelines established by 2 CFR §§ 200.500-200.521. An audit of the recipient conducted by the Auditor General in accordance with the provisions of 2 CFR Part 200 §§ 200.500-200.521 will meet the requirements of this part. In connection with the above audit requirements, the recipient shall fulfill the requirements relative to auditee responsibilities as provided in 2 CFR § 200.508. Attachment II Page 1 of 4 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. The schedule of expenditures should disclose the expenditures by contract number for each contract with the Department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the Department shall be fully disclosed in the audit report package with reference to the specific contract number. PART II: STATE REQUIREMENTS This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2), Florida Statutes. In the event the recipient expends $500,000 or more ($750,000 or more for fiscal years beginning on or after July 1, 2016) in state financial assistance during its fiscal year, the recipient must have a State single or project-specific audit conducted in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. The recipient agrees to provide a copy of the single audit to the Department's Single Audit Unit and its contract manager. In the event the recipient expends less than $500,000 (less than $750,000 for fiscal years beginning on or after July 1, 2016) in State financial assistance during its fiscal year, the recipient agrees to provide certification to the Department's Single Audit Unit and its contract manager that a single audit was not required. In determining the state financial assistance expended during its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Department of Children & Families, other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a nonstate entity for Federal program matching requirements. In connection with the audit requirements addressed in the preceding paragraph, the recipient shall ensure that the audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 or 10.650, Rules of the Auditor General. The schedule of expenditures should disclose the expenditures by contract number for each contract with the Department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the Department shall be fully disclosed in the audit report package with reference to the specific contract number. PART III: REPORT SUBMISSION Any reports, management letters, or other information required to be submitted to the Department pursuant to this agreement shall be submitted within 180 days after the end of the provider's fiscal year or within 30 (federal) or 45 (State) days of the recipient's receipt of the audit report, whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes: A. Contract manager for this contract(1 copy) Attachment II Page 2 of 4 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. B. Department of Children & Families ( 1 electronic copy and management letter, if issued ) Office of the Inspector General Single Audit Unit Building 5, Room 237 1317 Winewood Boulevard Tallahassee, FL 32399-0700 Email address: HQW.IG.Single.Audit@myflfamilies.com C. Reporting packages for audits conducted in accordance with 2 CFR Part 200 §§ 200.500-200.521, and required by Part I of this agreement shall be submitted, when required by § 200.512 (d) by or on behalf of the recipient directly to the Federal Audit Clearinghouse using the Federal Audit Clearinghouse's Internet Data Entry System at: http://harvester.census.gov/fac/collect/ddeindex.html and other Federal agencies and pass-through entities in accordance with 2 CFR § 200.512. D. Copies of reporting packages required by Part II of this agreement shall be submitted by or on behalf of the recipient directly to the following address: Auditor General Local Government Audits/342 Claude Pepper Building, Room 401 111 West Madison Street Tallahassee, Florida 32399-1450 Email address: flaudgen localgovt@aud.state.fl.us Providers, when submitting audit report packages to the Department for audits done in accordance with 2 CFR §§ 200.500-200.521, or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit or for- profit organizations), Rules of the Auditor General, should include, when available, correspondence from the auditor indicating the date the audit report package was delivered to them. When such correspondence is not available, the date that the audit report package was delivered by the auditor to the provider must be indicated in correspondence submitted to the Department in accordance with Chapter 10.558(3) or Chapter 10.657(2), Rules of the Auditor General. PART IV: RECORD RETENTION The recipient shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued and shall allow the Department or its designee, Chief Financial Officer or Auditor General access to such records upon request. The recipient shall ensure that audit working papers are made available to the Department or Attachment II Page 3 of 4 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. its designee, Chief Financial Officer or Auditor General upon request for a period of three years from the date the audit report is issued, unless extended in writing by the Department. Attachment II Page 4 of 4 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. ATTACHMENT III CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of congress, an officer or employee of congress, or an employee ofe member of congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract,grant,loan,or cooperative agreement. (2) If any funds other than federal appropriated'funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form- LLL,"Disclosure Form to Report Lobbying,"in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements)and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352,Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. " 4. fr f t Signature Date Sharon Crippen P-4 Name of Authorized Individual Application or Contract Number The Guidance Care/Center, Inc,____ Name of Organization 3000 41st Street Ocean. Marathon, FL 33050 Address of Organization CF 1123,PDF 03/96 Attachment III Guidance/Care Center,Inc. Page I of I Contract No.P-4 South Florida Behavioral Health Network,Inc. Attachment IV SCOPE OF WORK NAME OF PROVIDER: Guidance/Care Center NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: $150,000.00 for each year of the contract "Regular" Prevention Services Prevention Partnership Grant TYPE OF FUNDING: PPG X Children's Substance Abuse Adult Substance Abuse COST ALLOCATED TO: (check both if approved for both covered services) X Section I. DESCRIPTION OF SERVICES AND STRATEGIES FOR SERVICE DELIVERY I & IIIlTIN' :' ' e ►t©r�/ fir q '`,of r,Q'' 1�at1'' n ' ru' 'tf4 _l 4 i k rT �►���f,d�s "a�at�Qrt Q�?F�rQ ���,r! }�jirrt�� ,t�a�r eta pop�l�t�o� �' �; ��'' hovu, tie}` ,ii�i � ��d��"�- �u��fi�rr'��"s $S, Q l 4'L�� S ,,,;the � ,�s E'>„ �f!Qf it i�4;?� S j ��� t©wrftl���1�A/,y r��A�sre t� ,�7�A:Y, ;*��_4Th!�},5.1,1v±F? 1(I��,N� `?",T,"�l✓�� �N„M ,i The Guidance/Care Center's (GCC) will provide the Project SUCCESS program using the Substance Abuse and Mental Health and Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) Project SUCCESS program recognized in the National Registry of Evidence-based Programs and Practices (NREPP). The program will be available and accessible to high risk youth ages 12-18 who have experimented with alcohol, are showing early danger signs and multiple risk factors for substance abuse and who attend Monroe County High Schools. Project SUCCESS relies primarily on Education as a strategy. Services include school wide activities targeting the entire school population and are designed to increase awareness of mental health and substance abuse issues, small groups targeting youth identified as being at risk, prevention education groups targeting all 91h graders, and individual counseling to those in need of additional supportive counseling. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20-year olds by 10% by meeting the following objectives: reducing alcohol use, increasing the perception of harm and risk in youth and enhancing positive, pro-social protective factors. Goal 2: Increase capacity by providing level 2 prevention programming for those at high risk; thereby eliminating service gaps for these students by providing the funding and resources necessary to ensure successful program implementation, continuity of care and partnership capacity countywide. GCC partners with the Monroe County School District and the Monroe County Coalition for the provision of these services. Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 1 of 13 IONIC ta M0.� 1 �y *ft ' 600 t 4{ } j i +"t j# t 7.{ t£ls tj/"y IIw4�+ ,I��,� 1iw1''PS�I f�r'�,ct } t Y�KT�ti7Y}F'kn - sr�at ` ins;:=CSAFF,t i School wide activities Universal Information 2,500 Dissemination 9tn grade PES Selective Education 450 Screening Selective Problem ID and referral 750 Small groups Selective Education 40 Student Assistance Selective Problem ID and referral 750 One on One Indicated Education 35 Capacity Building Adults Universal Direct Education 250 Section II. TARGET POPULATION — RISK AND PROTECTIVE FACTORS �� �G�Tt��, �� ' ''710�"� tl,F� ;RT CIS 1�,N;`�",5„(�rt ;�d�Snu,i, tber`stri,�eble 'alit,: {�'p��►' t��r��es �`i�7©pj44�t t`r Description of participants to be served(describe criteria for program enrollment eligibility, geographic areas / Neighborhoods (list zip codes), risk factors of the neighborhoods, description of the sites(school, church, park, etc.), as well as any other significant demographic information), specific cultural characteristics, and describe according to the Comprehensive Community Action Plan priorities: Youth alcohol use - Abuse by "legal" age individuals, Youth/Adult marijuana use, Prescription drug misuse/abuse, over the counter drugs misuse/abuse, other illicit drug use. Participants will be students at the 3 High Schools in Monroe County and Middle School students in Marathon. School wide activities and Prevention Education Groups are universal in nature while small groups and individual counseling are targeted at youth identified as at risk. At risk students might be identified by parents, teachers, and other community agencies or by themselves. Project SUCCESS is designed to be implemented in school settings. Each counselor has been provided with adequate space and access to student populations to fully implement the program as designed. GCC has made changes to its Prevention programming for the coming year in that most all grade levels will be covered. Apple a Day will cover K through grade 4, Alcohol Literacy and Teen Intervene will cover middle schools and Project SUCCESS will be in the high schools. The comparison of percentage of Monroe County youth and Florida Statewide youth who reported having used a list of 14 various drugs in their lifetimes reveals that percentages for Monroe County youth exceed those for the state in every category (FYSAS 2010). A significantly greater percentage of Monroe County High School students (40.9%) than statewide students (33.6%) witnessed gang members selling drugs. The ethnicity of these children breaks down as follows: 52.9% White, 33.8% Hispanic, 10.10% Black, 1.45% Asian and 2.88% Other. Risk factors: Favorable attitudes towards ATOD Perceptions of harm Community Norms Self-regulation Protective factors: Prosocial opportunities/activities Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 2 of 13 Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness r, eS . �♦` vt( i{pG, ;1 y �t/J7S5y r i �t 7t/�` ,,r,, r, 'l' ,�a)� i(�( ,,&.,,., g/ (�+,tJt, i� , 72„ r )} 1 s IJr:t.�rtJ "i� J 7 Itn,i r 1 ,,- t I t tS t f! r'`i r 1,,.1 d`. Number of Unduplicated Universal — Direct or Indirect, Selective, Indicated Participants (if duplicated note); School wide Activities is a Universal Direct prevention strategy. 9 months out of the school year Project SUCCESS staff will conduct activities designed to inform and increase awareness of varying targets of prevention services (suicide awareness, 2500 mental health and substance use awareness for example). 9th grade Prevention Education Series is a Selective prevention strategy which 450 consists of 4 topics taught in 4 to 8 sessions to all 9tn graders enrolled in the district Screening is a Selective prevention strategy in which all students who are enrolled in 750 the school are screened for prevention and other needs. Small groups is a Selective prevention strategy which consists of small group 40 activities organized around various themes used to serve youth who are identified as being at risk. Student Assistance is a Selective prevention strategy in which students who are 750 identified as needing a services are provided that service by Project SUCCESS staff or referred elsewhere for the needed service. One on One is an Indicated prevention strategy in which a student can receive up to 35 3 individual prevention sessions as need. Capacity Building is a Universal Direct prevention strategy which will include presentations on ATOD prevention and other relevant topics in both school and non- 250 traditional settings. TARGET POPULATION - RISK AND PROTECTIVE FACTORS r ,cS !s j y 7}'yt J 4 S t t � I+ ) f t t i -, i} -•.tJ{) sr r F 1 }rf If r ,s I: I t t !; ! t, t t7 itr r}[,� '„J gy�{'ti7',' I rt o`. 1,� S4 it !,?r,J> O��b {,\, ,tr„ 2';i )sr„!{' J J J Irs�Jlr}J1J 1r tU}t rll{ r �,,�ri5 � f ryf lt(!,f`41 tt,s:.tl slit, „(,\s rr f J}•1 t ,u� JJ tt5 'sl' 1 S �„ t,�f(,t r �7 ,;! r�,{ J ,,;'•;, ` !$ '' I,, r r,,rl I, r tI "I�1 I�/P'r tl riF GtQ1�S Tarp i'ed ,J„ r'�l P 'r )t �1;J�1 Sr ! `Tal'{�I��-�,QCJUIi�t�Qt��4 `r!f$r 7{fiJ ! ) (I i(t s r (rrrr I £�,1j t •t t t t t t t t t t t} r} -7 t (1 �a) {� 1 t�\ „x�;��l;���,5;���,5;���,5;���,5;���,5;���,5;���1;���,5;���,5;���,5;���,5;���,5;���,5;���,5 School wide activities Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Prosocial opportunities/activities Positive peer influence, Healthy behaviors Increased knowledge/awareness 91h Grade Prevention Education Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Skill/competency Healthy behaviors Increased knowledge/awareness Screening Screening to identify and broad range of risk factors 1 & 2 with the intent to mitigate those risk factors Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 3 of 13 Small groups Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Student Assistance Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values One on one Indicated Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Capacity Building Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Increased knowledge/awareness Community values Skill/competency Section III. SITE LOCATIONS AND INFORMATION* i{. �17 rt: 4 ! itlrs 4•�.Sr i `t i i){ �4 tk tr .J J 4 _,t it r�l1%, ?ti r }it' t },ai4�,Gap��l�Sr r � , { tr, 44 { ������, Sr. £ { S I 4 { 1i tS'Y, ������`iwa4 i l P t tr;�rl. t 4 !"• r t 4 4 /� t s,�= tt r i}, }r jt i 4 t':. 4 r1 ri )r r s! t S,�{ v!4 }iS 4 t r t i tiuss4i �4 tr rtr�j� tt 4 s 4 4q i, S 7 A A S 7 A A S 7,5 Key West High School 2100 Flagler Avenue Key West 33040 X Coral Shores High School 89901 Old Highway Tavernier 33070 X Marathon Middle/High School 350 Sombrero Road Marathon 33050 x Total number to be served 2,500 *Changes in sites/locations of services must adhere to contractual requirement procedures. Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 4 of 13 Section IV. MAJOR REFERRAL SOURCES Monroe County Public Schools Parents Self-referral Other community agencies Section V. PERFORMANCE MEASURES Quality Performance Measures (Include fidelity measures, satisfaction survey information, supervision, training, staffing, and other required information pertaining to quality) l ,,>ti't�' �� U�1`�t`'�'1$�11�`��'a Average number of sessions 85%of 490 participants will complete Measured at the end of each cohort attended (participant retention) Project SUCCESS pre/posts, attendance records and minimally 85% of scheduled sessions 85 %of 490 youth will increase Project SUCCESS pre and post tests Collected immediately prior to the 1 st their attitudes and beliefs related session and immediately following the to risk of harm associated with last session underage drinking Collected immediately prior to the 1 st 85 %of 490 youth will have no session and immediately following the or a decrease in past 30 day Project SUCCESS pre and post tests last session alcohol use by curriculum completion Collected immediately prior to the 1 st 85 %of 490 youth will decrease Project SUCCESS pre and post tests session and immediately following the favorable attitudes toward last session alcohol and drug use #and %of youth/participants 90 %or participants show satisfaction Measured at the end of each program satisfied with services provided on the Satisfaction Survey cohort 100% of participant with pre/post tests matched and meeting outcomes will complete the Satisfaction Surveys Observation of service Curriculum fidelity checklist Three times per year in delivery/Fidelity checklist coordination with the Evaluation Supervisor/Observer Report Team, one time in Quarter 2, one time in Quarter 3, and one time in Quarter 4 unless the EBP indicates otherwise Documentation of structured Supervisory record, Supervisory Tool, or During regular supervisory sessions supervision Checklist and notes in staff file and not less than one time per month #and %of staff with necessary 100% At the time of contract monitoring training # and % of staff working Staff will show courses and documents toward Prevention from the Florida Certification Board at certification with the Florida 50% the time of contract monitoring. Certification Board Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 5 of 13 Quantity Performance Measures ,. { ,�} $ +p e, a #11XT* It } i 2 1 7 t f. 7 7 fsPr s -:+ r it l fris 1 4-r r t \ s 1 st,i r t�)�tf1,�j5 'r"' .. t� f}rtt l+r trs „t,r, ,,is f r y r t f 4 ► f n qq,, b F r �]rem lr MA f Q1is r 7 �� , ftt {{ nfvii ,�. I� orMnr � trl7r' l i t tft y}� ,',ii'7i7 cr, yt ,t;.r tr, ris +ice �{!L-iiJis Itlis l; j rh[tir rr (! 7 i,�j r,,� r 7 tt ,ir,ir,f i r,..at ttf 1 f„tf ti l,t rt ki r ''f t ,r�i i�t sl l tt� t ,rrfls sr !ir j rtsr ;(i s:s s s s s s s s s �s s s s: . N, I" tttttttttttttttttttt Prevention Education Series 450 4 to 8 85% Selective Project SUCCESS Of scheduled sessions and 85% of participant pre/post tests matched and meeting outcomes School Wide Activities 2500 9 90% Universal Small Groups 40 4-8 85% Selective N ewco mer group sessio ns 85% of other sched uled small group sessio ns and 85% of partici pant pre/po st tests match ed and Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 6 of 13 meetin 9 outco mes Individual Sessions 50 1-3 85% Indicated Sessio ns, with justific ation if differe nt and 85% of partici pant pre/po st tests match ed and meetin 9 outco mes Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 7 of 13 VI. TASK LIST rt r is ? ts, ( t hr t �! { / X1 � S/ E; rll \, �I17 ,+ y ill ' ���tSf' 7t{',.ys }' °'` y ,t a',\,t,i- a �j s {r' r''c C t r r'' ! ra i , t ,s, f ' , < t ,{, t i ti `T t I� (,i;, i,c,{ �+► y ,l t M"N' (�, 2 ���?1�'�` ss`"` n "i; .....\,f.\J\l.\A\l`\ Activity Title: Recruitment/Screening 750 N/A 85% and 85% Activity Description:. All students referred or presenting for of participant service will receive an initial screening of risk and protective pre/post tests factors matched and Frequency:One time upon program entry meeting Intensity:one session Duration: 15 mins. outcomes Activity Title: Intake/Assessment 50 45—60 mins. 85% and 85% Activity Description: Participants who become enrolled in of participant the program will complete a detailed intake of service needs pre/post tests Frequency: Once, upon enrollment in the program matched and Intensity: One session meeting Duration: 60 mins. outcomes Activity Title: Project SUCCESS Prevention Education Series 450 85%of 85% and 85% Curriculum scheduled of participant Activity Description:. 9tn graders will participate in a 4 topic sessions ( 6 g p p p� pre/post tests Prevention Education Curriculum -8) matched and Frequency: one time per week For 45-60 meeting Intensity: 6-8 sessions, based on class time restrictions mins. outcomes Duration: 45 to 50 mins. Activity Title: Pre- and Post-testing 490 45 to 60 min. 85 % and 85% Activity Description:. All large and small group participants sessions of participant will be pre and post tested for the knowledge, beliefs, pre/post tests attitudes and use of substances matched and Frequency:Twice meeting Intensity: once before first session, once at completion of outcomes last session Duration: 45 to 50 mins. Activity Title: Small group activities 40 45 to 60 min. 85% and 85% Activity Description:. At risk students will participate in sessions of participant small group sessions designed to mitigate risk factors and pre/post tests enhance protective factors matched and Frequency: One session per week meeting Intensity: 4-8 sessions depending on the group subject and outcomes with the exception of New Comers groups which only meet 3 times. Duration: 45 to 50 mins. Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 8 of 13 Section VII. EVIDENCE BASED PROGRAMS (EBP) Project SUCCESS SAMHSA approved, NREPP Section Vill. EVALUATION Outcome Measures (Include fidelity measures, satisfaction survey information, supervision, training, Staffing, and other required information pertaining to quality) (s, �► st, tiwth h , `" A +`" ;;n,, i ?+�� ia '�+utl,t11t T ,t 111f ' ', rB ,r ....... t ka*7 :r "sS i y r y , 1 I, 4 1 t t 7 1 ttt - ®'hflt@1 � '`4� ; +`'pQ1dQ -� �1111 ),1 'rC)'„ 1, 4�C ,��r, ltl�a#�'a �i1���!1A(1�1� � rf.}r risi r?r�} �} 1- Adhering to the Fidelity Implementation Plan, Project SUCCESS will utilize Fidelity checklists from the Project SUCCESS implementation manual at the end of each small and large group cohort as described above under Quality Performance Measures. This checklist assesses whether the facilitator appropriately addressed each major objective, activity, and primary point of the session. If a Prevention counselor falls below the 90% criterion on the Fidelity checklist at any time, the Program Supervisor will develop a plan to assist them in increasing necessary skills. Weekly Fidelity checks will then occur until a 90% criterion is achieved. 2- Supervision Meetings—Any problem areas in the small or large groups or in counseling sessions or other program activities will be discussed and addressed at weekly Supervision meetings. 3- Program effectiveness will be evaluated through results of the Pre and Posttests as well as results of the Satisfaction Surveys. 4- Activity Logs are maintained for all Universal and Selective activities. 5- Client charts are maintained for all Indicated Prevention activities and are included in the GCC Peer Review process. 6- All activities for Prevention will be consistent with the agency's Quality Assurance Quality Improvement Plan. GCC will coordinate with the Evaluation Team, Behavioral Science Research Institute (BSRI), for process and outcome data as required. The Data will support any processes from the Westcare Team. i t f s;r -r 4 £3 s r i 4 t+t r fi r � t r; � ,✓ ,:s i s r rr t + tt s 7 , .1 Average number of Attendance At end of the cohort of Entered into DOES sessions attended services (Participant Retention Staff training hours PBPS entry and quarterly 8 hours is required; PBPS (capacity building) training reports and provider check-ins Participant satisfaction Satisfaction surveys At the end of each Entered into DOES cohort; semi-annually Increase in perceptions Pre-posttest outcomes At the end of each Matched pre-posts; entry of harm cohort; semi-annually into DOES Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 9 of 13 Section IX. CAPACITY BUILDING ita hs {flh �p }ttute. `,yorral �x!! f{ 1' e ,f ► por pro+ho + w�1+ Qa>dr� e+wlth Qt ► tils gar©r� �aine� t It© ri},i., ; .s1'fi„ . �c+,i,L<, + "}s, ,t,,,i t * t,}�„1i + t ri }- ' ,(0 d ,t� ��! 's �l �tl 1 !'t { 2 + 2 ? 5�r�,�2� �t i i'}'} GCC currently receives funding from SFBHN Regular Prevention which supports An Apple A Day serving K through 41h grade, Alcohol Literacy Challenge and Teen Intervene in the Middle Schools. Since Project SUCCESS focuses on High School students there is no overlap. Prevention staff participate in clinical staff meetings in each location and can make referrals for higher levels of care as needed. List other prevention programming and providers in sites mentioned in Section III f this document. Describe how the program will coordinate with other funded organizations' progams and'services to avoid ! duplication of services. GCC is aware that the Florida Keys Children's Shelter operates Prevention services using the EBP All Stars. GCC and FKCS are currently in the process of scheduling a meeting to build capacity and cross learn about each other's programs to coordinate services and avoid duplication. List the coalition(s)within the target service areasin which prevention services will be provided under this Scope. Describe how the program will cooridnate with the coalition and share data/contribute to the ongoing Strategic Prevention Framework with the identified coalition(s). GCC works with the Monroe County Coalition by attending all meetings and coordinating activities county wide. MCC has been particularly helpful in supporting Project SUCCESS school wide activities by providing student hand-outs and incentives. GCC will coordinate and participate in MCC community events such as "No One's House Parent Information" and "Know the Law" campaigns. Section X. ADDITIONAL PREVENTION REQUIREMENTS 1. Site Schedule A final site schedule, on the Site Schedule form, with dates, times, and location of services shall be submitted no later than August 31 of the fiscal year or when requested by the Contract Manager. Sites schedules must be approved by SFBHN, in writing, and will be based on county need and distribution of services to avoid duplication in any geographical area or school to maximize SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity in writing and submitted to the Contract Manager for review and approval by the Prevention Director. The Contract Manager will reply with approval. The site schedules shall be submitted on the SFBHN Prevention Site Schedule format. 2. Memorandum of Understanding (MOU) with the Community Coalition To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition shall execute and /or maintain a memorandum of understanding (MOU) delineating the specific responsibilities of each. This MOU will be consistent with the strategies of the State of Florida Department of Children and Families' and the Managing Entity's (ME's) prevention strategy. The provider shall submit an executed copy of the MOU to the ME's Contract Manager within 30 days of the effective date of the contract (for newly executed MOUs) or within thirty (30) calendar days for renewed MOUs. SFBHN Contract Attachment— Guidance Document 10 Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 10 of 13 3. Memorandum of Understanding (MOU) With Sites To facilitate the coordination and delivery of services, all providers shall have executed Memoranda of Understanding (MOU)with the sites where services are being provided. All MOUs with the sites shall be current and up to date, outlining the terms of the agreement. 4. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work. 5. Meetings All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, BSRI, at regularly scheduled or specially called meetings when notified by the ME. The ME will make every attempt possible to schedule meetings with advanced notice; however, there may be meetings that may be called on short notice. These include, but are not limited to, Prevention provider meetings, meetings with Behavioral Science Research Institute, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, and other meetings as noticed by SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 6. Reports /Assignments and Special Reports /Assignments Providers are expected to submit reports as outlined in the contract. Prevention Partnership Grant (PPG) reporting is specifically described in the contract with dates for submission. Other reports will be requested by SFBHN. Special reports and assignments are requested from time to time to meet State/Local Department of Children and Families, State Block Grant, SFBHN, and other requirements and needs. Prevention providers are required to submit the reports in the format requested and by the timeline requested.These reports may be requested from different sources for different reasons. Requests generally come from SFBHN staff, including the Prevention Director, and may be requested verbally or in writing. There may be times when other collaborative partners request information and SFBHN will support these requests. 7. Training The Scope of Work outlines the requirements for training to support the State Block Grant reporting requirements for workforce development as well as for strengthening the Prevention workforce. All staff of provider organizations funded by this contract, whether full-time, part-time, contractual, or consultant, who report units in the Performance Based Prevention System (not those paid by cost reimbursement or that are vendors), is required to attend eight (8) hours of training per quarter.All providers shall attend scheduled training as required by the ME, meet the ME and the evaluation team, BSRI, for technical assistance and/or training, at regularly scheduled or specially called meetings when notified by the ME. 8. Report Cards Providers are required to comply with the measures on the Prevention Report Card. Grading for the measures will be according to compliance or lack thereof. Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 11 of 13 9. Data All providers are required to submit the program data monthly in the Performance Based Prevention System (PBPS) as required by the contract. The provider shall also: ■ Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract and consistent with the Scope of Work in the contract; ■ Ensure that all data submitted to PBPS is consistent with the data maintained in the provider's file and consistent with the Scope of Work in the contract; ■ Review the data submitted with the evaluation team, Behavioral Science Research Institute (BSRI), monthly to determine any discrepancies in the numbers related the evaluation and the Scope of Work and make corrections prior to submission for approval by the SFBHN Prevention Director; ■ Submit an email to the SFBHN Prevention Director and the designated SFBHN Data Analyst verifying that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. There shall be a designated individual and one back up individual at the provider organization responsible for verifying the data and submitting the email. This will imply that the data has been reviewed and is ready for submission. o The email subject line shall read: PBPS Data Submission Verification o The body of the email shall read: (name of organization) is submitting the PPG Prevention data for the month of (name of the month) in PBPS and we assure that the data is complete and correct. Our organization's data may be used to report to the State for the Block Grant report. Our organization's data may be used to reconcile with the payments for this month. ■ Failure to submit any data, or correct any errors in the data which results in a rejection rate of ten percent (10%) or higher of the monthly data submitted, will require the provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected will be corrected and resubmitted; and ■ In accordance with the provisions of s. 402.73(1), F. S., and Rule 65-29.001 F.A.C., corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 10. Evaluation Prevention providers shall work in collaboration with the evaluation team, Behavioral Science Research Institute (BSRI) by participating in meetings, training, and providing service data and other necessary identified data vital to the completion of the system-wide evaluation of the prevention services within the Strategic Prevention Framework. Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 12 of 13 Data will be provided to BSRI in the BSRI data system, DOES, and in any other requested format. The data includes the numbers for outcome data and process data required that contributes to the evaluation of the Prevention System of Care. Prevention providers are required to participate in fidelity checks, meetings, training, and other fidelity activities related to the outcomes in the Scope of Work and for the larger Prevention System of Care evaluation. BSRI will report compliance and collaboration to SFBHN per the BSRI Scope of Work requirements. Guidance/Care Center, Inc. Attachment IV Contract No. P-4 Scope of Work Page 13 of 13 ATTACHMENT D (Continued) Contractual Agreements Amendment #1 to Contract P-4 Guidance/Care Center and South Florida Behavioral Health Network, Inc. Amendment 41 Contract No. P-04 07/1/2019 THIS AMENDMENT, entered into between South Florida Behavioral Health Network, Inc. hereinafter referred to as the "ME" and Guidance/Care Center, Inc. hereinafter referred to as the "Network Provider," amends Contract No. P-04. PREAMBLE:This amendment revises contract language and adds Attachment V,Scope of Work for Fiscal Year 19-20. As a result,this amendment revises the Standard Contract; Attachment I; Exhibit C, Required Reports; and adds Attachment V, Prevention Scope of Work, Fiscal Year 19-20 as follows: 1. Page 13 of 13, Standard Contract, Section 51, is hereby amended as follows: 51. All Terms and Conditions Included This contract and its attachments, I, II, III, IV, & V and any exhibits referenced in said attachments, together with any documents incorporated by reference, including the ME prime contract (which can be found at http://www.sfbhn.org), contain all the terms and conditions agreed upon by the parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations, or agreements, either verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable, the remainder of the contract shall remain in full force and effect and such term or provision shall be stricken. In the event of a conflict between the provisions of the documents, the documents shall be interpreted in the following order of precedence: a. Attachment I, Exhibits, the Business Associate Agreement, and other attachments, if any; b. Any documents incorporated into any Exhibit or Attachment by reference; c.The Standard Contract; d. Any documents incorporated herein by reference BY SIGNING THIS CONTRACT,THE PARTIES AGREE THAT THEY HAVE READ AND AGREE TO THE ENTIRE CONTRACT,AS DESCRIBED IN SECTION 51.ABOVE. IN WITNESS THEREOF,the parties have caused this contract,attachments,exhibits,and any documents referenced herein,to be executed by their undersigned officials as duly authorized. NETWORK PROVIDER:Guidance/Care Center,Inc. SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK,INC. SIGNED SIGNED BY: BY: NAME: Maureen Dunleavy NAME: John W.Dow TITLE:Vice President TITLE: President and CEO DATE: DATE: Federal Tax ID#(or SSN)59-1458324 Network Provider Fiscal Year Ending Date 6 30 2. The replacement of Page 13 of the Standard Contract does not affect the original execution of this Contract. The original signatures are on file. Page 1 of 2 Amendment#1 Contract No.P-04 07/1/2019 3. Pages 1-52, Attachment 1, are hereby deleted in their entirety and Pages 1-52, Revised Attachment 1, are inserted in lieu thereof and attached hereto. 4. Pages 1-7, Exhibit C-1, Required Reports are hereby deleted in their entirety and Pages 1-19, Exhibit C,Required Reports, are inserted in lieu thereof and attached hereto. 5. Pages 1-8, Attachment V, Prevention Scope of Work, Fiscal Year 19-20, are hereby added and attached hereto. This amendment shall begin on July 1,2019. All provisions of the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform to this amendment. All provisions of the contract not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract. This amendment is hereby made a part of the contract. IN WITNESS THEREOF, the parties hereto have caused this eighty-nine (89) page amendment to be executed by their officials'thereunto duly authorized. GUIDANCE/CARE CENTER,INC. SOUTH FLORIDA AVIORAL HEALTH NETWORK,INC./Newcomer, SIGNED SIGNED BY: i BY:NAME: Frank Rabbito NAME: JM.D. TITLE: COO TITLE: President and CE DATE: ..w DATE: rt FEDERAL Tax ID#(or SSN):59-14SS324 Network Provider Fiscal Year Ending Date 6 30 Page 2 of 2 ',mngth F1Ioriida Behar i!€ rill t r.'allth Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Required Reports Due Date #of Copies Send to;: Response to Within 10 calendar days from 1(Electronic 1. ME Contract Manager Monitoring Reports the day the report is received Submission via E-mail) and Corrective Action 2. SFBHN staff member Plans issuing CAP External Quality Within 10 calendar days from 1(Electronic 1. ME Contract Manager Assurance Reviews, the day the report is received, Submission via E-mail) Monitoring Reports, or as requested by the 2. Director of Contract Surveys and Contract Manager Accountability Corrective Actions,as applicable Memorandum of Within 90 calendar days of 1(Electronic ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract(for newly executed Federally Qualified MOU's); Health Center(FQHC) Within 30 calendar days for or renewed MOU's; Updates to Federally Qualified P&P for FQHC's shall be Health Centers are submitted within 30 calendar required to submit days of adoption policies and procedures that explain the access to primary care services to the medically underserved behavioral health client Sliding Fee Scale Prior to contract execution 1(Electronic ME Contract Manager [reflecting the Submission via E-mail) uniform schedule of discounts referenced in 65E-14.018(4)] Final FY 2019-2020 Submitted annually prior to 1(Electronic 1. ME Contract Manager (1) Projected Cost contract execution. Submit Submission via E-mail) Center Operating and updates within 30 calendar 2.VP of Finance Capital days of execution of an Budget, amendment to the contract (2) Budget Narrative, affecting the budget. (3) Network Providers Agency Service Capacity Report, (4)Cost Center Personnel Detail Report Revised Exhibit C Page 1 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth F1Ioriida Behar i!€ rill Th'allth Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Program Description Annually, prior to contract 1(Electronic 1. ME Contract Manager (1)Organizational execution. Submit updates Submission via E-mail) Profile within 30 calendar days of 2.VP of Behavioral Health (2)Service Activity amendment Description (3)Supplemental Program Description Affidavit Regarding Annually prior to contract 1 ME Contract Manager Debarment execution,or as requested by the Contract Manager Incident Report Within 24 hours of Submission through Submission through IRAS occurrence, in IRAS accordance with CFOP 215-6 and reportable incidents defined CFOP 180-4 Mandatory Reporting Requirements to the Office of the Inspector General Acute Care Service Real-time data submission as Electronically KIS Express Acute Care Utilization Reporting mandated by subsection System for Public Receiving 394.9082(10), Florida Statutes Facilities, Detoxification and Addiction Receiving Facilities. Monthly Data Service data shall be Electronically KIS, PBPS,or other data Required by DCF submitted electronically, system designated by the ME FASAMS PAM 155-2 weekly, by 12:00 Noon every or the Department Wednesday. Final monthly shall be submitted electronically to the ME no later than the 4th of each month following the month of service ADA Client By the 4th business day 1(Electronic https://fsl6.formsite.com/D Communication following the Submission via E-mail) CFTraining/Monthly- Assessment Auxiliary reporting month Summary Aid Service Record Report/form login.html Monthly Summary Report (Applicable to agency's that employ Confirmation E-mail to the fifteen (15)or more ME Contract Manager employees) Revised Exhibit C Page 2 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth F1Ioriida Behar i!€ rill t r.'allth Nem€ rk.Inc 1/0/20 Revised Exhibit C Required Reports Monthly Service Monthly, by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day Department) after the month of service Invoice Review 1 As requested by SFBHN staff Supporting Submitted with the monthly Documentation invoice,as appropriate, and/or as requested by SFBHN staff Exhibit K, Pre- Monthly,with the monthly 1 1. ME Sr.Accountant(Fiscal Authorization invoice by the eighth (8th) Department) Utilization calendar day Management Roster after the month 2. ME ASOC Manager for Substance Abuse of service and Mental Health 3. ME CSOC Manager Residential Level II Services Exhibit AC, Monthly Monthly by the 5th calendar 1 ME Care Coordinator Care Coordination day after the month of service Report Narrative and Chart Final Invoice 1 ME Sr.Accountant(Fiscal By July 20 of each fiscal year Department) and/or 20 days after contract end date Designation of Within 5 working days of 1(Electronic ME Contact Manager Dispute Resolution contract execution Submission via E-mail) Officer Inventory Report 8/1/2019 ME Contract Manager 1(Electronic Submission via E-mail) Attestation of 8/1/2019 1(Electronic ME Contract Manager Network Provider's Submission via E-mail) Verification that all applicable employees and subcontractors with access to ME and/or DCF information systems have signed a DCF Security Agreement form CF0114, per the Attachment I and Standard Contract Revised Exhibit C Page 3 of 19 Guidance/Care Center, Inc. Contract No. P-4 ',mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Emergency 8/1/2019 1(Electronic 1. ME Contract Manager Preparedness Plan Submission via E-mail) 2.QA/QI Risk&Compliance Manager Civil Rights 8/1/2019 1(Electronic ME Contract Manager Compliance Checklist Submission via E-mail) (CF0946) Civil Rights 8/1/2019 1(Electronic ME Contract Manager Certificate(CF707) Submission via E-mail) Client Trust Fund 8/1/2019 1(Electronic ME Contract Manager Letter Submission via E-mail) Quality 8/1/2019 1(Electronic 1. ME Contract Manager Assurance/Quality Submission via E-mail) Improvement Plan 2.QA/QI Risk&Compliance Manager Signed Florida 8/1/2019 1(Electronic ME Contract Manager Department of Submission via E-mail) Children and Families Employment Screening Affidavit that all required staff have been screened or Network Provider is awaiting the results of screening Grievance 8/1/2019 1(Electronic 1. ME Contract Manager Procedures Submission via E-mail) a)Clients(applicants 2.VP of CQI or recipient of services) b)Agency Staff Attestation signed by 10/1/2019 1(Electronic ME Contract Manager the CEO/Executive Submission via E-mail) Director indicating that all applicable staff funded by this Contract have received a copy of the fully executed Contract and will receive a copy of any amendments made to this Contract. Revised Exhibit C Page 4 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports NVRA Voter July 5,2019 1(Electronic 1. ME Voter Registration Registration Agencies (Period: 04/01/19-06/30/19) Submission via E-mail) Activities Coordinator Quarterly Activities October 5,2019 Report Form (DS- (Period: 07/01/19-09/30/19) 2. ME Contract Manager DE131;effective January 5,2020 01/2012 or latest (Period: 10/01/19-12/31/19) revision thereof, if April 5,2020 applicable (Period: 01/01/20-03/31/20) July 5,2020 (Period: 04/01/20-06/30/20) Quarterly Financial October 31,2019 1(Electronic 1. ME VP of Finance Statements(Balance (Period: 07/01/19-09/30/19) Submission via E-mail) Sheet and Statement January 31,2020 2. ME Contract Manager of Activity) (Period: 10/01/19-12/31/19) April 30,2020 (Period: 01/01/20-03/31/20) July 31,2020 (Period: 04/01/20-06/30/20) Attestation indicating October 31,2019(Period: 1(Electronic ME Contract Manager the filing of Form 941 07/01/19-09/30/19)January Submission via E-mail) and payment of any 31,2020(Period: 10/01/19- taxes due to the IRS 12/31/19)April 30, have been paid. 2020(Period:01/01/20- 03/31/20)July 31, 2020(Period:04/01/20- 06/30/20) January 30,2020 1(Electronic 1. ME Contract Manager Continuous Quality (Period: 07/01/19-12/31/19) Submission via E-mail) Improvement July 30,2020 2.QA/QI Risk&Compliance Updates (Period: 01/01/20-06/30/20) Manager Year-End Financial Reports for Network Provider's Not Requiring Audits Per Attachment 11 Certification Due 180 days after the end of 1(Electronic 1. ME Contract Manager indicating that the Network Provider's fiscal Submission via E-mail) recipient expended year or within 30 days of the 2.VP of Finance less than$750,000 in recipient's receipt of the audit Federal Awards or in report,whichever occurs first, State Awards during directly to each of the the fiscal year following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Revised Exhibit C Page 5 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Schedule of State Due 180 days after the end of 1(Electronic 1. ME Contract Manager Earnings the Network Provider's fiscal Submission via E-mail) 2.VP of Finance year or within 30 days of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Projected Cost Due 180 days after the end of 1(Electronic 1. ME Contract Manager Center Operating and the Network Provider's fiscal Submission via E-mail) Capital Budget year or within 30 days of the 2.VP of Finance Actual Expenses& recipient's receipt of the audit Revenues Schedule report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Local Match Due 180 days after the end of 1(Electronic 1. ME Contract Manager Calculation Form- the Network Provider's fiscal Submission via E-mail) Template 9- year or within 30 days of the 2.VP of Finance Department of recipient's receipt of the audit Children and Families report,whichever occurs first, form,available at the directly to each of the following website: following unless otherwise required by Florida Statutes https://www.myfifa The schedule shall be based milies.com/service- on revenues and expenditures programs/samh/man recorded during the state's aging-entities/2019- fiscal year. contra ct-docs.shtmI Schedule of Bed-Day Due 180 days after the end of 1(Electronic 1. ME Contract Manager Availability Payments the Network Provider's fiscal Submission via E-mail) year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Revised Exhibit C Page 6 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Agency Prepared Due 180 days after the end of 1(Electronic 1. ME Contract Manager Financial Statements the Network Provider's fiscal Submission via E-mail) (Balance Sheet and year or within 30 days of the 2.VP of Finance Statement of Activity recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Year-End financial Reports for Network Provider's Requiring Audits Per Attachment 11 Correspondence Due 180 days after the end of 1(Electronic 1. ME Contract Manager from the Auditor the Network Provider's fiscal Submission via E-mail) showing proof of year or within 30 days of the 2.VP of Finance submission of the recipient's receipt of the audit Audit Report and report,whichever occurs first, Management Letter directly to each of the to the Network following unless otherwise Provider. required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Management letter Due 180 days after the end of 1(Electronic 1. ME Contract Manager addressed to the the Network Provider's fiscal Submission via E-mail) Network Provider year or within 30 days of the 2.VP of Finance issued by the Auditor recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Financial& Due 180 days after the end of 1(Electronic 1. ME Contract Manager Compliance Audit to the Network Provider's fiscal Submission via E-mail) include the necessary year or within 30 days of the 2.VP of Finance schedules per recipient's receipt of the audit Attachment II report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Revised Exhibit C Page 7 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Schedule of State Due 180 days after the end of 1(Electronic 1. ME Contract Manager Earnings the Network Provider's fiscal Submission via E-mail) 2.VP of Finance year or within 30 days of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of Related Due 180 days after the end of 1(Electronic 1. ME Contract Manager Party Transaction the Network Provider's fiscal Submission via E-mail) Adjustments year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Local Match Due 180 days after the end of 1(Electronic 1. ME Contract Manager Calculation Form- the Network Provider's fiscal Submission via E-mail) Template 9- year or within 30 days of the 2.VP of Finance Department of recipient's receipt of the audit Children and Families report,whichever occurs first, form,available at the directly to each of the following website: following unless otherwise required by Florida Statutes https://www.myfifa The schedule shall be based milies.com/service- on revenues and expenditures programs/samh/man recorded during the state's aging-entities/2019- fiscal year. contra ct-docs.shtmI Projected Cost Due 180 days after the end of 1(Electronic 1. ME Contract Manager Center Operating and the Network Provider's fiscal Submission via E-mail) Capital Budget year or within 30 days of the 2.VP of Finance Actual Expenses& recipient's receipt of the audit Revenues Schedule report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Revised Exhibit C Page 8 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth F1Ioriida Behar i!€ rill t r.'allth Nem€ rk.Inc 1/0/20 Revised Exhibit C Required Reports Schedule of Bed-Day Due 180 days after the end of 1(Electronic 1. ME Contract Manager Availability Payments the Network Provider's fiscal Submission via E-mail) year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Substance Abuse and Mental Health Outpatient Services Waitlist Reports Outpatient Wait List Monthly by the 5th for the 1(Electronic 1. ME Adult System of Care Report Form- preceding month's services. Submission via E-mail) Manager Exhibit AK, Part I and Part 11 2. ME Children's System of Care Manager Reports Required for Children's Mental Health Providers,as applicable Children's Crisis Per Exhibit S-Monthly Census One(1) Encrypted 1. ME Contract Manager Response Team Report by the 15th of every Electronic Submission (CCRT) month following the month of attachment to an 2. Children's System of Care service email to each Manager recipient Reports Required for Behavioral Health Network(BNet)Provider Alternative Services Within 15 calendar days after One(1) Encrypted 1. ME Contract Manager Provision end of month Electronic Submission Documentation attachment to an 2. ME BNet Coordinator (Other than email to each Pharmaceuticals) recipient 3.Children's Mental Health State Program Office Alternative Services Within 15 calendar days after One(1) Encrypted 1. ME Contract Manager Provision end of month Electronic Submission Documentation attachment to an 2. ME BNet Coordinator (Pharmaceuticals email to each only) recipient 3.Children's Mental Health State Program Office Statement of September 1 following close One(1) Encrypted 1. ME Contract Manager Program Cost of the contract year(June 30) Electronic Submission 2. ME BNet Coordinator attachment to an 3. Children's Mental email to each Health State Program recipient Office Required Reports for Receiving Facilities and/or Treatment Facilities Weapons and Within 15 calendar days after 1(Electronic 1. ME Contract Manager Firearms Court end of month for the Submission via E-mail) Petitions Monthly preceding month's 2. ME Data Analyst Report, Exhibit O information -Only CSU and CM HC Revised Exhibit C Page 9 of 19 Guidance/Care Center, Inc. Contract No. P-4 ',mngth F1lorii€€a Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Reports Required for Project for Assistance in Transition from Homelessness(PATH);Providers PATH Monthly Monthly, by the 5th calendar 1(Electronic 1. ME Contract Manager Report(generated day Submission via E-mail) from the HMIS after the month 2. ME Housing Coordinator system) of service PATH Monthly Monthly by the 10th calendar 1(Electronic 1. ME Contract Manager Enrollment Tracker day after the month of service Submission via E-mail) 2. ME Housing Coordinator Quarterly Summary No later than the 10th of the 1(Electronic https://www.pathpdx.org/ Report month following the quarter Submission via E-mail) of services PATH Annual Data No later than November 17th 1(Electronic https://www.pathpdx.org/ Report into the PATH Submission via E-mail) Data Exchange(PDX) data system Reports Required for Adult Mental Health Providers,as applicable Assisted Living October 5,2019 1(Electronic 1. ME Contract Manager Facility with a (Period: 07/01/19-09/30/19) Submission via E-mail) Limited Mental January 5,2020 2. ME Adult System of Care Health License Client (Period: 10/01/19-12/31/19) Manager Quarterly Report, per April 5,2020 Exhibit L (Period: 01/01/20-03/31/20) July 5,2020 (Period: 04/01/20-06/30/20) Report Required for Florida Assertive Community Treatment(FACT)Providers Vacant Position Monthly by the 7th of each 1(Electronic Report per Section month following the month of Submission via E-mail) 1. ME Contract Manager II.H., Reports in service Exhibit AF 2. ME Adult System of Care Manager FACT Enhancement October 5,2019 1(Electronic Reconciliation Report (Period: 07/01/19-09/30/19) Submission via E-mail) 1. ME Contract Manager per Section II.H., January 5,2020 Reports in Exhibit AF (Period: 10/01/19-12/31/19) 2. ME Adult System of Care April 5,2020 Manager (Period: 01/01/20-03/31/20) July 5,2020 (Period: 04/01/20-06/30/20) Revised Exhibit C Page 10 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth F1Ioriida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Ad-Hoc Quarterly October 5,2019 1(Electronic Report per Section (Period: 07/01/19-09/30/19) Submission via E-mail) 1. ME Contract Manager II.H., Reports in January 5,2020 Exhibit AF (Period: 10/01/19-12/31/19) 2. ME Adult System of Care April 5,2020 Manager (Period: 01/01/20-03/31/20) July 5,2020 (Period: 04/01/20-06/30/20) Outcomes and October 5,2019 1(Electronic Output Performance (Period: 07/01/19-09/30/19) Submission via E-mail) 1. ME Contract Manager Measures Report, January 5,2020 per Section II.H., (Period: 10/01/19-12/31/19) 2. ME Adult System of Care Report in Exhibit AF April 5,2020 Manager (Period: 01/01/20-03/31/20) July 5,2020 (Period: 04/01/20-06/30/20) Report Required for Miami-Dade Forensic Alternative(MDFAQ Providers Daily Census Report Daily, by 10:00 am, 1(Electronic Monday-Friday Submission via E-mail) Regional Forensic Coordinator Monthly Program By the 15th of each month 1(Electronic 1. ME Contract Manager Quality Review following the month of Submission via E-mail) Tracking Report services 2. Regional Forensic Coordinator Monthly By the 15th of each month 1(Electronic 1. ME Contract Manager Performance following the month of Submission via E-mail) Measures Report services 2. Regional Forensic Coordinator Reports Required for Forensic Services Providers Monthly Report for By 15th of each month 1 1. ME Forensic Coordinator Individuals on Conditional Release, 2. Mental Health if applicable Administrator Office Statewide Forensic Weekly 1 ME Forensic Coordinator Bed Census Report, if (Every Thursday by 5:00 pm) applicable Reports Required for Forensic Multidisciplinary Team Provider Monthly Forensic By 10th of each month for the 1(Electronic 1. ME Contract Manager Multidisciplinary preceding months'services Submission via E-mail) Team Report—DCF 2. Regional Forensic Template 25 Coordinator Monthly Vacant By 10th of each month for the 1(Electronic 1. ME Contract Manager Position(s) Reports preceding months'services Submission via E-mail) 2. Regional Forensic Coordinator Revised Exhibit C Page 11 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Monthly Court By 10th of each month for the 1(Electronic 1. ME Contract Manager Reports preceding months'services Submission via E-mail) 2. Regional Forensic Coordinator Reports Required for Consumer-[)riven',Agencies Enrollment/Member October 5,2019 1(Electronic ME Contract Manager ship Report (Period: 07/01/19-09/30/19) Submission via E-mail) January 5,2020 (Period: 10/01/19-12/31/19) April 5,2020 (Period: 01/01/20-03/31/20) July 5,2020 (Period: 04/01/20-06/30/20) Reports Required for Substance Abuse Services Providers Report for HIV Early January 5,2020 1(Electronic ME Contract Manager Intervention (Period: 07/01/19-12/31/19) Submission via E-mail) Services,SAPT Block July 5,2020 Grant Set Aside (Period: 01/01/20-06-30-20) Funded Services Only Annual Report for Upon Request 1(Electronic ME Contract Manager Evidenced-based Submission via E-mail) Injection Drug User Outreach Services, SAPT Block Grant Mandate, Designated Providers Only Annual Report for Upon Request 1(Electronic ME Contract Manager Pregnant Women Submission via E-mail) and Women with Dependent Children SAPT Block Grant Set Aside Funded Services Only Monthly Outcomes Due monthly, by the 4th of 1(Electronic 1. ME IT Office for Women's every month following the Submission via E-mail) Expansion Grant— month of service 2. ME Contract Manager Special Appropriation Reports Required for State Opioid Response Discretionary Grant Providers Monthly SOR Data Due monthly, by the 15th of 1(Electronic ME Contract Manager Collection Report- every month following the Submission via E-mail) State Opioid month of service Encrypted and Response Password Protected Discretionary Grant Services(SOR) Medication Assisted Treatment Services, OCA: MSSOR- Exhibit BB Revised Exhibit C Page 12 of 19 Guidance/Care Center, Inc. Contract No. P-4 ',mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Quarterly and Annual October 31,2019 1(Electronic 1. ME Contract Manager Expenditure Report (Period: 07/01/19-09/30/19) Submission via E-mail) (Exhibit BB) January 31,2020 2. VP of Finance (Period: 10/01/19-12/31/19) April 30,2020 (Period: 01/01/20-03/31/20) July 31,2020 (Period: 04/01/20-06/30/20) Annual Expenditure Report Due:7/15/2019 (Period: 07/01/19—06/30/20) Reports Required for Substance Abuse Prevention Services Providers Monthly Data Prevention service data shall Electronically PBPS,or other data system Required by DCF be submitted electronically to designated by the ME or the FASAMS PAM 155-2 PBPS no later than the 4th of Department each month following the month of service Monthly Data to the Monthly, by the 4th calendar Electronically DOES or any other format ME's contracted day after the month of service requested by BSRI evaluation entity- BSRI Monthly Service Monthly, by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day after the month Department) of service Invoice Review 1 ME Sr.Accountant(Fiscal Supporting Submitted with the monthly Department) Documentation- invoice from PBPS in a jpeg format Monthly E-Mail Monthly, by the 4th calendar 1(Electronic 1. ME Director or Prevention Notification to the day after the month of service Submission via E-mail) Services ME Prevention Services Director and 2. ME Data Analyst ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. Refer to Scope of Work Attachment to the Contract for specifics Revised Exhibit C Page 13 of 19 Guidance/Care Center, Inc. Contract No. P-4 ',mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Final Annual Site 8/31/2019 1(Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Memorandum of Within 30 calendar days of 1(Electronic 1. ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract(for newly executed 2. ME Director or Prevention Community Coalition MOU's) Services OR Within 30 calendar days for renewed MOU's Submission of Refer to Scope of Work 1(Electronic 1. ME Contract Manager Participant Attachment to the Contract Submission via E-mail) Satisfaction Survey for specifics 2. ME Director or Prevention Services Reports Required for Prevention Partnership Grant Providers Monthly E-Mail Monthly, by the 4th calendar 1(Electronic 1. ME Director or Prevention Notification to the day after the month of service Submission via E-mail) Services ME Prevention Services Director and 2. ME Data Analyst ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. Refer to Scope of Work Attachment to the Contract for specifics Program Status 7/15/2020 1(Electronic 1. ME Contract Manager Report (Period: 07/01/2019- Submission via E-mail) 06/30/2020) 2. ME Director or Prevention Services Within 30 calendar days of 1(Electronic 1. ME Contract Manager Memorandum of the effective date of the Submission via E-mail) Understanding contract(for newly executed 2. ME Director or Prevention (MOU)with a MOU's) Services Community Coalition OR Within 30 calendar days for renewed MOU's Submission of Refer to Scope of Work 1(Electronic 1. ME Contract Manager Participant Attachment to the Contract Submission via E-mail) Satisfaction Survey- for specifics 2. ME Director or Prevention Services Final Annual Site 8/31/2019 1(Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Revised Exhibit C Page 14 of 19 Guidance/Care Center, Inc. Contract No. P-4 ',mngth Horida Behar ioral Health Nem ork. Inc 1/0/20�9 Revised Exhibit C Required Reports Quarterly Financial October 31,2019 1(Electronic 1. ME Contract Manager Report of Program (Period: 07/01/19-09/30/19) Submission via E-mail) Expenses January 31,2020 2.VP of Finance (Period: 10/01/19-12/31/19) April 30,2020 (Period: 01/01/20-03/31/20) July 31,2020 (Period: 04/01/20-06/30/20) Reports Required for Evaluation Entity for Prevention Services Monthly Service Monthly by 20th calendar day 1(Electronic 1. ME Contract Manager Report after the month of service Submission via E-mail) (Deliverables per 2. ME Director of Prevention Attachment IV,Scope Services of Work) Quarterly October 31,2019 1(Electronic 1. ME Contract Manager, Expenditure Report (Period: 07/01/19-09/30/19) Submission via E-mail) January 31,2020 2. ME VP of Finance,and (Period: 10/01/19-12/31/19) May 1,2020 3. ME Director of Prevention (Period: 01/01/20-03/31/20) Services July 31,2020 (Period: 04/01/20-06/30/20) Reports Required for Providers Receiving Specific Appropriations Initial Projected 7/10/2019 1(Electronic 1. ME Contract Manager Return on Submission via E-mail) Investment-Per Exhibit AM Quarterly Updates on October 10,2019 1(Electronic 1. ME Contract Manager Return on (Period: 07/01/19-09/30/19) Submission via E-mail) Investment Report- January 10,2020 Per Exhibit AM (Period: 10/01/19-12/31/19) April 10,2020 (Period: 01/01/20-03/31/20) July 10,2020 (Period: 04/01/20-06/30/20) Reports Required for the Navigate Program Provider Quarterly Services October 31,2019 1(Electronic ME Contract Manager Report (Period: 07/01/19-09/30/19) Submission via E-mail) January 31,2020 (Period: 10/01/19-12/31/19) May 1,2020 (Period: 01/01/20-03/31/20) July 31,2020 (Period: 04/01/20-06/30/20) Revised Exhibit C Page 15 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth F1Ioriida Behar i!€ rill t r.'allth Nem€ rk.Inc 1/0/20 Revised Exhibit C Required Reports Navigate Program October 31,2019 1(Electronic ME Contract Manager Quarterly (Period: 07/01/19-09/30/19) Submission via E-mail) Expenditure Report January 31,2020 (Period: 10/01/19-12/31/19) May 1,2020 (Period: 01/01/20-03/31/20) July 31,2020 (Period: 04/01/20-06/30/20) Reports Required for Information and Referral Services Providers Information and Due monthly, by the 30th of 1(Electronic ME Contract Manager Referrals Provider's every month following the Submission via E-mail) Network(Jewish month of service Community Services of South Florida, Inc.) Exhibit P-1, Information and Referral Monthly Progress Report Reports Required for Infant Mental Health Program Providers Monthly Due monthly, by the 5th 1(Electronic 1. ME Contract Manager Demographic Report, calendar day of the month. Submission via E-mail) 2.VP of Behavioral Health Exhibit AU, Infant Mental Health Services.The report shall be submitted in a secured, password protected or encrypted format. Quarterly Infant July 5,2019 1(Electronic 1. ME Contract Manager Mental Health- (Period: 04/01/19-06/30/19) Submission via E-Mail) 2.VP of Behavioral Health Narrative Milestones October 5,2019 Report on Client (Period: 07/01/19-09/30/19) Outcomes.The January 5,2020 report shall be (Period: 10/01/19-12/31/19) submitted in a April 5,2020 secured, password (Period: 01/01/20-03/31/20) protected or encrypted format. Reports Required for the forensic Mental Health Services Program Appendix A, By the 10th of every month 1(Electronic ME Forensic Manager Conditional Release following the reporting month Submission via E-mail) Report Weekly Statewide Weekly by 12:00 Noon every 1(Electronic ME Forensic Manager Census Report Thursday Submission via E-mail) Revised Exhibit C Page 16 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth H€a€`ida Behar i!€ rill Health Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Appendix B, Monthly By the 10th of every month 1(Electronic ME Forensic Manager Diversion Report following the reporting month Submission via E-mail) Quarterly SMHFT Due within thirty(30) 1(Electronic ME Forensic Manager Visit Report calendar days of date of the Submission via E-mail) visit Staffing Report January 5,2020 1(Electronic ME Forensic Manager (Period: 07/01/19-12/31/19) Submission via E-mail) July 5,2020 (Period: 01/01/20-06-30-20) Reports Required for the Community Action Treatment Team(CAT Team)Program Weekly Census Weekly by 12:00 noon,every 1(Electronic Children's System of Care Report Monday Submission via E-mail) Manager Monthly shall be submitted Electronically KIS, FASAMS,or other data Monthly Data electronically to the ME no system designated by the ME Required by DCF later than the 4th of each or the Department FASAMS PAM 155-2 month following the month of service Appendix 1-Persons By the 8th calendar day of the 1(Electronic 1.Children's System of Care Served and month after the month of Submission via E-Mail) Manager Performance service 2.Contract Manager Measure Report Appendix 2- October 10,2019 1(Electronic 1.Children System of Care Quarterly (Period: 07/01/19-09/30/19) Submission via E-mail) Manager Supplemental Data January 10,2020 2.Contract Manager Report (Period: 10/01/19-12/31/19) April 10,2020 (Period: 01/01/20-03/31/20) July 10,2020 (Period: 04/01/20-06/30/20) Appendix 3-CAT Monthly, by the eighth (8th) 1 1. ME Sr.Accountant(Fiscal Team Monthly calendar day Department) Invoice after the month of service 2.Children's System of Care Manager Invoice Review Submitted with the monthly 1 1. ME Sr.Accountant(Fiscal Supporting invoice,as appropriate, Department) Documentation and/or as requested by SFBHN 2.Children's System of Care (incidental expenses) staff Manager Reports Required for the Mobile Response Teams Monthly MRT Monthly by the 10th following 1(Electronic 1. ME Contract Manager Tracker the month of service Submission via E-mail) 2. ME Data Analysts -Encrypted, password protected Revised Exhibit C Page 17 of 19 Guidance/Care Center, Inc. Contract No. P-4 ',mngth F1Ioriida Behar i!€ rill ttr.'allth Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Outreach Activities October 15,2019 1(Electronic 1. ME Contract Manager Log (Period: 07/01/19-09/30/19) Submission via E-mail) 2. ME Data Analysts January 15,2020 (Period: 10/01/19-12/31/19) April 15,2020 (Period: 01/01/20-03/31/20) July 15,2020 (Period: 04/01/20-06/30/20) Reports Required for Family Intensive Treatment(FIT)Service Providers Weekly-Child Each Monday by close of 1(Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit Al) Monthly Progress By the 15th day of the month 1(Electronic 1. Contract Manager Report(Reporting following the month of Submission via E-mail) 2.Child Welfare Integration Template 17 is services Coordinator available at: http://www.myflfami lies.com/service- programs/substance- abuse/manaina- entities Reports Required for the Families Engaged in Recovery and Safety(FERAS)Providers Weekly-Child Each Monday by close of 1(Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit Al) Monthly-Child By the 15th day of the month 1(Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services Monthly-FERAS By the 8th day of the month 1(Electronic Child Welfare Integration Outreach Log following the month of Submission via E-mail) Coordinator services Reports Required for Network Providers Serving Families Referred by the Motivational Support Program Monthly Progress By the 15th day of the month One(1) Password, Motivational Support Report(for following the month of protected and Specialist at the Motivational Behavioral Health services encrypted Electronic Support Program Network Treatment Network Submission Provider Providers refer to attachment to the Appendix 1 of assigned MSS Exhibit J) Revised Exhibit C Page 18 of 19 Guidance/Care Center, Inc. Contract No. P-4 `mngth F1Io`iida Behar i!€ rill t r.'allth Nem€ rk. Inc 1/0/20 Revised Exhibit C Required Reports Motivational Support By the 10th day of the month One(1) Password, 1.Child Welfare Integration Program Tracker following the month of protected and Coordinator (Banyan Health services encrypted Electronic Systems, per Exhibit Submission 2. Data Analyst AA) Motivational Support Every Monday, by Close of One(1) Password, Child Welfare Integration Program Weekly Business following the week protected and Coordinator Caseload (Banyan of service encrypted Electronic Health Systems,per Submission Exhibit AA) Clinical Consultant Services(CCS) CCS Tracker Every Monday, by Close of One(1) Password, Child Welfare Integration Business following the week protected and Coordinator of service encrypted Electronic Submission Reports Required for Network Providers Providing SA Treatment Services to Pregnant Women,Mother's and their Affected Families(OCA's:MS027 and MS081) Women's Special By the 8th day of the month One(1) Password, Data Analysts Appropriation Data following the month of protected and Reporting-Per services encrypted Electronic Exhibit AE Submission Note:When a regular due date for a required report falls on a weekend or a legal holiday,the due date is extended to the next business day immediately following the weekend or holiday. Revised Exhibit C Page 19 of 19 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 REVISED ATTACHMENT I A. Service to be Provided 1. Program/Service Specific Terms (1) "Behavioral Health Services" are mental health services and substance abuse prevention and treatment services as defined by s. 394.9082(2)(a), F.S., and in Chapter 397. F.S. (2) "Block Grants":The Community Mental Health Block Grant(CMHBG), pursuant to 42 U.S.C. s. 300x, et. seq.,and the Substance Abuse Prevention and Treatment Block Grant(SAPTBG), pursuant to 42 U.S.C. s. 300x-21, et. seq. (3) "Care Coordination" means the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure service linkage. Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures. The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations. (4) "Citrus Family Care Network" is the Southern Region's (Circuit 11 & 16) Lead Agency for Community Based Care provider under contract with the State of Florida Department of Children and Families for the child protection and child welfare system. (5) "Collaborative Planning Group Systems, Inc." is the entity contracted with the Department of Children and Families that maintains the database called Performance Based Prevention System (PBPS) that Network Providers contracted to provide substance abuse prevention services must utilize to upload substance abuse prevention data required by this contract. (6) "Comprehensive Continuous Integrated System of Care (CCISC) model" is a system design and implementation model for organizing services for individuals and families with co- occurring disorders that is designed to improve services capability on a statewide or regional basis to achieve: system level change; efficient use of resources; use of evidence- based and consensus based practices; and integrated mental health and substance abuse services throughout the system, by organizing a process in which every program improves their provision of co-occurring disorder services, and every clinical staff person improves their level of co-occurring disorder service competency based on their job and level of training. (7) "Continuous Quality Improvement" is an ongoing, systematic process of internal and external improvements in service provision and administrative functions, taking into Revised Attachment I HCO2 (f) Page 1 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 account both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. (8) "Contract Manager" is the ME employee who is responsible for enforcing the compliance with administrative and programmatic terms and conditions of a contract. The Contract Manager is the primary point of contact through which all contracting information flows between the ME and the Network Provider. All actions related to the contract shall be initiated by or coordinated with the Contract Manager. (9) "Co-occurring Disorder" is any combination of mental health and substance abuse in any individual, whether or not they have been already diagnosed. (10)"Co-occurring Disorder Service Capability" is the ability of any program to organize every aspect of its program infrastructure (policies, procedures, practices, documentation, and staff competencies), within its existing resources, to provide appropriately matched, integrated services to the individuals and families with co-occurring disorders that are routinely presenting for care in that program. Should services not be available at the Network Provider then then the consumer must be linked to an agency with the capability to meet the consumer's needs. (11)"Coordinated System of Care", as described in section 394.4573, F.S.is the array of behavioral health and related services in a region or community offered by all service providers, whether participating under a contract with a Managing Entity or by another method of community partnership or mutual agreement. The essential elements of a coordinated system of care include but are not limited to: Community interventions such as prevention, primary care for behavioral health needs, therapeutic and supportive services, crisis response services, and diversion programs. and early intervention; Services provided within the System of Care must be accessible and responsive to the needs of individuals, their families, and community stakeholders. (12)"Cost Analysis" is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. (13)"Cultural and Linguistic Competence" is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professional that enable effective work in cross-cultural situations that provides services that are respectful and/or responsive to cultural and linguistic needs. (14) "Department" means the State of Florida Department of Children and Families. (15) "Electronic Health Record (EHR)" is defined in s. 408.051(2)(a), F.S. Revised Attachment I HCO2 (f) Page 2 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 (16) "Evidenced-Based Practices (EBP) are programs, practices or strategies that are supported by research. EBP's are programs that have demonstrated effectiveness with established genera lizability (replicated in different settings and with different populations over time) through research. The Department has established two option For a list of approved registries used to identify, evaluate, and select EBP programs and strategies please refer to the Department's Guidance Document 1, Evidence Based Guidelines available at the following link: https://www.myflfamilies.com/service-programs/samh/managing-entities/2019-contract- docs.shtm I (17) "FASAMS DCF Pamphlet 155-2" is the Department of Children & Families, Pamphlet 155-2 - Mental Health and Substance Abuse Measurement and Data, , version 13.0, or the latest revised edition thereof, means a document promulgated by the Department that contains required data-reporting elements for substance abuse and mental health services, and which can be found at: https://www.myflfamilies.com/service-programs/samh/155-2/pamphlet-155-2-v13.shtml (18) "Financial and Services Accountability Management System (FASAMS)" is the Department's information management and fiscal accounting system for providers of community substance abuse and mental health services. (19) "Forensic Mental Health Services" are services provided to individuals with mental illness pursuant to Chapter 916, Florida Statutes. (20) "HIPAA" is the acronym for Health Insurance Portability and Accountability Act and shall mean the Privacy,Security, Breach Notification,and Enforcement Rules at 42 U.S.C. §1320d, and 45 C.F.R. Parts 160, 162, and 164. (21) "Individual(s) Served" (synonymous with Consumer, Participant) is an individual who receives substance abuse or mental health services, the cost of which is paid, either in part or whole, by Department appropriated funds or local match (matching). (22) "Knight Information Software (KIS)", (synonymous with Care Coordination, Utilization Management and Financial Reporting System) is the ME's online data system which Network Providers are required to use to collect and report data and performance outcomes on consumers served whose services are paid for, in part or in whole, by the ME's Substance Abuse and Mental Health (SAMH) contract, Medicaid, local match, Temporary Assistance for Needy Families (TANF), Purchase of Therapeutic Services (PTS) and Title 21 . The KIS,or other system designated by the ME, shall be utilized to upload consumer-related data as required by this contract. Revised Attachment I HCO2 (f) Page 3 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 (23) "Lead Agency for Community-Based Care (CBC)" is an agency under contract with the Florida Department of Children and Families that provides care for children in the child protection and child welfare system. (24)"Local Match" are funds received from governing bodies of local government, including city commissions, county commissions, district school boards, special tax districts, private hospital funds, private gifts both individual and corporate, bequests and funds received from community drives or any other sources. Matching requirements may be satisfied by any or all of the following: (a) Allowable costs supported by non-State or Federal grants incurred by the service provider during the effective funding period; (b) The value of third-party funds and in-kind contributions applicable to the matching requirement period; and, (c) Costs supported by fees and program income. See § 394.67, F.S. F.S. and 65E-14.005, F.A.C. (25) "Managing Entity(ME)" as defined in section 394.9082(2)(e), F.S., is a corporation selected by and under contract with the Department to manage the daily operational delivery of behavioral health services through a coordinated system of care. (26) "Mental Health Services" is defined pursuant to Chapter 394, F.S. (27)"Motivational Support Program" are services designed to reduce the incidence of child abuse and neglect resulting from parents' or caregivers' behavioral health and to improve outcomes for families in the child welfare system and/or community based care. (28) "Network Provider" is an entity that contracts with the ME and receives funding to provide services to consumers; in this contract the Network Provider is synonymous with provider or subcontractor. (29) "Our Kids of Miami-Dade/Monroe" is the Community Based Care provider under contract with the State of Florida Department of Children and Families for the child welfare system. (30)"Outcome for Individual Service Recipient" is a measure of the quantified result, impact, or benefit of services on the individual service recipient. (31) "Payer class" Medicare, Medicare HMO, Medicaid, Medicaid HMO, private-pay health insurance, private-pay health maintenance organization, private preferred provider organization,the Department of Children and Family Services, other government programs, self-pay patients, charity care and any other payer class other than the Department. Revised Attachment I HCO2 (f) Page 4 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 (32) "Payer of last resort" is a standard that is applied by the Network Provider to ensure that all options to collect payment for services rendered under this contract from "First Party Payer" (individual receiving services), "Second Party Payer or Responsible Party", and/or "Third Party Payer", as defined in Rule 65E-14, F.A.C. are pursued prior to billing the ME. The ME is always the payer of last resort. Refer to Rule 65E-14, F.A.C. and Exhibit B, Method of Payment. (33) "PBPS" is the Department's Performance Based Prevention System that collects data related to community assessments and plans and substance abuse prevention programs and activities. (34) "Performance Measures" are quantitative indicators, outcomes and outputs that are used by the Department to objectively measure performance and are used by the ME and Network Providers to improve services. (35)"Prevention" refers to the proactive approach to preclude, forestall, or impede the development of substance abuse or mental health related problems.These strategies focus on increasing public awareness and education, community-based processes, and incorporating evidence-based practices. Additional guidance regarding prevention services can be found in the Department's Guidance Document 10, Prevention Services and is available at the following link: https://www.myflfa m i l ies.co m/service-programs/sa m h/managing-entities/2019-co ntract- docs.shtm I Programs designed to prevent the development of mental, emotional, and behavioral disorders are commonly categorized in the following manner: (a) Universal Direct Prevention Directly serve an identifiable group of participants who have not been identified on the basis of individual risk. This includes interventions involving interpersonal and ongoing or repeated contact such as curricula, programs, and classes. These services shall address the following specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: information dissemination, education, alternatives or problem identification and referral services. (b) Universal Indirect Prevention Universal indirect services support population-based programs and policies implemented by coalitions.These services can also include meetings and events related to the design and implementation of components of the strategic prevention framework, including needs assessments, logic models and comprehensive community action plans. The services shall address the following specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: information dissemination, community-based processes and environmental strategies. Revised Attachment I HCO2 (f) Page 5 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 (c) Selective Prevention Preventive interventions that are targeted to individuals or to a subgroup of the population whose risk of developing mental, emotional, or behavioral disorders is significantly higher than average. The risk may be imminent or it may be a lifetime risk. Risk groups may be identified on the basis of biological, psychological, or social risk factors that are known to be associated with the onset of a disorder. Examples include programs offered to children exposed to risk factors, such as parental divorce, parental mental illness, death of a close relative, or abuse, to reduce risk for adverse mental, emotional, and behavioral outcomes. (d) Indicated Prevention Preventive interventions that are targeted to high-risk individuals who are identified as having minimal but detectable signs or symptoms that foreshadow mental, emotional, or behavioral disorders, as well as biological markers that indicate a predisposition in a person for such a disorder but who does not meet diagnostic criteria at the time of the intervention. (36) "Prevention Partnership Grant" is a program created by s. 397.99, F.S. designed to encourage school and community substance abuse prevention partnerships. The PPG program is funded through the federal Substance Abuse and Treatment Block Grant, administered by the Florida Department of Children and Families and managed by the ME. (37)"Prime Contract" is the contract between the Department of Children and Families and the ME. (38) "Program Description" is the document the Network Provider prepares and submits to the ME for approval prior to the start of the contract period, which provides a detailed description of the services to be provided under the contract pursuant to Rule 65E-14, F.A.C. It includes but is not limited to the Network Provider's organizational profile, the service activity description, a detailed description of each program and covered service funded in the contract, the geographic service area, service capacity, staffing information, and consumer and target population to be served. (39) "Projects for Assistance in Transition from Homelessness (PATH)" is a federal grant to support homeless individuals with mental illnesses, who may also have co-occurring substance abuse and mental health treatment needs. (40) "Protected Health Information" (PHI) relates to any information whether oral or recorded in any form or medium that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and 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. (41) "Provider Network" (subcontractor or Network Provider) refers to the group of direct service providers, facilities, and organizations under contract with a ME to provide a Revised Attachment I HCO2 (f) Page 6 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 comprehensive array of emergency, acute care, residential, outpatient, recovery support, and consumer support services including prevention services and any other services purchased by this contract. See section 394.9082, F.S. (42) "Quality Assurance" is a process that measures performance in achieving pre-determined standards,validates internal practice,and uses sound principles of evaluation to ensure that data are collected accurately, analyzed appropriately, reported correctly and acted upon in a timely manner. The process may employ peer review, outcomes assessment, and utilization management techniques to assess quality of care. (43) "Quality Improvement/Continuous Quality Improvement" is a management technique to assess and improve internal operations and network services. It focuses on organizational systems rather than individual performance and seeks to continuously improve quality.The process involves setting goals implementing systematic changes, measuring outcomes, and making subsequent appropriate improvements. Quality improvement activities will assess compliance with contract requirements, state and Federal law and associated administrative rules, regulations, and operating procedures and validate quality improvement systems and findings. (44) "Recovery-Oriented System of Care" is defined as a coordinated network of community- based services and supports that are person-centered and build on the strengths and resilience of individuals, families and communities to achieve abstinence, and improved health and the quality of life for individuals, families, and communities.' (45)"Representative Payee" refers to an entity/individual that is legally authorized to receive Supplemental Security Income, Social Security Income, Veterans Administration benefits, or other federal benefits on behalf of an individual served. (46)Request for Application#10H17GN1:The Department's most recent Prevention Partnership Grant Request for Application for Fiscal Years 2018-2021. (47)"SAMH" stands for the Substance Abuse and Mental Health Programs within the Department. (48) "SAVE/VIS Program" is the U.S. Department of Homeland Security (DHS) administers the Systematic Alien Verification for Entitlements (SAVE) program. This program verifies immigration status and eligibility of alien applicants for federal benefits. The alien status verification system under SAVE is entitled the Alien Status Verification Index (ASVI), as described at 60 Federal Register 52694, 52697 (1995) administered by the Computer Sciences Corporation (CSC) as the Verification Information System (VIS). The SAVE/VIS Program can and may provide assistance in verifying eligibility in cases where a consumer ' See https://www.samhsa.gov/sites/default/files/rose resource aide book.pdf accessed May,2018. Revised Attachment I HCO2 (f) Page 7 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 does not possess sufficient documentation. (49) "Seclusion and Restraint Data System" referred to as SAN DR, is the Department of Children and Families'web-based data system used to collect and report the frequency and types of seclusion and restraint events that involve persons served in state-contracted and non-state contracted community substance abuse and mental health programs, and state mental health treatment facilities. All facilities, as defined in section 394.455(10), F.S.,are required to report each seclusion and restraint event to the Department of Children and Families in accordance with but not limited to Rule 65E-5.180, F.A.C. (50)"SOAR" stands for Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access and Recovery and is a Substance Abuse and Mental Health Services Administration (SAMHSA) technical assistance initiative designed to help individuals increase earlier access to SSI and SSDI through improved approval rates on initial Social Security applications by providing training, technical assistance, and strategic planning to Network Service Providers. (51) "Stakeholder(s)" are individuals/groups with an interest in the provision of treatment services for substance abuse, mental health services, and/or co-occurring disorders in the circuits outlined in Section A.2.c.(2), of this Contract. This includes, but is not limited to,the key community constituents included in section 394.9082, F.S. (52) "Statewide Inpatient Psychiatric Programs (SIPP)" are residential inpatient facilities under contract with the Agency for Health Care Administration (AHCA) under the Medicaid Institutes for Mental Disease (IMD) 1915B waiver for children under age 18 to provide diagnostic and active treatment services in a secure setting. (53) "Substance abuse" is s a pattern of chronic or harmful use of alcohol, illicit or prescribed drugs that result in adverse physical, psychological, or social consequences. Substance abuse prevention and treatment services, pursuant to Chapter 397, F.S.,which are provided using state or federal funding. (54) "Substance Abuse and Mental Health Information System (SAMHIS)" is the Department's web-based data system for reporting data such as but not limited to, Demographic, Temporary Assistance to Needing Families data, Seclusion and Restraint data by the Managing Entity and all Network Service Providers in accordance with this contract. (55) "TANF Participant" is a person or family member of that person defined in 45 C.F.R. Part 260.30 and section 414.1585 and subsection 414.0252(9), F.S. (56) "Temporary Assistance to Needy Families(TANF)"are cash assistance forfamilies,including any family receiving cash assistance payments or TANF diversion services from any state program as defined in under 42 U.S.C. ss. 601, et. seq., and ch. 414, F.S. (57)"Unit Measurement" synonymous with "measurement standard" is used in billing the ME Revised Attachment I HCO2 (f) Page 8 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 for services.The definition of each unit of measure can be found in Rule 65E-14, F.A.C. (58) "Utilization Management" is a system to ensure maximum, cost-effective, and clinically appropriate utilization of behavioral health services. The goal of the program is to eliminate waitlists and maximize utilization as well as diverting individuals served to more clinically appropriate services when applicable. (59) "Verifiable Service" is a service provision that is documented in compliance with the requirements contained in Rule 65E-14, F.A.C. (60)"Wait List" is a master list for the Network, maintained by a Managing Entity that shows: (a) The number of individuals waiting for access to the recommended service or program; (b) The length of time each individual has been on the waiting list; and (c) The interim services provided to the individual. 2. General Description a. General Statement The Prevention Partnership Grants (PPG) program created by s. 397.99, F.S., is designed to encourage school and community substance abuse prevention partnerships. The PPG program is funded through the federal Substance Abuse Prevention and Treatment Block Grant (Block Grant), administered by the Florida Department of Children and Families and managed by the ME. The services provided under this contract are to fund rigorous, effective, evidence-based, substance abuse prevention programs and strategies intended to prevent or reduce Florida substance use and abuse rates at the community level. The strategies, activities, and services must be consistent with the local community ME- approved local Needs Assessment Logic Model (HALM), the Comprehensive Community Action Plan (CCAP) and with the Network Provider's Application filed with the Department in response to the Request for Applications# 10H17GN1, herein incorporated by reference and made part of this contract. The Network Provider shall work in collaboration with the funded ME Evaluation Entity, by participating in meetings and providing service data vital for the completion of a system-wide evaluation of the prevention services within the Strategic Prevention Framework. The evaluation of the prevention system is expected to be the systematic collection and analysis of information about program activities, characteristics, and outcomes to reduce uncertainty, improve effectiveness, and assist in decision-making. The information gathered from the evaluation process will help the ME,the State and communities become more skillful and exact Revised Attachment I HCO2 (f) Page 9 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 in describing what they plan to do, monitor what they are doing, and improve the prevention system of care. Evaluation results can and should be used to determine what efforts should be sustained and to assist in sustainability planning efforts. The ME will provide substantial input, in collaboration with the Network Provider and the Evaluation Entity, both in planning and implementation of the evaluation process and activities and will make recommendations regarding the continuance of the activities. b. Authority Section 394.9082, F.S., the Prime Contract, and the Request for Applications # 10H17GN1, provides the ME with the authority to contract for these services. c. Scope of Service The following scope of service applies to the contract period and any renewal or extension. (1) The Network Provider is responsible for the administration and provision of services to the target population(s) indicated in Exhibit A, Consumers/Participants to be Served, and in accordance with the tasks outlined in Section B.1.a., of this contract, and the Scope of Work found in Attachment V. Services shall also be delivered at the locations specified in, and in accordance with the Program Description, as required by Rule 65E-14.021, F.A.C. which is herein incorporated by reference, and maintained in the ME's Contract Manager's file. (2) Services are to be delivered in the following county(ies): Miami-Dade County X Monroe County d. Major Program Goals The overall scope of the grant activities for the PPG program are to: (1) Develop effective substance abuse prevention and early intervention strategies for the target populations; and, (2) Conduct prevention activities serving students who are not involved in substance abuse, intervention activities serving students who are experimenting with substance use, or both prevention and intervention activities, if a comprehensive approach is indicated as a result of a needs assessment. (3) PPG activities must relate to the local community department-approved local Needs Assessment Logic Model (HALM)to show target population and subpopulation problems to be addressed.The goals and objectives of the Comprehensive Community Action Plan (CCAP) will call for evidence-based prevention program activities or strategies for which Revised Attachment I HCO2 (f) Page 10 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 there is a demonstrated need. The CCAP guides the selection of evidence-based prevention program activities or strategies for which there is limited or no current local capacity. The principles of cultural competency must be incorporated into their needs assessment logic model and the CCAP. Each community must also include a written sustainability plan in their response which details their plan to sustain activities after funding has ended. e. Minimum Programmatic Requirements The Network Provider shall maintain the following minimum programmatic requirements: (1) System of Care The individual-centered and family-focused system of care will: (a) Be driven by the needs and choices of the individuals served; (b) Promote family and personal self-determination and choice; (c) Be ethically,socially,and culturally responsive;and (d) Be dedicated to excellence and quality results. (2) Guiding Principles Guiding principles specify that services are as follows: (a) Inclusive - involve and engage families and consumers as full partners to participate in the planning and delivery of services; (b) Comprehensive - incorporating a broad array of service and supports (e.g. physical, emotional,clinical, social,educational and spiritual); (c) Individualized- meeting the individual's exceptional needs and strengths; (d) Community-based- provided in the least restrictive,clinically appropriate setting; (e) Coordinated-both at the system and service delivery levels to ensure that multiple services are provided and change as seamlessly as possible when warranted; (f) Cultural and linguistic competence (g) Gender responsive, and Revised Attachment I HCO2 (f) Page I of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 (h) Sexual orientation 3. Consumers to be Served See Exhibit A,Consumers/Participants to be Served B. MANNER OF SERVICE PROVISION 1. Service Tasks The following tasks must be completed for each fiscal year covered in the contract period. a. Task List (1) Based on consumer needs, the Network Provider shall adhere to services as outlined in the approved Prevention Program Description, incorporated herein by reference and as set forth in Attachment V,Scope of Work in addition to providing services from the list of approved covered services listed in Exhibit G,Covered Service Funding by OCA.Any change in the array of services shall be justified in writing and submitted to the ME's Contract Manager for review and approval. (2) The Network Provider shall ensure that all staff is properly trained as required by the substance abuse licensing Rule 65D-30, F.A.C. (3) The Network Provider shall serve the number of persons indicated in Exhibit D, Substance Abuse and Mental Health Required Outcomes/Outputs within the covered services listed in Exhibit G,Covered Service Funding by OCA. (4) The Network Provider shall ensure the fidelity of each EBP the agency is utilizing. (5) The Network Provider shall develop and implement policies so that all applicable providers' employees abide by the terms and conditions of Paragraph 25., Information Security Obligations, of the Standard Contract. The Network Provider shall submit to the Managing Entities Contract Manager, by 8 01 2019,verification that all Network Provider employees and subcontractors who have access to ME and Department information systems have completed the Security Agreement form as identified in Paragraph 25. Information Security Obligations, of the Standard Contract. (6) For licensable services purchased by this Contract, such as substance abuse prevention services, the Network Provider shall have and maintain correct and current Department of Children and Families and Agency for Health Care Administration (AHCA) licenses and only bill for services under those licenses. In the event any of the Network Provider's license(s) are Revised Attachment I HCO2 (f) Page 12 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 suspended, revoked, expired or terminated, the ME shall suspend payment for services delivered by the Network Provider under such license(s) until said license(s) are reinstated. (7) By 08/01/2019, the Network Provider must to the ME's Contract Manager grievance procedures, which include an appeal process with the ME, should the grievance not be resolved at the Network Provider level, which applicants for, and recipients of, services being provided under this contract, may use to present grievances to the Network Provider, or to the ME about contracted services. Should any updates to the grievance procedures occur during the term of this contract, the Network Provider must submit the amended procedures to the Contract Manager within thirty (30)calendar days of the amendment. The Network Provider must post and provide copies of the grievance procedures to all consumers receiving services with funds provided for in this Contract. (8) By 08/01/2019,the Network Provider shall submit to the ME's Contract Manager a disaster plan consistent with Paragraph 29., Emergency Preparedness, of the Standard Contract. (9) Should the ME conduct a mock emergency drill, the Network Provider shall participate by activating their emergency/disaster plan and reporting on preparedness activities, response activities, and post-recovery activities. (10) By 08/01/2019,the Network Provider shall submit to the ME's Contract Manager a completed Civil Rights Compliance Questionnaire. (11) The Network Provider shall execute or maintain if executed, a Memorandum of Understanding (MOU) or contract with the appropriate Federally Qualified Health Center or other medical facility. The MOU provides for the integration of behavioral health services and primary health care services for all participants and consumers in care. Referral and linkage processes will be necessary for all participants/consumers who do not have a primary care provider at entry into the services in the system of care. Follow up and coordination of services are essential to meeting participant/consumer health and behavioral health needs which result in: • Improved access to primary care services; • Improved prevention, early identification, and intervention to reduce the incidence of serious physical illnesses, including chronic disease; • Increased availability of integrated, holistic care for physical and behavioral disorders; and • Improved overall health status of consumers Revised Attachment I HCO2 (f) Page 13 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 The relationships should be cooperative and reciprocal; that is, the partnership adds value to the program strategies and outcomes and achieves a level of systems improvement beyond the current standards. Programs and coalitions are required, based on the Strategic Prevention Framework(SPF)and all of the Prevention philosophy,to work together to achieve larger system outcomes based on the planning process and following the principles of integrated care. In addition, all funded providers will be contractually required to work comprehensively with the funded Evaluation entity. The MOU shall be submitted within ninety(90) days of the effective date of this contract to the ME's Contract Manager on or before the due date(s)as specified in Exhibit C, Required Reports. The Network Provider shall submit copies of any amendment to the MOU,to the ME's Contract Manager, within thirty (30) calendar days of execution. Federally Qualified Health Centers are required to submit policies and procedures that explain the access to primary care services to the medically underserved behavioral health consumer. (12) By 08/01/2019, the Network Provider shall submit to the ME's Contract Manager a Quality Assurance Plan that details how the Network Provider will ensure and document that quality services are being provided to the consumers served,which is herein incorporated by reference. The Network Provider shall submit updates as amended of the Quality Assurance Plan within thirty(30)days of adoption. The Quality Assurance Plan should address the minimum guidelines for the Network Provider's continuous quality improvement program, including, but not limited to: (a) Individual care and services standards to include transfers and referrals, co-occurring supportive services, trauma informed services, and cultural and linguistic competence, integrated care, recovery-oriented system of care principles. (b) Individual records maintenance and compliance. (c) Staff development standards. (d) Service-environment safety and infection control standards. (e) Peer review and utilization management review procedures. (f) Incident reporting policies and procedures that include verification of corrective action and a provision that specifies that a person who files an incident report, in good faith, may not be subjected to any civil action by virtue of that incident report. (g) Fraud, waste, abuse and other potential wrongdoing auditing, monitoring, and remediation procedures. Revised Attachment I HCO2 (f) Page 14 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (h) Evidence-based practices (EBPs) utilized by the agency and how these EBPs are monitored to ensure fidelity to the model. (i) The Continuous Quality Improvement Initiatives identified in Section B.1.a.(18) below. (13) By 10/01/2019,the Network Provider must submit an attestation signed by the CEO/Executive Director indicating that all applicable staff funded by this Contract have received a copy of this fully executed contract and will receive copies of any amendments made to this Contract. (14) Linkage and Referral Process (a) The Network Provider's policies and procedures must address the referral and linkage process which should include a "warm handoff"when referring consumers to all levels of services.This includes, but is not limited to, referrals within a Network Provider from one level of care to another, i.e. residential to outpatient; referrals outside of the Network Provider when a service is not offered by the Network Provider; and referrals to services upon discharge from the Network Provider, regardless if a planned or unplanned discharge. This also includes when a consumer presents at the Network Provider for a service; however, they are not actually admitted to the service for varying reasons. Such referral services include, but are not limited to, detoxification services, linkages with community programs such as housing, employment, parenting supports, and primary health care. (b) A warm handoff consists of the Network Provider coordinating and facilitating the consumer's admission to the next appropriate level of care by direct communication and follow-up with the receiving provider.These efforts must be documented and maintained in the consumer's clinical record and should include detailed information including dates, times, and names of people spoken to. (c) When a referral is made for a service at another provider with the expectation to return to the referring provider, i.e.detoxification,the referring Network Provider should initiate the warm handoff and maintain follow-up with the receiving provider to coordinate entry back to the referring Network Provider.This must be documented and maintained in the consumer's clinical record and should include detailed information including dates,times, names of people spoken to, and final disposition, i.e. date returned or justification when not returning. (15) Continuous Quality Improvement Programs (a) The Network Provider must maintain a continuous quality improvement program and Revised Attachment I HCO2 (f) Page 15 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 report on the continuous quality improvement activities. The program is the responsibility of the Director and is subject to review and approval by the governing board of the service Network Provider. Each director shall designate a Quality Assurance Officer/Compliance Officer who will be responsible for the continuous quality improvement program. The continuous quality Improvement program should objectively and systematically monitor and evaluate the appropriateness and quality of care to ensure that services are rendered consistent with prevailing professional standards,and identify and resolve problems. (b) The quality improvement program must include at minimum: i. Activities to ensure that fraud, waste and abuse do not occur. ii. Composition of quality assurance review committees and subcommittees, purpose,scope,and objectives of the continuous quality assurance committee and each subcommittee, frequency of meetings, minutes of meetings, and documentation of meetings. iii. A framework for evaluating outcomes, including: 1. Output measures, such as capacities, technologies, and infrastructure that make up the system of care. 2. Process measures, such as administrative and components of the services. 3. Outcome measures pertaining to the outcomes of services; iv. A system of analyzing those factors which have an effect on performance; V. A system of reporting the results of continuous quality improvement reviews; and, vi. Best practice models for use in improving performance in those areas which are deficient. vii. Establishment of a Seclusion and Restraint Oversight Committee per Chapter 65E- 5.180, F.A.C. for agencies utilizing seclusion and/or restraint. (16) Continuous Quality Improvement Initiatives - Providers must comply with all of the provisions for the initiatives outlined below: (a) Integration of Behavioral Health Services and Primary Health Care Revised Attachment I HCO2 (f) Page 16 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 It is the goal of the ME to ensure the integration of behavioral health services and primary care services to all the consumers in care. The integration will be ensured through linkage of the behavioral health provider with the primary health care provider of the consumer through an electronic health record or other means of contact(phone, in person, etc). Referral and linkage processes will be necessary for all consumers who do not have a primary health care provider at entry into the system of care. Follow up and coordination of services are essential to meeting consumer health and behavioral health needs. Many individuals with behavioral health issues have chronic health conditions and may have neglected their primary health needs for some time. The ME and the Southern Region are committed to developing an integrated system of care that incorporates comprehensive screening and monitoring tools that identify those affected by chronic health conditions and a system of care that meets their needs. Network Providers will be implementing Integrated Primary and Behavioral Health techniques and initiatives to meet this need. This initiative will be addressed through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the Health Integration Initiative. As part of the plan or component of the plan must include the following: i. Identification of the Federally Qualified Health Center or other medical facility where consumers who have been identified as needing primary health care services are referred to or the process established by the Network Provider to coordinate services with consumers' private primary health care provider should such exist. ii. A process to track and report outcomes of successful referrals and linkages of consumers of behavioral health services to primary health care services. In addition to tracking and reporting outcomes of consumers referred for behavioral health services by a primary health care provider to the Network Provider. The outcomes must be reported in the semi-annual Continuous Quality Improvement Updates. iii. Identification of at least two Integrated Healthcare Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. iv. Participation in the regional Healthcare Integration Committee meetings to Revised Attachment I HCO2 (f) Page 17 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 develop the processes and training germane to this initiative. V. Attendance of appropriate staff at the regional trainings regarding Integrated Healthcare, as requested by the ME staff. Participation in the trainings will be documented in the Continuous Quality Improvement Updates. (b) Trauma Informed Care Many individuals with behavioral health issues have experienced trauma that affects their development and adjustment.The ME and the Southern Region are committed to developing a system of care that incorporates comprehensive assessment tools that identify those affected by trauma and a system of care that meets their needs. Network Providers will be implementing the Trauma Informed Care (TIC) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the TIC initiative.As part of the plan or component of the plan must include the following: i. Identification of at least two TIC Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. ii. Participation in the regional TIC meetings to develop the process for identifying and responding to those affected by trauma. iii. Attendance at the regional trainings regarding TIC as applicable. Applicable trainings will be documented in the Continuous Quality Improvement Updates. iv. Participation in all TIC related activities to ensure staff and agency become competent in all areas of trauma informed care. (c) Cultural and Linguistic Competence It is the goal of the ME to become a culturally and linguistically proficient network, through the full implementation of The National Standards for Cultural and Linguistically Appropriate Services (the National CLAS Standards). The National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and behavioral health care. In order to accomplish this task the Network Provider: i. Identification of at least two CLC Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. Revised Attachment I HCO2 (f) Page 18 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 ii. Participation in the regional CLC meetings. iii. Collaborate with the ME to identify and utilize the Network Provider's data to (1) identify sub-populations (i.e., racial, ethnic, Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, or Two-Spirited (LGBTQI-2S), minority groups) vulnerable to disparities and (2) implement strategies to decrease the differences in access, service use, and outcomes among sub-populations. These strategies should include the use of the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care; iv. Agrees to implement effective language access services to meet the needs of their limited-English-proficient consumers, and/or deaf and hard-of-hearing consumers and increase their access to behavioral health care by providing sign language, translation, and interpretive services required to meet the communication needs of consumers, including English, Spanish and Creole. Services will meet the cultural needs and preferences of the populations served. (d) Integration of Behavioral Health and the Child Welfare System i. The Network Provider will ensure that behavioral health services are available to consumers referred by the Community Based Care Organizations (CBC) or by the Department's Child Protective Investigators in cases where behavioral health indicators are present during the initial child abuse/neglect investigation or at any point during child protective supervision or out-of-home care. Priority will be given to cases where a child is at risk for immediate removal or has been removed from the family, with a goal of reunification in the family safety plan. Services may also be provided for the enrolled parent(s)'/caregiver(s)'family members, household residents, or significant others in need of behavioral health prevention or treatment services, as well as children in relative placements. For a detailed description of the consumer eligibility criteria please refer to the approved Motivational Support Program Protocols and Family Intensive Treatment Team Protocols, herein incorporated by reference and available upon request to the MEs Contract Manager. ii. The coordination of efforts between the CBC,the ME and Network Providers is essential to the efficient service delivery for child-welfare involved families in behavioral health treatment. The ME and the Southern Region's Lead Agency for Community-Based Care are committed to developing an integrated system of care that meets the needs of children and their families as there is significant overlap between consumers. Network Providers will be implementing the Child Welfare Integration (CWI) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the CWI initiative. Revised Attachment I HCO2 (f) Page 19 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'Pi-A, Behavioral Health Network,Inc. j t;;'2019 As part of the plan or component of the plan must include the following: 1. Identification of at least two CWI Champions who will attend trainings and meetings. The names of the CWI Champions will be submitted upon request by ME staff. In the event of change in staff occur, the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days. 2. Participation in the CWI meetings to develop the process for identifying and responding to child-welfare involved families. 3. Attendance at trainings regarding CWI when notified by the ME. Attendance applicable trainings will be documented in the Continuous Quality Improvement Updates. 4. Participation in all CWI related activities to ensure staff and agency become knowledgeable of the Child Welfare system. (e) Mandatory Accreditation Accreditation by an accrediting organization recognized by the Department, as required by Chapter 397, F.S., is a requirement for licensure renewal of clinical substance abuse treatment services. The licensable substance abuse treatment components are listed in subsection 65D- 30.002 (17), F.A.C. Network Provider applicants for licensure and licensed network providers must meet the most current best practice standards related to the licensable service components of the accrediting organization. For a list of accrediting organizations recognized by the Department visit the following website: http://www.myflfamilies.com/service-programs/substance-abuse/licensure-regulation The Network Provider shall take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2020, as required by this section, in order to promote best practices and the highest quality of care. The Network Provider shall provide the ME with their full accreditation and licensing reports upon request. Failure to meet the accreditation requirements will be considered by the ME to be a breach of this Contract and this contract may be subject to termination. (17) Continuous Quality Improvement Updates The Network Provider shall submit semi-annual updates, by the dates specified in Exhibit C, Required Reports, on the implementation and progress of the following activities: Revised Attachment I HCO2 (f) Page 20 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 (a) Integration of Behavioral Health Services and Primary Care; (b) Trauma Informed Care; (c) Cultural and Linguistic Competence initiative; (d) Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; (e) Mandatory Accreditation Requirements: Monitoring processes to ensure that all licensable substance abuse treatment components funded by this Contract meet the most current best practice standards related to the licensable service components of the accrediting organization,as required by Rule 65D-30.003(2), F.A.C., Department Licensing and Regulatory Standards; (f) Recovery-oriented system of care principles; (g) Evidence of the implementation of the integration of behavioral health services and primary health care, evidence of tracking and ensuring the successful referrals and linkages of consumers of behavioral health services to primary health care services and consumers referred from the primary health care provider to the Network Provider for behavioral health services, and include progress on the implementation as described in the Network Provider's action plan to include the following: • The number of behavioral health consumers identified as needing primary care. • Number of successful linkages to primary care. (18) Care Coordination and Reporting Requirements If requested by the ME, the Network Provider shall participate and comply with Care Coordination activities as defined in section 394.4573(1)(a), F.S. (19) Program Status Report The Network Provider shall submit an annual detailed report of the services and activities performed and the progress of the Program in meeting the performance measures, goals, objectives and tasks as described in Attachment V, Scope of Work. The report shall be submitted by the due date specified in Exhibit C, Required Reports. (20) PPG Specific Financial Report The Network Providers shall submit a quarterly detailed financial report of Program Expenses which are used to track all expenses associated with this Contract and reconcile these expenditures with the payments made to the Network Provider by the dates specified in Exhibit C, Required Reports. The financial reports track both grant award-funded and match Revised Attachment I HCO2 (f) Page 21 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 funded expenses and encourages expenditure planning and projection. Pursuant to Rule 65E- 14.021, F.A.C.,the Network Provider shall use the Department's form CF-MH 1037. The form CF-MH 1037 and the corresponding instructions are available at the following website: https://eds.myfifamilies.comZDCFFormslnternet/SearchZDCFFormSearch.aspx (21) Financial Audit Reports (a) The Network Provider shall submit quarterly financial statements consisting of Balance Sheet and Statement of Activity (income statement) per the schedule and to the individual(s) identified in the Exhibit C, Required Reports. The Network Provider agrees to provide the ME with any requests for additional financial statements/documentation. (b) Network Providers who withhold income taxes, social security tax, or Medicare tax from employee's paychecks or who must pay the employer's portion of social security or Medicare tax must use Form 941, Employer's Quarterly Federal Tax Return, to report those taxes. On a quarterly basis, and by the dates specified in Exhibit C, Required Reports, the Network Provider, shall submit an attestation that the 941 has been filed timely and any taxes due have been paid timely to IRS. (c) The Network Provider shall complete and submit the Department-approved Local Match Calculation Form, per the schedule and to the individual(s) identified in the Exhibit C, Required Reports. The Department-approved Local Match Calculation Form, Template 9— Local Match Calculation Form is available at the following website: https://www.myflfamilies.com/service-programs/samh/managing-entities/2019- contract-docs.shtml (22) The Network Provider shall implement and maintain fiscal operational procedures.These shall contain but, not be limited to procedures relating to overpayments,charge-backs that directly apply to subcontractors and documentation of cost sharing(match) that comply with state and federal rules, regulations and/or ME policies and procedures and shall comply with the requirements in Section 7., Audits, Inspections, Investigations, Records, and Retention. (23) The Network Provider shall maintain in one place for easy accessibility and review by ME and/or Department staff all policies,procedures,tools,and plans adopted by the Network Provider. The Network Provider's policies, procedures,and plans must conform to state and federal laws, the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/requirements contained in applicable Department of Children and Families and ME operating procedures. Revised Attachment I HCO2 (f) Page 22 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (24)The Network Provider shall maintain a mechanism for monitoring, updating, and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations, and the ME's policies and procedures. (25) The Network Provider shall make available upon request all plans, policies, procedures, and manuals to ME staff, Department staff, Network Provider staff, and to consumers/stakeholders if applicable and appropriate. (26) The Network Provider shall comply with Children and Families Operating Procedure 215-8, OVERSIGHT OF HUMAN SUBJECT RESEARCH AND INSTITUTIONAL REVIEW BOARD DESIGNATION. The policy and guidance can be found at: http://www.dcf.state.fl.us/admin/publications/policies/215-8.pdf Approval from the Department through the ME is mandatory for all research conducted by any employee, contracted organization or individual, or any public or private vendor, even if the aforementioned has their own Institutional Review Board which has granted approval. (27) The Network Provider shall participate in the State's Peer Review process,when implemented, to assess the quality, appropriateness, and efficacy of services provided to individuals pursuant to 45 CFR 96.136. (28) The Network Provider shall attend required trainings and/or meetings as required by the ME, meet with the ME's staff at regularly scheduled or specially called meetings when notified by the ME. (29) Develop and Disseminate Consumer Manual The Network Providers shall assist the ME in developing and maintaining a manual for service recipients which includes information about access procedures, recipient rights and responsibilities(including grievance and appeal procedures). This information will be available for use by the consumers within each subcontractor location. (30) Work and Social Opportunities for Peer Specialists Nationwide, health systems have accepted peers as a valuable part of the workforce. A shift to a more person-centered approach, a focus on integrated health, and a demand for more workers have increased the role peer specialists play in Florida's mental health and substance abuse systems. In keeping with Florida's goal of increasing the number of peer specialists, The Network Provider is encouraged to provide employment and social opportunities to individuals who have lived experience of mental health and/or substance use condition and/or lived experience of trauma. Revised Attachment I HCO2 (f) Page 23 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (31) Assist Stakeholder Involvement in Planning,Evaluation,and Service Delivery (a) At the ME's request, the Network Provider will assist the ME in engaging local stakeholders, per section 394.9082 F.S., in its support activities for the Department's local plans. (b) The Network Provider shall work with the ME to provide performance, utilization, and other information for the Department's Substance Abuse and Mental Health Services Plan, and annual updates thereof, and to provide appropriate information for the Department's Long-Range Program Plan and its Annual Business Plan. (32) Develop,Maintain and Improve Reporting The Network Provider shall submit reports included in Exhibit C, Required Reports. The Network Provider agrees to submit ad hoc and additional reports as determined by the ME and/or the Department. In all cases, the delivery of reports, ad hoc or scheduled, shall not be construed to mean acceptance of those reports. Acceptance, in writing, of required reports shall constitute a separate act and shall be approved by the ME's Contract Manager. The ME reserves the right to reject reports as incomplete, inadequate or unacceptable. (33) Consumer Satisfaction Survey The Network Provider shall conduct satisfaction surveys of individuals served pursuant to FASAMS DCF Pamphlet 155-2. The Network Provider shall utilize a Department-approved satisfaction survey instrument. Failing to provide the required number of satisfaction surveys and/or utilizing a survey instrument other than that approved by the Department will result in a corrective action and an imposed financial penalty. (34) Department-Sponsored Surveys The Network Provider must participate in any Department-sponsored satisfaction surveys. (35) If requested by the ME, the Network Provider agrees to assist in the development and implementation of the Care Coordination and Utilization Management (UM) System and shall maintain the capacity to perform the following functions including, but not limited to: (a) ME-approved automated, standardized, and screening and assessment instruments to improve proper evaluation and placement of individuals; (b) Automated referral and electronic consent for release of confidential information with the ME and other Network Providers, to the extent permitted by law; Revised Attachment I HCO2 (f) Page 24 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Behavioral Health Network,Inc. j t;;'2019 (c) Integrated processes for intake, admission, discharge and follow-up; (d) Encounter and progress notes to support all services provided under this contract and that automatically generate state and Medicaid billing and payment in the event Medicaid compensable services are provided to individuals eligible for Medicaid; (e) Utilization management, including but not limited to Wait Lists and capacity management; (f) Determination of financial and clinical eligibility of Individuals Served; (g) Processes to ensure the Department is the payer of last resort; (h) Electronic capability for billing, invoice payment and claims adjudication, and/or Medicaid billing and payment(HIPAA 837 and 835 Transactions); (i) Automated processes for state and federal data analysis and reporting; and (j) Full compliance with federal and state laws, rules and regulations pertaining to security and privacy of protected health information. b. Task Limits The Network Provider shall perform services in accordance with applicable, rules, statutes, licensing standards and policies and procedures. The Network Provider agrees to abide by the approved Program Description, and is not authorized by the ME to perform any tasks related to the project other than those described in the approved Program Description and in this contract, without the express written consent of the ME. The Network Provider shall ensure that services are performed in accordance with applicable rules, statutes, and licensing standards. 2. Staffing Requirements a. Staffing Levels (1) The Network Provider shall maintain staffing levels in compliance with applicable rules, statutes, licensing standards and policies and procedures. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations. Revised Attachment I HCO2 (f) Page 25 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 (2) The Network Provider shall engage in recruitment efforts to maintain as much as possible staff with the ethnic and racial composition of the consumers served. The ME, at its sole discretion may request documentation evidencing recruitment efforts. b. Professional Qualifications (1) The Network Provider shall comply with applicable rules, statutes, requirements, and standards with regard to professional qualifications. See Exhibit F, SAMH Programmatic State and Federal Laws,Rules,and Regulations and the requirements specified in Sections 43-45.of the Standard Contract. (2) The Network Provider shall provide employment screening for all mental health personnel and all chief executive officers, owners, directors, and chief financial officers of service Network Providers using the standards for Level II screening set forth in Chapter 435, and s. 408.809 F.S., except as otherwise specified in s. 394.4572(1)(b)-(d), F.S. For the purposes of this contract, "Mental health personnel" includes all program directors, professional clinicians, staff members, and volunteers working in public or private mental health programs and facilities who have direct contact with individuals held for examination or admitted for mental health treatment. (3) Additionally, the Network Provider shall provide employment screening for substance abuse personnel using the standards set forth in Chapter 397.451, F.S., Background Checks for Service Provider Personnel. "All owners, directors, and chief financial officers of service providers are subject to level 2 background screening as provided under chapter 435. All service provider personnel who have direct contact with children receiving services or with adults who are developmentally disabled receiving services are subject to level 2 background screening as provided under chapter 435. A volunteer who assists on an intermittent basis for fewer than 40 hours per month and is under direct and constant supervision by persons who meet all personnel requirements of this chapter is exempt from fingerprinting and background check requirements." (4) Network Providers who have programs for children are required to meet the requirements of s. 39.001(2), (a) and (b) F.S which states the following: (a) A Network Provider that contracts for any program for children, all personnel, including owners, operators, employees, and volunteers, in the facility must be of good moral character. A volunteer who assists on an intermittent basis for less than 10 hours per month need not be screened if a person who meets the screening requirement of this section is always present and has the volunteer within his or her line of sight. (b) Employment screening and rescreening no less frequently than once every 5 years, pursuant to chapter 435, using the level 2 standards set forth in that chapter for personnel in programs for children or youths. c. Staffing Changes Revised Attachment I HCO2 (f) Page 26 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 The Network Provider shall notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding the positions of Chief Executive Officer, Chief Financial Officer, Medical Director, and Clinical Director, IT Director, Dispute Resolution Officer, Data Security Officer, Single Point of Contact in accordance with Section 504 of the Rehabilitation Act of 1973 as required by Paragraph 33. of the Standard Contract, or any individuals with similar functions. Additionally, the Network Provider will notify the ME's Contract Manager in writing, of changes in the Executive Director or any senior management position. d. Subcontractors (1) This contract allows the Network Provider to subcontract for the provision of services related to the performance required under this Contract, subject to the provisions relating to Assignments and Subcontracts in the Standard Contract and referenced therein. Written requests by the Network Provider to subcontract for the provision of services under this contract will be routed through the ME's Contract Manager for approval.The ME is not obligated nor will it pay for any services delivered prior to its written approval of the act of subcontracting. The act of subcontracting shall not in any way relieve the Network Provider of any responsibility for the contractual obligations of this contract.The pre-approval process applies to Subcontractors and not Independent Contractors as defined below. (2) The ME has adopted the following definitions for vendors, subcontractors and/or independent contractors who are contracted by the Network Provider to do work contemplated under this contract: (a) Vendor: A person or company offering something for sale. (b) Subcontractor: A business to business relationship; contracting a business or person outside of one's own company to do work as part of a larger project. (c) Independent Contractor: a person who is in an independent trade, business, or profession in which they offer their services and/or expert advice to an individual or organization. The general rule is that an individual is an independent contractor if the payer has the right to control or direct only the result of the work and not what will be done and how it will be done. The earnings of a person who is working as an independent contractor are subject to Self-Employment Tax. (3) The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non- profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. Revised Attachment I HCO2 (f) Page 27 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 While the above-referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916 (a)(5), and 45 CFR, Part 96.135(a)(5)]. (4) Any vendor, subcontractor, or independent contractor the Network Provider contracts to do work contemplated under this contract, and who meets the definition of a Business Associate as defined in 45 CFR 160.103, must sign a legally binding document with the Network Provider that contains the same restrictions and conditions of the Business Associate Agreement between the Network Provider with the ME. The binding document must meet the requirements of 45 CFR s.164.504(e), Standard: Business Associate Contracts, the Privacy Rule, the Security Rule, the Breach Notification Rule, the Health Information Technology for Economic and Clinical Health ("HITECH") Act, the provisions included in the Network Provider's Business Associate Agreement with the ME, the ME's contractual requirements, and other laws and regulations pertaining to access, use, disclosure, and management of Protected Health Information ("PHI") without limitation, PHI in an electronic format (EPHI) created, received, maintained, or transmitted by the Network Provider or its subcontractors incidental to Network Provider's performance of this Contract. (5) All agreements, for services contemplated under this contract, shall adopt the applicable terms and conditions of the Network Provider's contract with the ME, including but not limited to, any Federal block grant requirements. In addition, all subcontract agreements shall contain the applicable terms and conditions, and any amendments thereto,found in the ME's contract with the Department (Prime Contract), which is incorporated herein by reference. Subcontract agreements shall include a detailed scope of work; term of the agreement, method of payment, clear and specific deliverables; and performance standards. (6) The Network Provider shall maintain individual subcontractor files for each subcontractor and provide a copy of all subcontract's agreements prior to the execution of those subcontracts and any amendments to the ME's Contract Manager. (7) All independent contractor agreements, and subcontractor agreement, vendor agreements, and business associate agreements, or other legally binding agreements, for work contemplated under this contract shall be available upon request by ME staff and at the time of monitoring. (8) The Network Provider shall implement and maintain procedures for subcontract procurement, development, performance, and management that comply with state and federal rules, regulation, and/or ME policies and procedures, in addition to identifying the ME's pre-approval process for approving the Network Providers act of subcontracting. (9) The Network Provider shall not subcontract for substance abuse/mental health services Revised Attachment I HCO2 (f) Page 28 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 with any person, entity,vendor, purchase orders or any like purchasing arrangements that: (a) is barred, suspended, or otherwise prohibited from doing business with any government entity, or has been barred, suspended, or otherwise prohibited from doing business with any government entity in accordance with s. 287.133. F.S.; (b) is under investigation or indictment for criminal conduct,or has been convicted of any crime which would adversely reflect on their ability to provide services,or which adversely reflects their ability to properly handle public funds; (c) has had a contract terminated by the department or ME for failure to satisfactorily perform or for cause; (d) has failed to implement a corrective action plan approved by the ME, the department, or any other governmental entity, after having received due notice, or (e) is ineligible for contracting pursuant to the standards in s. 215.1473(2), F.S. (10) Regardless of the amount of the subcontract, the Network Provider must immediately terminate a subcontract for cause, if at any time during the lifetime of the agreement/subcontract, a person, entity, vendor, purchase orders or any like purchasing arrangements, is: (a) Found to have submitted a false certification under s. 287.135, F.S., (b) Placed on the Scrutinized Companies with Activities in Sudan List or (c) Placed on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or (d) Placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel (11) Unless the Department agrees to an alternative payment method as authorized in section 394.9082, F.S., and prior to entering into any subcontract, or an amendment which modifies the previously negotiated unit cost rate or adds additional Covered Services, the Network Provider shall conduct a cost analysis for said subcontract, in accordance with Rule 65E-14. F.A.C. A cost analysis is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. Subcontractors will be required to comply with Rule 65E-14, F.A.C., Unit Cost Method of Payment, including but not limited to, Covered Services, unit measurements, descriptions, program areas, data elements, maximum unit cost rates, required fiscal reports, program description, setting unit cost rates, payment for services including allowable and unallowable units and requests for payments. (12) The Network Provider shall monitor the performance of all subcontractors and perform follow up actions as necessary. The Network Provider shall notify the ME immediately upon discovery hours of conditions related to subcontractor performance that could impair continued service delivery. Revised Attachment I HCO2 (f) Page 29 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 3. Service Location and Equipment a. Service Delivery Location The location of services will be as specified in the approved Program Description required by Rule 65E-14, F.A.C. b. Service Times (1) A continuum of services shall be provided on the days and times as specified in the approved Program Description Attachment V,Scope of Work. (2) The Network Provider shall notify the M E's Contract Manager, in writing, at least ten (10) calendar days prior to any changes in days and times where services are being provided pursuant to Rule 65E-14, F.A.C. c. Changes in Location The Network Provider shall notify the M E's Contract Manager, in writing, at least ten(10)calendar days prior to any changes in location where services are being provided pursuant to Rule 65E-14, F.A.C. d. Equipment The Network Provider shall furnish all appropriate equipment necessary for the effective delivery of the services purchased. In the event that the Network Provider is allowed to purchase any non-expendable property with funds under this contract, the Network Provider will ensure compliance with the Tangible Property Requirements, Department operating Policies and Procedures as outlined in CFOP 40-5, CFOP 80-2, Rule 65E-14, F.A.C., which are incorporated herein by reference and may be obtained from the ME's Contract Manager. The provider shall submit an inventory report, as specified in the Network Provider Inventory List, incorporated herein by reference, and by the date(s) listed in Exhibit C, Required Reports. The Network Provider Inventory List form may be requested from ME Contract Manager. 4. Deliverables a. Services The Network Provider shall deliver the services specified in and described in the Program Description submitted by the Network Provider and as set forth in Exhibit G,Covered Service Funding by OCA and in Attachment V,Scope of Work. b. Records and Documentation The Network Provider shall protect confidential records from disclosure and protect consumer confidentiality in accordance with ss. 397.501(7), 394.455(6), 394.4615, and 414.295, F.S., and also the Revised Attachment I HCO2 (f) Page 30 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 Health Insurance Portability and Accountability Act(HIPAA),42 CFR Part 2,and any other applicable State, and Federal laws, rules, and regulations. c. Reports Where this contract requires the delivery of reports to the ME, mere receipt by the ME shall not be construed to mean or imply acceptance of those reports. It is specifically intended by the parties that acceptance of required reports shall require a separate act in writing. The ME reserves the right to reject reports as incomplete, inadequate, or unacceptable according to the parameters set forth in the resulting contract. The ME, at its sole option, may allow additional time within which the Network Provider may remedy the objections noted by the ME or the ME may, after having given the Network Provider a reasonable opportunity to comply with the report requirements,declare this agreement to be in default. (1) The Network Provider shall submit to the M E financial and programmatic reports specified in Exhibit C,Required Reports, by the dates specified or as requested by ME staff. (2) Upon request, the network provider shall submit to the ME and the Department information regarding the amount and number of services paid for by the Substance Abuse Prevention and Treatment Block Grant. (3) The Network Provider shall provide performance information or reports other than those required by this agreement at the request of the ME, the Southern Region's SAMH Regional Director, or their designee. For requests that are complex and difficult to address, all parties will develop and implement a mutually viable work plan. (4) The Network Provider shall ensure that its audit report will include the standard schedules that are outlined in Rule 65E-14, F.A.C. and submitted within the timeframes specified in Exhibit C, Required Reports. (5) The Network Provider shall submit prevention services data to PBPS, maintained by Collaborative Planning Group Systems, Inc. and/or any other data reporting mechanism as directed by the ME. The data shall be submitted electronically no later than the 4th of each month following the month of service. The Network Provider shall also: (a) Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract. (b) Ensure that one-hundred percent (100%) of all data submitted to PBPS and/or any other data reporting mechanism as directed by the ME is consistent with the data maintained in the Network Providers service documentation and or/consumer files. (c) The Network Provider will accurately report the performance measures specified in Attachment V,Scope of Work. Revised Attachment I HCO2 (f) Page 31 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (d) Resubmit corrected records no later than the next monthly submission deadline. The failure to submit any data set orthe Network Provider's total monthly submission per data set,which results in a rejection rate of 5% or higher of the number of monthly records submitted will require the Network Provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected records will be corrected and resubmitted; and (e) Upon submission of the monthly data,the Network Provider's Director of Prevention/Supervisor, shall send an e-mail to the ME's Director of Prevention Services and any other ME staff, attesting that the data submitted has been reviewed and approved. Refer to Attachment V, Scope of Work for instructions. (f) In accordance with the provisions of section 402.73(1), F.S.,and Rule 65-29.001, F.A.C.,corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties maybe imposed for failures to implementor to make acceptable progress on such corrective action plans. Failure to implement corrective action plans to the satisfaction of the ME and after receiving due notice, shall be grounds for contract termination. (6) Upon request, the Network Provider shall submit to the ME and/or the Department, information regarding the amount and number of services paid for by Substance Abuse Prevention and Treatment Block Grant. 5. Performance Specifications a. Performance Measures (1) The Network Provider shall meet the performance standards and required outcomes as specified in Exhibit D,Substance Abuse and Mental Health Required Performance Outcomes/Outputs and as outlined in Attachment V, Scope of Work. (2) The Network Provider agrees that the PBPS, Collaborative Planning Group Systems, Inc., KIS, FASAMS, SAMHIS,or other data reporting system designated by the ME, will be the source for all data used to determine compliance with performance standards and outcomes in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. PBPS maintained by Collaborative Planning Group Systems, Inc. Any conflicts will be clarified by the ME and the Network Provider shall adhere to the ME's resolution. The Network Provider shall submit all service related data for consumers funded in whole or in part by SAMH funds, local match, or Medicaid. b. Performance Measurement Terms FASAMS DCF Pamphlet 155-2, provides the data files and file layout requirements for collecting and reporting data on persons served in state-contracted community substance abuse and mental health Network Provider agencies. The elements used for various performance measures which are Revised Attachment I HCO2 (f) Page 32 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 quantitative indicators, outcomes, and outputs used by the ME to objectively measure a Network Provider's performance and contains policies and procedures for submitting the required data. Collaborative Planning Group Systems, Inc., or any other data system designated by the ME and/or the Department, maintains the procedures for submitting the required prevention data into PBPS.The ME will also monitor the Network Provider for the performance measures. c. Performance Evaluation Methodology (1) The Network Provider shall collect information and submit performance data and individual consumer outcomes, to the ME data system in compliance with FASAMS DCF Pamphlet 155-2 requirements. The specific methodologies for each performance measure may be found at the following website: https://www.myflfamilies.com/service-programs/samh/155-2/pamphlet-155-2-v13.shtml (2) The Network Provider is expected to have the capability to engage in organized performance improvement activities, and to be able to participate in partnership with the department and ME in performance improvement projects that are related to system wide transformation and improvement of services for individuals and families. (3) By execution of this contract the Network Provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth in this contract. If the Network Provider fails to meet these standards, the ME, at its exclusive option, may allow a reasonable period, not to exceed six(6) months, for the Network Provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the ME within the prescribed time and if no extenuating circumstances can be documented by the Network Provider to the ME's satisfaction,the ME must terminate the contract. The ME has the sole authority to determine whether there are extenuating or mitigating circumstances. (4) The ME will monitor the standards and outcomes specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs,the standards and outcomes and in Attachment V, Scope of Work., during the contract period, to determine if the Network Provider is achieving the levels that are specified. (5) Substance abuse prevention data information may be found on the Exhibit D Report which is transmitted to the ME Director of Prevention Services, as requested. 6. Network Provider Responsibilities a. Network Provider Unique Activities (1) The Network Provider shall adhere to the deliverables as set forth in Attachment V, Scope of Work. Revised Attachment I HCO2 (f) Page 33 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (2) In the event of a dispute as to the ME's determination regarding consumer eligibility and/or placement into the appropriate level of care,the ME's dispute resolution process, as described in the Standard Contract shall be followed. An eligibility dispute shall not preclude the provision of services to Individuals Served, unless the dispute resolution process reverses the ME's determination. (3) The Network Provider is responsible for the satisfactory performance of the tasks referenced in this contract. By executing this contract, the Network Provider recognizes its responsibility for the tasks, activities, and deliverables described herein and warrants that it has fully informed itself of all relevant factors affecting the accomplishment of the tasks, activities and deliverables and agrees to be fully accountable for the performance thereof whether performed by the Network Provider or its subcontractors. (4) The Network Provider agrees that services other than those set out in this contract will be provided only upon receipt of a written authorization from the ME's Contract Manager or an authorized ME staff member. The department through the ME has final authority to make any and all determinations that affect the health safety and well-being of the residents of the State of Florida. (5) The Network Provider shall be responsible for the fiscal integrity of all funds under this contract, and for demonstrating that a comprehensive audit and tracking system exists to account for funding by consumer and have the ability to provide an audit trail. The Network Provider's financial management and accounting system must have the capability to generate financial reports on individual service recipient utilization, cost, claims, billing, and collections for the ME. The Network Provider must maximize all potential sources of revenue to increase services, and institute efficiencies that will consolidate infrastructure and management functions in order to maximize funding. (6) The Network Provider shall ensure that the invoices submitted to the ME reconcile with the amount of funding and services specified in this contract, as well as the Network Provider's agency audit report and consumer information system and reconciled with KIS, PBPS,or other data reporting system designated by the ME. (7) The Network Provider shall make available source documentation of units billed by Network Provider upon request from the ME staff. The Network Provider shall track all units billed to the ME by program and by Other Cost Accumulator(OCA). (8) A Network Provider that receives federal block grant funds from the Substance Abuse Prevention and Treatment or Community Mental Health Block Grants agrees to comply with Subparts I and II of Part B of Title XIX of the Public Health Service Act,s.42 U.S.C.300x-21 et seq. (as approved September 22, 2000) and the Health and Human Services (HHS) Block Grant regulations (45 C.F.R. Part 96). (9) A Network Provider that receives funding from the SAPTBG certifies compliance with all of the requirements of the Substance Abuse and Mental Health Services Administration (SAMHSA) Charitable Choice provisions and the implementing regulations of 42 C.F.R. s. 54a. Revised Attachment I HCO2 (f) Page 34 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (10) A Network Provider that receives block grant funding shall monitor its compliance with block grant requirements and activities. (11) A Network Provider that receives block grant funding shall comply with state or federal requests for information related to block grant. (12) A Network Provider that receive CMH block grant funding and have been designated as a prevention provider for the purposes of H.R. Res. 3547, 113th Cong. (2014) (enacted), compliance with federal requirements. (13) None of the funds provided under the following grants may be used to pay the salary of an individual at a rate in excess of Level II of the Executive Schedule: Block Grants for Community Mental Health Services, Substance Abuse Prevention and Treatment Block Grant, Projects for Assistance in Transition from Homelessness, Project Launch, Florida Youth Transition to Adulthood; and Florida Children's Mental Health System of Care Expansion Implementation Project. (14) Any compensation paid for an expenditure subsequently disallowed as a result of the Managing Entity's or any Network Service Providers' non-compliance with state or federal funding regulations shall be repaid to the Department upon discovery. (15) The Network Provider shall make available to the ME and the Department all records pertaining to service delivery. These records shall be made available at all reasonable times for inspection, review, copying, or audit. Service delivery records include but are not limited to, invoicing, fiscal management, data management, incident reporting, consumer records, and such documents determined to assure accountability of service provision and/or the expenditure of state and federal funds. (16) The Network Provider shall assist the ME and the Department in developing legislative budget requests based upon identified needs of the community. (17) The Network Provider shall provide to the ME, copies of, including but not limited to, evaluations, assessments, surveys, monitoring reports that pertain to licensure, accreditation, or other administrative or programmatic review, when those reports identify deficiencies that require corrective action.The Network Provider shall submit to the ME all of the applicable reports, including copies of the corrective action plan(s)within ten(10)calendar days of receipt by the Network Provider from the reviewing entity. (18) The Network Provider shall cooperate with the ME and the Department when investigations are conducted regarding a regulatory complaint of the Network Provider. When additional information or documentation is requested by the ME, the Network Provider will submit the information within twenty-four(24) hours of the request unless otherwise specified in the ME's request. (19) The Network Provider shall maintain human resource policies and procedures that provide safeguards to ensure compliance with laws, rules and regulations. Integrate current and/or new state/federal requirements and policy initiatives into its operations upon provision by the Department and/or ME of the same. Revised Attachment I HCO2 (f) Page 35 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 (20) The Network Provider shall maintain in one place for easy accessibility and review by ME and/or Department staff all policies, procedures, tools, and plans adopted by the Network Provider. The Network Provider's policies, procedures,and plans must conform to state and federal laws,the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/ requirements contained in applicable Department of Children and Families and ME operating procedures. (21) The Network Provider shall maintain a mechanism for monitoring, updating, and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations, and the ME's policies and procedures. (22) Pursuant to s. 394.74(3)(e), F.S., the Network Provider shall maintain data on the performance standards specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes and Outputs,for the types of services provided under this contract. (23) The Network Provider shall comply with all other applicable federal laws, state statutes and associated administrative rules as may be promulgated or amended. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations, and ME policies and procedures. (24) Records relating solely to actions taken in carrying out the requirements of this contract and records obtained by the ME and/or the Department to determine a Network Provider's compliance with this section are confidential and exempt from s. 119.07(1) and s. 24(a), Access to Public Records and Meetings, Article. I, Constitution of the State of Florida. Such records are not admissible in any civil or administrative action except in disciplinary proceedings by the Department of Health or the appropriate regulatory board, and are not part of the record of investigation and prosecution in disciplinary proceedings made available to the public by the Department of Health or the appropriate regulatory board. Meetings or portions of meetings of continuous quality improvement program committees that relate solely to actions taken pursuant to this section are exempt from s.286.011.F.S. b. Coordination with other Providers/Entities (1) The Network Provider shall develop, maintain,and improve coordination and integrated care systems as follows: (i) Partnerships and collaborations with other community organizations/entities is expected to add value to the programs, services, strategies and community activities funded under this Contract. (ii) The Network Provider agrees to fulfill their designated role in implementing and/or maintaining a system of care in support of the Southern Region's SAMH Program Office's approved working agreement with the Department's contracted Community Based Care (CBC) providers. The intent of the working agreement is to establish a formal linkage of partnerships with a shared vision for improving outcomes for families involved in the child welfare system by providing integrated community support and Revised Attachment I HCO2 (f) Page 36 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 services. (iii) The Network Provider may be required to enter into agreements with other external stakeholders (2) The failure of other providers or entities does not relieve the network provider of any accountability for tasks or services that the Network Provider is obligated to perform pursuant to this contract. c. State and Federal Laws, Rules, and Regulations See Exhibit F,SAMH Programmatic State and Federal Laws, Rules, and Regulations 7. Managing Entity Responsibilities a. Managing Entity Obligations (a)The ME shall only subcontract with entities that are fiscally sound, and that can adequately ensure the accountability of public funds. (b)The ME shall assess the Network Provider's financial stability, using a risk assessment approach; the risk assessment approach will examine the impact of programmatic requirements on the Network Provider's financial stability. Any issues identified as a result of the financial risk assessment shall be reported to the Department during the quarterly/monthly reconciliation and performance review identified in the Prime Contract. (c)The ME will provide administrative and programmatic oversight to ensure that the Network Provider comply with all consumer-related services and other requirements of this contract. (d)The ME is solely responsible for the oversight of the Network Provider and enforcement of all terms and conditions of this contract. Any and all inquiries and/or issues arising under this contract are to be brought solely and directly to the ME for consideration and resolution between the Network Provider and the ME. In any event, the ME's decision on all issues is final and solely subject to the ME's appeal process and legal rights of the Network Provider. (e)The ME reserves the right terminate this contract in whole or in part,for non-performance as determined by the ME and to procure the services purchased through this contract to another entity and/or Network Provider. (f) The ME is responsible for the administration, management, and oversight, and through subcontracts, the provision of behavioral health services in Miami Dade and Monroe Counties. Revised Attachment I HCO2 (f) Page 37 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 (g)The ME shall monitor and take action when necessary so that services which meet the standards defined herein will be provided throughout the contract period. (h)lf applicable, the ME will ensure that the Network Provider utilizes the approved consumer assessment and placement tool designated by the ME. Standardized tools and assessments approved by the ME must be used to determine placement and level of care. (i) The ME shall work with the Department to redirect administrative cost savings into improved access to quality care, promotion of service continuity, required implementation of EBPs, the expansion of the services array, and necessary infrastructure development. It acknowledges the benefits to be realized, include improved access to quality care, promotion of service continuity, implementation of EBPs, improved performance and outcomes, expansion of the service array, and necessary infrastructure development. b. Monitoring Requirements (1) The ME will monitor the Network Provider in accordance with this contract and the ME's Contract Accountability Policies and Procedures which can be obtained from the designated ME Contract Manager, and is incorporated herein by reference. The Network Provider shall comply with any coordination or documentation required by the ME's monitor(s) to successfully evaluate the programs, and shall provide complete access to all budget and financial information related to services provided under this contract, regardless of the source of funds. (2) Network Providers with electronic health record (EHR)or electronic medical record systems (EMR)shall provide access to ME funded service and consumer data contained in these systems to the ME's monitoring team and provide sufficient resources to facilitate the monitoring process of services provided under this contract. Resources is defined but is not limited to, personnel, terminals, guest read-only accounts, privileges for monitors to access consumer records, and/or remote access into the systems by the monitors. (3) The ME will monitor the Network Provider on its performance of all tasks and special provisions of the contract. (4) The ME will provide a written report to the Network Provider within thirty (30) calendar days of the conclusion of the monitoring. If the report indicates corrective action is necessary, the Network Provider shall have ten (10) calendar days from receipt of the monitoring report to respond in writing to the request. In the sole discretion of the ME, if there is a threat to health, life, safety or well-being of consumers,the ME may require immediate corrective action or take such other action as the ME deems appropriate. Failure to implement corrective action plans to the satisfaction of the ME and after receiving due notice, shall be grounds for contract termination in whole or in part. Revised Attachment I HCO2 (f) Page 38 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 c. Training and Technical Assistance (1) The ME's contact manager, or designee, will provide training and technical assistance concerning the terms and conditions of this contract and may maintain a documentation trail demonstrating any training and/or technical assistance efforts. (2)The ME will provide technical assistance and support to the Network Provider to ensure the continued integration of services and support for consumers, to include but not limited to, quality improvement activities to implement evidenced-based practice treatment protocols,the application of process improvement methods to improve the coordination of access and services that are culturally and linguistically appropriate. (3) The ME will provide technical assistance and support to the Network Provider for the maintenance and reporting of data on the performance standards that are specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. In addition, the ME may convene cross-organizational training and assistance to help non- accredited Network Providers become accredited. (4)The ME implements a training program for its staff and the Network Provider staff. The trainings assure that staff receives externally mandated and internal training. The ME may coordinate training or directly provide training to Network Provider staff. d. Managing Entity Determinations The ME has exclusive authority to make the following determination(s) and to set the procedures that the Network Provider shall follow in obtaining the required determination(s): (1) Whether the Network Provider is meeting the terms and conditions of this contract, to include the Standard Contract, Attachment I, any documents incorporated into any attachment by reference, Program Description, and any documents incorporated by herein by reference. (2) The ME reserves the exclusive right to make certain determinations in these specifications.The absence of the ME setting forth a specific reservation of rights does not mean that all other areas of this contract are subject to mutual agreement.The ME reserves the right to make exclusively any and all determinations that it deems are necessary to protect the best interests of the State of Florida and the health, safety, and welfare of the consumers who are served by the ME either directly or through any one of its contracted Network Providers. (3) In the event of any disputes regarding the eligibility of individuals served, the determination made by the ME is final and binding on all parties. C. Method of Payment Revised Attachment I HCO2 (f) Page 39 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 Exhibit B, Method of Payment Exhibit G,Covered Service Funding by OCA Exhibit H, Funding Detail and Local Match Monthly Payment Request(Incorporated herein by reference and available from the ME's Contract Manager D. Special Provisions 1. The Network Provider is expected to maintain its administration cost to 10.00%or less for Fiscal Year 2019-2020 for SAMH services purchased under this contract. The cost savings shall be reallocated to support the increase of direct services, improved access to quality care, promotion of service continuity, and the implementation and/or expansion in the use of evidence-based practices.The Network Provider's Projected Covered Service Operating and Capital Budget shall evidence the reduction and redistribution of the cost savings. 2. Intern Registration Requirements pursuant to section 491.0045, F.S. (a) The Network Provider shall monitor and ensure that an individual who has not satisfied the postgraduate or post-master's level experience requirements, as specified in s. 491.005(1)(c), (3)(c),or(4)(c), F.S., register as an intern in the profession for which he or she is seeking licensure before commencing the post-master's experience requirement or for an individual who intends to satisfy part of the required graduate-level practicum, internship, or field experience, outside the academic arena for any profession, the network provide must monitor and ensure that the individual registers as an intern in the profession for which he or she is seeking licensure before commencing the practicum, internship, or field experience. (b) An intern registration is valid for five (5)years. (c) A registration issued on or before March 31, 2017, expires March 31, 2022, and may not be renewed or reissued.Any registration issued after March 31, 2017, expires 60 months after the date it is issued. A subsequent intern registration may not be issued unless the candidate has passed the theory and practice examination described in s.491.005(1)(d), (3)(d),and (4)(d), F.S. (d) An individual who has held a provisional license issued by the board may not apply for an intern registration in the same profession. 3. Real-time Data Entry: When required by the Prime Contract, state and/or federal rules, regulations, or policies, the Network Provider shall submit to the ME real-time data in KIS Express, or other similar data Revised Attachment I HCO2 (f) Page 40 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 structure, for services purchased by this contract. The Network Provider agrees to implement the new data reporting system when notified and as directed by the ME. 4. Incident Reports a. The Network Provider shall submit incident reports into the Incident Reporting and Analysis System (IRAS) on all reportable incidents per CFOP 215-6, within one (1) business day of the incident occurring. In the event an incident has an immediate impact on the health or safety of a consumer, has potential media impact, or involves employee-related incidents of criminal activity, the Network Provider must notify the ME Risk and Compliance Coordinator immediately upon discovery. Certain incidents may warrant additional follow-up by the ME. Follow-up may include on-site investigations or requests for additional information or documentation. When additional information or documentation is requested, the Network Provider will submit the information requested by the ME within 24 hours unless otherwise specified in the request. It is the responsibility of the Network Provider to maintain a monthly log listing all incidents occurring at the agency, including those submitted to the Office of the Inspector General and those not reportable in IRAS, with the following information: Consumer's initials, incident report tracking number from IRAS(if applicable), incident report category, date and time of incident, and follow-up action taken. a. All Network Providers (inpatient and outpatient) will report seclusion and restraint events in SAMHIS (SANDR) and in accordance with Rule 65E-5.180(7)(g), F.A.C. 5. Mandatory Reporting Requirements a. The Network Provider and any subcontractor must comply with and inform its employees of the following mandatory reporting requirements. Each employee of the Network Provider, and of any subcontractor, providing services in connection with this contract who has any knowledge of a reportable incident shall report such incident as follows: 1) Reportable incidents that may involve an immediate or impending impact on the health or safety of a consumer shall be immediately reported to the Contract Manager; and 2) Other reportable incidents shall be reported to the ME and Department's Office of Inspector General by completing a Notification/Investigation Request (form CF 1934) and emailing the request to the Office of Inspector General at ig_complaints@dcf.state.fl.us. The Network Provider and subcontractor may also mail the completed form to the Office of Inspector General, 1317 Winewood Boulevard, Building 5, 2nd Floor,Tallahassee, Florida,32399-0700;or via fax at(850)488-1428. A reportable incident is defined in Children and Families Operating Procedures CFOP 180-4 (CFOP 180-4) Mandatory Reporting Requirements to The Office of The Inspector General, which can be obtained from the Contract Manager. Revised Attachment I HCO2 (f) Page 41 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 b. In the event of a breach or potential breach of Protected Health Information,the Network Provider is directed to the reporting requirements delineated in the executed Business Associate Agreement, incorporated herein by reference. 6. Service Provision Requirements for Substance Abuse Prevention and Treatment Block Grants a. As applicable, the Network Provider shall comply with the requirements set forth in 45 C.F.R. Subpart L—Substance Abuse Prevention and Treatment Block Grant and with the requirements of 42 C.F.R. Part 2. b. In accordance with 45 C.F.R. s. 96.131(b), the Network Provider that receive Block Grant funds and that serve injection drug users shall publicize the following notice: "This program receives federal Substance Abuse Prevention and Treatment Block Grant funds and serves people who inject drugs. This program is therefore federally required to give preference in admitting people into treatment as follows: 1. Pregnant injecting drug users; 2. Pregnant drug users; 3. People who inject drugs; and 4. All others." c. A Network Provider that receives SAPT block grant funding for the purpose of primary prevention of substance use, shall comply with 45 C.F.R. s. 96.125. d. Behavioral health services shall be provided to persons pursuant to s. 394.674, F.S., including those individuals who have been identified as requiring priority by state or federal law. The identified priority populations are found in Exhibit A, Consumer/Participants to be Served, however persons in categories (i) and (ii) below are specifically identified as persons to be given immediate priority over those in any other categories. These individuals may not be placed on a wait list without receiving interim services within the required timeframes. (i) Pursuant to 45 C.F.R. s. 96.131, priority admission to pregnant women and women with dependent children by Network Service Providers receiving SAPT Block Grant funding. If the clinically appropriate services cannot be provided for the pregnant woman, interim services, not later than forty (48) hours after the woman seeks treatment services, shall be provided pursuant to 45 C.F.R. s. 96.123; (ii) Pursuant to 45 C.F.R. s. 96.126 (b), (1) and (2), adherence with the requirement to provide interim services for injection drug users by Network Service Providers receiving SAPT Block Grant funding and until the clinically appropriate level of treatment can be provided to the individual as follows: 45 C.F.R. s. 96.126(b), (1)-(2)Capacity of treatment for intravenous substance abusers and any other requirement. (1) 14 days after making the request for admission to such a program;or (2) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services, including Revised Attachment I HCO2 (f) Page 42 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 referral for prenatal care, are made available to the individual not later than 48 hours after such request. e. Outreach Services to Injection Drug Users:The Network Provider shall carry out outreach activities to encourage injection drug users in need of treatment to undergo such treatment pursuant to the requirements in 45 C.F.R. s. 96.126(e).,The Network Provider shall document the services to demonstrate the provision of these services per the documentation requirements for Outreach services specified in Rule 65E-14, FAC. f. As required by 45 C.F.R.ss.96.17,the Network Provider may be requested to provide information to the ME for the purposes of reporting on SAPTBG activities to the Department g. The Network Provider shall ensure compliance with 45 C.F.R. Subpart C—Financial Management. h. The Network Provider must meet the invoicing requirements outlined in Exhibit B, Method of Payment. i. The Network Provider agrees to comply with the data submission requirements outlined in FASAMS DCF Pamphlet 155-2 and by the dates specified in Exhibit C, Required Reports. j. In addition to the modifiers to procedure codes that are currently required to be utilized as per FASAMS DCF Pamphlet 155-2, the Network Provider is directed to utilize the modifiers required for Block Grant funds, where applicable. The Network Provider also agrees to report to the ME and/or the Department, information regarding the amount and number of services paid for by the Community Mental Health Services Block Grant and/or the Substance Abuse Prevention and Treatment Block Grant. k. Only if such services are purchased through this contract is the Network Provider responsible for complying with the reporting requirements outlined in Exhibit AB, Substance Abuse Prevention and Treatment Block Grant (SAPTBG) Early Intervention Funded Services for Human Immunodeficiency Virus (HIV) by the dates and to the individual(s) listed in Exhibit C, Required Reports. Subject to other applicable state and/or federal requirements, the ME may require additional reports from the Network Provider. I. Only if such services are purchased through this contract is the Network Provider responsible for complying with the for SAPTBG set-aside funded services for pregnant women and women with dependent children services, SAPTBG set-aside funded services for HIV Early Intervention Programs and the SAPTBG set-aside funds for Evidenced-based Outreach Services to Injection Drug Users as outlined in Exhibit C, Required Reports. m. The Network Provider shall make available, either directly or by arrangement with others, tuberculosis services to include counseling, testing, and referral for evaluation and treatment pursuant to 45 C.F.R. s.96.17 and in compliance with Ch. 65D-30.004(9). F.A.C. n. The Network Provider shall use SAPTBG funds provided under this contract to support both Revised Attachment I HCO2 (f) Page 43 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 substance abuse treatment services and appropriate co-occurring disorder treatment services for individuals with a co-occurring mental disorder only if the funds allocated are used to support substance abuse prevention and treatment services and are tracked to the specific substance abuse activity as listed in Exhibit G,Covered Service Funding by OCA. o. The Network Provider is required to participate in the peer-based fidelity assessment process to assess the quality, appropriateness, and efficacy of treatment services provided to individuals under this contract pursuant to 45 C.F.R. 96.136. p. The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non-profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. While the above- referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916(a)(5), and 45 C.F.R., Part 96.135(a)(5)]. 7. The Network Provider agrees to maximize the use of state residents,state products,and other Florida- based businesses in fulfilling their contractual duties under this contract. 8. Option for Increased Services The Network Provider acknowledges and agrees that the contract may be amended to include additional, negotiated, services as deemed necessary by the ME. Additional services can only be increased if the Network Provider demonstrates competence in the provision of contractual services and meets whatever criteria are established by the ME from time to time. The ME in its sole discretion shall determine at what time and to which Network Provider and what amounts are to be given to Network Providers for additional services. 9. Sliding Fee Scale Prevention services are exempt from the Sliding Fee Scale requirements per Rule 65E-14.018, F.A.C. 10. Transportation Disadvantaged The Network Provider agrees to comply with the provisions of chapter 427, F.S., Part I, Transportation Services, and Chapter 41-2, F.A.C., Commission for the Transportation Disadvantaged, if public funds provided under this contract will be used to transport consumers. The Network Provider agrees to comply with the provisions of Children and Families Operating Procedures 40-50 (CFOP 40-5) Revised Attachment I HCO2 (f) Page 44 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 Acquisition of Vehicles For Transporting Disadvantaged Consumers if public funds provided under this contract will be used to purchase vehicles which will be used to transport consumers. 11. Medicaid Enrollment,if applicable Those Network Providers with SAMH contracts that meet Medicaid provider criteria and with funding in excess of $500,000 annually shall enroll as a Medicaid provider. This process shall be initiated within ninety (90) days of contract execution. A waiver of the ninety (90) day requirement may be granted, in writing, by the Department's Director of Substance Abuse and Mental Health Program Office,through the ME. 12. National Provider Identifier(NPI) (a) All network providers shall obtain and use an NPI, a HIPAA standard unique health identifier for health care providers. (b) An application for an NPI may be submitted online at https://n ppes.cros.h hs.gov/N PP ES/StaticForwa rd.do?forwa rd=static.n p ista rt. (c) Additional information can be obtained from one of the following websites: (1) The Florida Medicaid HIPAA located at: http://www.fdhc.state.fl.us/hipaa/index.shtmi (2) The National Plan and Provider Enumeration System (NPPES) located at: https://nppes.cros.hhs.gov/NPPES/Welcome.do (3) The CMS NPI located at: http://www.cros.hhs.gov/NationalProvldentStand/ 13. Ethical Conduct The Network Provider understands that performance under this contract involves the expenditure of public funds from both the state and federal governments, and that the acceptance of such funds obligates the Network Provider to perform its services in accordance with the very highest standards of ethical conduct. No employee, director, officer, agent of the Network Provider shall engage in any business, financial or legal relationships that undermine the public trust, whether the conduct is unethical,or lends itself to the appearance of ethical impropriety. Network Providers' directors, officers or employees shall not participate in any matter that would inure to their special gain, and shall recuse themselves accordingly. Public funds may not be used for purposes of lobbying, or for political contributions, or for any expense related to such activities, pursuant to Paragraph 20. of the Standard Contract of this contract. The Network Provider understands that the ME contracts with the department, and as a subcontractor, recognizes that the department is a public agency which is mandated to conduct business in the sunshine, pursuant to section 286.011, F.S., and chapter 119, Florida Law, and that all issues relating to the business of the department, the ME and the Network Provider are public record and subject to full disclosure. The Network Provider understands that Revised Attachment I HCO2 (f) Page 45 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 attempting to exercise undue influence on the ME, the department and its employees to allow deviation or variance from the terms of this contract other than a negotiated, publicly disclosed amendment, is prohibited by the State of Florida, pursuant to section 286.011, F.S. The Network Provider's conduct is subject to all state and federal laws governing the conduct of entities engaged in the business of providing services to government. 14. Information Technology Resources If applicable,the Network Providers must receive written approval from the ME prior to purchasing any Information Technology Resource (ITR)with contract funds. The Contract Manager is responsible for serving as the liaison between the Network Provider and the ME during the completion of the process as instructed by the Contract Manager. The Network Provider will not be reimbursed for any ITR purchases made prior to obtaining the ME's written approval. 15. Programmatic,Fiscal&Contractual Contract File References All of the documentation submitted by the Network Provider which may include, but not be limited to the Network Provider's original proposal, Program Description, Projected Covered Service Operating and Capital Budget, Agency Capacity Report and Personnel Detail Record, are herein incorporated by reference for programmatic, contractual and fiscal assurances of service provision These referenced contractual documents will be part of the Contract Manager's file. Documents incorporated by reference in this contract are available in the ME Contract Manager's file. 16. Employee Loans Funds provided by the ME to the Network Provider under this contract shall not be used by the Network Provider to make loans to their employees, officers, directors and/or subcontractors. Violation of this provision shall be considered a breach of contract and the termination of this contract shall be in accordance with the Paragraph 40. of the Standard Contract. A loan is defined as any advancement of money for which the repayment period extends beyond the next scheduled pay period. 17. Travel The Network Provider's internal procedures will assure that: travel voucher Form DFS-AA-15, State of Florida Voucher for Reimbursement of Traveling Expenses, incorporated herein by reference, be utilized completed and maintained on file by the Network Provider. Original receipts for expenses incurred during officially authorized travel, items such as car rental and air transportation, parking and lodging, tolls and fares, must be maintained on file by the Network Provider. Section 287.058 (1) (b) F.S., requires that bills for any travel expense shall be maintained in accordance with Section 112.061, F.S. governing payments for traveling expenses. CFOP 40-1 (Official Travel of State Employees and Non-Employees) provides further explanation, clarification, and instruction regarding the reimbursement of traveling expenses necessarily incurred during the performance of business. The Network Provider must retain on file documentation of all travel expenses to include the following Revised Attachment I HCO2 (f) Page 46 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 data elements: name of the traveler, dates of travel, travel destination, purpose of travel, hours of departure and return, per diem or meals allowance, map mileage, incidental expenses, signature of payee and payee's supervisor. 18. Property and Title to Vehicles a. Property (1) Nonexpendable property is defined as tangible personal property of a non-consumable nature that has an acquisition value or cost of $1,000 or more per unit and an expected useful life of at least one year, and hardback covered bound books that are not circulated to students or the general public, the value or cost of which is $250 or more. Hardback books with a value or cost of$100 or more should be classified as nonexpendable property only if they are circulated to students or to the general public. All computers, including all desktop and laptop computers, regardless of the acquisition cost or value are classified as nonexpendable property. Motor vehicles include any automobile, truck, airplane, boat or other mobile equipment used for transporting persons or cargo. (2) When state property will be assigned to a provider for use in performance of a contract, the title for that property or vehicle shall be immediately transferred to the provider where it shall remain until this contract is terminated or until other disposition instructions are furnished by the ME's Contract Manager. When property is transferred to the provider, the department shall pay for the title transfer. The provider's responsibility starts when the fully accounted for property or vehicle is assigned to and accepted by the provider. Business arrangements made between the provider and its subcontractors shall not permit the transfer of title of state property to subcontractors. While such business arrangements may provide for subcontractor participation in the use and maintenance of the property under their control,the ME shall hold the provider solely responsible for the use and condition of said property. Provider inventories shall be conducted in accordance with CFOP 80-2. (3) If any property is purchased by the provider with funds provided by this contract, the provider shall inventory all nonexpendable property including all computers. A copy of which shall be submitted to the along with the expenditure report for the period in which it was purchased. At least annually, the provider shall submit a complete inventory of all such property to the ME whether new purchases have been made or not. (4) The Network Provider Inventory List, incorporated herein by reference, and available from the designated ME Contract Manager upon request, shall include, at a minimum,the identification number; year and/or model, a description of the property, its use and condition, current location, the name of the property custodian, class code (use state standard codes for capital assets), if a group, record the number and description of the components making up the group, name, make, or manufacturer, serial number(s), if any, and if an automobile, the VIN and certificate number; acquisition date, original acquisition cost, funding source, information needed to calculate the federal and/or state share of its cost. (5) The ME's Contract Manager must provide disposition instructions to the provider prior to the Revised Attachment I HCO2 (f) Page 47 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 end of the contract period. The provider cannot dispose of any property that reverts to the ME or department without the Contract Manager's approval. The provider shall furnish a Closeout Inventory Form no later than 30 days before the completion or termination of this contract. The Closeout Inventory Form shall include all nonexpendable property including all computers purchased by the provider. The Closeout Inventory Form shall contain, at a minimum,the same information required by the annual inventory. (6) The provider hereby agrees that all inventories required by this contract shall be current and accurate and reflect the date of the inventory. If the original acquisition cost of a property item is not available at the time of inventory,an estimated value shall be agreed upon by both the provider and the ME and shall be used in place of the original acquisition cost. (7) Title (ownership) to and possession of all property purchased by the provider pursuant to this contract shall be vested in the ME upon completion or termination of this contract. During the term of this contract, the provider is responsible for insuring all property purchased by or transferred to the provider is in good working order. The provider hereby agrees to pay the cost of transferring title to and possession of any property for which ownership is evidenced by a certificate of title. The provider shall be responsible for repaying to the ME the replacement cost of any property inventoried and not transferred to the ME upon completion or termination of this contract. When property transfers from the provider to the ME, the provider shall be responsible for paying for the title transfer. (8) If the provider replaces or disposes of property purchased by the provider pursuant to this contract, the provider is required to provide accurate and complete information pertaining to replacement or disposition of the property as required on the provider's annual inventory. (9)The provider hereby agrees to indemnifythe ME and the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. (10) A formal contract amendment is required prior to the purchase of any property item not specifically listed in the approved contract budget. b.Title to Vehicles (1) Title (ownership) to, and possession of, all vehicles acquired with funds from this contract shall be vested in the ME upon completion or termination of the contract. The provider will retain custody and control during the contract period, including extensions and renewals. (2) During the term of this contract, title to vehicles furnished by the state or acquired at the direction of the state (using state or federal funds) shall not be vested in the provider. Subcontractors shall not be assigned or transferred title to these vehicles. The provider hereby agrees to indemnifythe ME or the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. 19. Health Insurance Portability and Accountability Act(HIPAA) Revised Attachment I HCO2 (f) Page 48 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 a. In compliance with 45 CFR s.164.504(e),the Network Provider shall comply with the provisions of the Business Associate Agreement, incorporated herein by reference to this Contract, governing the safeguarding, use and disclosure of Protected Health Information created, received, maintained, or transmitted by the Network Provider or its subcontractor's incidental to Network Provider's performance of this Contract. b. A violation or breach of any of the assurances as stipulated in the Business Associate Agreement shall constitute a material breach of this contract. 20. National Voter Registration Act(NVRA) of 1993 a. The Network Provider shall comply with the National Voter Registration Act (NVRA) of 1993, Pub. L. 103-31 (1993), section 97.025, F.S. b. As a Voter Registration Agency, the Network Providers shall designate a Voting Registration Activities Coordinator and provide the contact information of the Coordinator by the date and to the individual(s) identified in Exhibit C, Required Reports.The Network Provider shall notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding this position. c. As a Voter Registration Agency, the Network Provider shall provide individuals seeking services and/or individuals served with an opportunity at admission or when they change an address, to either register or update their voter registration.The National Voter Registration Act Preference Form/Application are DS-DE77-ENG and DS-DE77-SPN, are available at the link provided in paragraph f., below d. The Network Provider shall submit a NVRA Voter Registration Agencies Quarterly Activities Report Form, DS-DE131, by the dates and to the individual(s) identified in Exhibit C,Required Reports. The Quarterly Activity Report Form is available at the link provided in paragraph f., below. e. Any person aggrieved by a violation of either the National Voter Registration Act or a voter registration or removal procedure under the Florida Election Code may file a written complaint with the Department of State by completing and submitting the NVRA Complaint Form (DS-DE 18). f. The Department of State has published all form referenced herein, along with online training and additional guidance to implement NVRA at: http://dos.myflorida.com/elections/for-voters/voter-registration/nationa I-voter-registration- act Revised Attachment I HCO2 (f) Page 49 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 21. Special Insurance Provisions a. The Network Provider shall notify the ME Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance including but not limited to, cancellation or modification to policy limits. b. The Network Provider acknowledges that, as an independent contractor,the Network Providers, and its subcontractors, at all tiers are not covered by the State of Florida Risk Management Trust Fund for liability created by s. 284.30, F.S. c. The Network Provide shall obtain and provide proof to the ME's Contract Manager of comprehensive general liability insurance coverage (broad form coverage), specifically including premises,fire and legal liability to cover managing the Network Provider and all of its employees. The limits of Network Provider's coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. d. The Managing Entity shall cause all Network Service Providers, at all tiers, who the Managing Entity reasonably determines to present a risk of significant loss to the Managing Entity or the Department, to obtain and provide proof to Managing Entity and the Department of comprehensive general liability insurance coverage (broad form coverage), specifically including premises, fire and legal liability covering the Network Service Provider and all of its employees. The limits of coverage for the Managing Entity's Network Service Providers, at all tiers, shall be in such amounts as the Managing Entity reasonably determines to be sufficient to cover the risk of loss. e. If any officer, employee, or agent of the Managing Entity operates a motor vehicle in the course of the performance of its duties under this contract,the Managing Entity shall obtain and provide proof to the Department of comprehensive automobile liability insurance coverage.The limits of the Managing Entity's coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. f. If any officer, employee, or agent of any Network Service Provider, at all tiers, operates a motor vehicle in the course of the performance of the duties of the Network Service Provider, the Managing Entity shall cause the Network Service Provider to obtain and provide proof to the Managing Entity and the Department of comprehensive automobile liability insurance coverage with the same limits. g. The Managing Entity shall obtain and provide proof to the Department of professional liability insurance coverage, including errors and omissions coverage, to cover the Managing Entity and all of its employees. If any officer, employee, or agent of the Managing Entity administers any prescription drug or medication or controlled substance in the course of the performance of the duties of the Managing Entity under this contract,the professional liability coverage shall include medical malpractice liability and errors and omissions coverage,to cover the Managing Entity and Revised Attachment I HCO2 (f) Page 50 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi_A, Behavioral Health Network,Inc. j t;;'2019 all of its employees.The limits of the coverage shall be no less than$300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. h. If any officer, employee, or agent of the Network Service Provider, at all tiers, provides any professional services or provides or administers any prescription drug or medication or controlled substance in the course of the performance of the duties of the Network Service Provider, the Managing Entity shall cause the Network Service Provider, at all tiers,to obtain and provide proof to the Managing Entity and the Department of professional liability insurance coverage, including medical malpractice liability and errors and omissions coverage, to cover all Network Service Provider employees with the same limits. i. The ME and the Department shall be exempt from, and in no way liable for, any sums of money that may represent a deductible or self-insured retention under any such insurance.The payment of any deductible on any policy shall be the sole responsibility of the Network Provider purchasing the insurance. j. All such insurance policies of the Network Providers, and its subcontractors at all tiers, shall be provided by insurers licensed or eligible to do and that are doing business in the State of Florida. Each insurer must have a minimum rating of"A" by A. M. Best or an equivalent rating by a similar insurance rating firm and shall name the ME and the Department as an additional insured under the policy(ies). The Network Provider shall use its best good faith efforts to cause the insurers issuing all such general, automobile, and professional liability insurance to use a policy form with additional insured provisions naming the ME and the Department as an additional insured or a form of additional insured endorsement that is acceptable to the ME and the Department in the reasonable exercise of its judgment. k. All such insurance proposed by the Managing Entity shall be submitted to and confirmed by the Contract Manager annually by March 31. I. The requirements of this section shall be in addition to, and not in replacement of, the requirements of Section 10, of the Standard Contract to which this Attachment I is attached, but in the event of any inconsistency between the requirements of this section and the requirements of the Standard Contract, the provisions of this section shall prevail and control. E. List of Exhibits The Network Provider agrees to comply with the exhibits listed below. The following exhibits,or the latest revisions thereof,are incorporated in and made a part of the contract. 1. Exhibit A,Clients/Participants to be Served 2. Exhibit B, Method of Payment 3. Exhibit C, Required Reports Revised Attachment I HCO2 (f) Page 51 of 52 Guidance/Care Center, Inc. Contract No. P-4 South Florida Q'pi-A, Behavioral Health Network,Inc. j t;;'2019 4. Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes and Outputs 5. Exhibit F, State and Federal Laws, Rules and Regulations 6. Exhibit G,Covered Service Funding by OCA 7. Exhibit H, Funding Detail &Local Match Plan Revised Attachment I HCO2 (f) Page 52 of 52 Guidance/Care Center, Inc. Contract No. P-4 Florida &P South Behavioral 1100 Health r , Inc. Attachment IV SCOPE OF WORK NAME OF PROVIDER: Guidance/Care Center NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: $150,000.00 for each year of the contract "Regular" Prevention Prevention Partnership TYPE OF FUNDING: Services Grant (PPG) X Children's Substance Abuse Adult Substance Abuse COST ALLOCATED TO: (check both if approved for both covered services) X Section I. DESCRIPTION OF SERVICES AND STRATEGIES FOR SERVICE DELIVERY ";rr ttA t i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i i t t; The Guidance/Care Center's (GCC) will provide the Project SUCCESS program using the Substance Abuse and Mental Health and Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) Project SUCCESS program recognized in the National Registry of Evidence-based Programs and Practices (NREPP). The program will be available and accessible to high risk youth ages 12-18 who have experimented with alcohol, are showing early danger signs and multiple risk factors for substance abuse and who attend Monroe County High Schools. Project SUCCESS relies primarily on Education as a strategy. Services include school wide activities targeting the entire school population and are designed to increase awareness of mental health and substance abuse issues, prevention education groups targeting all 9th graders, and individual counseling to those in need of additional supportive counseling. And at Marathon High School Champions of Change which is a group of high school students working under the direction of the Project SUCCESS counselor to help promote prevention activities and awareness throughout the school year. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20-year olds by 10% by meeting the following objectives: reducing alcohol use, increasing the perception of harm and risk in youth and enhancing positive, pro-social protective factors. Goal 2: Increase capacity by providing level 2 prevention programming for those at high risk; thereby eliminating service gaps for these students by providing the funding and resources necessary to ensure successful program implementation, continuity of care and partnership capacity countywide. GCC partners with the Monroe County School District and the Monroe County Coalition for the provision of these services. Guidance/Care Center, Inc. Attachment V Contract No. P-4 1 of 16 Inserted 7/1/2019 Yh �ir�{ t 1 1 1 t 7 School wide activities Universal Information 2,500 Dissemination gtngrade PIES Selective Education 450 Screening Selective Problem ID and referral 1,20 Student Assistance Selective Problem I D and referral 1,200 One on One Indicated Education 35 Champions of Change Selective Alternatives 30 Capacity Building Adults Universal Direct Education 250 Guidance/Care Center, Inc. Attachment V Contract No. P-4 2of16 Inserted 7/1/2019 Section II. TARGET POPULATION — RISK AND PROTECTIVE FACTORS ilii �� N �� sry� �4 � f ;r� sS ,sl�„i ! rt IS 't tts 1 Pl r yr fIS {y(s tlts r t r S,�ry r r s{ st+1 tf1 s{!r „I,ty 1 s sr t s y} Ijt?l stir 'k! r { 1sr 1sf r frr,{,tl?(} rr(rft 411 s ri tr (1{ is r Y,i l r r tt.'rtr Ssssr„ !s .J i t( ry y. {{ Description of participants to be served (describe criteria for program enrollment eligibility, geographic areas /'Neighborhoods (list zip codes), risk factors of the neighborhoods, description of the sites (school, church, park, etc.), as well as any other significant demographic information), specific cultural characteristics, and describe according to the Comprehensive Community Action Plan priorities: Youth alcohol use - Abuse by "legal" age individuals, Youth/Adult marijuana use, Prescription 'drug misuse/abuse, over the counter drugs misuse/abuse, other illicit drug use. Participants will be students at the 3 High Schools in Monroe County and Middle School students in Marathon. School wide activities and Prevention Education Groups are universal in nature while small groups and individual counseling are targeted at youth identified as at risk. At risk students might be identified by parents, teachers, and other community agencies or by themselves. Project SUCCESS is designed to be implemented in school settings. Each counselor has been provided with adequate space and access to student populations to fully implement the program as designed. GCC has made changes to its Prevention programming for the coming year in that most all grade levels will be covered. Apple a Day will cover K through grade 4, Alcohol Literacy and Teen Intervene will cover middle schools and Project SUCCESS will be in the high schools. The comparison of percentage of Monroe County youth and Florida Statewide youth who reported having used a list of 14 various drugs in their lifetimes reveals that percentages for Monroe County youth exceed those for the state in every category (FYSAS 2010). A significantly greater percentage of Monroe County High School students (40.9%) than statewide students (33.6%) witnessed gang members selling drugs. The ethnicity of these children breaks down as follows: 52.9%White, 33.8% Hispanic, 10.10% Black, 1.45% Asian and 2.88% Other. Risk factors: Favorable attitudes towards ATOD Perceptions of harm Community Norms Self-regulation Protective factors: Prosocial opportunities/activities Guidance/Care Center, Inc. Attachment V Contract No. P-4 3of16 Inserted 7/1/2019 Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness t,, N' +�,fi�/ �tr�,, 1{ 1� r+�! lr ,+{ � nl� lsf�� + �� !! is ttt}� i ) �/ Si t,i , +` !i ,,tSrJ t' ,r,rtt ,d 3„ t tlt t" V,s,l t,r,, r, rnr;'.y�JS t, i y�,,,{ �,y1= + s 1,,,7e, 1 �y ,,{ 5 14 S tifti r 4 I ` , 1 S'rl� v r ' n -S ,Sc 17�, s r lr1 t i s h t'• a tsl, ,� + t ..) !(£ t r 7 t ,. r ff tr ,1JR s +t -. 4t S s 1 s r yy} s l � S J r , ( r r+ 7• ,<3,,, �"t� f > s ,•.4 :r1 ,? s, 1 ,C.. 7 , fJ Number of Unduplicated Universal —Direct or Indirect, Selective, Indicated Participants (if duplicated note) School wide Activities is a Universal Direct prevention strategy. 9 months out of the school year Project SUCCESS staff will conduct activities designed to inform and increase awareness of varying targets of prevention 2500 services (suicide awareness, mental health and substance use awareness for example). 9th grade Prevention Education Series is a Selective prevention 450 strategy which consists of 4 topics taught in 4 to 8 sessions to all 9th graders enrolled in the district Screenina is a Selective prevention strategy in which all students who are 1,200 enrolled in the school are screened for prevention and other needs. Student Assistance is a Selective prevention strategy in which students 1,200 who are identified as needing a services are provided that service by Project SUCCESS staff or referred elsewhere for the needed service. One on One is an Indicated prevention strategy in which a student can 35 receive up to 3 individual prevention sessions as need. Capacity Buildina is a Universal Direct prevention strategy which will include presentations on ATOD prevention and other relevant topics in 250 both school and non- traditional settings. Champions of Change consists of high school students working under the 30 direction of the Marathon High School Prevention Counselor to promote the goals of Prevention within the school Guidance/Care Center, Inc. Attachment V Contract No. P-4 4of16 Inserted 7/1/2019 TARGET POPULATION — RISK AND PROTECTIVE FACTORS �} Jt,r� tlgl� ..r I.`,�' >tS i � ,%S J+J rr ,✓ ,it i 4j rl.1t 11sSr I,sl r ) t,r3\tt(rS 1 1 t R{ tf\ `itr rt r ?, r I!{„:,��( f r5, t� vJ,1 ,.". S r\ £ r -yT ri 'li t''�t;rl i i} } } } } i i i i i i i i i i i i i School wide activities Favorable attitudes towards 1 &2 ATOD Perceptions of harm Prosocial opportunities/activities gin Grade Prevention Education Favorable attitudes towards 1 &2 ATOD Perceptions of harm Self- regulation Screening Screening to identify and broad range of risk 1 &2 factors with the intent to mitigate those risk factors Student Assistance Favorable attitudes towards 1 &2 ATOD Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors I ncreased knowledge/awareness Self- Esteem Positive family communications Community values One on one Indicated Favorable attitudes towards 1 &2 ATOD Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors I ncreased knowledge/awareness Self- Pefinam Guidance/Care Center, Inc. Attachment V Contract No. P-4 5of16 Inserted 7/1/2019 Champions of Change Favorable attitudes towards 1 &2 ATOD Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors I ncreased knowledge/awareness Self- Pefinam Capacity Building Favorable attitudes towards 1 &2 ATOD Perceptions of harm Increased knowledge/awareness Community values Skill/competency Section III. SITE LOCATIONS AND INFORMATION* f t l, srrrt t i itt (t i s s t � s t i t t s t . t Key West High School 2100 Flagler Avenue Key West 33040 X Coral Shores High School 89901 Old Highway Tavernier 33070 X Marathon Middle/High School 350 Sombrero Road Marathon 33050 X Total number to be served 2,500 *Changes in sites/locations of services must adhere to contractual requirement procedures. Guidance/Care Center, Inc. Attachment V Contract No. P-4 6of16 Inserted 7/1/2019 Section IV. MAJOR REFERRAL SOURCES Monroe County Public Schools Parents Self-referral Other community agencies Section V. PERFORMANCE MEASURES Quality Performance Measures :: S r \ l s r tt s }} t ;:Y I r t ! t r s s 1, s {, l � ,`t, { >l ,. I�+� .urr r , .,As ,i„„ yi t!t s,1{Ki'1 C1'� 1! t rtp^7,,u ,i,i,i,i,i,i,i,i,}+' Average number of 85% of 490 participants Measured at the end of sessions attended will complete Project each cohort (participant SUCCESS pre/posts, 85 % of 480 youth Project SUCCESS pre and Collected immediately will increase their post tests prior to the 1 st session attitudes and beliefs and immediately related to risk of following the last harm associated with session underage drinking o Project SUCCESS re and Collected immediately 85 /o of 480 youth � p will have no or a post tests prior to the 1st session decrease in past 30 and immediately day alcohol use by following the last curriculum session completion Project SUCCESS pre and post tests 85 % of 480 youth Collected immediately will decrease prior to the 1 st session favorable attitudes and immediately toward alcohol and following the last drug use session #and % of 90 % or participants Measured at the end of youth/participants show satisfaction on the each program cohort satisfied with Satisfaction Survey Guidance/Care Center, Inc. Attachment V Contract No. P-4 7of16 Inserted 7/1/2019 Observation Curriculum Three times per year in of service fidelity checklist coordination with the delivery/Fidelit Supervisor/Obs Evaluation Team, one y checklist erver Report time in Quarter 2, one time in Quarter 3, and one time in Quarter 4 unless the EBP indicates otherwise Documentation of Supervisory record, During regular structured Supervisory Tool, or supervisory sessions supervision Checklist and notes in and not less than one staff file time per month # and % of staff with 100% At the time of contract necessary training monitoring # and % of staff Staff will show courses working toward and documents from the Prevention 50% Florida Certification certification with Board at the time of the Florida contract monitoring. Certification Board Guidance/Care Center, Inc. Attachment V Contract No. P-4 8of16 Inserted 7/1/2019 Quantity Performance Measures ©� \ ,4T,,, li` ( ','J- r Y• �` v (s t. , r,,\,i SS ri r { 7 ..}r { r t 4„ t v, sJr t i4c)�, ,r, f+ 5- + r( r � s S+, r r( rr N ,,s N, it'r,stt.'r'• f rt r; r xY}},r t.+t i4 v I:,J,.(� v ,'Y ,+ 1 Ill i[�{l l 8 ) yr� i , 4,:� jA 1 t 7 • I� ,/ f?t 1�,3 � ;k� k�� "�:r`,��1t e� I + rr? t ,,ri/ f !+4}�!� r3� �� .I�`` ,7 r � ,,t r' r„} ,t � ����_;;' I�i,} t �, {r 5/{y� z• { f,,j�, tilr t, t7t r� ) 4,„ tn, \+, „21 y 1 vi t I v l;. it lr r r �ty�.} t .,i Irs !{,sf\ t ;i }ri r l rs,+, s T lJ 4 Ir ij} ,s t)r r jt 1 t t VO ! rt:t r A �� �`'rt,. ,rl:; r ,IS Jr �ii s i i i .f.....\.\,t;}..1 u. :. ' "#rri' �7,4 tJ;, t tr:;, y�,}, s` + u/,I { i,lr� { Ikl S t}{�trt,"'ice# �� lt����� � ,,7!6` � .;� s ?T�,#R,,���C� ttr +r, 't �+y c.,?y.ta, SS'' ,�,' ,j�, ,It, f' :I, ,i ,\,tit t} s}, v.y „�,,,, •l(J >k, ,rt o,t, rS{,vy\t`ir, (,,;1;f }i 17j7 t,} , ��I��t�'�� �,� 7 �i� � �►����� �, t t , t{,,,} t >, { r' rat ij Cyr � ' ,► ,u yFf ,r rtitA�v,H00�f +, ' Lire ? 1 ' iSf i7 i7 f7 i7 i7: it t- i7 i7 i i it i i i i i i i i 7 1 t i ss(+Y {r t 1r='r Prevention Education Series 450 4 to 8 85% Selectiv Project SUCCESS Of e schedule d sessions and 85% of participa nt pre/post tests matched and meeting outcome s School Wide Activities 2500 9 90% Univers al Individual Sessions 35 1-3 85% Indicate Sessio ns, d with justific ation if differe nt Guidance/Care Center, Inc. Attachment V Contract No. P-4 9of16 Inserted 7/1/2019 Champions of Change 30 85% Univers Of al scheduled sessions and 85% of participant pre/post tests matched and VI. TASK LIST TM, Activity Title: Recruitment/Screening 1,200 N/A 85% of Activity Description:. All students referred or presenting for participant service will receive an initial screening of risk and protective will have factors screening Freauency:One time upon program entry tools Intensity. one session available Duration: 15 mins. for audit Activity Title: Intake/Assessment 50 45—60 mins. 85% of Activity Description: Participants who become enrolled in the participant program will complete a detailed intake of service needs s will Freauency: Once, upon enrollment in the program Intensity- One have session assessme Duration: 60 mins. nt tools available in their Activity Title: Project SUCCESS Prevention Education Series 450 85% of 85% and Curriculum scheduled 85% of Activity Description:. 9th graders will participate in a 4 topic sessions participant Prevention Education Curriculum 6 pre/post Freauencv.-.one time per week —8) tests Intensity. 6—8 sessions, based on class time restrictions For 45—60 matched Duration: 45 to 50 mins. mins. and Activity Title: Pre- and Post-testing 480 45 to 60 85 % and Activity Description:. All large group participants will be pre and min. 85% of post tested for the knowledge, beliefs, attitudes and use of sessions participant substances pre/post Freauency:Twice tests Intensity. once before first session, once at completion of last matched session and Duration: 45 to 50 mins. meeting outcomes Guidance/Care Center, Inc. Attachment V Contract No. P-4 10 of 16 Inserted 7/1/2019 Champions of Change: Pre- and Post-testing 30 N/A 85 % and Activity Description:. All Champion of Change participants will be 85% of pre and post tested for the knowledge, beliefs, attitudes and use of participant substances pre/post Freauency.Twice tests Intensity: once at the beginning of participation and once at matched completion of participation and Duration: 30 minutes meeting outcomes Section VII. EVIDENCE BASED PROGRAMS (EBP) I r rrir t t rr rt�s M < �,'Y° I' t Gt a++ tr tr tr tr.tr tr tr tr t;r tr tr tr -'r} y 77 Ir ,JI r ;„ "t t 1:. (, n."? kt R d f\ij12 t !Jt ti fs I, Project SUCCESS SAMHSA approved, NREPP Guidance/Care Center, Inc. Attachment V Contract No. P-4 11 of 16 Inserted 7/1/2019 Section VIII. EVALUATION Outcome Measures 7;> ,h,a; ,S' ,•\-;t r Y'S tr ,t, / r s„? ) ,sFj,„t1�t, i ,i\' Ili 4,L.,,7.. t tr rs, r ,U r ,t, ,,Ji ts. t, L.+,S,.,. ,l;t+ t+ t+ t,+ t,r,.�t+ (y, 1 r tr i r s Fr, 1- Adhering to the Fidelity Implementation Plan, Project SUCCESS will utilize Fidelity checklists from the Project SUCCESS implementation manual at the end of each small and large group cohort as described above under Quality Performance Measures. This checklist assesses whether the facilitator appropriately addressed each major objective, activity, and primary point of the session. If a Prevention counselor falls below the 90% criterion on the Fidelity checklist at any time, the Program Supervisor will develop a plan to assist them in increasing necessary skills. Weekly Fidelity checks will then occur until a 90% criterion is achieved. 2- Supervision Meetings—Any problem areas in the large groups or in counseling sessions or other program activities will be discussed and addressed at weekly Supervision meetings. 3- Program effectiveness will be evaluated through results of the Pre and Posttests as well as results of the Satisfaction Surveys. 4- Activity Logs are maintained for all Universal and Selective activities. 5- Client charts are maintained for all Indicated Prevention activities and are included in the GCC Peer Review process. 6- All activities for Prevention will be consistent with the agency's Quality Assurance Quality Improvement Plan. GCC will coordinate with the Evaluation Team, Behavioral Science Research Institute (BSRI), for process and outcome data as required. The Data will support any processes from the Westcare Team. +I ! (i t t 4 { I 1 , i 7 1 t { :r ,,3, k, f 1 ri-- '( t l ✓„}st,.#, it >t .r` !;} it \ta } r t f ! Jaa,.;rt iI t 11I !it' t1 t `)... —71r t r ! ��t ��(' � sf r y i. J, 10 I,lt rt� tt ss t °! 4 it Average number of sessions Attendance At end of the cohort Entered into DOES attended (Participant of services Retention) Staff training hours PBPS entry Quarterly 8 hours is required; PBPS (capacity building) and training and provider check-ins reports Participant satisfaction Satisfaction surveys At the end of each Entered into DOES cohort; semi-annually Guidance/Care Center, Inc. Attachment V Contract No. P-4 12 of 16 Inserted 7/1/2019 Increase in perceptions of Pre-posttest outcomes At the end of each Matched pre-posts; entry harm cohort; semi- into DOES or submitted to annually BSRI at set intervals Section IX. CAPACITY BUILDING it t s;, 1 S;, +,lk,) at,}, t 1, -,r ` '--$ �{r ,t), }t+ a, 5 t,+ ,�+, ;y� ( A; �t } t#.. :, 1 't r`' 1 +.� 1'. + I'" '. 'il I ;I r�I, },t I,, t� In , r r v �, h + , f r 4e , 4 , „ t, 4r,+ , „p ,, t j f GCC currently receives funding from SFBHN Regular Prevention which supports An Apple A Day serving K through 4th grade, Alcohol Literacy Challenge and Teen Intervene in the Middle Schools. GCC is also proposing to implement the Project SUCCESS PES curriculum in the Monroe County Middle Schools utilizing Regular Prevention Staff. Since Project SUCCESS focuses on High School students there is no overlap. Prevention staff participate in clinical staff meetings in each location and can make referrals for higher levels of care as needed. List other prevention programming and providers in sites mentioned in Section III f this document Describe how the; program will coordinate with other funded organizations' programs and services to avoid duplication of services. GCC is aware that the Florida Keys Children's Shelter operates Prevention services using the EBP All Stars and SNAP. GCC and FKCS are currently in the process of scheduling a meeting to build capacity and cross learn about each other's programs to coordinate services and avoid duplication. List the coalition(s) within the target service areas in which prevention services will be provided under this Scope. Describe how the program will coordinate with the coalition and share data/contribute to the ongoing Strategic Prevention Framework with the identified coalition(s) GCC works with the Monroe County Coalition by attending all meetings and coordinating activities county wide. MCC has been particularly helpful in supporting Project SUCCESS school wide activities by providing student hand- outs and incentives. GCC will coordinate and participate in MCC community events such as "No One's House Parent Information" and "Know the Law" campaigns. Guidance/Care Center, Inc. Attachment V Contract No. P-4 13 of 16 Inserted 7/1/2019 Section X. ADDITIONAL PREVENTION REQUIREMENTS 1. Site Schedule A final site schedule, on the Site Schedule form, with dates, times, and location of services shall be submitted no later than August 31 of the fiscal year or when requested by the Contract Manager. Sites schedules must be approved by SFBHN, in writing, and will be based on county need and distribution of services to avoid duplication in any geographical area or school to maximize SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity in writing and submitted to the Contract Manager for review and approval by the Prevention Director. The Contract Manager will reply with approval. The site schedules shall be submitted on the SFBHN Prevention Site Schedule format. 2. Memorandum of Understanding (MOU) with the Community Coalition To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition shall execute and /or maintain a memorandum of understanding (MOU) delineating the specific responsibilities of each. This MOU will be consistent with the strategies of the State of Florida Department of Children and Families' and the Managing Entity's (ME's) prevention strategy. The provider shall submit an executed copy of the MOU to the ME's Contract Manager within 30 days of the effective date of the contract (for newly executed MOUs) or within thirty (30) calendar days for renewed MOUs. SFBHN Contract Attachment— Guidance Document 10 3. Memorandum of Understanding (MOU) with Sites To facilitate the coordination and delivery of services, all providers shall have executed Memoranda of Understanding (MOU) with the sites where services are being provided. All MOUs with the sites shall be current and up to date, outlining the terms of the agreement. 4. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work. 5. Meetings All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, BSRI, at regularly scheduled or specially called meetings when notified by the ME. The ME will make every attempt possible to schedule meetings with advanced notice; however, there may be meetings that may be called on short notice. These include, but are not limited to, Prevention provider meetings, meetings with Behavioral Science Research Institute, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, and other meetings as noticed by SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 6. Reports /Assignments and Special Reports /Assignments Providers are expected to submit reports as outlined in the contract. Prevention Partnership Grant (PPG) reporting is specifically described in the contract with dates for submission. Other reports will be requested by SFBHN. Special reports and assignments are requested from time to time to meet State/Local Department of Children and Families, State Block Grant, SFBHN, and other requirements and needs. Prevention Guidance/Care Center, Inc. Attachment V Contract No. P-4 14 of 16 Inserted 7/1/2019 providers are required to submit the reports in the format requested and by the timeline requested. These reports may be requested from different sources for different reasons. Requests generally come from SFBHN staff, including the Prevention Director, and may be requested verbally or in writing. There may be times when other collaborative partners request information and SFBHN will support these requests. 7. Training The Scope of Work outlines the requirements for training to support the State Block Grant reporting requirements for workforce development as well as for strengthening the Prevention workforce. All staff of provider organizations funded by this contract, whether full-time, part-time, contractual, or consultant, who report units in the Performance Based Prevention System (not those paid by cost reimbursement or that are vendors), is required to attend eight (8) hours of training per quarter. All providers shall attend scheduled training as required by the ME, meet the ME and the evaluation team, BSRI, for technical assistance and/or training, at regularly scheduled or specially called meetings when notified by the ME. 8. Report Cards Providers are required to comply with the measures on the Prevention Report Card. Grading for the measures will be according to compliance or lack thereof. 9. Data All providers are required to submit the program data monthly in the Performance Based Prevention System (PBPS) as required by the contract. The provider shall also: ■ Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract and consistent with the Scope of Work in the contract; ■ Ensure that all data submitted to PBPS is consistent with the data maintained in the provider's file and consistent with the Scope of Work in the contract; ■ Review the data submitted with the evaluation team, Behavioral Science Research Institute (BSRI), monthly to determine any discrepancies in the numbers related the evaluation and the Scope of Work and make corrections prior to submission for approval by the SFBHN Prevention Director; ■ Submit an email to the SFBHN Prevention Director and the designated SFBHN Data Analyst verifying that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. There shall be a designated individual and one back up individual at the provider organization responsible for verifying the data and submitting the email. This will imply that the data has been reviewed and is ready for submission. o The email subject line shall read: PBPS Data Submission Verification o The body of the email shall read: (name of organization) is submitting the PPG Prevention data for the month of (name of the month) in PBPS and we assure that the data is complete and correct. Our organization's data may be used to report to the State for the Block Grant report. Our organization's data may be used to reconcile with the payments for this month. ■ Failure to submit any data, or correct any errors in the data which results in a rejection rate Guidance/Care Center, Inc. Attachment V Contract No. P-4 15 of 16 Inserted 7/1/2019 of ten percent (10%) or higher of the monthly data submitted, will require the provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected will be corrected and resubmitted; and ■ In accordance with the provisions of s. 402.73(1), F. S., and Rule 65-29.001 F.A.C., corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 10. Evaluation Prevention providers shall work in collaboration with the evaluation team, Behavioral Science Research Institute(BSRI) by participating in meetings, training, and providing service data and other necessary identified data vital to the completion of the system-wide evaluation of the prevention services within the Strategic Prevention Framework. Data will be provided to BSRI in the BSRI data system, DOES, and in any other requested format. The data includes the numbers for outcome data and process data required that contributes to the evaluation of the Prevention System of Care. Guidance/Care Center, Inc. Attachment V Contract No. P-4 16 of 16 Inserted 7/1/2019 ATTACHMENT D (Continued) Contractual Agreements Amendment #2 to Contract P-4 Guidance/Care Center and South Florida Behavioral Health Network, Inc. Amendment 42 Contract No. P-04 06/30/2020 THIS AMENDMENT, entered into between South Florida Behavioral Health Network, Inc. hereinafter referred to as the "ME" and Guidance/Care Center, Inc. hereinafter referred to as the "Network Provider," amends Contract No. P-04. PREAMBLE:This amendment revises contract language and adds Attachment VI,Scope of Work for Fiscal Year 20-21. As a result,this amendment revises the Standard Contract;Attachment I; Exhibit C, Required Reports;and adds Attachment VI, Prevention Scope of Work, Fiscal Year 20-21 as follows: 1. Page 1-13, Revised Standard Contract, as previously amended on Page 1 of Amendment #1, are hereby deleted in their entirety and Pages 1-16, Revised Standard Contract, are inserted in lieu thereof and attached hereto. The replacement of the Standard Contract does not affect the original execution of this Contract. The original signatures are on file. 2. Pages 1-52, Revised Attachment 1, as previously amended on Page 2 of Amendment #1, are hereby deleted in their entirety and Pages 1-46, Revised Attachment 1,are inserted in lieu thereof and attached hereto. 3. Pages 1-19, Revised Exhibit C, Required Reports, as previously amended on Page 1 of Amendment #1, are hereby deleted in their entirety and Pages 1-19, Exhibit C, Revised Required Reports, are inserted in lieu thereof and attached hereto. 4. Pages 1-10, Attachment VI, Prevention Scope of Work, Fiscal Year 20-21, are hereby added and attached hereto. Signature Page follows Page 1 of 2 Amendment 92 Contract No. P-04 06/30/2020 This amendment shall begin onjgly 1,2020. All provisions of the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform to this amendment. All provisions of the contract not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract. This amendment is hereby made a part of the contract. IN WITNESS THEREOF, the parties hereto have caused this 2q_(nine ty-three J page amendment to be executed by their officials'thereunto duly authorized. GUIDANCE/CARE CENTER,INC. SOUTH FLORIDA BEHTA (kAL HEALTH NETWORK,INC. SIGNED SIGNED BY: BY: NAME: Frank C. Rabbito NAME: John Newcomer MD I TITLE: Chief 0 erations Officer TITLE: CEOe'l DATE: 6/30/2020 DATE: FEDERAL Tax I D#(or SSN):59-1458324 Pursuant to Authority in WCGCC 2020-02 Executed subject to dispute and negotiations over Ft_ Statute119 Language in Section 14 Page 2 of 2 ............. ........... ......... .................. ................ .......... THRIVING MIND SOUTH FLORIDA" CFDA No(s).See Post Award Notice Client Services❑x Non-Client Services ❑ CSFA No(s).See Post Award Notice Subrecipient ❑x Vendor ❑ Federal Funds N State Funds ❑x STANDARD CONTRACT THIS CONTRACT is entered into between the South Florida Behavioral Health Network, Inc., d.b.a Thriving Mind South Florida("SFBHN") hereinafter referred to as the "Managing Entity" (ME) and Guidance/Care Center, Inc., hereinafter referred to as the"Network Provider". 1. Contract Document The Network provider shall provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, and documents incorporated by reference which constitute the contract document. 2. Provisions of the Prime Contract All provisions, terms and conditions, or amendments, addendum, changes or revisions applicable to the Network Provider made subsequent to the initial execution of the Prime Contract, i.e.,the Contract entered into between the Department of Children and Families("DCF"or"Department")and SFBHN(ME), not in conflict with this Contract,shall be binding upon the Network Provider and the Network Provider agrees to comply with same.The Prime Contract is incorporated by reference in this Contract.A copy of the Prime Contract can be found at the ME's website at www.thrivinl mind.orl;. In case of conflict with the provisions, terms and conditions of the Prime Contract and this Contract,the provisions, terms and conditions of this Contract will prevail.In the event of a conflict between the provisions of the documents of this Contract,the documents shall be interpreted in the order of precedence listed in Section 55. of this Standard Contract. 3. Effective and Ending Dates This contract shall begin on July 1,2019.It shall end at midnight,local time in Miami-Dade County, Florida on June 30,2021, subject to the survival of terms of Section 52. 4. Official Payee and Representatives(Names,Addresses,Telephone Numbers and E-Mail Addresses) a. The Network Provider name and mailing address of the b. The name, address, and telephone of the Contract official payee to whom the payment shall be made is: Manager for the ME for this contract is: Guidance/Care Center, Inc. Elba Taveras 3000 41st Street Ocean South Florida Behavioral Health Network, Marathon, FL 33050 Inc.d.b.a.Thriving Mind South Florida 7205 Corporate Center Drive, Suite 200 Miami, FL 33126 Tel. (786) 507-7462 E-Mail: Etaveras@thrivingmind.org C. The name of the contact person and street address where d. The name, address, and telephone number of the the Network Provider's financial and administrative representative of the Network Provider responsible for the records are maintained is: administration of the program under this contract is: Kristen Chaffee, Regional Controller Maureen Dunleavy,Vice President 100 2nd Avenue South#901 WestCare/Guidance/Care Center, Inc. St. Petersburg, FL 30100 1205 Fourth Street Office number:727-490-6767 x 30111 Key West, FL 33040-3707 Mobile number: 727-465-6083 Email• maureen.dunleavy@westcare.com Fax number:727-825-0573 Office: (305)434-7660 ext.31221 E-Mail: kristen.chaffee@westcare.com Cell: (305) 896-5964 Revised Standard Contract Page 1 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" The ME's Contract Manager is the primary point of contact through which all contracting information flows between the ME and the Network Provider. Upon change of representatives(names,addresses,telephone numbers and e-mail addresses) by either party,notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 5. Contract Amount The ME shall pay for contracted services according to the terms and conditions of this Contract in an amount not to exceed $450,000.00, subject to the availability of funds and satisfactory performance of all terms by the Network Provider. Of the total Contract amount, the ME will be required to pay $450,000.00, subject to the delivery and billing for services. The remaining amount of 5Q.00 represents"Uncompensated Units Reimbursement Funds",which the ME,at its sole discretion and subject to the availability of funds, may pay to the Network Provider, in whole or in part, or not at all, for Exemplary Performance by the Network Provider. Exemplary Performance will be determined by the Network Provider delivering and billing for services in excess of those units of service the ME will be required to pay. Should the Network Provider receive any funding from the "Uncompensated Units Reimbursement Funds", then the amount of Local Match as it appears on Exhibit B,Method of Payment and in Exhibit H, Funding Detail,will automatically change, utilizing the formula prescribed in the Method of Payment section of this contract. The ME's obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature and the Contract between the ME and the Department.Any costs or services eligible to be paid for under any other contract or from any other source are not eligible for payment under this Contract. 6. Contract Payment a. The Network Provider shall request payment monthly through submission of a properly completed invoice, per the requirements of this Contract,within eight(8)calendar days following the end of the month for which payment is being requested. b. If no services are due to be invoiced from the preceding month,the network provider shall submit a written document to the ME indicating this information within eight(8)calendar days following the end of the month.Should the Network Provider fail to submit an invoice or written documentation (should no services be due to be invoiced from the preceding month), within thirty (30) calendar days following the end of the month, then the ME at its sole discretion will consider these funds as lapse and may reallocate these funds within the network of providers. If the Network Provider fails to submit an invoice or written documentation for two(2)consecutive months within a twelve(12)month period,the ME at its sole discretion can terminate the contract in whole or in part. c. The ME has ten (10) working days, subject to the availability of funds, and/or the ME's receipt of payment from the Department, to inspect, and approve for goods and services, unless the bid specifications, purchase order, or this Contract specify otherwise.The ME's determination of acceptable services shall be conclusive.The ME receipt of reports and other submissions by the Network Provider does not constitute acceptance thereof, which occurs only through a separate and express act of the Contract Manager or other designated ME employee. The MEs failure to pay the Network Provider within the ten (10)working days will result in penalties as referenced in the Prime Contract. Invoices returned to a Network Provider due to preparation errors will result in a non-interest-bearing payment delay. Interest penalties less than one (1) dollar will not be paid unless the Network Provider requests payment. Payment shall be made only upon written acceptance by the ME and shall remain subject to the subsequent audit or review to confirm contract compliance. 7. Overpayment and Offsets a. The Network Provider shall return to the ME any overpayments due to unearned funds or funds disallowed that were disbursed to the Network Provider by the ME and any interest attributable to such funds. Should repayment not be made promptly upon discovery by the Network Provider or its auditor or upon written notice by the ME,the Network Provider will be charged interest at the lawful rate of interest on the outstanding balance until returned. Payments made for services subsequently determined by the ME to not be in full compliance with contract requirements shall be deemed overpayments.The ME shall have the right at any time to offset or deduct from any payment due under this or any other contract or agreement any amount due to the ME from the Network Provider under this or any other contract or agreement. If this Contract involves federal or state financial assistance,the following applies:The Grantee shall return to the ME any unused funds; any accrued interest earned; and any unmatched grant funds,as detailed in the Final Financial Report, no later than 60 days following the ending date of this Contract. b. The funds paid to the Network Provider are continually subject to Review, Revision and Adjustment after evaluation of Utilization and Performance measures monitored by ME. 8. Financial Consequences for Network Provider's Failure to Perform Revised Standard Contract Page 2 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" If the Network Provider fails to perform in accordance with this Contract or perform the minimum level of service required by this Contract, the ME will apply financial consequences as provided for in Section 9, Financial Penalties for Failure to take Corrective Action.The parties agree that the penalties provided for under Section 9. constitute financial consequences under sections 287.058(1)(h)and 215.971(1)(c),F.S.The foregoing does not limit additional financial consequences,which may include but are not limited to refusing payment,withholding payments until deficiency is cured,tendering only partial payments,applying payment adjustments for additional financial consequences orfor liquidated damages to the extent that this Contract so provides, or termination of this Contract per Section 10.and requisition of services from an alternate source.Any payment made in reliance on the Network Provider's evidence of performance, which evidence is subsequently determined to be erroneous, will be immediately due as an overpayment in accordance with Section 7., Overpayment and Offsets, to the extent of such error. Financial consequences directly related to the deliverables under this Contract. 9. Financial Penalties for Failure to Take Corrective Action a. In accordance with the provisions of section 402.73(1), F.S., and Rule 65-29.001, F.A.C., should the ME require a corrective action to address noncompliance under this Contract, incremental penalties listed in Section 9.b. (i)—(iii) shall be imposed for Network Provider failure to achieve the corrective action. These penalties are cumulative and may be assessed upon each separate failure to comply with instructions from the ME to complete corrective action, but shall not exceed ten (10%) of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. These penalties do not limit or restrict the ME's application of any other remedy available to it under law or this Contract. b. The increments of penalty imposition that shall apply,unless the ME determines that extenuating circumstances exist, shall be based upon the severity of the noncompliance,nonperformance,or unacceptable performance that generated the need for corrective action plan, in accordance with the following standards: (i) Noncompliance that is determined by the ME to have a direct effect on client health and safety shall result in the imposition of a ten percent (10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. (i i) Noncompliance involving the provision of service not having a direct effect on client health and safety shall result in the imposition of a five percent(5%) penalty. (iii) Noncompliance as a result of unacceptable performance of administrative tasks shall result in the imposition of a two percent(2%) penalty. c.The deadline for payment shall be as stated in the Order imposing the financial penalties. In the event of non-payment, the ME may deduct the amount of the penalty from invoices submitted by the Network Provider. 10. Termination a. This contract may be terminated by either party without cause upon no less than thirty(30) calendar days' notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the representative of the Network Provider responsible for administration of the program.This provision shall not limit the ME's ability to terminate this Contract for cause according to other provisions herein. b. In the event funds for payment pursuant to this Contract become unavailable, the ME may terminate this Contract upon no less than twenty-four(24) hours' notice in writing to the Network Provider.Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery. The ME shall be the final authority as to the availability and adequacy of funds. In the event of termination of this contract, the Network Provider will be compensated for any work satisfactorily completed through the date of termination. c. In the event the Network Provider fails to fully comply with the terms and conditions of this contract, the ME may terminate the Contract upon no less than twenty-four (24) hours' in writing to the Network Provider, excluding Saturday,Sunday,and Holidays.Such notice may be issued without providing an opportunity for cure if it specifies the nature of the non-compliance and states that provision for cure would adversely affect the interests of the State or is not permitted by law or regulation.Otherwise,notice of termination will be issued after the Network Provider's failure to fully cure such noncompliance within the time specified in a written notice of noncompliance issued by the ME specifying the nature of the noncompliance and the actions required to cure such noncompliance. The ME's failure to demand performance of any provision of this Contract shall not be deemed a waiver of such performance. The ME's waiver of any one breach of any provision of this Contract shall not be deemed to be a waiver of any other breach and neither event shall be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the ME's right to remedies at law or in equity. Revised Standard Contract Page 3 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" d. Failure to have performed any contractual obligations with the ME in a manner satisfactory to the ME will be a sufficient cause for termination. To be terminated as a Network Provider under this provision, the Network Provider must have: (1) previously failed to satisfactorily perform in a contract with the ME, been notified by the ME of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of the ME; or(2) had a contract terminated by the ME for cause. Termination shall be upon no less than twenty-four(24) hour notice in writing. e. If this Contract is for an amount of$1 Million or more,the ME may terminate this Contract at any time the Network Provider is found to have submitted a false certification under section 287.135,F.S.,or,been placed on the Scrutinized Companies with Activities in Sudan List or the or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Regardless of the amount of this Contract, they may terminate this Contract at any time the Network Provider is found to have been placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel. 11. Transition Activities Continuity of service is critical when service under this Contract ends and service commences under a new contract.Accordingly, when service will continue through another provider upon the expiration or earlier termination of this Contract, the Network Provider shall, without additional compensation, complete all actions necessary to smoothly transition service to the new provider.This includes but is not limited to the transfer of relevant data and files,as well as property funded or provided pursuant to this Contract.The Network Provider shall be required to support an orderly transition to the next provider no later than the expiration or earlier termination of this Contract and shall support the requirements fortransition as specified in an ME-approved Transition Plan,which shall be developed jointly with the new provider in consultation with the ME. 12. Use of Funds for Lobbying Prohibited The Network Provider shall comply with the provisions of sections 11.062 and 216.347, F.S.,which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature,judicial branch,or a State agency. 13. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Financial Services.The duties of this office are found in section 215.422, F.S., which include disseminating information relative to prompt payment and assisting vendors in receiving their payments in a timely manner from a State agency.The Vendor Ombudsman may be contacted at(850)413- 5516. 14. Public Records a. The Network Provider shall allow public access to all documents, papers, letters,or other public records as defined in subsection 119.011(12), F.S. as prescribed by subsection 119.07(1) F.S., made or received by the Network Provider in conjunction with this Contract except that public records which are made confidential by law must be protected from disclosure.As required by section 287.058(1)(c), F.S., it is expressly understood that the Network Provider's failure to comply with this provision shall constitute an immediate breach of contract for which the ME may unilaterally terminate this Contract. b. As required by section 119.0701, F.S., to the extent that the Network Provider is acting on behalf of the Department or the ME within the meaning of section 119.011(2), F.S.,the Network Provider shall: (i) Keep and maintain public records that ordinarily and necessarily would be required by the Department and the ME in order to perform the service. (ii) Upon request from the ME or the Department's custodian of public records,provide to the ME or the Department a copy of requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law. (iii) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Network Provider does not transfer the records to the ME or the Department. (iv) Upon completion of the contract,transfer,at no cost,to the ME or the Department all public records in possession of the Network Provider or keep and maintain public records required by the Department to perform the service. If the Provider transfers all public records to the ME or the Department upon completion of the contract, the Network Provider shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Network Provider keeps and maintains public records upon completion of the contract, the Network Provider shall meet all applicable requirements for retaining public records.All records stored electronically must be provided to the ME or the Department, upon request from the Revised Standard Contract Page 4 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" Department's or the ME's custodian of public records, in a format that is compatible with the information technology systems of the ME and the Department. C. IF THE PROVIDER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: (305) 858-3335 EXT. 7458;iro iriguez a)sfbhn.oir ; OR BY MAIL AT 7205 CORPORATE CENTER DRIVE,SUITE 200,MIAMI, FLORIDA 33126.YOU MAY ALSO CONTACT THE CUSTODIAN OF PUBLIC RECORDS FOR THE DEPARTMENT OF CHILDREN AND FAMILES AT 850-487-1111, OR BY EMAIL AT DCFCI.usto °Ian a)MYFLFAMILIES.COM, OR BY MAIL AT: DEPARTMENT OF CHILDREN AND FAMILIES, 1317 WINEWOOD BLVD.,TALLAHASSEE, FL 32399. 15. Audits, Inspections,Investigations, Records and Retention a. The Network Provider shall establish and maintain books,records and documents(including electronic storage media) sufficient to reflect all income and expenditures of funds(to include funds used to meet the local match requirements per 65E-14 F.A.C., if applicable), provided by the ME under this Contract. Upon demand, and at no additional cost to the ME or the Department, the Network Provider will facilitate the duplication and transfer of any records or documents during the term of this Contract and the required retention period in Section 15. b. below.These records shall be made available at all reasonable times for inspection, review,copying,or audit by Federal,State,ME,or other personnel duly authorized. b. Retention of all client records,financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this Contract shall be maintained by the Network Provider during the term of this Contract and retained for a period of seven (7) years after completion of the Contract or longer when required by law. In the event an audit is required under this Contract, records shall be retained for a minimum period of seven (7) years after the audit report is issued or until resolution of any audit findings or litigation based on the terms of this Contract, at no additional cost to the ME or the Department. c. At all reasonable times for as long as records are maintained, persons duly authorized by the ME, State, and Federal auditors, pursuant to 2 C.F.R. §200.336, shall be allowed full access to and the right to examine any of the Network Provider's contracts and related records and documents, regardless of the form in which kept. d. A financial and compliance audit shall be provided to the ME and other entities as specified in this contract and in Attachment II, Financial and Compliance Audit. e. The Network Provider shall comply and cooperate immediately with any inspections,reviews,investigations,or audits deemed necessary by The Office of the Inspector General (section 20.055, F.S.). f. The Network Provider shall include the aforementioned audit, inspections, investigations and record keeping requirements in all subcontracts and assignments. g. No record may be withheld nor may the Network Provider attempt to limit the scope of any of the foregoing inspections, reviews,copying,transfers or audits based on any claim that any record is exempt from public inspection or is confidential, proprietary or trade secret in nature; provided, however, that this provision does not limit any exemption to public inspection or copying to any such record. 16. Inspections and Corrective Action The Network Provider shall permit all persons who are duly authorized by the ME and the Department to inspect and copy any records, papers, documents,facilities,goods and services of the Network Provider which are relevant to this Contract, and to interview any clients, employees and subcontractor employees of the Network Provider to assure the ME of the satisfactory performance of the terms and conditions of this Contract. Following such review, the ME will deliver to the Network Provider a written report of its findings,and may direct the development, by the Network Provider,of a corrective action plan where appropriate. The Network Provider hereby agrees to timely correct all deficiencies identified in the corrective action plan.This provision will not limit the ME's choice of remedies under law, rule, or this Contract. Failure to implement corrective action plans to the satisfaction of the ME, after receiving due notice, shall be grounds for contract termination. 17. Federal Law If this Contract contains federal funds and it is determined by the ME that the Network Provider is a subrecipient, the Network Provider must adhere to the terms below: a. The Network Provider shall comply with the provisions of Federal law and regulations including, but not limited to, 2 CFR, Part 200, and other applicable regulations. b. If this Contract contains $10,000 or more of Federal Funds, the Network Provider shall comply with Executive Order Revised Standard Contract Page 5 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR, Part 60 if applicable. c. If this Contract contains over $150,000 of Federal Funds, the Network Provider shall comply with all applicable standards,orders,or regulations issued under section 306 of the Clean Air Act, as amended (42 U.S.C.§7401 et seq.), section 508 of the Federal Water Pollution Control Act,as amended(33 U.S.C.§1251 et seq.), Executive Order 11738, as amended and where applicable, and Environmental Protection Agency regulations(2 CFR, Part 1500).The Network Provider shall report any violations of the above to the ME and to the Department. d. No Federal Funds received in connection with this Contract may be used by the Network Provider,or agent acting for the Network Provider,or subcontractor to influence legislation or appropriations pending before the Congress or any State legislature. If this Contract contains Federal funding in excess of$100,000,the Network Provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment III. All disclosure forms as required by the Certification Regarding Lobbying from must be completed and returned to the ME Contract Manager, prior to payment under this Contract. e. If this Contract provides services to children up to age 18, the Network Provider shall comply with the Pro-Children Act of 1994(20 U.S.C. §6081). Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation or the imposition of an administrative compliance order on the responsible entity,or both. f. If the Network Provider is a federal subrecipient or pass through entity,the Network Provider and its subcontractors who are federal subrecipients or pass-through entities are subject to the following: A contract award (see 2 CFR § 180.220)must not be made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines in 2 CFR, Part 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies,as well as parties declared ineligible under statutory or regulatory authority otherthan Executive Order 12549. g. If the Network Provider is a federal subrecipient or pass through entity,the Network Provider and its subcontractors who are federal subrecipients or pass-through entities, must determine whether or not its subcontracts are being awarded to a "contractor" or a "subrecipient," as those terms are defined in 2 CFR, Part 200. If a Network Provider's subcontractor is determined to be a subrecipient,the Network Provider must ensure the subcontractor adheres to all the applicable requirements in 2 CFR, Part 200. 18. Confidential Client and Other Information Except as provided by this Contract,the Network Provider shall not disclose but shall protect and maintain the confidentiality of any client information and any other information made confidential by Florida Law or Federal laws or regulations that is obtained or accessed by the Network Provider or its subcontractors incidental to performance under this Contract. State laws providing for confidentiality of client and other information include but are not limited to sections 39.0132,39.00145, 39.202, 39.809, 39.908, 63.162, 63.165, 383.412, 394.4615, 397.501, 409.821, 409.175, 410.037, 410.605, 414.295, 415.107, 741.3165 and 916.107,F.S. Federal laws and regulations to the same effect include section 471(a)(8) of the Social Security Act, section 106(b)(2)(A)(viii) of the Child Abuse Prevention and Treatment Act,7 U.S.C.§2020(e)(8),42 U.S.C.§602 and 2 CFR§200.303 and 2 CFR§200.337,7 CFR§272.1(c),42 CFR§§2.1-2.3,42 CFR§§431.300-306,45 CFR§205. A summary of Florida Statutes providing for confidentiality of this and other information are found in Part II of the Attorney General's Government in the Sunshine Manual,as revised from time-to-time. The Network Provider shall not use or disclose any information concerning a recipient of services under this Contract for any purpose prohibited by State or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 19. Health Insurance Portability and Accountability Act In compliance with 45 CFR§ 164.504(e),the Network Provider shall comply with the provisions of the Business Associate Agreement, incorporated herein by reference, governing the safeguarding, use and disclosure of Protected Health Information created, received, maintained, or transmitted by the Network Provider or its subcontracts incidental to the Network Provider's performance of this Contract. Revised Standard Contract Page 6 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" 20. Client Risk Prevention a. If services to clients are to be provided under this Contract, the Network Provider and any subcontractors shall, in accordance with the client risk prevention system,report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6. The Network Provider shall immediately report any knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number(1-800-96ABUSE). As required by Chapters 39 and 415, F.S.,this provision is binding upon both the Network Provider and its employees. b. The ME monitors timely submissions of incident reports and may impose financial penalties as described in Section 8. Financial Consequences for Network Provider's Failure to Perform. 21. Human Subject Research The Network Provider shall comply with the requirements of CFOP 215-8 for any activity underthis Contract involving human subject research within the scope of 45 CFR,Part 46,and 42 U.S.C.section 289,et seq.,and may not commence such activity until review and approval by the Department of Children and Families Human Protections Review Committee and a duly constituted Institutional Review Board. 22. Support to the Deaf or Hard-of-Hearing a. The Network Provider and its subcontractors shall comply with section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §794, as implemented by 45 C.F.R. Part 84(hereinafter referred to as Section 504),the Americans with Disabilities Act of 1990, 42 U.S.C. 12131, as implemented by 28 C.F.R. Part 35 (hereinafter referred to as ADA), and the Children and Families Operating Instruction (CFOP) 60-10, Chapter 4, entitled "Auxiliary Aids and Services for the Deaf or Hard-of- Hearing. b. If the Network Provider or any of its subcontractors employs fifteen(15)or more employees,the Network Provider and subcontractor shall designate a Single-Point-of-Contact to ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504,the ADA,and CFOP 60-10,Chapter 4.The Network Provider's Single-Point-of-Contact and that of its Subcontractors will process the compliance data into the Department's HHS Compliance reporting Database by the 4th business day of the month, covering the previous month's reporting, and forward confirmation of submission to the Contract Manager. The name and contact information for the Network Provider's Single-Point-of-Contact shall be furnished to the Contract Manager prior to the execution of this Contract, within ten (10) calendar days of staffing change, or within fourteen (14) calendar days of the effective date of this requirement. c. The Network Provider shall,within thirty(30)days of the effective date of this requirement, contractually require that its subcontractors comply with section 504, the ADA, and CFOP 60-10, Chapter 4. A Single-Point-of-Contact shall be required for each subcontractor that employs fifteen (15) or more employees.This Single-Point-of-Contact will ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the Network Provider's Single-Point-of-Contact. d. The Single-Point-of-Contact shall ensure that employees are aware of the requirements, roles and responsibilities, and contact points associated with compliance with Section 504,the ADA, and CFOP 60-10, Chapter 4. Further,employees of the Network Provider and their subcontractors with fifteen (15)or more employees shall attest in writing that they are familiar with the requirements of Section 504,the ADA,CFOP 60-10,Chapter 4.This attestation shall be maintained in the employee's personnel file. e. The Network Provider's Single-Point-of-Contact will ensure that conspicuous Notices which provide information about the availability of appropriate auxiliary aids and services at no-cost to the deaf or hard-of-hearing customers or companions are posted near where people enter or are admitted within the agent locations. Such Notices must be posted immediately by the Network Provider and subcontractors. The approved Notice is available at: https://www.myflfamilies.com/service-programs/individual-with-disability/providers/. f. The Network Provider and its subcontractors shall document the customer's or companion's preferred method of communication and any requested auxiliary aids/services provided in the customer's record. Documentation, with supporting justification, must also be made if any request was not honored. The Network Provider shall distribute Customer Feedback forms to customers or companions and provide assistance in completing the forms as requested by the customer or companion. g. If customers or companions are referred to other agencies,the Network Provider must ensure that the receiving agency is notified of the customer's or companion's preferred method of communication and any auxiliary aids/service needs. h. The Department requires each contract/subcontract provider agency's direct service employees to complete training on serving our customers who are Deaf or Hard-of-Hearing: httr)s://v�ivivi.myflfamilies.com/service- Revised Standard Contract Page 7 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" prol;rams/individual-with-disability/Iaroviders/ and sign the Attestation of Understanding. Direct service employees performing under this Contract will also print their certificate of completion, attach it to their Attestation of Understanding,and maintain them in their personnel file. 23. Emergency Preparedness If the tasks to be performed pursuant to this Contract include the physical care or supervision of clients, the Network Provider shall, within thirty (30) days of the execution of this contract, submit to the Contract Manager an emergency preparedness plan which shall include provisions for records protection,alternative accommodations for clients in substitute care, supplies, and a recovery plan that will allow the Network Provider to continue functioning in compliance with the executed contract in the event of an actual emergency. For the purpose of disaster planning,the term"supervision"includes a child who is under the jurisdiction of a dependency court.Children may remain in their homes, be placed in a non-licensed relative/non-relative home or be placed in a licensed foster care setting. No later than twelve months following the ME's original acceptance of a plan and every twelve (12) months thereafter, the Network Provider shall submit a written certification that it has reviewed its plan, along with any modifications to the plan, or a statement that no modifications were found necessary.The ME agrees to respond in writing within thirty(30)days of receipt of the original or updated plan, accepting, rejecting, or requesting modifications. In the event of an emergency, the Department or the ME may exercise oversight authority over such Network Provider in order to assume implementation of agreed emergency relief provisions. 24. Insurance a. Continuous adequate liability insurance coverage shall be maintained by the Network Provider during the existence of this Contract and any renewal(s)and extension(s)thereof and in accordance with the requirements in Attachment I.By execution of this Contract,unless it is a State agency or subdivision as defined by subsection 768.28(2),F.S.,the Network Provider accepts full responsibility for identifying and determining the type(s)and extent of liability insurance necessary to provide reasonable financial protections for the Network Provider and the clients to be served under this Contract. The limits of coverage under each policy maintained by the Network Provider do not limit the Network Provider's liability and obligations under this Contract. Upon the execution of this Contract,the Network Provider shall furnish the ME written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida.The ME reserves the right to require additional insurance as specified in this Contract.The Network Provider shall notify the Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance, to include but not limited to,cancellation or modification to policy limits. b. To the fullest extent permitted by law,and not withstanding any other provision of this Contract,the Network Provider by signing this Contract acknowledges the value of obtaining Cyber Liability insurance, has considered all of the risks, and assumes all of the risks and liability associated with not obtaining such insurance. The Network Provider will indemnify, defend, and hold the ME harmless from any and all claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs (including reasonable attorneys' and court fees and expenses) arising out of or related to any Breach or alleged Breach of Unsecured PHI created, received, maintained,transmitted, or otherwise used by the Network Provider and arising from the Network Provider's breach, or failure to perform pursuant to this Contract (collectively, a "Claim") up to and including the Appellate Court level and until the case is resolved. If the Network Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the ME shall be to the extent permitted by section 768.28, F.S. or other applicable law, and without waving the limits of sovereign immunity. 25. Indemnification a. The Network Provider shall be fully liable for the actions of its agents,employees,partners,or subcontractors and shall fully indemnify, defend, and hold harmless the ME, State and the Florida Department of Children and Families (DCF), and its officers,agents,and employees,from suits,actions,damages,and costs of every name and description,including attorneys'fees, arising from or relating to any alleged act or omission by the Network Provider, its agents,employees, partners, or subcontractors, provided, however,that the Network Provider shall not indemnify for that portion of any loss or damages caused by the negligent act or omission of the ME. b. The Network Provider shall fully indemnify, defend and hold harmless the ME, the State and the DCF, from any suits, actions, damages, and costs of every name and description, including attorneys' fees, arising from or relating to violation of infringement of a trademark, copyright, patent, trade secret or intellectual property right, provided, however, that the foregoing obligation shall not apply to the ME's misuse or modification of Network Provider's products or a ME's operation or use of Network Provider's products in a manner not contemplated by the contract or the purchase order. If any product is the subject of an infringement suit or in the Network Provider's opinion is likely Revised Standard Contract Page 8 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" to become the subject of such a suit, the Network Provider may at its sole expense procure for the ME the right to continue using the product or modify it to become non-infringing. If the Network Provider is not reasonably able to modify or otherwise secure the ME the use, the ME shall not be liable for any royalties. The Network Provider's indemnification for violation or infringement of a trademark, copyright, patent, trade secret or intellectual property right shall encompass all such items used or accessed by the Network Provider, its officers, agents or subcontractors in the performance of this contract or delivered to the ME for the use of the ME, its employees, agents or contractors. c. The Network Provider shall protect, defend, and indemnify, including attorney's fees and cost, the ME for any and all claims and litigation (including litigation initiated by the ME)arising from or relating to Network Provider's claim that a document contains proprietary or trade secret information that is exempt from disclosure or the scope of the Network Provider's redaction, as provided for under Section 37.,Network Provider's Confidential and Exempt Information. d. The ME shall not be liable for any cost,expense,or compromise incurred or made by the Network Provider in any legal action. The Network Provider's inability to evaluate liability or its evaluation of liability shall not excuse its duty to defend and indemnify after receipt of notice. Only an adjudication or judgment after the highest appeal is exhausted finding the ME negligent shall excuse the Network Provider of performance under this provision,in which case the ME shall have no obligation to reimburse the Network Provider for costs of its defense. If the Network Provider is an agency or subdivision of the State,its obligation to indemnify,defend and hold harmless the ME s hall be to the extent permitted by section 768.28, F.S. or other applicable law,and without waiving the limits of sovereign immunity. 26. Independent Contractor a. In performing its obligations under this Contract,the Network Provider shall at all times be acting in the capacity of an independent contractor and not as an officer, employee, or agent of the ME or the State of Florida, except where the Network Provider is a State agency. Neither the Network Provider nor its agents, employees, subcontractors or assignees shall represent to others that it is an agent,officer or employee of or has the authority to bind the ME or the Department by virtue of this Contract, unless specifically authorized in writing to do so.This Contract does not create any right in any individual to State retirement, leave benefits or any other benefits of State employees as a result of performing the duties or obligations of this Contract. b. The ME will not furnish services of support(e.g., office space, office supplies,telephone service, secretarial or clerical support) to the Network Provider, or its subcontractor or assignee, unless specifically agreed to by the ME in this Contract. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Network Provider,the Network Provider's officers,employees, agents,subcontractors,or assignees shall be the sole responsibility of the Network Provider and its subcontractors.The parties agree that no joint employment is intended and that, regardless of any provision directing the manner of provision of services, the Network Provider and its subcontractors alone shall be responsible for the supervision, control, hiring and firing, rates of pay and terms and conditions of employment of their own employees. 27. Assignments and Subcontracts a. The Network Provider shall not assign the responsibility for this Contract to another party without prior written approval of the ME, upon the ME's sole determination that such assignment will not adversely affect the public interest; however,in no event may the Network Provider assign or enter into any transaction havi ng the effect of assigning or transferring any right to receive payment under this Contract which right is not conditioned on full and faithful performance of Network Provider's duties hereunder. Any sublicense, assignment, or transfer otherwise occurring without prior approval of the ME shall be null and void. The Network Provider shall not subcontract for any of the work contemplated under this Contract without prior written approval of the ME,which shall not be unreasonably withheld. b. The Network Provider shall ensure that all subcontract agreements, at any tier, for work contemplated under this Contract,adhere to all of the requirements of the ME's Prime Contract with the Department and all the requirements of this Contract. A copy of the Prime Contract can be found at the ME's website. vrvrvr.thrivinmind.ar . c. To the extent permitted by Florida Law, and in compliance with Section 25., Indemnification, of this Standard Contract, the Network Provider is responsible for all work performed and for all commodities produced pursuant to this Contract whether actually furnished by the Network Provider or its subcontractors.Any subcontracts shall be evidenced by a written document.The Network Providerfurther agrees that neitherthe ME nor the Department shall be liable to the subcontractor in any way or for any reason.The Network Provider,at its expense,will defend the ME against such claims. d. The Network Provider shall make payments to any subcontractor within seven (7) working days after receipt of payment from the ME in accordance with section 287.0585, F.S., unless otherwise stated in the contract between the Network Provider and subcontractor. Failure to pay within seven (7)working days will result in a penalty that Revised Standard Contract Page 9 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" shall be charged against the Network Provider and paid by the Network Provider to the subcontractor in the amount of one-half of one percent(.005)of the amount due per day from the expiration of the period allowed for payment.Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15%) percent of the outstanding balance due. e. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under its contract with the ME to another governmental agency in the State of Florida or to a provider of the Department's selection,upon giving prior written notice to the ME.In the event the State of Florida approves transfer of the ME's obligations,the Network Provider remains responsible for all work performed and all expenses incurred in connection with the contract.This Contract shall remain binding upon the successors in interest of the Network Provider,the ME and the Department. f. The Network Provider shall include, or cause to be included, in all subcontracts (at any tier) the substance of all clauses contained in this Standard Contract that mention or describe subcontract compliance. as well as all clauses applicable to that portion of the Network Provider's performance being performed by or through the subcontract. 28. Civil Rights Requirements In accordance with Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act of 1990, or the Florida Civil Rights Act of 1992, as applicable the Network Provider shall not discriminate against any employee (or applicant for employment) in the performance of this contract because of race, color, religion, sex, national origin, disability, age, or marital status. Further,the Network Provider shall not to discriminate against any applicant, client, or employee in service delivery or benefits in connection with any of its programs and activities in accordance with 45 CFR 80, 83, 84, 90, and 91, Title VI of the Civil Rights Act of 1964, or the Florida Civil Rights Act of 1992, as applicable and CFOP 60-16. These requirements shall apply to all contractors,subcontractors,sub-grantees or others with whom it arranges to provide services or benefits to clients or employees in connection with its programs and activities.The Network Provider shall complete the Civil Rights Certificate, CF Form 707 and the Civil Rights Compliance Checklist, CF Form 946 in accordance with CFOP 60-16 and 45 CFR 80. 29. State and Federal Whistle-blower Act Requirements a. In accordance with subsection 112.3187, F.S., the Network Provider and its subcontractors shall not retaliate against an employee for reporting violations of law, rule, or regulation that creates substantial and specific danger to the public's health, safety, or welfare to an appropriate agency. Furthermore, agencies or independent contractors shall not retaliate against any person who discloses information to an appropriate agency alleging improper use of governmental office,gross waste of funds, or any other abuse or gross neglect of duty on the part of an agency, public officer, or employee. The Network Provider and any subcontractor shall inform its employees that they and other persons may file a complaint with the Office of Chief Inspector General, Agency Inspector General, the Florida Commission on Human Relations or the Whistle-blower's Hotline number at 1-800-543-5353. b. Pursuant to Section 11(c) of the OSH Act of 1970 and the subsequent federal laws expanding the act, the Network Provider is prohibited from discriminating against employees for exercising their rights under OSH Act. Details of the OSH Act can be found at this website: https://www.whistleblowers.gov/ 30. DEO and Workforce Florida The Network Provider understands the DCF,the Department of Economic Opportunity, and Worksource Florida, Inc., have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment.The ME encourages Network Provider participation with the Department of Economic Opportunity and Workforce Florida, Inc. 31. Transitioning Young Adults The Network Provider understands the Department's interest in assisting young adults aging out of the dependency system. The ME encourages Network Provider participation with the local Community-Based Care Lead Agency Independent Living Program to offer gainful employment to youth in foster care and young adults transitioning from the foster care system. 32. Sponsorship or Financial Support As required by section 286.25, F.S., if the Network Provider is a non-governmental organization which sponsors a program financed wholly or in part by State funds, including any funds obtained through this Contract, it shall, in publicizing, advertising, or describing the sponsorship of the program State: "Sponsored by(Network Provider's Name),Thriving Mind South Florida and the State of Florida, Department of Children and Families". If the sponsorship reference is in written material,the words"Thriving Mind South Florida" and "State of Florida, Department of Children and Families" shall appear Revised Standard Contract Page 10 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" in at least the same size letters or type as the name of the organization. If the sponsorship reference includes any logos or marks, then the logo for Thriving Mind South Florida and for the Department of Children and Families shall appear at least the same size as that for the Network Provider or other entities referenced. 33. Publicity Without limitation, the Network Provider and its employees, agents, and representatives will not, without prior ME or Department written consent in each instance, use in advertising, publicity or any other promotional endeavor any ME or State mark,the name of the ME's or State's mark,the name of the ME,the State, or any ME or State affiliate or any officer or employee of the ME or the State,or represent,directly or indirectly,that any product or service provided by the Network Provider has been approved or endorsed by the ME or the State,or refer to the existence of this Contract in press releases, advertising or materials distributed to the Network Provider's prospective customers. 34. Public Entity Crime and Discriminatory Contractors Pursuant to section 287.133, F.S. and 287.134, F.S., the following restrictions are placed on the ability of persons on the convicted vendor list or the discriminatory vendor list.When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, or an entity or affiliate has been placed on the discriminatory vendor list, such person, entity or affiliate may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or the repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity;and may not transact business with any public entity; provided, however,that the prohibition on persons or affiliates placed on the convicted vendor shall be limited to business in excess of the threshold amount provided in section 287.017, F.S., for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. This provision applies to the Network Provider and all their subcontractors. 35. Employee Gifts The Network Provider agrees that it will not offer to give or give any gift to any ME or Department employee during the service performance period of this Contract and for a period of two (2) years thereafter. In addition to any other remedies available to the ME and the Department,any violation of this provision will result in referral of the Network Provider's name and description of the violation of this term to the Department of Management Services for the potential inclusion of the Network Provider's name on the suspended vendors list for an appropriate period.The Network Provider will ensure that its subcontractors, if any, comply with these provisions. 36. Intellectual Property a. It is agreed that all intellectual property, inventions, written or electronically created materials, including manuals, presentations, films, or other copyrightable materials, arising in relation to Network Provider's performance under this Contract, and the performance of all of its officers, agents and subcontractors in relation to this Contract, are works for hire for the benefit of the Department,fully compensated for by the contract amount,and that neither the Network Provider nor any of its officers,agents nor subcontractors may claim any interest in any intellectual property rights accruing under or in connection with the performance of this Contract. It is specifically agreed that the Department shall have exclusive rights to all data processing software falling within the terms of section 119.084, F.S., which arises or is developed in the course of or as a result of work or services performed under this Contract,or in any way connected herewith. Notwithstanding the foregoing provision, if the Network Provider is a university and a member of the State University System of Florida,then section 1004.23, F.S.,shall apply. b. If the Network Provider uses or delivers to the Department for its use or the use of its employees, agents or contractors, any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the compensation paid pursuant to this contract includes all royalties or costs arising from the use of such design,device,or materials in any way involved in the work contemplated by this contract. For the purposes of this provision, the term "use" shall include use by the Network Provider during the term of this contract and use by the ME, agents, or contractors and the Department during the term of this contract and perpetually thereafter. c. All applicable subcontracts shall include a provision that the Federal awarding agency reserves all patent rights with respect to any discovery or invention that arises or is developed in the course of or under the subcontract. Notwithstanding the foregoing provision, if the Network Provider or one of its subcontractors is a university and a Revised Standard Contract Page 11 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" member of the State University of Florida, then section 1004.23, F.S., shall apply, but the Department shall retain a perpetual, fully-paid, non-exclusive license for its use and the use of its contractors of any resulting patented, copyrighted or trademarked work products. 37. Network Provider's Confidential and Exempt Information a. Unless exempted by law,all public records are subject to public inspection and copying under Florida's Public Records Law, Chapter 119, F.S.Any claim by Network Provider of trade secret(proprietary)confidentiality for any information contained in Network Provider's documents(reports, deliverables or work papers, etc., in paper or electronic form) submitted to the ME in connection with this Contract will be waived, unless the claimed confidential information is submitted in accordance with Section 37. b. below. b. The Network Provider must clearly label any portion of the documents, data or records submitted that it considers exempt from public inspection or disclosure pursuant to Florida's Public Records Law as proprietary or trade secret. The labeling will include a justification citing specific statutes and facts that authorize exemption of the information from public disclosure. If different exemptions are claimed to be applicable to different portions of the protected information, the Network Provider shall include information correlating the nature of the claims to the particular protected information. c. The ME, when required to comply with a public records request including documents submitted by the Network Provider, may require the Network Provider to expeditiously submit redacted copies of documents marked as confidential or trade secret in accordance with Section 37.b.above.Accompanying the submission shall be an updated version of the justification under Section 37. b. correlated specifically to redacted information, either confirming that the statutory and factual basis originally asserted remain unchanged or indicating any changes affecting the basis from the asserted exemption from public inspection or disclosure.The redacted copy must exclude or obliterate only those exact portions that are claimed to be proprietary or trade secret. If the Network Provider fails to promptly submit a redacted copy, the ME is authorized to produce the records sought without any redaction of proprietary or trade secret information. d. The Network Provider shall be responsible for defending its claim that each and every portion of the redactions of proprietary or trade secret information are exempt from inspection and copying under Florida's Public Records Law. 38. Real Property Any State funds provided for the purchase of or improvements to real property are contingent upon the Network Provider granting to the State a security interest in the property at least to the amount of the State funds provided for at least five (5)years from the date of purchase or the completion of the improvements or as further required by law.As a condition of receipt of State funding for this purpose, if the Network Provider disposes of the property before the Department's interest is vacated, the Network Provider will refund the proportionate share of the State's initial investment, as adjusted by depreciation. 39. Information Security a. An appropriately skilled individual shall be identified by the Network Provider to function as its Information Security Officer.The Information Security Officer shall act as the liaison to the ME's and the Department's security staff and will maintain an appropriate level of information security for the ME's and the Department's information systems or any client or other confidential information the Network Provider is collecting or using in the performance of this Contract. An appropriate level of security includes approving and tracking all who request or have access,through the Network Provider's access, to ME or Department information systems or any client or other confidential information. The Information Security Officer will ensure that any access to the ME or Department information systems or any client or other confidential information is removed immediately upon such access no longer being required for Network Provider's performance under this Contract. b. The Network Provider shall provide the latest Department Security Awareness Training to all who request or have access, through the Network Provider's access, to ME and/or Department information systems or any client or other confidential information. c. All who request or have access,through the All Network Provider access,to ME or Department information systems or any client or other confidential information shall comply with and be provided a copy of CFOP 50-2, and shall sign the DCF Security Agreement form CF 0114 annually or immediately upon hire and annually thereafter. The Network Provider shall maintain a copy of the signed DCF Security Agreement form CF 0114 in the personnel file. The Network Provider agrees to submit copies of each signed DCF Security Agreement form CF 0114 to the Contract Manager and the ME's Vice President of IT and Data Analytics upon request. A copy of CF 0114 may be obtained from the Contract Manager. Revised Standard Contract Page 12 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" d. The Network Provider shall make every effort to protect and avoid unauthorized release of any personal or confidential information by ensuring both data and storage devices are encrypted as prescribed in CFOP 50-2.The Network Provider shall require the same of all subcontractors. e. The Network Provider agrees to notify the Contract Manager as soon as possible, but no later than four(4) business days following the determination of any potential or actual unauthorized disclosure or access to ME or Department information systems or to any client or other confidential information. The Network Provider shall require the same notification requirements of all subcontractors. f. The Network Provider shall prevent unauthorized disclosure or access,from or to ME and/or Department information systems or client or other confidential information. Client or other confidential information on systems and network capable devises shall be encrypted per CFOP 50-2. g. The Network Provider shall, at its own cost, comply with section 501.171. F.S. The Network Provider shall also, at its own cost, implement measures deemed appropriate by the ME and/or the Department to avoid or mitigate potential injury to any person due to potential or actual unauthorized disclosure or access to ME or Department information systems or to any client or other confidential information. The Network Provider shall adhere to the requirements of the Business Associate Agreement, incorporated herein by reference. A violation or breach of any of the assurances as stipulated in the Business Associate Agreement must constitute a material breach of this Contract. 40. Accreditation The ME is committed to ensuring provision of the highest quality services to the persons we serve.Accordingly,the ME has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service,the majority of the ME's Network Providers will take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2021. 41. Notice of Legal Action The Network Provider shall notify the ME of legal actions taken against them or potential actions such as lawsuits, related to services provided through this Contract or that may impact the Network Provider's ability to deliver the contractual services,or adversely impact the ME and/or the Department.The Contract Manager will be notified within ten(10)calendar days of Network Provider becoming aware of such actions or from the day of the legal filing,whichever comes first. 42. Unauthorized Aliens and Employment Eligibility Verification (E-Verify) Unauthorized aliens shall not be employed. Employment of unauthorized aliens shall be cause for unilateral cancellation of this Contract by the ME for violation of section 274A of the Immigration and Nationality Act(8 U.S.C. § 1324 a) and section 101 of the Immigration Reform and Control Act of 1986. The Network Provider and its subcontractors will enroll in and use the E-Verify system established by the U.S. Department of Homeland Security to verify the employment eligibility of its employees and its subcontractors' employees performing under this Contract. Employees assigned to the contract means all persons employed or assigned(including subcontractors)by the Network Provider or a subcontractor during the contract term to perform work pursuant to this contract within the United States and its territories. 43. Employment Screening The Network Provider shall ensure that all staff utilized by the Network Provider and its subcontractors (hereinafter, "Contracted Staff")that are required by Florida law and by CFOP 60-25,Chapter 2,which is hereby incorporated by reference to be screened in accordance with chapter435,F.S.,are of good moral character and meet the Level 2 Employment Screening standards specified by sections 435.04, 110.1127, and subsection 39.001(2), F.S., as a condition of initial and continued employment that shall include but not be limited to: a. Employment history checks; b. Fingerprinting for all criminal record checks; c. Statewide criminal and juvenile delinquency records checks through the Florida Department of Law Enforcement (FDLE); d. Federal criminal records checks from the Federal Bureau of Investigation via the Florida Department of Law Enforcement;and e. Security background investigation, which may include local criminal record checks through local law enforcement agencies. f. Attestation by each employee, subject to penalty of perjury, to meeting the requirements for qualifying for employment pursuant to chapter 435 and agreeing to inform the employer immediately if arrested for any of the disqualifying offenses while employed by the employer. Revised Standard Contract Page 13 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" 44. Employment Screening Affidavit The Network Provider shall sign the Florida Department of Children and Families Employment Screening Affidavit each State fiscal year(no two such affidavits shall be signed more than 13 months apart) for the term of the Contract stating that all required staff have been screened or the Network Provider is awaiting the results of screening. 45. Office of Inspector General Request for Reference Check The Department requires,as applicable,the use of the Officer of Inspector General's Request for Reference Check form(CF 774),which states: "As part of the screening of an applicant being considered for appointment to a career service, selected exempt service, senior management, or OPS position with the Department of Children and Families or a Contract or sub- contract provider, a check with the Office of Inspector General (IG) is required to determine if the individual is or has been a subject of an investigation with the IG's Office.The request will only be made on the individual that is being recommended to be hired for the position if that individual has previously worked for the Contract or sub-contract provider, or if that individual is being promoted,transferred or demoted within the Contract or sub-contract provider." 46. Pride Articles which are the subject of or are required to carry out this Contract shall be purchased from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this Contract, the Network Provider shall be deemed to be substituted for the Department insofar as dealings with PRIDE.This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of products/services available from PRIDE may be obtained by contacting PRIDE,(800) 643-8459. 47. Recycled Products The Network Provider shall procure any recycled products or materials,which are the subject of or are required to carry out this Contract, in accordance with the provisions of sections 403.7065, F.S. 48. Renegotiations or Modifications Modifications of provisions of this contract shall be valid only when they have been reduced to writing and duly signed by both parties.The rate of payment and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment when these have been established through the appropriations process and subsequently included in the ME's prime contract with the Department. 49. Dispute Resolution a. The parties agree to cooperate in resolving any differences in interpreting the contract, including but not limited to, client eligibility and/or placement into the appropriate level of care,a general dispute arising out of, or relating to this contract, or contesting a financial penalty for failure to comply with requirements of a corrective action plan.Within five(5)working days of the execution of this contract,each party shall designate a Dispute Resolution Officer with the requisite authority to act as its representative for dispute resolution purposes and provide that information to the other p a rty. b. Within five(5)working days from delivery to the Dispute Resolution Officer of the other party of a written request for dispute resolution,the representatives will conduct a face-to-face meeting to resolve the disagreement amicably.If the parties are not able to meet within the five (5) working days due to scheduling difficulties, the meeting shall occur as mutually agreed to by the parties,but no laterthan ten(10)working days from the date of receipt of the written request for dispute resolution. If the representatives are unable to reach a mutually satisfactory resolution at the face-to-face meeting, the dispute resolution process in Section 49.c. shall be followed. In the event of a dispute regarding client eligibility and/or placement into the appropriate level of care,the dispute shall not preclude the Network Provider from providing the provision of services to eligible individuals until the dispute is resolved. c. If the representatives are unable to reach a mutually satisfactory resolution,either representative may request referral of the issue to the President/Chief Executive Officer of the respective parties. Upon referral to this next step, the President/Chief Executive Officer of the parties shall confer in an attempt to amicably resolve the issue. If the President/Chief Executive Officer of the parties cannot resolve the issue,the issue shall be presented at the discretion of the ME either to the Board of Directors Executive Committee and/or the ME's Board of Directors.Should the dispute not be resolved atthe Board of Directors Executive Committee and/or the ME'sfull Board of Directors level,the decision of the ME shall prevail subject to any legal rights that the Network Provider may have and/or wish to exercise.Venue for any court action will be in Miami-Dade County,Florida.This provision shall not limit the parties'rights of termination under Section 10. Revised Standard Contract Page 14 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" 50. Notice Any notice that is required under this contract shall be in writing and sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery. Said notice shall be sent to the representative of the Network Provider responsible for administration of the program,to the designated address contained in this contract. 51. Final Invoice The final invoice for payment shall be submitted to the ME no more than twenty(20)days, per the requirements stipulated in the Method of Payment section of this Contract, after the contract ends or is terminated. If the Network Provider fails to do so, all rights to payment are forfeited and the ME will not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the Network Provider and necessary adjustments thereto, have been approved by the ME. 52. Survival of Terms Unless a provision hereof expressly states otherwise, all provisions hereof concerning obligations of the Network Provider and remedies available to the ME survive the ending date or an earlier termination of this Contract.The Network Provider's performance pursuant to such surviving provisions shall be without further payment, as the contract payments received during the term of this Contract are consideration for such performance. 53. Governing Law and Venue This Contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with Florida law,without regard to Florida provisions for conflict of laws.State Courts of competent jurisdiction in Florida shall have exclusive jurisdiction in any action regarding this Contract and venue shall be in Miami-Dade County, Florida. 54. Electronic Signature.This Contract may be executed by electronic signature as follows: a. a fax copy of this Contract with a signature page that displays the image of a handwritten signature;or b. a digital file that is transmitted by one party to the other which,when displayed on an electronic video display terminal, presents an image of this Contract with a signature page bearing the image of a handwritten signature. 55. All Terms and Conditions Included This contract and it attachments, I, II, III, & IV, V, &VI and any exhibits referenced in said attachments, together with any documents incorporated by reference, including the ME prime contract(which can be found at http:!/www.thrivingmind.org), contain all the terms and conditions agreed upon by the parties. There are no provisions,terms,conditions,or obligations other than those contained herein, and this contract shall supersede all previous communications, representations, or agreements, either verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable,the remainder of the contract shall remain in full force and effect and such term or provision shall be stricken. In the event of a conflict between the provisions of the documents,the documents shall be interpreted in the following order of precedence: a.Attachment I through Attachment VI,Exhibits,the Business Associate Agreement; b.Any documents incorporated into any Exhibit or Attachment by reference or included as a subset thereof; c.This Standard Contract; d.Any documents incorporated into this Contract by reference. Remainder of page left blank intentionally Revised Standard Contract Page 15 of 16 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLORIDA" BY SIGNING THIS CONTRACT, THE PARTIES AGREE THAT THEY HAVE READ AND AGREE TO THE ENTIRE CONTRACT, AS DESCRIBED IN SECTION 55.ABOVE. IN WITNESS THEREOF,the parties have caused this contract,attachments,exhibits,and any documents referenced herein,to be executed by their undersigned officials as duly authorized. NETWORK PROVIDER:Guidance/Care Center,Inc. SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK,INC. SIGNED SIGNED BY: BY: NAME:Maureen DunleavV NAME: John W.Newcomer,M.D. TITLE: Vice President TITLE:President and CEO DATE: DATE: Federal Tax ID#(or SSN)59-1458324 Network Provider Fiscal Year Ending Date 6 30 Revised Standard Contract Page 16 of 16 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 REVISED ATTACHMENT I A. Service to be Provided 1. Program/Service Specific Terms (1) "Behavioral Health Services" are mental health services and substance abuse prevention and treatment services as defined by s. 394.9082(2)(a), F.S., and in Chapter 397. F.S. (2) "Block Grants":The Community Mental Health Block Grant(CMHBG), pursuant to 42 U.S.C. s. 300x, et. seq., and the Substance Abuse Prevention and Treatment Block Grant(SAPTBG), pursuant to 42 U.S.C. s. 300x-21, et. seq. (3) "Care Coordination" means the implementation of deliberate and planned organizational relationships and service procedures that improve the effectiveness and efficiency of the behavioral health system by engaging in purposeful interactions with individuals who are not yet effectively connected with services to ensure service linkage. Examples of care coordination activities include development of referral agreements, shared protocols, and information exchange procedures. The purpose of care coordination is to enhance the delivery of treatment services and recovery supports and to improve outcomes among priority populations. (4) "Child Welfare Integration and Support Team" (CWIST): Child Welfare Integration and Support Team (CWIST) assists families under the investigation of Department of Children and Families. The CWIST responds to the needs of families in Miami-Dade County while promoting the integration of behavioral health services,substance abuse services,and child welfare systems. The CWIST consists of a clinician and family navigator that will respond to requests by the Department of Children and Families (DCF) to assist in case consultation and care coordination for families under investigation. The CWIST approach is to facilitate the assessment of the family and determine needed interventions by providing immediate consultation through teamwork with Subject Matter Experts, individuals from specific professional disciplines, DCF, and other involved stakeholders. (5) "Citrus Family Care Network" is the Southern Region's (Circuit 11 & 16) Lead Agency for Community Based Care provider under contract with the State of Florida Department of Children and Families for the child protection and child welfare system. (6) "Collaborative Planning Group Systems, Inc." is the entity contracted with the Department of Children and Families that maintains the database called Performance Based Prevention System (PBPS) that Network Providers contracted to provide substance abuse prevention services must utilize to upload substance abuse prevention data required by this contract. (7) "Continuous Quality Improvement" is an ongoing, systematic process of internal and external improvements in service provision and administrative functions, taking into Revised Attachment I HCO2 (f) Page 1 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 account both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. (8) "Contract Manager" is the ME employee who is responsible for enforcing the compliance with administrative and programmatic terms and conditions of a contract. The Contract Manager is the primary point of contact through which all contracting information flows between the ME and the Network Provider. All actions related to the contract shall be initiated by or coordinated with the Contract Manager. (9) "Co-occurring Disorder" is any combination of mental health and substance use in any individual, whether or not they have been already diagnosed. (10)"Co-occurring Disorder Service Capability" is the ability of any program to organize every aspect of its program infrastructure (policies, procedures, practices, documentation, and staff competencies), within its existing resources, to provide appropriately matched, integrated services to the individuals and families with co-occurring disorders that are routinely presenting for care in that program. Should services not be available at the Network Provider then then the individual served must be linked to an agency with the capability to meet the individual's served needs. (11)"Coordinated System of Care", as described in section 394.4573, F.S.is the array of behavioral and related services in a region or community offered by all service providers, whether participating under a contract with a Managing Entity or by another method of community partnership or mutual agreement. (12)"Cost Analysis" is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. (13)"Cultural and Linguistic Competence" is a set of congruent behaviors,attitudes, and policies that come together in a system, agency, or among professional that enable effective work in cross-cultural situations that provides services that are respectful and/or responsive to cultural and linguistic needs. (14) "Department" means the State of Florida Department of Children and Families. (15) "Electronic Health Record (EHR)" is defined in s. 408.051(2)(a), F.S. (16) "Evidenced-Based Practices (EBP) are programs, practices or strategies that are supported by research. EBP's are programs that have demonstrated effectiveness with established genera lizability (replicated in different settings and with different populations over time) through research. The Department has established two option For a list of approved registries used to identify, evaluate, and select EBP programs and strategies please refer to the Department's Guidance Document 1, Evidence Based Guidelines available at the following link: https://www.myflfa m i l ies.com/service-programs/sa m h/managing-entities/i ndex.shtm I Revised Attachment I HCO2 (f) Page 2 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 Note: Click on FY20-21 ME Templates and click on Guidance Document 1, Evidence Based Guidelines (17) "FASAMS DCF Pamphlet 155-2" is the Department of Children & Families, Pamphlet 155-2 - Mental Health and Substance Abuse Measurement and Data means a document promulgated by the Department that contains required data-reporting elements for substance use and mental health services, and which can be found at: https://www.myflfamilies.com/service-programs/samh/fasams/index.shtml (18) "Financial and Services Accountability Management System (FASAMS)"is the Department's information management and fiscal accounting system for providers of community substance use and mental health services. (19) "Forensic Mental Health Services" are services provided to individuals with mental illness pursuant to Chapter 916, Florida Statutes. (20) "HIPAA" is the acronym for Health Insurance Portability and Accountability Act and shall mean the Privacy,Security, Breach Notification,and Enforcement Rules at 42 U.S.C.§1320d, and 45 C.F.R. Parts 160, 162, and 164. (21) "Individual(s)Served" (synonymous with Client,Consumer, Participant)is an individual who receives substance use or mental health services, the cost of which is paid, either in part or whole, by Department appropriated funds or local match (matching). (22) "Knight Information Software (KIS) is the ME's online data system which Network Providers that do not have their own data system are required to use to collect and report data and performance outcomes on individual served whose services are paid for, in part or in whole, by the ME's contract, Medicaid, local match, Temporary Assistance for Needy Families (TANF), Purchase of Therapeutic Services (PTS) and Title 21 . The KIS, or other system designated by the ME, must be utilized to upload individual served-related data as required by this contract. (23) "Lead Agency for Community-Based Care (CBC)" is an agency under contract with the Florida Department of Children and Families that provides care for children in the child protection and child welfare system. (24)"Local Match" means funds received from governing bodies of local government, including city commissions, county commissions, district school boards, special tax districts, private hospital funds, private gifts both individual and corporate, and bequests and funds received from community drives or any other sources. See § 394.67, F.S. F.S. and 65E-14.005, F.A.C. (25) "Managing Entity(ME)" as defined in section 394.9082(2)(e), F.S., is a corporation selected Revised Attachment I HCO2 (f) Page 3 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) ;2020 by and under contract with the Department to manage the daily operational delivery of behavioral health services through a coordinated system of care. (26) "Mental Health Services" is defined pursuant to Chapter 394,67(15) F.S. (27)"Motivation al Support Program" are services provided in Monroe County designed to reduce the incidence of child abuse and neglect resulting from parents' or caregivers' behavioral health and to improve outcomes for families in the child welfare system and/or community-based care. (28) "Network Provider" is an entity that contracts with the ME and receives funding to provide services to consumers; in this contract the Network Provider is synonymous with provider or subcontractor. (29)"Outcome for Individual Service Recipient" is a measure of the quantified result, impact, or benefit of services on the individual service recipient. (30) "PBPS" is the Department's Performance Based Prevention System that collects data related to community assessments and plans and substance use prevention programs and activities. (31) "Performance Measures" are quantitative indicators, outcomes and outputs that are used by the Department to objectively measure performance and are used by the ME and Network Providers to improve services. (32)"Prevention" refers to the proactive approach to preclude, forestall, or impede the development of substance abuse or mental health related problems.These strategies focus on increasing public awareness and education, community-based processes, and incorporating evidence-based practices. Additional guidance regarding prevention services can be found in the Department's Guidance Document 10, Prevention Services and is available at the following link: https://www.myflfa m i l ies.com/service-programs/sa m h/managing-entities/i ndex.shtm I Note:Click on FY20-21 ME Templates and click on Guidance Document 10, Prevention Services (33) "Prevention Partnership Grant" is a program created by s. 397.99, F.S. designed to encourage school and community substance abuse prevention partnerships. The PPG program is funded through the federal Substance Abuse and Treatment Block Grant, administered by the Florida Department of Children and Families and managed by the ME. (34)"Prime Contract" is the contract between the Department of Children and Families and the ME. Revised Attachment I HCO2 (f) Page 4 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 (35) "Program Description" is the document the Network Provider prepares and submits to the ME for approval prior to the start of the contract period, which provides a detailed description of the services to be provided under the contract pursuant to Rule 65E-14, F.A.C. It includes but is not limited to the Network Provider's organizational profile, the service activity description, a detailed description of each program and covered service funded in the contract, the geographic service area, service capacity, staffing information, r and target population to be served. (36) "Projects for Assistance in Transition from Homelessness (PATH)" is a federal grant to support homeless individuals with mental illnesses, who may also have co-occurring substance use and mental health treatment needs. (37) "Protected Health Information" (PHI) relates to any information whether oral or recorded in any form or medium that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and 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. (38) "Provider Network" (subcontractor or Network Provider) refers to the group of direct service providers, facilities, and organizations under contract with a ME to provide a comprehensive array of emergency, acute care, residential, outpatient, recovery support, and support services including prevention services and any other services purchased by this contract. See section 394.9082, F.S. (39) "Quality Assurance" is a process that measures performance in achieving pre-determined standards,validates internal practice,and uses sound principles of evaluation to ensure that data are collected accurately, analyzed appropriately, reported correctly and acted upon in a timely manner.The process may employ peer review, and outcomes assessment,to assess quality of care. (40) "Quality Improvement/Continuous Quality Improvement" is a management technique to assess and improve internal operations and network services. It focuses on organizational systems rather than individual performance and seeks to continuously improve quality.The process involves setting goals implementing systematic changes, measuring outcomes, and making subsequent appropriate improvements. Quality improvement activities will assess compliance with contract requirements, state and Federal law and associated administrative rules, regulations, and operating procedures and validate quality improvement systems and findings. (41) "Representative Payee" refers to an entity/individual that is legally authorized to receive Supplemental Security Income, Social Security Income, Veterans Administration benefits, or other federal benefits on behalf of an individual served. (42) Request for Application #10H17GN1" is the Department's most recent Prevention Revised Attachment I HCO2 (f) Page 5 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 Partnership Grant Request for Application for Fiscal Years 2018-2021. (43) "SAMH" stands for the Substance Abuse and Mental Health Programs within the Department. (44) "SAVE/VIS Program" is the U.S. Department of Homeland Security (DHS) administers the Systematic Alien Verification for Entitlements (SAVE) program. This program verifies immigration status and eligibility of alien applicants for federal benefits. The alien status verification system under SAVE is entitled the Alien Status Verification Index (ASVI), as described at 60 Federal Register 52694, 52697 (1995) administered by the Computer Sciences Corporation (CSC) as the Verification Information System (VIS). The SAVE/VIS Program can and may provide assistance in verifying eligibility in cases where a consumer does not possess sufficient documentation. (45) "Seclusion and Restraint Data System"referred to as SAN DR,is the Department of Children and Families'web-based data system used to collect and report the frequency and types of seclusion and restraint events that involve persons served in state-contracted and non-state contracted community substance abuse and mental health programs, and state mental health treatment facilities. All facilities, as defined in section 394.455(10), F.S.,are required to report each seclusion and restraint event to the Department of Children and Families in accordance with but not limited to Rule 65E-5.180, F.A.C. (46)"SOAR" stands for Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access and Recovery and is a Substance Abuse and Mental Health Services Administration (SAMHSA) technical assistance initiative designed to help individuals increase earlier access to SSI and SSDI through improved approval rates on initial Social Security applications by providing training, technical assistance, and strategic planning to Network Service Providers. (47) "Stakeholder(s)" are individuals/groups with an interest in the provision of treatment services for substance use, mental health services, and/or co-occurring disorders in the circuits outlined in Section A.2.c.(2), of this Contract. This includes, but is not limited to,the key community constituents included in section 394.9082, F.S. (48) "Statewide Inpatient Psychiatric Programs (SIPP)" are residential inpatient facilities under contract with the Agency for Health Care Administration (AHCA) under the Medicaid Institutes for Mental Disease (IMD) 1915B waiver for children under age 18 to provide diagnostic and active treatment services in a secure setting. (49) "Substance abuse" as defined in Chapter 397, F.S. means the misuse or abuse of, or dependence on alcohol, illicit drugs, or prescription medications. As an individual progresses along this continuum of misuse, abuse, and dependence, there is an increased need for substance abuse intervention and treatment to help abate the problem. (50) "Substance Abuse and Mental Health Information System (SAMHIS)" is the Department's web-based data system for reporting data such as but not limited to, Demographic, Revised Attachment I HCO2 (f) Page 6 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 Temporary Assistance to Needing Families data, Seclusion and Restraint data and Incident reports by the Managing Entity and all Network Service Providers in accordance with this contract. (51) "TANF Participant" is a person or family member of that person defined in 45 C.F.R. Part 260.30 and section 414.1585 and subsection 414.0252(9), F.S. (52) "Temporary Assistance to Needy Families (TANF)" as defined by 42 U.S.C. ss. 601, et. seq., and ch. 414, F.S. , is a federal block grant component which provides funding to states to help move recipients into work. In the context of the Department, Office of Substance Abuse and Mental Health (SAMH), TANF is a funding stream for providing substance use disorder services or mental health services to families receiving TANF cash assistance benefits. (53)Third Party Payer" means commercial insurers such as workers' compensation, TRICARE, Medicare, Health Maintenance Organizations, Managed Care Organizations, or other payers liable, to the extent that they are required by contract or law, to participate in the cost of providing services to a specific individual. (54)"Warm Hand-off" as defined by the U.S. Department of Health and Human Services is a transfer of care between two members of the health care team, where the handoff occurs in front of the patient and family. This transparent handoff of care allows patients and families to hear what is said and engages patients and families in communication, giving them the opportunity to clarify or correct information or ask questions about their care. Warm handoffs engage the patient through structured communication and improve safety by helping prevent communication breakdowns. 2. General Description a. General Statement The Prevention Partnership Grants (PPG) program created by s. 397.99, F.S., is designed to encourage school and community substance abuse prevention partnerships. The PPG program is funded through the federal Substance Abuse Prevention and Treatment Block Grant (Block Grant), administered by the Florida Department of Children and Families and managed by the ME. The services provided under this contract are to fund rigorous, effective, evidence-based, substance abuse prevention programs and strategies intended to prevent or reduce Florida substance use and abuse rates at the community level. The strategies, activities, and services must be consistent with the local community ME- approved local Needs Assessment Logic Model (HALM), the Comprehensive Community Action Plan (CCAP) and with the Network Provider's Application filed with the Department in response to the Request for Applications# 10H17GN1, herein incorporated by reference and made part of this contract. Revised Attachment I HCO2 (f) Page 7 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 The Network Provider shall work in collaboration with the funded ME Evaluation Entity, by participating in meetings and providing service data vital for the completion of a system-wide evaluation of the prevention services within the Strategic Prevention Framework. The evaluation of the prevention system is expected to be the systematic collection and analysis of information about program activities, characteristics, and outcomes to reduce uncertainty, improve effectiveness, and assist in decision-making. The information gathered from the evaluation process will help the ME, the State and communities become more skillful and exact in describing what they plan to do, monitor what they are doing, and improve the prevention system of care. Evaluation results can and should be used to determine what efforts should be sustained and to assist in sustainability planning efforts. The ME will provide substantial input, in collaboration with the Network Provider and the Evaluation Entity, both in planning and implementation of the evaluation process and activities and will make recommendations regarding the continuance of the activities. b. Authority Section 394.9082, F.S., the Prime Contract, and the Request for Applications # 10H17GN1, provides the ME with the authority to contract for these services. c. Scope of Service The following scope of service applies to the contract period and any renewal or extension. (1) The Network Provider is responsible for the administration and provision of services to the target population(s)indicated in Exhibit A,Individualsto be Served/Participantsto be Served, and in accordance with the tasks outlined in Section B.1.a., of this contract, and the Scope of Work found in Attachment IV. Services shall also be delivered at the locations specified in, and in accordance with the Program Description, as required by Rule 65E-14.021, F.A.C.which is herein incorporated by reference, and maintained in the ME's Contract Manager's file. (2) Services are to be delivered in the following county(ies): Miami-Dade County X Monroe County d. Major Program Goals The overall scope of the grant activities for the PPG program are to: (1) Develop effective substance abuse prevention and early intervention strategies for the target populations; and, (2) Conduct prevention activities serving students who are not involved in substance abuse, intervention activities serving students who are experimenting with substance use, or Revised Attachment I HCO2 (f) Page 8 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thr t S oath tloriida �at�����or ill Theafth Nemork. n(%) ;2020 both prevention and intervention activities, if a comprehensive approach is indicated as a result of a needs assessment. (3) PPG activities must relate to the local community department-approved local Needs Assessment Logic Model (HALM)to show target population and subpopulation problems to be addressed.The goals and objectives of the Comprehensive Community Action Plan (CCAP) will call for evidence-based prevention program activities or strategies for which there is a demonstrated need. The CCAP guides the selection of evidence-based prevention program activities or strategies for which there is limited or no current local capacity. The principles of cultural competency must be incorporated into their needs assessment logic model and the CCAP. Each community must also include a written sustainability plan in their response which details their plan to sustain activities after funding has ended. e. Minimum Programmatic Requirements The Network Provider shall maintain the following minimum programmatic requirements: (1) System of Care The individual-centered and family-focused system of care will: (a) Be driven by the needs and choices of the individuals served; (b) Promote family and personal self-determination and choice; (c) Be ethically,socially,and culturally responsive;and (d) Be dedicated to excellence and quality results. (2) Guiding Principles Guiding principles specify that services are as follows: (a) Inclusive- involve and engage families and Individuals to be Served as full partners to participate in the planning and delivery of services; (b) Comprehensive - incorporating a broad array of service and supports (e.g. physical, emotional,clinical,social,educational, community and spiritual); (c) Individualized- meeting the individual's exceptional needs and strengths; (d) Strengths based—focus on the strengths of the individual served, not their deficits; (e) Community-based- provided in the least restrictive,clinically appropriate setting; (f) Coordinated-both at the system and service delivery levels to ensure that Revised Attachment I HCO2 (f) Page 9 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork.ln(%) ;2020 multiple services are provided and change as seamlessly as possible when warranted; (g) Cultural and linguistic competence (h) Gender responsive, (i) Sexual orientation, and (j) Recovery-oriented and recovery-supported 3. Consumers to be Served See Exhibit A,Individuals/Participants to be Served B. MANNER OF SERVICE PROVISION 1. Service Tasks The following tasks must be completed for each fiscal year covered in the contract period. a. Task List (1) Based on needs, the Network Provider shall adhere to services as outlined in the in addition to providing services from the list of approved covered services listed in Exhibit G,Covered Service Funding by OCA.Any change in the array of services shall be justified in writing and submitted to the ME's Contract Manager for review and approval. (2) The Network Provider shall ensure that all staff is properly trained as required by the substance abuse licensing Rule 65D-30, F.A.C. (3) The Network Provider shall serve the number of persons indicated Attachment VI, Scope of Work, within the covered services listed in Exhibit G,Covered Service Funding by OCA. (4) The Network Provider shall ensure the fidelity of each EBP the agency is utilizing. (5) The Network Provider shall develop and implement policies so that all applicable providers' employees abide by the terms and conditions of Paragraph 39., Information Security, of the Standard Contract. The Network Provider shall submit to the Managing Entities Contract Manager, by 8/03/2020, verification that all Network Provider employees and subcontractors who have access to ME and Department information systems have completed the Security Agreement form as identified in Paragraph 39. Information Security, of the Standard Contract. Revised Attachment I HCO2 (f) Page 10 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil ton;)t S oath tloriida �at�����or ill Theafth Nemork. n(%) ;2020 (6) For licensable services purchased by this Contract, such as substance abuse prevention services, the Network Provider shall have and maintain correct and current Department of Children and Families and Agency for Health Care Administration (AHCA) licenses and only bill for services under those licenses. In the event any of the Network Provider's license(s) are suspended, revoked, expired or terminated, the ME shall suspend payment for services delivered by the Network Provider under such license(s) until said license(s) are reinstated. (7) By 08/03/2020, the Network Provider must to the ME's Contract Manager grievance procedures, which include an appeal process with the ME, should the grievance not be resolved at the Network Provider level, which applicants for, and recipients of, services being provided under this contract, may use to present grievances to the Network Provider, or to the ME about contracted services. Should any updates to the grievance procedures occur during the term of this contract, the Network Provider must submit the amended procedures to the Contract Manager within thirty (30)calendar days of the amendment. The Network Provider must post and provide copies of the grievance procedures to all individuals receiving services with funds provided for in this Contract. (8) By 08/03/2020,the Network Provider shall submit to the ME's Contract Manager a disaster plan consistent with Paragraph 23., Emergency Preparedness, of the Standard Contract. (9) Should the ME conduct a mock emergency drill, the Network Provider shall participate by activating their emergency/disaster plan and reporting on preparedness activities, response activities, and post-recovery activities. (10) By 08/03/2020,the Network Provider shall submit to the ME's Contract Manager a completed Civil Rights Compliance Questionnaire. (11) The Network Provider shall execute or maintain if executed, a Memorandum of Understanding (MOU) or contract with the appropriate Federally Qualified Health Center or other medical facility. The MOU provides for the integration of behavioral health services and primary health care services for all participants and consumers in care. Referral and linkage processes will be necessary for all participants/consumers who do not have a primary care provider at entry into the services in the system of care. Follow up and coordination of services are essential to meeting participant/consumer health and behavioral health needs which result in: • Improved access to primary care services; • Improved prevention, early identification, and intervention to reduce the incidence of serious physical illnesses, including chronic disease; • Increased availability of integrated, holistic care for physical and behavioral disorders;and Revised Attachment I HCO2 (f) Page I of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork.ln(%) ;2020 • Improved overall health status of consumers The relationships should be cooperative and reciprocal; that is, the partnership adds value to the program strategies and outcomes and achieves a level of systems improvement beyond the current standards. Programs and coalitions are required, based on the Strategic Prevention Framework(SPF)and all of the Prevention philosophy,to work together to achieve larger system outcomes based on the planning process and following the principles of integrated care. In addition, all funded providers will be contractually required to work comprehensively with the funded Evaluation entity. Newly executed MOU's must be submitted within ninety(90)calendar days of the effective date of this contract to the ME's Contract Manager.The Network Provider must submit copies of any amendment to the MOU, to the ME's Contract Manager, within thirty (30) calendar days of execution. Network Providers that operate Federally Qualified Health Centers are required to submit policies and procedures that explain the access to primary care services to the medically underserved behavioral health individual served.Any revisions to the policy and procedure must be submitted to the ME's Contract Manager within 30 calendar days of its adoption. (12) By 08/03/2020, the Network Provider shall submit to the ME's Contract Manager a Quality Assurance Plan that details how the Network Provider will ensure and document that quality services are being provided to the individuals served,which is herein incorporated by reference. The Network Provider shall submit updates as amended of the Quality Assurance Plan within thirty(30)days of adoption. The Quality Assurance Plan should address the minimum guidelines for the Network Provider's continuous quality improvement program, including, but not limited to: (a) Individual care and services standards to include transfers and referrals, co-occurring supportive services, trauma informed services, and cultural and linguistic competence, integrated care, recovery-oriented system of care principles. (b) Individual records maintenance and compliance. (c) Staff development standards. (d) Service-environment safety and infection control standards. (e) Peer review procedures. (f) Incident reporting policies and procedures that include verification of corrective action and a provision that specifies that a person who files an incident report, in good faith, may not be subjected to any civil action by virtue of that incident report. Revised Attachment I HCO2 (f) Page 12 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork.ln(%) ;2020 (g) Fraud, waste, abuse and other potential wrongdoing auditing, monitoring, and remediation procedures. (h) Evidence-based practices (EBPs) utilized by the agency and how these EBPs are monitored to ensure fidelity to the model. (i) The Continuous Quality Improvement Initiatives identified in Section B.1.a.(16) below. (13) By 10/01/2019,the Network Provider must submit an attestation signed by the CEO/Executive Director indicating that all applicable staff funded by this Contract have received a copy of this fully executed contract and will receive copies of any amendments made to this Contract. (14) Linkage and Referral Process (a) The Network Provider's policies and procedures must address the referral and linkage process which include a "warm handoff" when referring individuals to all levels of services.This includes, but is not limited to, referrals within a Network Provider from one level of care to another, i.e. residential to outpatient; referrals outside of the Network Provider when a service is not offered by the Network Provider; and referrals to services upon discharge from the Network Provider, regardless if a planned or unplanned discharge. This also includes when an individual present at the Network Provider for a service; however, they are not actually admitted to the service for varying reasons. Such referral services include, but are not limited to, detoxification services, linkages with community programs such as housing, employment, parenting supports, and primary health care. (b) A warm handoff consists of the Network Provider coordinating and facilitating the individual's admission to the next appropriate level of care by direct communication and follow-up with the receiving provider.These efforts must be documented and maintained in the individuals' clinical record and should include detailed information including dates, times, and names of people spoken to. (c) When a referral is made for a service at another provider with the expectation to return to the referring provider, i.e.detoxification,the referring Network Provider should initiate the warm handoff and maintain follow-up with the receiving provider to coordinate entry back to the referring Network Provider.This must be documented and maintained in the individual's clinical record and should include detailed information including dates,times, names of people spoken to, and final disposition, i.e. date returned or justification when not returning. (15) Continuous Quality Improvement Programs (a) The Network Provider must maintain a continuous quality improvement program and Revised Attachment I HCO2 (f) Page 13 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil ton; .S oath tloriida �at�����or ill Theafth Nemork.ln(%) /2020 report on the continuous quality improvement activities. The program is the responsibility of the Director and is subject to review and approval by the governing board of the service Network Provider. Each director shall designate a Quality Assurance Officer/Compliance Officer who will be responsible for the continuous quality improvement program. The continuous quality Improvement program should objectively and systematically monitor and evaluate the appropriateness and quality of care to ensure that services are rendered consistent with prevailing professional standards and identify and resolve problems. (b) The quality improvement program must include at minimum: i. Activities to ensure that fraud, waste and abuse do not occur. ii. Composition of quality assurance review committees and subcommittees, purpose,scope,and objectives of the continuous quality assurance committee and each subcommittee, frequency of meetings, minutes of meetings, and documentation of meetings. iii. A framework for evaluating outcomes, including: 1. Output measures, such as capacities, technologies, and infrastructure that make up the system of care. 2. Process measures, such as administrative and components of the services. 3. Outcome measures pertaining to the outcomes of services; iv. A system of analyzing those factors which have an effect on performance; V. A system of reporting the results of continuous quality improvement reviews;and, vi. Best practice models for use in improving performance in those areas which are deficient. vii. Establishment of a Seclusion and Restraint Oversight Committee per Chapter 65E- 5.180, F.A.C. for agencies utilizing seclusion and/or restraint. (16) Continuous Quality Improvement Initiatives - Providers must comply with all of the provisions for the initiatives outlined below: (a) Integration of Behavioral Health Services and Primary Health Care Revised Attachment I HCO2 (f) Page 14 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thr t S oath tloriida �at�����or ill Theafth Nemork.ln(%) ;2020 It is the goal of the ME to ensure the integration of behavioral health services and primary care services to all the individuals in care. The integration will be ensured through linkage of the behavioral health provider with the primary health care provider of the consumer through an electronic health record or other means of contact(phone, in person, etc). Referral and linkage processes will be necessary for all individuals who do not have a primary health care provider at entry into the system of care. Follow up and coordination of services are essential to meeting an individual's health and behavioral health needs. Many individuals with behavioral health issues have chronic health conditions and may have neglected their primary health needs for some time. The ME and the Southern Region are committed to developing an integrated system of care that incorporates comprehensive screening and monitoring tools that identify those affected by chronic health conditions and a system of care that meets their needs. Network Providers will be implementing Integrated Primary and Behavioral Health techniques and initiatives to meet this need. This initiative will be addressed through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the Health Integration Initiative. As part of the plan or component of the plan must include the following: i. Identification of at least two Integrated Healthcare Champions who will attend trainings and meetings. The names of the Integrated Healthcare Champions will be submitted upon request by ME staff. In the event of change in staff occur,the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days, ii. Identification of the Federally Qualified Health Center or other medical facility where individuals who have been identified as needing primary health care services are referred to or the process established by the Network Provider to coordinate services with the individuals' private primary health care provider should such exist. iii. A process to track and report referrals of: • behavioral health services to primary health care services, and • From a primary health care provider to behavioral health services. iv. Participation in the regional Healthcare Integration Committee meetings to develop the processes and training germane to this initiative. V. Attendance of appropriate staff at the regional trainings regarding Integrated Healthcare, as requested by the ME staff. Participation in the trainings will be Revised Attachment I HCO2 (f) Page 15 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork.ln(%) ;2020 documented in the Continuous Quality Improvement Updates. (b) Trauma Informed Care Many individuals with behavioral health issues have experienced trauma that affects their development and adjustment.The ME and the Southern Region are committed to developing a system of care that incorporates comprehensive assessment tools that identify those affected by trauma and a system of care that meets their needs. Network Providers will be implementing the Trauma Informed Care (TIC) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the TIC initiative.As part of the plan or component of the plan must include the following: i. Identification of at least two TIC Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. ii. Participation in the regional TIC meetings to develop the process for identifying and responding to those affected by trauma. iii. Attendance at the regional trainings regarding TIC as applicable. Applicable trainings will be documented in the Continuous Quality Improvement Updates. iv. Participation in all TIC related activities to ensure staff and agency become competent in all areas of trauma informed care. (c) Cultural and Linguistic Competence It is the goal of the ME to become a culturally and linguistically proficient network, through the full implementation of The National Standards for Cultural and Linguistically Appropriate Services (the National CLAS Standards). The National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and behavioral health care. In order to accomplish this task, the Network Provider: i. Identification of at least two CLC Champions at the beginning of the contract term and submit the names of the individuals when requested by ME staff. ii. Participation in the regional CLC meetings. iii. Collaborate with the ME to identify and utilize the Network Provider's data to (1) identify sub-populations (i.e., racial, ethnic, Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, or Two-Spirited (LGBTQI-2S), minority groups) vulnerable to disparities and (2) implement strategies to decrease the differences in access, service Revised Attachment I HCO2 (f) Page 16 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork.ln(%) ;2020 use, and outcomes among sub-populations. These strategies should include the use of the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care; iv. Agrees to implement effective language access services to meet the needs of individuals with limited-English-proficiency, and/or who are deaf and hard-of-hearing consumers and increase their access to behavioral health care by providing sign language, translation,and interpretive services required to meet the communication needs of the individual seeking and or receiving services , including English, Spanish and Creole. Services will meet the cultural needs and preferences of the populations served. (d) Integration of Behavioral Health and the Child Welfare System i. The Network Provider will ensure that behavioral health services are available to consumers referred by the Community Based Care Organizations (CBC) or by the Department's Child Protective Investigators in cases where behavioral health indicators are present during the initial child abuse/neglect investigation or at any point during child protective supervision or out-of-home care. Priority will be given to cases where a child is at risk for immediate removal or has been removed from the family, with a goal of reunification in the family safety plan. Services may also be provided for the enrolled parent(s)'/caregiver(s)'family members, household residents, or significant others in need of behavioral health prevention or treatment services, as well as children in relative placements. For a detailed description of the eligibility criteria please refer to the approved CWIST Protocols and Family Intensive Treatment Team Protocols, herein incorporated by reference and available upon request to the MEs Contract Manager. ii. The coordination of efforts between the CBC,the ME and Network Providers is essential to the efficient service delivery for child-welfare involved families in behavioral health treatment. The ME and the Southern Region's Lead Agency for Community-Based Care are committed to developing an integrated system of care that meets the needs of children and their families. Network Providers will be implementing the Child Welfare Integration (CWI) initiative through a continuous quality improvement plan or component in the existing agency wide continuous quality improvement plan that delineates participation in the CWI initiative. As part of the plan or component of the plan must include the following: 1. Identification of at least two CWI Champions who will attend trainings and meetings. The names of the CWI Champions will be submitted upon request by ME staff. In the event of change in staff occur, the Network Provider must notify the ME's Contract Manager, in writing within ten (10) calendar days. 2. Attendance at scheduled CWI meetings including Integration Workgroup meetings to develop the process for identifying and responding to child-welfare Revised Attachment I HCO2 (f) Page 17 of 46 Guidance/Care Center, Inc. Contract No. P-04 'hriOno tend �otgth Florilda 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork.ln(%) ;2020 involved families. 3. Attendance at trainings regarding CWI when notified by the ME. Attendance applicable trainings will be documented in the Continuous Quality Improvement Updates. 4. Participation in all CWI related activities to ensure staff and agency become knowledgeable of the Child Welfare system. (e) Mandatory Accreditation The Network Provider shall take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2021, as required by this section, in order to promote best practices and the highest quality of care. The Network Provider shall provide the ME with their full accreditation and licensing reports upon request. Network Provider applicants for licensure and licensed network providers must meet the most current best practice standards related to the licensable service components of the accrediting organization. Accreditation by an accrediting organization recognized by the Department, as required by Chapter 397, F.S., is a requirement for licensure renewal of clinical substance abuse treatment services. The licensable substance abuse treatment components are listed in subsection 65D- 30.002 (17), F.A.C. Failure to meet the accreditation requirements will be considered by the ME to be a breach of this Contract and this contract may be subject to termination. (17) Continuous Quality Improvement Updates The Network Provider shall submit semi-annual updates, by the dates specified in Exhibit C, Required Reports, on the implementation and progress of the following activities: (a) Integration of Behavioral Health Services and Primary Care; (b) Trauma Informed Care; (c) Cultural and Linguistic Competence initiative; (d) Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; (e) Mandatory Accreditation Requirements: Monitoring processes to ensure that all licensable substance abuse treatment components funded by this Contract meet the most current best practice standards related to the licensable service components of the accrediting organization,as required by Rule 65D-30.003(2), F.A.C., Department Licensing Revised Attachment I HCO2 (f) Page 18 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork.ln(%) ;2020 and Regulatory Standards; (f) Recovery-oriented system of care principles; (g) Evidence of the implementation of the integration of behavioral health services and primary health care, evidence of tracking and ensuring the successful referrals and linkages of individuals receiving behavioral health services to primary health care services and individuals referred from the primary health care provider to the Network Provider for behavioral health services, and include progress on the implementation as described in the Network Provider's action plan to include the following: • The number of individuals receiving behavioral health services that are identified as needing primary care. (18) Care Coordination and Reporting Requirements If requested by the ME, the Network Provider shall participate and comply with Care Coordination activities as defined in section 394.4573(1)(a), F.S. (19) Program Status Report The Network Provider shall submit an annual detailed report of the services and activities performed and the progress of the Program in meeting the performance measures, goals, objectives and tasks as described in Attachment VI, Scope of Work. The report shall be submitted by the due date specified in Exhibit C, Required Reports. (20) PPG Specific Financial Report The Network Providers shall submit an annual detailed financial report of Program Expenses which are used to track all expenses associated with this Contract and reconcile these expenditures with the payments made to the Network Provider by the dates specified in Exhibit C, Required Reports. The financial reports track both grant award-funded and match funded expenses and encourages expenditure planning and projection. Pursuant to Rule 65E- 14.021, F.A.C.,the Network Provider shall use the Department's form CF-MH 1037. The form CF-MH 1037 and the corresponding instructions are available at the following website: https://eds.myflfamilies.com/DCFFormslnternet/Search/DCFFormSearch.aspx (21) Financial Audit Reports (a) The Network Provider shall submit quarterly financial statements consisting of Balance Sheet and Statement of Activity (income statement) per the schedule and to the individual(s) identified in the Exhibit C, Required Reports. The Network Provider agrees to provide the ME with any requests for additional financial statements/documentation. (b) Network Providers who withhold income taxes, social security tax, or Medicare tax from Revised Attachment I HCO2 (f) Page 19 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 employee's paychecks or who must pay the employer's portion of social security or Medicare tax must use Form 941, Employer's Quarterly Federal Tax Return, to report those taxes. On a quarterly basis, and by the dates specified in Exhibit C, Required Reports, the Network Provider, shall submit an attestation that the 941 has been filed timely and any taxes due have been paid timely to IRS. (c) The Network Provider shall complete and submit the Department-approved Local Match Calculation Form, per the schedule and to the individual(s) identified in the Exhibit C, Required Reports. The Department-approved Local Match Calculation Form, Template 9— Local Match Calculation Form is available at the following website: https://www.myflfa m i l ies.com/service-progra ms/sa m h/ma nagi ng-entities/i ndex.shtm I Note: Click on FY20-21 ME Templates and click on Reporting Template 9 — Local Match Calculation Form (22) The Network Provider shall implement and maintain fiscal operational procedures.These shall contain but, not be limited to procedures relating to overpayments,charge-backs that directly apply to subcontractors and documentation of cost sharing(match) that comply with state and federal rules, regulations and/or ME policies and procedures and shall comply with the requirements in Section 7., Audits, Inspections, Investigations, Records, and Retention. (23) The Network Provider shall maintain in one place for easy accessibility and review by ME and/or Department staff all policies,procedures,tools,and plans adopted by the Network Provider. The Network Provider's policies, procedures, and plans must conform to state and federal laws, the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/requirements contained in applicable Departmentof Children and Families and ME operating procedures. (24)The Network Provider shall maintain a mechanism for monitoring, updating, and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations, and the ME's policies and procedures. (25) The Network Provider shall make available upon request all plans, policies, procedures, and manuals to ME staff, Department staff, Network Provider staff, and to individuals served /stakeholders if applicable and appropriate. (26) The Network Provider shall comply with Children and Families Operating Procedure 215-8, OVERSIGHT OF HUMAN SUBJECT RESEARCH AND INSTITUTIONAL REVIEW BOARD DESIGNATION. The policy and guidance can be found at: http://www.dcf.state.fl.us/admin/publications/policies/215-8.pdf Approval from the Department through the ME is mandatory for all research conducted by any Revised Attachment I HCO2 (f) Page 20 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork.ln(%) /2020 employee, contracted organization or individual, or any public or private vendor, even if the aforementioned has their own Institutional Review Board which has granted approval. (27) The Network Provider shall attend required trainings and/or meetings as required by the ME, meet with the ME's staff at regularly scheduled or specially called meetings when notified by the ME. (28) Consumer Resource Manual The Network Provider must assist the ME in developing and maintaining the Community Resource Manual. This manual must be available for use by individuals served within each subcontractor location where services are provided. (29) Work and Social Opportunities for Peer Specialists Nationwide, health systems have accepted peers as a valuable part of the workforce. A shift to a more person-centered approach, a focus on integrated health, and a demand for more workers have increased the role peer specialists play in Florida's mental health and substance use systems. In keeping with Florida's goal of increasing the number of peer specialists, The Network Provider is encouraged to provide employment and social opportunities to individuals who have lived experience of mental health and/or substance use condition and/or lived experience of trauma. (30) Assist Stakeholder Involvement in Planning,Evaluation,and Service Delivery (a) At the ME's request, the Network Provider will assist the ME in engaging local stakeholders, per section 394.9082 F.S., in its support activities for the Department's local plans. (b) The Network Provider shall work with the ME to provide performance, utilization, and other information for the Department's Substance Abuse and Mental Health Services Plan, and annual updates thereof, and to provide appropriate information for the Department's Long-Range Program Plan and its Annual Business Plan. (31) Consumer Satisfaction Survey The Network Provider shall conduct satisfaction surveys of individuals served pursuant to FASAMS DCF Pamphlet 155-2. The Network Provider shall utilize a Department-approved satisfaction survey instrument. Failing to provide the required number of satisfaction surveys and/or utilizing a survey instrument other than that approved by the Department will result in a corrective action and an imposed financial penalty. Revised Attachment I HCO2 (f) Page 21 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 (32) Department-Sponsored Surveys The Network Provider must participate in any Department-sponsored satisfaction surveys. (33) The Network Provider must notify the ME within forty-eight(48) hours of conditions related to performance that may interrupt the continuity of service delivery of involve media coverage. b. Task Limits The Network Provider shall perform services in accordance with applicable, rules, statutes, licensing standards and policies and procedures. The Network Provider agrees to abide by the approved Program Description, and is not authorized by the ME to perform any tasks related to the project other than those described in the approved Program Description and in this contract, without the express written consent of the ME. The Network Provider shall ensure that services are performed in accordance with applicable rules, statutes, and licensing standards. 2. Staffing Requirements a. Staffing Levels (1) The Network Provider shall maintain staffing levels in compliance with applicable rules, statutes, licensing standards and policies and procedures. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations. (2) The Network Provider shall engage in recruitment efforts to maintain as much as possible staff with the ethnic and racial composition of the individuals served. The ME, at its sole discretion may request documentation evidencing recruitment efforts. b. Professional Qualifications (1) The Network Provider shall comply with applicable rules, statutes, requirements, and standards with regard to professional qualifications. See Exhibit F,SAMH Programmatic State and Federal Laws, Rules,and Regulations. (2) The Network Provider shall provide employment screening for all mental health personnel and all chief executive officers, owners, directors, and chief financial officers of service Network Providers using the standards for Level II screening set forth in Chapter 435, and s. 408.809 F.S., except as otherwise specified in s. 394.4572(1)(b)-(d), F.S. For the purposes of this contract, "Mental health personnel" includes all program directors, professional clinicians, staff members, and volunteers working in public or private mental health programs and facilities who have direct contact with individuals held for examination or admitted for mental health treatment. (3) Additionally, the Network Provider shall provide employment screening for substance abuse personnel using the standards pursuant to Chapter 397.451, F.S., Revised Attachment I HCO2 (f) Page 22 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 (4) Network Providers who have programs for children are required to meet the requirements of s. 39.001(2), (a) and (b) F.S. c. Staffing Changes The Network Provider shall notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding the positions of Chief Executive Officer, Chief Financial Officer, Medical Director, Clinical Director, IT Director, Dispute Resolution Officer, Data Security Officer, Single Point of Contact (section 504 of the ADA. d. Subcontractors (1) This contract allows the Network Provider to subcontract for the provision of services related to the performance required under this Contract, subject to the provisions relating to Assignments and Subcontracts in the Standard Contract and referenced therein. Written requests by the Network Provider to subcontract for the provision of services under this contract will be routed through the ME's Contract Manager for approval. The ME is not obligated nor will it pay for any services delivered prior to its written approval of the act of subcontracting. The act of subcontracting shall not in any way relieve the Network Provider of any responsibility for the contractual obligations of this contract.The pre-approval process applies to Subcontractors and not Independent Contractors as defined below. (2) The ME has adopted the following definitions for vendors, subcontractors and/or independent contractors who are contracted by the Network Provider to do work contemplated under this contract: (a) Vendor: A person or company offering something for sale. (b) Subcontractor: A business to business relationship; contracting a business or person outside of one's own company to do work as part of a larger project. (c) Independent Contractor: a person who is in an independent trade, business, or profession in which they offer their services and/or expert advice to an individual or organization. The general rule is that an individual is an independent contractor if the payer has the right to control or direct only the result of the work and not what will be done and how it will be done. The earnings of a person who is working as an independent contractor are subject to Self-Employment Tax. (3) The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non- profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant Revised Attachment I HCO2 (f) Page 23 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 relationship as distinguished from a procurement relationship, typically funded by contract. While the above-referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916 (a)(5), and 45 CFR, Part 96.135(a)(5)]. (4) Any vendor, subcontractor, or independent contractor the Network Provider contracts to do work contemplated under this contract, and who meets the definition of a Business Associate as defined in 45 CFR 160.103, must sign a legally binding document with the Network Provider that contains the same restrictions and conditions of the Business Associate Agreement between the Network Provider with the ME. The binding document must meet the requirements of 45 CFR s.164.504(e), Standard: Business Associate Contracts, the Privacy Rule, the Security Rule, the Breach Notification Rule, the Health Information Technology for Economic and Clinical Health ("HITECH") Act, the provisions included in the Network Provider's Business Associate Agreement with the ME, the ME's contractual requirements, and other laws and regulations pertaining to access, use, disclosure, and management of Protected Health Information ("PHI") without limitation, PHI in an electronic format (EPHI) created, received, maintained, or transmitted by the Network Provider or its subcontractors incidental to Network Provider's performance of this Contract. (5) All agreements, for services contemplated under this contract, shall adopt the applicable terms and conditions of the Network Provider's contract with the ME, including but not limited to, any Federal block grant requirements. In addition, all subcontract agreements shall contain the applicable terms and conditions, and any amendments thereto, found in the ME's contract with the Department (Prime Contract), which is incorporated herein by reference. Subcontract agreements shall include a detailed scope of work; term of the agreement, method of payment, clear and specific deliverables; and performance standards. (6) The Network Provider shall maintain individual subcontractor files for each subcontractor and provide a copy of all subcontract's agreements prior to the execution of those subcontracts and any amendments to the ME's Contract Manager. (7) All independent contractor agreements, and subcontractor agreement, vendor agreements, and business associate agreements, or other legally binding agreements, for work contemplated under this contract shall be available upon request by ME staff and at the time of monitoring. (8) The Network Provider shall implement and maintain procedures for subcontract procurement, development, performance, and management that comply with state and federal rules, regulation, and/or ME policies and procedures, in addition to identifying the ME's pre-approval process for approving the Network Providers act of subcontracting. (9) The Network Provider shall not subcontract for substance abuse/mental health services with any person, entity,vendor, purchase orders or any like purchasing arrangements that: Revised Attachment I HCO2 (f) Page 24 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 (a) is barred, suspended, or otherwise prohibited from doing business with any government entity, or has been barred, suspended, or otherwise prohibited from doing business with any government entity in accordance with s. 287.133. F.S.; (b) is under investigation or indictment for criminal conduct,or has been convicted of any crime which would adversely reflect on their ability to provide services,or which adversely reflects their ability to properly handle public funds; (c) has had a contract terminated by the department or ME for failure to satisfactorily perform or for cause; (d) has failed to implement a corrective action plan approved by the ME, the department, or any other governmental entity, after having received due notice, or (e) is ineligible for contracting pursuant to the standards in s. 215.1473(2), F.S. (10) Regardless of the amount of the subcontract, the Network Provider must immediately terminate a subcontract for cause, if at any time during the lifetime of the agreement/subcontract, a subcontractor, person, entity, vendor, purchase orders or any like purchasing arrangements, is: (a) Found to have submitted a false certification under s. 287.135, F.S., or (b) Placed on the Scrutinized Companies with Activities in Sudan List or (c) Placed on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or (d) Placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel (11) Unless the Department agrees to an alternative payment method as authorized in section 394.74, F.S., and prior to entering into any subcontract, or an amendment which modifies the previously negotiated unit cost rate or adds additional Covered Services, the Network Provider shall conduct a cost analysis for said subcontract, in accordance with Rule 65E-14. F.A.C. A cost analysis is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. Subcontractors will be required to comply with Rule 65E-14, F.A.C., Unit Cost Method of Payment, including but not limited to, Covered Services, unit measurements, descriptions, program areas, data elements, maximum unit cost rates, required fiscal reports, program description, setting unit cost rates, payment for services including allowable and unallowable units and requests for payments. (12) The Network Provider shall monitor the performance of all subcontractors and perform follow up actions as necessary. The Network Provider shall notify the ME within forty-eight (48) hours of conditions related to subcontractor performance that could impair continued service delivery. 3. Service Location and Equipment Revised Attachment I HCO2 (f) Page 25 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 a. Service Delivery Location The location of services will be as specified in the approved Program Description required by Rule 65E-14, F.A.C. b. Service Times (1) A continuum of services shall be provided on the days and times as specified in the approved Program Description Attachment VI,Scope of Work. (2) The Network Provider shall notify the M E's Contract Manager, in writing, at least ten (10) calendar days prior to any changes in days and times where services are being provided pursuant to Rule 65E-14, F.A.C. c. Changes in Location The Network Provider shall notify the M E's Contract Manager, in writing,at least ten(10)calendar days prior to any changes in location where services are being provided pursuant to Rule 65E-14, F.A.C. d. Equipment The Network Provider shall furnish all appropriate equipment necessary for the effective delivery of the services purchased. In the event that the Network Provider is allowed to purchase any non-expendable property with funds under this contract, the Network Provider will ensure compliance with the Tangible Property Requirements, Department operating Policies and Procedures as outlined in CFOP 40-5, CFOP 80-2, Rule 65E-14, F.A.C., which are incorporated herein by reference and may be obtained from the ME's Contract Manager. The provider shall submit an inventory report, as specified in the Network Provider Inventory List, incorporated herein by reference, and by the date(s) listed in Exhibit C, Required Reports. The Network Provider Inventory List form may be requested from ME Contract Manager. 4. Deliverables a. Services The Network Provider shall deliver the services specified in and described in the Program Description submitted by the Network Provider and as set forth in Exhibit G, Covered Service Funding by OCA and in Attachment VI,Scope of Work. b. Reporting (1) The Network Provider must submit reports included in Exhibit C, Required Reports. In all cases, the delivery of reports, ad hoc or scheduled, must not be construed to mean acceptance of those reports. Acceptance, in writing, of required reports must constitute a separate act and must be approved by the ME's Contract Manager. The ME reserves the right to reject reports as incomplete, inadequate or unacceptable. Revised Attachment I HCO2 (f) Page 26 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 (2) The Network Provider must provide performance information or reports other than those required by this agreement at the request of the ME, the Southern Region's SAMH Regional Director, or their designee. For requests that are complex and difficult to address, all parties will develop and implement a mutually viable work plan. (3) The ME, at its sole option, may allow additional time within which the Network Provider may remedy the objections noted by the ME or the ME may, after having given the Network Provider a reasonable opportunity to comply with the report requirements, declare this agreement to be in default. c. Electronic Data Submission The Network Provider agrees to comply with the data submission requirements outlined in FASAMS DCF Pamphlet 155-2, and in SAMHIS, PBPS, as applicable, by the dates specified in Exhibit C, Required Reports. (1) Upon request, the network provider shall submit to the ME and the Department information regarding the amount and number of services paid for by the Substance Abuse Prevention and Treatment Block Grant. (2) The Network Provider shall submit prevention services data to PBPS, maintained by Collaborative Planning Group Systems, Inc. and/or any other data reporting mechanism as directed by the ME.The data shall be submitted electronically no later than the 4th of each month following the month of service. The Network Provider shall also: (a) Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract. (b) Ensure that one hundred percent (100%) of all data submitted to PBPS and/or any other data reporting mechanism as directed by the ME is consistent with the data maintained in the Network Providers service documentation and or/consumer files. (c) The Network Provider will accurately report the performance measures specified i n Attachment VI,Scope of Work. (d) Resubmit corrected records no later than the next monthly submission deadline. The failure to submit any data set or the Network Provider's total monthly submission per data set,which results in a rejection rate of 5% or higher of the number of monthly records submitted will require the Network Provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected records will be corrected and resubmitted; and (e) Upon submission of the monthly data,the Network Provider's Director of Prevention/Supervisor, shall send an e-mail to the ME's Director of Prevention Services and any other ME staff, attesting that the data submitted has been reviewed and approved. Refer to Attachment VI,Scope of Work for instructions. (f) In accordance with the provisions of section 402.73(1), F.S.,and Rule 65-29.001, F.A.C.,corrective Revised Attachment I HCO2 (f) Page 27 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) ;2020 action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties maybe imposed for failures to implementor to make acceptable progress on such corrective action plans. Failure to implement corrective action plans to the satisfaction of the ME and after receiving due notice, shall be grounds for contract termination. 5. Performance Specifications a. Performance Measures (1) The Network Provider shall meet the performance standards and required outcomes as specified in Exhibit D,Substance Abuse and Mental Health Required Performance Outcomes/Outputs and as outlined in Attachment VI, Scope of Work. (2) The Network Provider agrees that the PBPS, Collaborative Planning Group Systems, Inc., KIS, FASAMS, SAMHIS, or other data reporting system designated by the ME, wi I I be the source for all data used to determine compliance with performance standards and outcomes in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. PBPS maintained by Collaborative Planning Group Systems, Inc. Any conflicts will be clarified by the ME and the Network Provider shall adhere to the ME's resolution. The Network Provider shall submit all service-related data for individuals receiving services funded in whole or in part by SAMH funds, local match, or Medicaid. b. Performance Measurement Terms FASAMS DCF Pamphlet 155-2, provides the data files and file layout requirements for collecting and reporting data on persons served in state-contracted community substance use and mental health Network Provider agencies. The elements used for various performance measures which are quantitative indicators, outcomes, and outputs used by the ME to objectively measure a Network Provider's performance and contains policies and procedures for submitting the required data. Collaborative Planning Group Systems, Inc., or any other data system designated by the ME and/or the Department, maintainsthe procedures for submitting the required prevention data into PBPS.The ME will also monitor the Network Provider for the performance measures. c. Performance Evaluation Methodology (1) The Network Provider shall collect information and submit performance data and individual served outcomes, to the ME data system in compliance with FASAMS DCF Pamphlet 155-2 requirements. The specific methodologies for each performance measure may be found at the following website: https://www.myflfa m i l ies.com/service-programs/sa m h/fasa ms/i ndex.shtm I (2) The Network Provider is expected to have the capability to engage in organized performance Revised Attachment I HCO2 (f) Page 28 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 improvement activities, and to be able to participate in partnership with the department and ME in performance improvement projects that are related to system wide transformation and improvement of services for individuals and families. (3) By execution of this contract the Network Provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth in this contract. If the Network Provider fails to meet these standards, the ME, at its exclusive option, may allow a reasonable period, not to exceed six(6) months, for the Network Provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the ME within the prescribed time and if no extenuating circumstances can be documented by the Network Providerto the ME's satisfaction,the ME must terminate the contract. The ME has the sole authority to determine whether there are extenuating or mitigating circumstances. (4) The ME will monitor the standards and outcomes specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs, the standards and outcomes and in Attachment VI, Scope of Work., during the contract period, to determine if the Network Provider is achieving the levels that are specified. (5) Substance abuse prevention data information may be found on the Exhibit D Report which is transmitted to the ME Director of Prevention Services, as requested. 6. Network Provider Responsibilities a. Network Provider Unique Activities (1) The Network Provider shall adhere to the deliverables as set forth in (2) In the event of a dispute as to the ME's determination regarding consumer eligibility and/or placement into the appropriate level of care,the ME's dispute resolution process, as described in the Standard Contract shall be followed. An eligibility dispute shall not preclude the provision of services to Individuals Served, unless the dispute resolution process reverses the ME's determination. (3) The Network Provider is responsible for the satisfactory performance of the tasks referenced in this contract. By executing this contract, the Network Provider recognizes its responsibility for the tasks, activities, and deliverables described herein and warrants that it has fully informed itself of all relevant factors affecting the accomplishment of the tasks, activities and deliverables and agrees to be fully accountable for the performance thereof whether performed by the Network Provider or its subcontractors. (4) The Network Provider agrees that services other than those set out in this contract will be provided only upon receipt of a written authorization from the ME's Contract Manager or an authorized ME staff member. The department through the ME has final authority to make any and all determinations that affect the health safety and well-being of the residents of the State of Florida. (5) The Network Provider shall be responsible for the fiscal integrity of all funds under this contract, and for demonstrating that a comprehensive audit and tracking system exists to account for funding Revised Attachment I HCO2 (f) Page 29 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 by individual served consumer and has the ability to provide an audit trail. The Network Provider's financial management and accounting system must have the capability to generate financial reports on individual service recipient utilization, cost, claims, billing, and collections for the ME.The Network Provider must maximize all potential sources of revenue to increase services, and institute efficiencies that will consolidate infrastructure and management functions in order to maximize funding. (6) The Network Provider shall ensure that the invoices submitted to the ME reconcile with the amount of funding and services specified in this contract, as well as the Network Provider's agency audit report and information system and this information is reconciled with KIS, PBPS, or other data reporting system designated by the ME. (7) The Network Provider shall make available source documentation of units billed by Network Provider upon request from the ME staff.The Network Provider shall track all units billed to the ME by program and by Other Cost Accumulator(OCA). (8) A Network Provider that receives block grant funding shall comply with state or federal requests for information related to Substance Abuse Prevention and Treatment and Community Mental Health Services block grants. (9) Any compensation paid for an expenditure subsequently disallowed as a result of the Managing Entity's or any Network Service Providers' non-compliance with state or federal funding regulations shall be repaid to the Department upon discovery. (10) The Network Provider shall make available to the ME and the Department all records pertaining to service delivery. These records shall be made available at all reasonable times for inspection, review, copying, or audit. Service delivery records include but are not limited to, invoicing, fiscal management, data management, incident reporting, clinical records for individuals served, and such documents determined to assure accountability of service provision and/or the expenditure of state and federal funds. (11) The Network Provider shall assist the ME and the Department in developing legislative budget requests based upon identified needs of the community. (12) The Network Provider shall provide to the ME, copies of, including but not limited to, evaluations, assessments, surveys, monitoring reports that pertain to licensure, accreditation, or other administrative or programmatic review, when those reports identify deficiencies that require corrective action.The Network Provider shall submit to the ME all of the applicable reports, including copies of the corrective action plan(s)within ten(10)calendar days of receipt bythe Network Provider from the reviewing entity. (13) The Network Provider shall cooperate with the ME and the Department when investigations are conducted regarding a regulatory complaint of the Network Provider. When additional information or documentation is requested by the ME, the Network Provider will submit the information within twenty-four(24) hours of the request unless otherwise specified in the ME's request. (14) The Network Provider shall maintain human resource policies and procedures that provide safeguards to ensure compliance with laws, rules and regulations. Integrate current and/or new Revised Attachment I HCO2 (f) Page 30 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork.ln(%) ;2020 state/federal requirements and policy initiatives into its operations upon provision by the Department and/or ME of the same. (15) The Network Provider shall maintain in one place for easy accessibility and review by ME and/or Department staff all policies, procedures, tools, and plans adopted by the Network Provider. The Network Provider's policies, procedures,and plans must conform to state and federal laws,the Florida Administrative Code, state and federal regulations, state and federal rules, and minimally meet expectations/ requirements contained in applicable Department of Children and Families and ME operating procedures. (16) The Network Provider shall maintain a mechanism for monitoring, updating, and disseminating policies and procedures regarding compliance with current government laws, rules, practices, regulations,and the ME's policies and procedures. (17) The Network Provider shall comply with all other applicable federal laws, state statutes and associated administrative rules as may be promulgated or amended. See Exhibit F, SAMH Programmatic State and Federal Laws, Rules,and Regulations, and ME policies and procedures. (18) Records relating solely to actions taken in carrying out the quality assurance and /or quality improvement program requirements of this contract and records obtained by the ME and/or the Department to determine a Network Provider's compliance of said programs in accordance with 394.907, F.S.and 397.4103 F.S. are confidential and exempt from s. 119.07(1) F.S.and s. 24(a),Article. I, Constitution of the State of Florida. b. Coordination with other Providers/Entities (1) The Network Provider shall develop, maintain,and improve coordination and integrated care systems as follows: (i) Partnerships and collaborations with other community organizations/entities is expected to add value to the programs, services, strategies and community activities funded under this Contract. (ii) The Network Provider agrees to fulfill their designated role in implementing and/or maintaining a system of care in support of the ME Working Agreement, incorporated herein by reference, with the Community Based Care (CBC). The intent of the working agreement is to establish a formal linkage of partnerships with a shared vision for improving outcomes for families involved in the child welfare system by providing integrated community support and services. (iii) The Network Provider may be required to enter into agreements with other external stakeholders (2) The failure of other providers or entities does not relieve the network provider of any accountability for tasks or services that the Network Provider is obligated to perform pursuant Revised Attachment I HCO2 (f) Page 31 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 to this contract. c. State and Federal Laws, Rules, and Regulations See Exhibit F,SAMH Programmatic State and Federal Laws, Rules, and Regulations 7. Managing Entity Responsibilities a. Managing Entity Obligations (a)The ME shall only subcontract with entities that are fiscally sound, and that can adequately ensure the accountability of public funds. (b)The ME shall assess the Network Provider's financial stability, using a risk assessment approach; the risk assessment approach will examine the impact of programmatic requirements on the Network Provider's financial stability. Any issues identified as a result of the financial risk assessment shall be reported to the Department during the quarterly/monthly reconciliation and performance review identified in the Prime Contract. (c)The ME will provide administrative and programmatic oversight to ensure that the Network Provider comply with all behavioral health treatment and prevention services requirements, as applicable,and other requirements of this contract. (d)The ME is solely responsible for the oversight of the Network Provider and enforcement of all terms and conditions of this contract. Any and all inquiries and/or issues arising under this contract are to be brought solely and directly to the ME for consideration and resolution between the Network Provider and the ME. In any event, the ME's decision on all issues is final and solely subject to the ME's appeal process and legal rights of the Network Provider. (e)The ME reserves the right terminate this contract in whole or in part,for non-performance as determined by the ME and to procure the services purchased through this contract to another entity and/or Network Provider. (f) The ME is responsible for the administration, management, and oversight, and through subcontracts, the provision of behavioral health services in Miami Dade and Monroe Counties. (g)The ME shall monitor and take action when necessary so that services which meet the standards defined herein will be provided throughout the contract period. (h)lf applicable, the ME will ensure that the Network Provider utilizes the approved assessment and placement tool designated by the ME. Standardized tools and assessments approved by the ME must be used to determine placement and level of care. (i) The ME shall work with the Department to redirect administrative cost savings into improved access to quality care, promotion of service continuity, required implementation Revised Attachment I HCO2 (f) Page 32 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 of EBPs, the expansion of the services array, and necessary infrastructure development. It acknowledges the benefits to be realized, include improved access to quality care, promotion of service continuity, implementation of EBPs, improved performance and outcomes, expansion of the service array, and necessary infrastructure development. b. Monitoring Requirements (1) The ME will monitor the Network Provider in accordance with this contract and the ME's Contract Accountability Policies and Procedures which can be obtained from the designated ME Contract Manager and is incorporated herein by reference. The Network Provider shall comply with any coordination or documentation required by the ME's monitor(s) to successfully evaluate the programs and shall provide complete access to all budget and financial information related to services provided under this contract, regardless of the source of funds. (2) Network Providers with electronic health record (EHR)or electronic medical record systems (EMR) shall provide access to ME funded service and service data contained in these systems for individuals funded under this Contract to the ME's monitoring team and provide sufficient resources to facilitate the monitoring process of services provided under this contract. Resources is defined but is not limited to, personnel, terminals, guest read-only accounts, privileges for monitors to access clinical/service records, and/or remote access into the systems by the monitors. (3) The ME will monitor the Network Provider on its performance of all tasks and special provisions of the contract. (4) The ME will provide a written report to the Network Provider within thirty (30) calendar days of the conclusion of the monitoring. If the report indicates corrective action is necessary, the Network Provider will have ten (10) calendar days from receipt of the monitoring report to respond in writing to the request. In the sole discretion of the ME, if there is a threat to health, life,safety or well-being of individuals receiving services,the ME may require immediate corrective action or take such other action as the ME subjects the Network Provider to the remedies expressed in the Standard Contract. c. Training and Technical Assistance (1) The ME's contact manager, or designee, will provide training and technical assistance concerning the terms and conditions of this contract and may maintain a documentation trail demonstrating any training and/or technical assistance efforts. (2)The ME will provide technical assistance and support to the Network Provider to ensure the continued integration of services and support for individuals served, to include but not limited to, quality improvement activities to implement evidenced-based practice treatment protocols, the application of process improvement methods to improve the coordination of access and services that are culturally and linguistically appropriate. (3) The ME will provide technical assistance and support to the Network Provider for the Revised Attachment I HCO2 (f) Page 33 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 maintenance and reporting of data on the performance standards that are specified in Exhibit D, Substance Abuse and Mental Health Required Performance Outcomes/Outputs. In addition, the ME may convene cross-organizational training and assistance to help non- accredited Network Providers become accredited. (4)The ME implements a training program for its staff and the Network Provider staff. The trainings assure that staff receives externally mandated and internal training. The ME may coordinate training or directly provide training to Network Provider staff. d. Managing Entity Determinations The ME has exclusive authority to make the following determination(s) and to set the procedures that the Network Provider shall follow in obtaining the required determi nation(s): (1) Whether the Network Provider is meeting the terms and conditions of this contract, to include the documents that constitute this contract, any documents incorporated into any attachment by reference, Program Description, policies and procedures, and any documents incorporated herein by reference. (2) The ME reserves the exclusive right to make certain determinations in these specifications. The absence of the ME setting forth a specific reservation of rights does not mean that all other areas of this contract are subject to mutual agreement.The ME reserves the right to make exclusively any and all determinations that it deems are necessary to protect the best interests of the State of Florida and the health, safety, and welfare of the individuals who are served by the ME either directly or through any one of its contracted Network Providers. (3) In the event of any disputes regarding the eligibility of individuals served, the determination made by the ME is final and binding on all parties. C. Method of Payment Exhibit B, Method of Payment Exhibit G,Covered Service Funding by OCA Exhibit H, Funding Detail and Local Match Monthly Payment Request (Incorporated herein by reference and available from the ME's Contract Manager D. Special Provisions 1. The Network Provider is expected to maintain its administration cost to 10.00%or less for Fiscal Year 2020-2021 for SAMH services purchased under this contract. The cost savings shall be reallocated to support the increase of direct services, improved access to quality care, promotion of service continuity, and the implementation and/or expansion in the use of evidence-based practices.The Network Provider's Revised Attachment I HCO2 (f) Page 34 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 Projected Covered Service Operating and Capital Budget shall evidence the reduction and redistribution of the cost savings. 2. The ME contracts with Mobile Response Teams (MRT's) in both Miami-Dade and Monroe Counties. MRTs provide on-demand crisis intervention services in any setting in which a behavioral health crisis is occurring, including homes, schools and emergency rooms. MRTs are multi-disciplinary teams of behavioral health professionals and paraprofessionals with specialized crisis intervention and operations training. Mobile response services are available 24/7 with the ability to respond within 60 minutes. MRT staff triage calls in order to determine the level of severity and prioritize calls that meet the clinical threshold required for an in-person response. The primary goals of the MRTs is to lessen trauma, divert from emergency departments or juvenile/criminal justice, and prevent unnecessary psychiatric hospitalizations. MRTs are designed to be accessible in the community at any time. The Network Provider must provide the contact information for the Southern Region's Mobile Response Teams to parents and caregivers of children, adolescents, and young adults between the ages of 18 and 25, inclusive, who receive behavioral health services. For Miami-Dade County the MRT Network Provider is Banyan Health Systems, Inc. The 24-Hour Crisis Hotline is (305) 774-3616 or(305) 774-3617. Website: https://banyanhealth.org/service/mobile-response-team/ For Monroe County, the MRT Network Provider is Guidance Care/Center, Inc. The 24-Hour Crisis Hotline is: (305)434-7660, option #8. Website: http:// uidancecarecenter.org/ 3. Intern Registration Requirements pursuant to section 491.0045, F.S. (a) The Network Provider shall monitor and ensure that an individual who has not satisfied the postgraduate or post-master's level experience requirements, as specified in s. 491.005(1)(c), (3)(c),or(4)(c), F.S., register as an intern in the profession for which he or she is seeking licensure before commencing the post-master's experience requirement or for an individual who intends to satisfy part of the required graduate-level practicum, internship, or field experience, outside the academic arena for any profession, the network provide must monitor and ensure that the individual registers as an intern in the profession for which he or she is seeking licensure before commencing the practicum, internship, or field experience. (b) An intern registration is valid for five (5)years. (c) A registration issued on or before March 31, 2017, expires March 31, 2022, and may not be renewed or reissued.Any registration issued after March 31, 2017, expires 60 months after the date it is issued. A subsequent intern registration may not be issued unless the candidate has passed the theory and practice examination described in s.491.005(1)(d), (3)(d), and (4)(d), F.S. Revised Attachment I HCO2 (f) Page 35 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 (d) An individual who has held a provisional license issued by the board may not apply for an intern registration in the same profession. 4. Real-time Data Entry: When required by the Prime Contract, state and/or federal rules, regulations, or policies, the Network Provider shall submit to the ME real-time data in KIS Express, or other similar data structure, for services purchased by this contract. The Network Provider agrees to implement the new data reporting system when notified and as directed by the ME. 5. Incident Reports a. The Network Provider shall submit incident reports into the Incident Reporting and Analysis System (IRAS) on all reportable incidents per CFOP 215-6, within one (1) business day of the incident occurring. Failure to comply with the reporting requirements constitutes a lack of compliance with licensure status or contract provisions. The Network Provider may be assessed financial consequences for failure to perform pursuant to section 8., of the Standard Contract In the event an incident has an immediate impact on the health or safety of a consumer, has potential media impact, or involves employee-related incidents of criminal activity, the Network Provider must notify the ME Continuous Quality Improvement Manager and the ME Contract Manager immediately upon discovery. Certain incidents may warrant additional follow-up by the ME. Follow-up may include on-site investigations or requests for additional information or documentation. When additional information or documentation is requested, the Network Provider will submit the information requested by the ME within 24 hours unless otherwise specified in the request. It is the responsibility of the Network Provider to maintain a monthly log listing all incidents occurring at the agency, including those submitted to the Office of the Inspector General and those not reportable in IRAS, with the following information: Consumer's initials, incident report tracking number from IRAS(if applicable), incident report category,date and time of incident,and follow-up action taken. b. All Network Providers (inpatient and outpatient) will report seclusion and restraint events in SAMHIS(SANDR) and in accordance with Rule 65E-5.180(7)(g), F.A.C. 6. Mandatory Reporting Requirements a. The Network Provider and any subcontractor must comply with and inform its employees of the following mandatory reporting requirements. Each employee of the Network Provider, and of any subcontractor, providing services in connection with this contract who has any knowledge of a reportable incident must report such incident as follows: 1) A reportable incident is defined in CFOP 180-4, which can be obtained from the ME's Contract Manager 2) Reportable incidents that may involve an immediate or impending impact on the health Revised Attachment I HCO2 (f) Page 36 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thr t S oath tloriida �at�����or ill Theafth Nemork. n(%) /2020 or safety of a client shall be immediately reported to the ME's Continuous Quality Improvement Manager and the ME Contract Manager. 3) Other reportable incidents must be reported to the ME's and Department's Office of Inspector General. Notification to the Inspector General shall be through the Internet at https://www.myflfamilies.com/admin/ig/rptfraudl.shtml or by completing a Notification/Investigation Request(form CF 1934) and emailing the request to the Office of Inspector General at IG.Complaints@myflfamilies.com. The Network Provider and subcontractor may also mail the completed form to the Office of Inspector General, 1317 Winewood Boulevard, Building 5, 2nd Floor, Tallahassee, Florida, 32399-0700; or via fax at(850) 488-1428. b. In the event of a breach or potential breach of Protected Health Information, the Network Provider is directed to the reporting requirements delineated in the executed Business Associate Agreement, incorporated herein by reference. 7. Service Provision Requirements for Federal Block Grants a. Network Provider that receives federal block grant funds from the Substance Abuse Prevention and Treatment or Community Mental Health Block Grants agrees to comply with Subparts I and II of Part B of Title XIX of the Public Health Service Act, s. 42 U.S.C. 300x-21 et seq. (as approved September 22, 2000) and the Health and Human Services (HHS) Block Grant regulations (45 C.F.R. Part 96). b. A Network Provider that receives funding from the SAPTBG certifies compliance with all of the requirements of the Substance Abuse and Mental Health Services Administration (SAMHSA) Charitable Choice provisions and the implementing regulations of 42 C.F.R. s. 54a. c. A Network Provider that receives block grant funding must monitor its compliance with block grant requirements and activities. d. The Network Provider must comply with ME, state and federal requests for information related to the SAPT and CMHS block grants. e. None of the funds provided under the following grants may be used to pay the salary of an individual at a rate in excess of Level II of the Executive Schedule: Block Grants for Community Mental Health Services, Substance Abuse Prevention and Treatment Block Grant, Projects for Assistance in Transition from Homelessness, Project Launch, Florida Youth Transition to Adulthood; and Florida Children's Mental Health System of Care Expansion Implementation Project. f. As applicable, the Network Provider shall comply with the requirements set forth in 45 C.F.R. Subpart L—Substance Abuse Prevention and Treatment Block Grant and with the requirements of 42 C.F.R. Part 2. g. A Network Provider that receives SAPT block grant funding for the purpose of primary prevention of substance use, shall comply with 45 C.F.R. s. 96.125. Revised Attachment I HCO2 (f) Page 37 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) ;2020 h. Behavioral health services shall be provided to persons pursuant to s. 394.674, F.S., including those individuals who have been identified as requiring priority by state or federal law. The identified priority populations are found in Exhibit A, Individuals/Participants to be Served, however persons in categories (i) and (ii) below are specifically identified as persons to be given immediate priority over those in any other categories.These individuals may not be placed on a wait list without receiving interim services within the required timeframes. (i) Pursuant to 45 C.F.R. s. 96.131, priority admission to pregnant women and women with dependent children by Network Service Providers receiving SAPT Block Grant funding. If the clinically appropriate services cannot be provided for the pregnant woman, interim services, not later than forty(48) hours after the woman seeks treatment services, shall be provided pursuant to 45 C.F.R. s. 96.123; (i i) Pursuant to 45 C.F.R. s. 96.126 (b), (1) and (2), adherence with the requirement to provide interim services for injection drug users by Network Service Providers receiving SAPT Block Grant funding and until the clinically appropriate level of treatment can be provided to the individual as follows: 45 C.F.R.s. 96.126(b), (1)-(2)Capacity of treatment for intravenous substance abusers and any other requirement. (1) 14 days after making the request for admission to such a program;or (2) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services, including referral for prenatal care, are made available to the individual not later than 48 hours after such request. i. In accordance with 45 C.F.R. s. 96.131 (a) and (b), the Network Provider that receive Block Grant funds and that serve injection drug users must publicize the following notice: "This program receives federal Substance Abuse Prevention and Treatment Block Grant funds and serves people who inject drugs.This program is therefore federally required to give preference in admitting people into treatment as follows: 1. Pregnant injecting drug users; 2. Pregnant drug users; 3. People who inject drugs; and 4. All others." j. In accordance with 45 CFR s. 96.123(a)(7) and s. 96.132(b), the Network Provider that receives block grant treatment or prevention funds (or both, as the case may be) shall ensure that continuing education in such services are available to the employees who provide such services or activities and this must be documented to demonstrate the provision of said education. k. Outreach Services to Injection Drug Users:The Network Provider shall carry out outreach activities to encourage injection drug users in need of treatment to undergo such treatment pursuant to the requirements in 45 C.F.R. s. 96.126(e)., The Network Provider shall document the services to demonstrate the provision of these services per the documentation requirements for Outreach services specified in Rule 65E-14, F.A.C. Revised Attachment I HCO2 (f) Page 38 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) ;2020 I. The Network Provider shall ensure compliance with 45 C.F.R. Subpart C—Financial Management. m. Only if such services are purchased through this contract is the Network Provider responsible for complying with the reporting requirements outlined in Exhibit AB, Substance Abuse Prevention and Treatment Block Grant (SAPTBG) Early Intervention Funded Services for Human Immunodeficiency Virus (HIV) by the dates and to the individual(s) listed in Exhibit C, Required Reports. Subject to other applicable state and/or federal requirements, the ME may require additional reports from the Network Provider. n. Only if such services are purchased through this contract is the Network Provider responsible for complying with the for SAPTBG set-aside funded services for pregnant women and women with dependent children services, SAPTBG set-aside funded services for HIV Early Intervention Programs and the SAPTBG set-aside funds for Evidenced-based Outreach Services to Injection Drug Users as outlined in Exhibit C, Required Reports. o. The Network Provider shall make available, either directly or by arrangement with others, tuberculosis services to include counseling, testing, and referral for evaluation and treatment pursuant to 45 C.F.R. s.96.17 and in compliance with Ch. 65D-30.0042, 6., F.A.C. p. The Network Provider shall use SAPTBG funds provided under this contract to support both substance abuse treatment services and appropriate co-occurring disorder treatment services for individuals with a co-occurring mental disorder only if the funds allocated are used to support substance abuse prevention and treatment services and are tracked to the specific substance abuse activity as listed in Exhibit G,Covered Service Funding by OCA. q. The Network Provider is required to participate in the peer-based fidelity assessment process to assess the quality, appropriateness, and efficacy of treatment services provided to individuals under this contract pursuant to 45 C.F.R. 96.136. r. The United States Public Health Service Act, Sections 1931(a)(1)(E), and 1916 (a)(5), and Title 45 of the Code of Federal Regulations, Part 96.135(a)(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and Community Mental Health Services funds "To provide financial assistance to any entity other than a public or non-profit private entity". Ordinarily, the term "financial assistance" is used to describe a grant relationship as distinguished from a procurement relationship, typically funded by contract. While the above- referenced statute and regulations preclude States from providing grants to for-profit entities, procurement contracts may be entered into with for-profit entities. This is the latest interpretation from the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration (4/5/2009). [PHS Act, ss. 1931(a)(1)(E), and 1916(a)(5), and 45 C.F.R., Part 96.135(a)(5)]. 8. The Network Provider agrees to maximize the use of state residents,state products,and other Florida- based businesses in fulfilling their contractual duties under this contract. 9. Option for Increased Services The Network Provider acknowledges and agrees that the contract may be amended to include additional, negotiated, services as deemed necessary by the ME. Additional services can only be Revised Attachment I HCO2 (f) Page 39 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 increased if the Network Provider demonstrates competence in the provision of contractual services and meets whatever criteria are established by the ME from time to time. The ME in its sole discretion shall determine at what time and to which Network Provider and what amounts are to be given to Network Providers for additional services. 10. Sliding Fee Scale Prevention services are exempt from the Sliding Fee Scale requirements per Rule 65E-14.018, F.A.C. 11. Transportation Disadvantaged The Network Provider agrees to comply with the provisions of chapter 427, F.S., Part I, Transportation Services, and Chapter 41-2, F.A.C., Commission for the Transportation Disadvantaged, if public funds provided under this contract will be used to transport consumers. The Network Provider agrees to comply with the provisions of Children and Families Operating Procedures 40-50 (CFOP 40-5) Acquisition of Vehicles for Transporting Disadvantaged Consumers if public funds provided under this contract will be used to purchase vehicles which will be used to transport consumers. 12. National Provider Identifier(NPI) (a) All network providers shall obtain and use an NPI, a HIPAA standard unique health identifier for health care providers. (b) An application for an NPI may be submitted online at: https://hmsa.com/portaI/provider/zav_pel.ph.NAT.500.htm (c) Additional information can be obtained from one of the following websites: (1) The Florida Medicaid HIPAA located at: https://hmsa.com/portal/provider/zav pel.3h.NAT.500.htm (2) The National Plan and Provider Enumeration System (NPPES) located at: https://nppes.cros.hhs.gov/NPPES/Welcome.do (3) The CMS NPI located at: https://www.cros.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvldentStand/ 13. Ethical Conduct The Network Provider understands that performance under this contract involves the expenditure of public funds from both the state and federal governments, and that the acceptance of such funds obligates the Network Provider to perform its services in accordance with the very highest standards of Revised Attachment I HCO2 (f) Page 40 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrq)) S South tloriida �at�����orill Theafth Nemork.ln(%) /2020 ethical conduct. No employee, director, officer, agent of the Network Provider shall engage in any business, financial or legal relationships that undermine the public trust, whether the conduct is unethical, or lends itself to the appearance of ethical impropriety. Network Providers' directors, officers or employees shall not participate in any matter that would inure to their special gain and shall recuse themselves accordingly. Public funds may not be used for purposes of lobbying, or for political contributions, or for any expense related to such activities, pursuant to Section 12.,. of the Standard Contract of this contract. The Network Provider understands that the ME contracts with the department, and as a subcontractor, recognizes that the department is a public agency which is mandated to conduct business in the sunshine, pursuant to section 286.011, F.S., and chapter 119, Florida Law, and that all issues relating to the business of the department, the ME and the Network Provider are public record and subject to full disclosure. The Network Provider understands that attempting to exercise undue influence on the ME, the department and its employees to allow deviation or variance from the terms of this contract other than a negotiated, publicly disclosed amendment, is prohibited by the State of Florida, pursuant to section 286.011, F.S. The Network Provider's conduct is subject to all state and federal laws governing the conduct of entities engaged in the business of providing services to government. 14. Information Technology Resources If applicable,the Network Providers must receive written approval from the ME prior to purchasing any Information Technology Resource (ITR)with contract funds. The Contract Manager is responsible for serving as the liaison between the Network Provider and the ME during the completion of the process as instructed by the Contract Manager. The Network Provider will not be reimbursed for any ITR purchases made prior to obtaining the ME's written approval. 15. Programmatic,Fiscal&Contractual Contract File References All of the documentation submitted by the Network Provider which may include, but not be limited to the Network Provider's original proposal, Program Description, Projected Covered Service Operating and Capital Budget, Agency Capacity Report and Personnel Detail Record, are herein incorporated by reference for programmatic, contractual and fiscal assurances of service provision These referenced contractual documents will be part of the Contract Manager's file. Documents incorporated by reference in this contract are available in the ME Contract Manager's file. 16. Employee Loans Funds provided by the ME to the Network Provider under this contract shall not be used by the Network Provider to make loans to their employees, officers, directors and/or subcontractors. Violation of this provision shall be considered a breach of contract and the termination of this contract shall be in accordance with the Section 10. of the Standard Contract. A loan is defined as any advancement of money for which the repayment period extends beyond the next scheduled pay period. 17. Travel The Network Provider's internal procedures will assure that: travel voucher Form DFS-AA-15, State of Florida Voucher for Reimbursement of Traveling Expenses, incorporated herein by reference, be Revised Attachment I HCO2 (f) Page 41 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����orill Theafth Nemork. n(%) /2020 utilized completed and maintained on file by the Network Provider. Original receipts for expenses incurred during officially authorized travel, items such as car rental and air transportation, parking and lodging, tolls and fares, must be maintained on file by the Network Provider. Section 287.058 (1) (b) F.S., requires that bills for any travel expense shall be maintained in accordance with Section 112.061, F.S. governing payments for traveling expenses. CFOP 40-1 (Official Travel of State Employees and Non-Employees) provides further explanation, clarification, and instruction regarding the reimbursement of traveling expenses necessarily incurred during the performance of business. The Network Provider must retain on file documentation of all travel expenses to include the following data elements: name of the traveler, dates of travel, travel destination, purpose of travel, hours of departure and return, per diem or meals allowance, map mileage, incidental expenses, signature of payee and payee's supervisor. 18. Property and Title to Vehicles a. Property (1) Nonexpendable property is defined as tangible personal property of a non-consumable nature that has an acquisition value or cost of $1,000 or more per unit and an expected useful life of at least one year, and hardback covered bound books that are not circulated to students or the general public, the value or cost of which is $250 or more. Hardback books with a value or cost of $100 or more should be classified as nonexpendable property only if they are circulated to students or to the general public. All computers, including all desktop and laptop computers, regardless of the acquisition cost or value are classified as nonexpendable property. Motor vehicles include any automobile, truck, airplane, boat or other mobile equipment used for transporting persons or cargo. (2) When state property will be assigned to a provider for use in performance of a contract, the title for that property or vehicle shall be immediately transferred to the provider where it shall remain until this contract is terminated or until other disposition instructions are furnished by the ME's Contract Manager. When property is transferred to the provider, the department shall pay for the title transfer. The provider's responsibility starts when the fully accounted for property or vehicle is assigned to and accepted by the provider. Business arrangements made between the provider and its subcontractors shall not permit the transfer of title of state property to subcontractors. While such business arrangements may provide for subcontractor participation in the use and maintenance of the property under their control, the ME shall hold the provider solely responsible for the use and condition of said property. Provider inventories shall be conducted in accordance with CFOP 80-2. (3) If any property is purchased by the provider with funds provided by this contract, the provider shall inventory all nonexpendable property including all computers. A copy of which shall be submitted to the along with the expenditure report for the period in which it was purchased. At least annually,the provider shall submit a complete inventory of all such property to the ME whether new purchases have been made or not. (4) The Network Provider Inventory List, incorporated herein by reference, and available from the designated ME Contract Manager upon request, shall include, at a minimum, the identification Revised Attachment I HCO2 (f) Page 42 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) ;2020 number;year and/or model,a description of the property, its use and condition,current location, the name of the property custodian, class code (use state standard codes for capital assets), if a group, record the number and description of the components making up the group, name, make, or manufacturer, serial number(s), if any, and if an automobile, the VIN and certificate number; acquisition date, original acquisition cost, funding source, information needed to calculate the federal and/or state share of its cost. (5) The ME's Contract Manager must provide disposition instructions to the provider prior to the end of the contract period. The provider cannot dispose of any property that reverts to the ME or department without the Contract Manager's approval. The provider shall furnish a Closeout Inventory Form no later than 30 days before the completion or termination of this contract. The Closeout Inventory Form shall include all nonexpendable property including all computers purchased by the provider.The Closeout Inventory Form shall contain, at a minimum, the same information required by the annual inventory. (6) The provider hereby agrees that all inventories required by this contract shall be current and accurate and reflect the date of the inventory. If the original acquisition cost of a property item is not available at the time of inventory, an estimated value shall be agreed upon by both the provider and the ME and shall be used in place of the original acquisition cost. (7) Title (ownership) to and possession of all property purchased by the provider pursuant to this contract shall be vested in the ME upon completion or termination of this contract. During the term of this contract, the provider is responsible for insuring all property purchased by or transferred to the provider is in good working order. The provider hereby agrees to pay the cost of transferring title to and possession of any property for which ownership is evidenced by a certificate of title. The provider shall be responsible for repaying to the ME the replacement cost of any property inventoried and not transferred to the ME upon completion or termination of this contract. When property transfers from the provider to the ME, the provider shall be responsible for paying for the title transfer. (8) If the provider replaces or disposes of property purchased by the provider pursuant to this contract, the Network Provider is required to provide accurate and complete information pertaining to replacement or disposition of the property as required on the provider's annual inventory. (9) The provider hereby agrees to indemnify the ME and the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. (10)A formal contract amendment is required prior to the purchase of any property item not specifically listed in the approved contract budget. b. Title to Vehicles (1) Title (ownership) to, and possession of, all vehicles acquired with funds from this contract shall be vested in the ME upon completion or termination of the contract. The provider will retain custody and control during the contract period, including extensions and renewals. Revised Attachment I HCO2 (f) Page 43 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 (2) During the term of this contract,title to vehicles furnished by the state or acquired at the direction of the state(using state or federal funds)shall not be vested in the provider. Subcontractors shall not be assigned or transferred title to these vehicles. The provider hereby agrees to indemnify the ME or the department against any claim or loss arising out of the operations of any motor vehicle purchased by or transferred to the provider pursuant to this contract. 19. National Voter Registration Act(NVRA) of 1993 a. The Network Provider shall comply with the National Voter Registration Act (NVRA) of 1993, Pub. L. 103-31 (1993), ss. 97.021 and 97.058, F.S., and ch. 1S-2.048, F.A.C., in accordance with Guidance 25— National Voter Registration Act Guidance. b. As a Voter Registration Agency, the Network Providers shall designate a Voting Registration Activities Coordinator and provide the contact information of the Coordinator by the date and to the individual(s) identified in Exhibit C-1, Required Reports. The Network Provider shall notify the ME's Contract Manager, in writing within (10) calendar days of staffing changes regarding this position. c. As a Voter Registration Agency, the Network Provider shall provide individuals seeking services and/or individuals served with an opportunity at admission or when they change an address, to either register or update their voter registration. The National Voter Registration Act Preference Form/Application are DS-DE77-ENG and DS-DE77-SPN, are available at the link provided in paragraph f., below d. The Network Provider shall submit a NVRA Voter Registration Agencies Quarterly Activities Report Form, DS-DE131, by the dates and to the individual(s) identified in Exhibit C-1, Required Reports. The Quarterly Activity Report Form is available at the link provided in paragraph f., below. e. Any person aggrieved by a violation of either the National Voter Registration Act or a voter registration or removal procedure under the Florida Election Code may file a written complaint with the Department of State by completing and submitting the NVRA Complaint Form (DS-DE 18). f. The Department of State has published all form referenced herein, along with online training and additional guidance to implement NVRA at: http://dos.myflorida.com/elections/for-voters/voter-registration/national-voter-registration- act 20. Special Insurance Provisions a. The Network Provider shall notify the ME Contract Manager within thirty (30) calendar days if there is a modification to the terms of insurance including but not limited to, cancellation or Revised Attachment I HCO2 (f) Page 44 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thew; S South tloriida �at�����orill Theafth Nemork. n(%) /2020 modification to policy limits. b. The Network Provider acknowledges that, as an independent contractor, the Network Providers, and its subcontractors, at all tiers are not covered by the State of Florida Risk Management Trust Fund for liability created by s. 284.30, F.S. c. The Network Provide shall obtain and provide proof to the ME's Contract Manager of comprehensive general liability insurance coverage (broad form coverage), specifically including premises, fire and legal liability to cover managing the Network Provider and all of its employees. The limits of Network Provider's coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. d. If any officer, employee, or agent of the Network Provider operates a motor vehicle in the course of the performance of its duties under this contract, the Network Provider shall obtain and provide proof to the Department and the Managing Entity of comprehensive automobile liability insurance coverage.The limits of the Network Provider's coverage shall be no less than $300,000 per occurrence with a minimal annual aggregate of no less than $1,000,000. e. If any officer, employee, or agent of the Network Service Provider, at all tiers, provides any professional services or provides or administers any prescription drug or medication or controlled substance in the course of the performance of the duties of the Network Service Provider, the Managing Entity shall cause the Network Service Provider, at all tiers,to obtain and provide proof to the Managing Entity and the Department of professional liability insurance coverage, including medical malpractice liability and errors and omissions coverage, to cover all Network Service Provider employees with the same limits. f. The ME and the Department shall be exempt from, and in no way liable for, any sums of money that may represent a deductible or self-insured retention under any such insurance.The payment of any deductible on any policy shall be the sole responsibility of the Network Provider purchasing the insurance. g. All such insurance policies of the Network Providers, and its subcontractors at all tiers, shall be provided by insurers licensed or eligible to do and that are doing business in the State of Florida. Each insurer must have a minimum rating of"A" by A. M. Best or an equivalent rating by a similar insurance rating firm and shall name the ME and the Department as an additional insured under the policy(ies). The Network Provider shall use its best good faith efforts to cause the insurers issuing all such general, automobile, and professional liability insurance to use a policy form with additional insured provisions naming the ME and the Department as an additional insured or a form of additional insured endorsement that is acceptable to the ME and the Department in the reasonable exercise of its judgment. h. The requirements of this section shall be in addition to, and not in replacement of, the requirements of Section 24, Insurance, of the Standard Contract. but in the event of any inconsistency between the requirements of this section and the requirements of the Standard Contract, the provisions of this section shall prevail and control. Revised Attachment I HCO2 (f) Page 45 of 46 Guidance/Care Center, Inc. Contract No. P-04 0 0 (Contnil thrw� oath tloriida �at�����or ill Theafth Nemork.tn(%) /2020 i. If the Network Provider is an agency or subdivision of the State, its obligation to indemnify, defend and hold harmless the ME shall be to the extent permitted by section 768.28, F.S. or other applicable law, and without waving the limits of sovereign immunity. E. List of Exhibits The Network Provider agrees to comply with the exhibits listed below. The following exhibits,or the latest revisions thereof,are incorporated in and made a part of the contract. 1. Exhibit A,Clients/Participants to be Served 2. Exhibit B, Method of Payment 3. Exhibit C, Required Reports 4. Exhibit D,Substance Abuse and Mental Health Required Performance Outcomes and Outputs 5. Exhibit F,State and Federal Laws, Rules and Regulations 6. Exhibit G,Covered Service Funding by OCA 7. Exhibit H, Funding Detail&Local Match Plan Revised Attachment I HCO2 (f) Page 46 of 46 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 2 1 2020 Exhibit C Required Reports Required Reports Due Date #of Copies Send to Response to Within 10 business days from 1(Electronic 1. ME Contract Manager Monitoring Reports the day the report is received Submission via E-mail) and Corrective Action 2. SFBHN staff member Plans issuing CAP External Quality Within 10 calendar days from 1 (Electronic 1. ME Contract Manager Assurance Reviews, the day the report is received, Submission via E-mail) Monitoring Reports, or as requested by the 2. Director of Contract Surveys and Contract Manager Accountability Corrective Actions,as applicable Memorandum of Within 90 calendar days of 1(Electronic ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract between the ME and Federally Qualified the Network Provider(for Health Center(FQHC) newly executed MOU's); or Within 30 calendar days for Federally Qualified renewed MOU's; Updates to Health Centers are P&P for FQHC's shall be required to submit submitted within 30 calendar policies and days of adoption procedures that explain the access to primary care services to the medically underserved behavioral health client Sliding Fee Scale Prior to contract execution 1(Electronic ME Contract Manager [reflecting the Submission via E-mail) uniform schedule of discounts referenced in 65E-14.018(4)] Final FY 2020-2021 Submitted annually prior to 1(Electronic 1. ME Contract Manager (1) Projected Cost contract execution. Submit Submission via E-mail) Center Operating and updates within 30 calendar 2.VP of Finance Capital days of execution of an Budget, amendment to the contract (2) Budget Narrative, affecting the budget. (3) Network Providers Agency Service Capacity Report, (4)Cost Center Personnel Detail Report Revised Exhibit C Page 1 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 2 1 2020 Exhibit C Required Reports Program Description Annually, prior to contract 1(Electronic 1. ME Contract Manager (1)Organizational execution. Submit updates Submission via E-mail) Profile within 30 calendar days of 2.VP of Behavioral Health (2)Service Activity amendment Description (3)Supplemental Program Description(s) Affidavit Regarding Annually prior to contract 1 ME Contract Manager Debarment execution,or as requested by the Contract Manager Incident Report Within 24 hours of Submission through Submission through IRAS occurrence, in IRAS accordance with CFOP 215-6 and reportable incidents defined CFOP 180-4 Mandatory Reporting Requirements to the Office of the Inspector General Acute Care Service Real-time data submission as Electronically KIS Express Acute Care Utilization Reporting mandated by subsection System for Public Receiving 394.9082(10), Florida Statutes Facilities, Detoxification and Addiction Receiving Facilities. Monthly Data Service data shall be Electronically KIS, PBPS,or other data Required by DCF submitted electronically, system designated by the ME FASAMS PAM 155-2 weekly, by 12:00 Noon every or the Department Wednesday. Final monthly shall be submitted electronically to the ME no later than the 4th of each month following the month of service ADA Client By the 4th business day 1(Electronic https://fsl6.formsite.com/D Communication following the Submission via E-mail) CFTraininp/Monthly- Assessment Auxiliary reporting month Summary- Aid Service Record Report/form loin.html Monthly Summary Report (Applicable to agency's that employ Confirmation E-mail to the fifteen (15)or more ME Contract Manager employees) Revised Exhibit C Page 2 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 2/1/2020 Exhibit C Required Reports Monthly Service Monthly, by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day Department) after the month of service Invoice Review 1 As requested by ME staff Supporting Submitted with the monthly Documentation invoice,as appropriate, and/or as requested by SFBHN staff Exhibit K, Pre- Monthly,with the monthly 1 1. ME Sr.Accountant(Fiscal Authorization invoice by the eighth (8th) Department) Utilization calendar day Management Roster after the month 2. ME ASOC Manager for Substance Abuse of service and Mental Health 3. ME CSOC Manager Residential Level II Services Exhibit AC, Monthly Monthly by the 5th calendar 1 ME Care Coordinator Care Coordination day after the month of service Report Narrative and Chart Final Invoice 1 ME Sr.Accountant(Fiscal By July 20 of each fiscal year Department) and/or 20 days after contract end date Designation of Within 5 working days of 1(Electronic ME Contact Manager Dispute Resolution contract execution Submission via E-mail) Officer Inventory Report ME Contract Manager 8/3/2020 1(Electronic Submission via E-mail) Attestation of 8/3/2020 1(Electronic ME Contract Manager Network Provider's Submission via E-mail) Verification that all applicable employees and subcontractors with access to ME and/or DCF information systems have signed a DCF Security Agreement form CF0114, per the Attachment I and Standard Contract Revised Exhibit C Page 3 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Emergency 8/3/2020 1(Electronic 1. ME Contract Manager Preparedness Plan Submission via E-mail) 2. ME Continuous Quality Improvement Manager Civil Rights 8/3/2020 1(Electronic ME Contract Manager Compliance Checklist Submission via E-mail) (CF0946) Civil Rights 8/3/2020 1(Electronic ME Contract Manager Certificate(CF707) Submission via E-mail) Client Trust Fund 8/3/2020 1(Electronic ME Contract Manager Letter Submission via E-mail) Quality 8/3/2020 1(Electronic 1. ME Contract Manager Assurance/Quality Submission via E-mail) Improvement Plan 2. ME Continuous Quality Improvement Manager Signed Florida 8/3/2020 1 (Electronic ME Contract Manager Department of Submission via E-mail) Children and Families Employment Screening Affidavit that all required staff have been screened or Network Provider is awaiting the results of screening Attestation signed by 10/1/2020 1(Electronic ME Contract Manager the CEO/Executive Submission via E-mail) Director indicating that all applicable staff funded by this Contract have received a copy of the fully executed Contract and will receive a copy of any amendments made to this Contract. Revised Exhibit C Page 4 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports NVRA Voter July 5,2020 1(Electronic 1. ME Voter Registration Registration Agencies (Period: 04/01/20-06/30/20) Submission via E-mail) Activities Coordinator Quarterly Activities October 5,2020 Report Form (DS- (Period: 07/01/20-09/30/20) 2. ME Contract Manager DE131;effective January 5,2021 01/2012 or latest (Period: 10/01/20-12/31/20) revision thereof, if April 5,2021 applicable (Period: 01/01/21-03/31/21) July 5,2021 (Period: 04/01/21-06/30/21) Quarterly Financial October 31,2020 1(Electronic 1. ME VP of Finance Statements(Balance (Period: 07/01/20-09/30/20) Submission via E-mail) Sheet and Statement January 31,2021 2. ME Contract Manager of Activity) (Period: 10/01/20-12/31/20) April 30,2021 (Period: 01/01/21-03/31/21) July 31,2021 (Period: 04/01/21-06/30/21) Attestation indicating October 31,2020 1(Electronic ME Contract Manager the filing of Form 941 (Period: 07/01/20-09/30/20) Submission via E-mail) and payment of any January 31,2021 taxes due to the IRS (Period: 10/01/20-12/31/20) have been paid. April 30,2021 (Period: 01/01/21-03/31/21) July 31,2021 (Period: 04/01/21-06/30/21) Quarterly Peer October 31,2020 One(1) Encrypted and ME Peer Services Manager Specialist Report (Period: 07/01/20-09/30/20) password protected January 31,2021 Electronic Submission (Period: 10/01/20-12/31/20) April 30,2021 (Period: 01/01/21-03/31/21) July 31,2021 (Period: 04/01/21-06/30/21) January 30,2021 1(Electronic 1. ME Contract Manager Continuous Quality (Period: 07/01/20-12/31/20) Submission via E-mail) Improvement July 30,2021 2. ME Continuous Quality Updates (Period: 01/01/21-06/30/21) Improvement Manager Year-End financial Reports for Network Provider's Not Requiring Audits Per Attachment 11 Certification Due 180 days after the end of 1(Electronic 1. ME Contract Manager indicating that the Network Provider's fiscal Submission via E-mail) recipient expended year or within 30 days of the 2.VP of Finance less than $750,000 in recipient's receipt of the audit Federal Awards or in report,whichever occurs first, directly to each of the Revised Exhibit C Page 5 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 2 1 2020 Exhibit C Required Reports State Awards during following unless otherwise the fiscal year required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of State Due 180 days after the end of 1(Electronic 1. ME Contract Manager Earnings the Network Provider's fiscal Submission via E-mail) 2.VP of Finance year or within 30 days of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Projected Cost Due 180 days after the end of 1(Electronic 1. ME Contract Manager Center Operating and the Network Provider's fiscal Submission via E-mail) Capital Budget year or within 30 days of the 2.VP of Finance Actual Expenses& recipient's receipt of the audit Revenues Schedule report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Local Match Due 180 days after the end of 1(Electronic 1. ME Contract Manager Calculation Form- the Network Provider's fiscal Submission via E-mail) Template 9- year or within 30 days of the 2.VP of Finance Department of recipient's receipt of the audit Children and Families report,whichever occurs first, form,available at the directly to each of the following website: following unless otherwise required by Florida Statutes https://www.myflfa The schedule shall be based milies.com/service- on revenues and expenditures programs/samh/man recorded during the state's aging-entities/2020- fiscal year. contract-docs.shtml Revised Exhibit C Page 6 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc. 7/1/2020 Exhibit C Required Reports Schedule of Bed-Day Due 180 days after the end of 1(Electronic 1. ME Contract Manager Availability Payments the Network Provider's fiscal Submission via E-mail) year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Agency Prepared Due 180 days after the end of 1(Electronic 1. ME Contract Manager Financial Statements the Network Provider's fiscal Submission via E-mail) (Balance Sheet and year or within 30 days of the 2.VP of Finance Statement of Activity recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Year-End Financial Reports for Network Provider's Requiring Audits Per Attachment II Correspondence Due 180 days after the end of 1(Electronic 1. ME Contract Manager from the Auditor the Network Provider's fiscal Submission via E-mail) showing proof of year or within 30 days of the 2.VP of Finance submission of the recipient's receipt of the audit Audit Report and report,whichever occurs first, Management Letter directly to each of the to the Network following unless otherwise Provider. required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Management letter Due 180 days after the end of 1(Electronic 1. ME Contract Manager addressed to the the Network Provider's fiscal Submission via E-mail) Network Provider year or within 30 days of the 2.VP of Finance issued by the Auditor recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Revised Exhibit C Page 7 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 2 1 2020 Exhibit C Required Reports Financial& Due 180 days after the end of 1(Electronic 1. ME Contract Manager Compliance Audit to the Network Provider's fiscal Submission via E-mail) include the necessary year or within 30 days of the 2.VP of Finance schedules per recipient's receipt of the audit Attachment II report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of State Due 180 days after the end of 1(Electronic 1. ME Contract Manager Earnings the Network Provider's fiscal Submission via E-mail) 2.VP of Finance year or within 30 days of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of Related Due 180 days after the end of 1(Electronic 1. ME Contract Manager Party Transaction the Network Provider's fiscal Submission via E-mail) Adjustments year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Local Match Due 180 days after the end of 1(Electronic 1. ME Contract Manager Calculation Form- the Network Provider's fiscal Submission via E-mail) Template 9- year or within 30 days of the 2.VP of Finance Department of recipient's receipt of the audit Children and Families report,whichever occurs first, form,available at the directly to each of the following website: following unless otherwise https://www.myflfa required by Florida Statutes milies.com/service- The schedule shall be based programs/samh/man on revenues and expenditures aging-entities/2020- recorded during the state's contract-docs.shtml fiscal year. Revised Exhibit C Page 8 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc. 7/1/2020 Exhibit C Required Reports Projected Cost Due 180 days after the end of 1(Electronic 1. ME Contract Manager Center Operating and the Network Provider's fiscal Submission via E-mail) Capital Budget year or within 30 days of the 2.VP of Finance Actual Expenses& recipient's receipt of the audit Revenues Schedule report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Schedule of Bed-Day Due 180 days after the end of 1(Electronic 1. ME Contract Manager Availability Payments the Network Provider's fiscal Submission via E-mail) year or within 30 days of the 2.VP of Finance recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes The schedule shall be based on revenues and expenditures recorded during the state's fiscal year. Reports Required for Children's Mental Health Providers,as applicable Children's Crisis Per Exhibit S-Monthly Census One(1) Encrypted 1. ME Contract Manager Response Team Report by the 15th of every Electronic Submission (CCRT) month following the month of attachment to an 2. Children's System of Care service email to each Manager recipient Reports Required for Behavioral Health Network(BNet)Provider Alternative Services Within 15 calendar days after One(1) Encrypted 1. ME Contract Manager Provision end of month Electronic Submission Documentation attachment to an 2. ME BNet Coordinator (Other than email to each Pharmaceuticals) recipient 3.Children's Mental Health State Program Office Alternative Services Within 15 calendar days after One(1) Encrypted 1. ME Contract Manager Provision end of month Electronic Submission Documentation attachment to an 2. ME BNet Coordinator (Pharmaceuticals email to each only) recipient 3.Children's Mental Health State Program Office Statement of September 1 following close One(1) Encrypted 1. ME Contract Manager Program Cost of the contract year(June 30) Electronic Submission 2. ME BNet Coordinator attachment to an 3. Children's Mental email to each Health State Program recipient Office Revised Exhibit C Page 9 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Reports Required for Project for Assistance in Transition from Homelessness v(PATH)Providers PATH Monthly Monthly, by the 5th calendar 1(Electronic Report(generated day Submission via E-mail) from the HMIS after the month ME Housing Coordinator system) of service PATH Monthly Client Monthly by the 10th calendar 1(Electronic Tracker day after the month of service Submission via E-mail- Encrypted and ME Housing Coordinator Password Protected) Quarterly Summary No later than the 10th of the 1(Electronic https://www.pathpdx.org/ Report month following the quarter Submission via E-mail) of services PATH Annual Data No later than November 17th 1(Electronic https://www.pathpdx.org/ Report into the PATH Submission via E-mail) Data Exchange(PDX) data system Reports Required for Adult Mental Health Providers,as applicable Assisted Living Provider to Maintain the 1 (Electronic Requestor Facility with a Report on file and submit Submission via E-mail) Limited Mental upon Request by ME staff Encrypted and Health License Client October 5,2020 Password Protected Quarterly Report, per (Period: 07/01/20-09/30/20) Exhibit L January 5,2021 (Period: 10/01/20-12/31/20) April 5,2021 (Period: 01/01/21-03/31/21) July 5,2021 (Period: 04/01/21-06/30/21) Report Required for Florida Assertive Community Treatment(FACT)Providers Vacant Position Monthly by the 7th of each 1(Electronic Report per Section month following the month of Submission via E-mail) 1. ME Contract Manager II.H., Reports in service Exhibit AF 2. ME Director of the Adult System of Care FACT Enhancement October 5,2020 1(Electronic Reconciliation Report (Period: 07/01/20-09/30/20) Submission via E-mail) 1. ME Contract Manager per Section II.H., January 5,2021 Reports in Exhibit AF (Period: 10/01/20-12/31/20) 2. ME Director of the Adult April 5,2021 System of Care (Period: 01/01/21-03/31/21) July 5,2021 (Period: 04/01/21-06/30/21) Revised Exhibit C Page 10 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Ad-Hoc Quarterly October 5,2020 1(Electronic Report per Section (Period: 07/01/20-09/30/20) Submission via E-mail) 1. ME Contract Manager II.H., Reports in January 5,2021 Exhibit AF (Period: 10/01/20-12/31/20) 2. ME Director of the Adult April 5,2021 System of Care (Period: 01/01/21-03/31/21) July 5,2021 (Period: 04/01/21-06/30/21) Outcomes and October 5,2020 1(Electronic Output Performance (Period: 07/01/20-09/30/20) Submission via E-mail) 1. ME Contract Manager Measures Report, January 5,2021 per Section II.H., (Period: 10/01/20-12/31/20) 2. ME Director of the Adult Report in Exhibit AF April 5,2021 System of Care (Period: 01/01/21-03/31/21) July 5,2021 (Period: 04/01/21-06/30/21) Report Required for Miami-Dade Forensic Alternative(MDFAQ Providers Daily Census Report Daily, by 10:00 am, 1(Electronic Regional Forensic Monday-Friday Submission via E-mail) Coordinator Monthly Program By the 15th of each month 1(Electronic 1. ME Contract Manager Quality Review following the month of Submission via E-mail) Tracking Report services 2. ME Director of the Adult System of Care Monthly By the 15th of each month 1(Electronic 1. ME Contract Manager Performance following the month of Submission via E-mail) Measures Report services 2. ME Director of the Adult System of Care Reports Required for Forensic Services Providers Monthly Report for By 15th of each month 1 Mental Health Administrator Individuals on Office Conditional Release, if applicable Statewide Forensic Weekly 1 ME Director of the Adult Bed Census Report, if (Every Thursday by 5:00 pm) System of Care applicable Reports Required for Forensic Multidisciplinary Team Provider Monthly Forensic By 10th of each month for the 1(Electronic ME Director of Adult System Multidisciplinary preceding months'services Submission via E-mail) of Care Team Report—DCF Template 25: https://www.myflfa milies.com/service- programs/samh/man Revised Exhibit C Page 11 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports aging-entitiesZ2020- contract-docs.shtml Monthly Vacant By 10th of each month for the 1(Electronic ME Director of Adult System Position(s) Reports preceding months'services Submission via E-mail) of Care Monthly Court By 10th of each month for the 1(Electronic ME Director of Adult System Reports preceding months'services Submission via E-mail) of Care Reports Required for Consurner-briven Agencies Enrollment/Member October 5,2020 1(Electronic ME Contract Manager ship Report (Period: 07/01/20-09/30/20) Submission via E-mail) January 5,2021 (Period: 10/01/20-12/31/20) April 5,2021 (Period: 01/01/21-03/31/21) July 5,2021 (Period: 04/01/21-06/30/21) Reports Required for Substance Abuse Services Providers Report for HIV Early January 5,2021 1(Electronic ME Contract Manager Intervention (Period: 07/01/20-12/31/20) Submission via E-mail) Services,SAPT Block July 5,2021 Grant Set Aside (Period: 01/01/21-06-30-21) Funded Services Only Annual Report for Upon Request 1(Electronic ME Contract Manager Evidenced-based Submission via E-mail) Injection Drug User Outreach Services, SAPT Block Grant Mandate, Designated Providers Only Annual Report for Upon Request 1(Electronic ME Contract Manager Pregnant Women Submission via E-mail) and Women with Dependent Children SAPT Block Grant Set Aside Funded Services Only Monthly Outcomes Due monthly, by the 4th of 1(Electronic 1. MEITOffice for Women's every month following the Submission via E-mail) Expansion Grant— month of service 2. ME Contract Manager Special Appropriation Revised Exhibit C Page 12 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florid (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Reports Required for State Opioid Response Discretionary Grant Providers Monthly SOR Data Due monthly, by the 15th of 1(Electronic ME Contract Manager Collection Report- every month following the Submission via E-mail) State Opioid month of service Encrypted and Response Password Protected Discretionary Grant Services(SOR) Medication Assisted Treatment Services, OCA: MSSOR- Exhibit BB Quarterly and Annual October 31,2020 1(Electronic 1. ME Contract Manager Expenditure Report (Period: 07/01/20-09/30/20) Submission via E-mail) (Exhibit BB) January 30,2021 2. VP of Finance (Period: 10/01/20-12/31/20) April 30,2021 (Period: 01/01/21-03/31/21) July 31,2021 (Period: 04/01/21-06/30/21) Annual Expenditure Report Due:7/15/2021 (Period: 07/01/20—06/30/21) Reports Required for Substance Abuse Prevention Services Providers Monthly Data Prevention service data shall Electronically PBPS,or other data system Required by DCF be submitted electronically to designated by the ME or the FASAMS PAM 155-2 PBPS no later than the 4th of Department and/or PBPS each month following the month of service Monthly Data to the Monthly, by the 4th calendar Electronically DOES or any other format ME's contracted day after the month of service requested by BSRI evaluation entity- BSRI Monthly Service Monthly, by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day after the month Department) of service Invoice Review 1 ME Sr.Accountant(Fiscal Supporting Submitted with the monthly Department) Documentation- invoice from PBPS in a jpeg format Revised Exhibit C Page 13 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Monthly E-Mail Monthly, by the 4th calendar 1(Electronic 1. ME Director or Prevention Notification to the day after the month of service Submission via E-mail) Services ME Prevention Services Director and 2. ME Data Analyst ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. Refer to Scope of Work Attachment to the Contract for specifics Final Annual Site 8/31/2020 1(Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Memorandum of Within 30 calendar days of 1(Electronic 1. ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract(for newly executed 2. ME Director or Prevention Community Coalition MOU's) Services OR Within 30 calendar days for renewed MOU's Reports Required for Prevention Partnership Grant Providers Monthly E-Mail Monthly, by the 4th calendar 1(Electronic 1. ME Director or Prevention Notification to the day after the month of service Submission via E-mail) Services ME Prevention Services Director and 2. ME Data Analyst ME Data Analyst verify that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. Refer to Scope of Work Attachment to the Contract for specifics Program Status July 15,2021 1(Electronic 1. ME Contract Manager Report (Period: 7/1/20-6/30/21) Submission via E-mail) 2. ME Director or Prevention Services Revised Exhibit C Page 14 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Memorandum of Within 30 calendar days of 1(Electronic 1. ME Contract Manager Understanding the effective date of the Submission via E-mail) (MOU)with a contract(for newly executed 2. ME Director or Prevention Community Coalition MOU's) Services OR Within 30 calendar days for renewed MOU's Final Annual Site 8/31/2020 1(Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Financial Report of July 31,2021 1(Electronic 1. ME Contract Manager, Program Expenses (Period: 07/01/20-06/30/21) Submission via E-mail) 2. ME VP of Finance,and 3. ME Director of Prevention Services Reports Required for Evaluation Entity for Prevention Services Monthly Service Monthly by 20th calendar day 1(Electronic 1. ME Contract Manager Report after the month of service Submission via E-mail) (Deliverables per 2. ME Director of Prevention Attachment IV,Scope Services of Work) Quarterly October 31,2020 1(Electronic 1. ME Contract Manager, Expenditure Report (Period: 07/01/20-09/30/20) Submission via E-mail) January 30,2021 2. ME VP of Finance,and (Period: 10/01/20-12/31/20) April 30,2021 3. ME Director of Prevention (Period: 01/01/21-03/31/21) Services July 31,2021 (Period: 04/01/21-06/30/21) Reports Required for Providers Receiving Specific Appropriations Initial Projected 7/10/2020 1(Electronic 1. ME Contract Manager Return on Submission via E-mail) Investment-Per Exhibit AM Quarterly Updates on October 10,2020 1(Electronic 1. ME Contract Manager Return on (Period: 07/01/20-09/30/20) Submission via E-mail) Investment Report- January 10,2021 Per Exhibit AM (Period: 10/01/20-12/31/20) April 10,2021 (Period: 01/01/21-03/31/21) July 10,2021 (Period: 04/01/21-06/30/21) Revised Exhibit C Page 15 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Reports Required for the Navigate Program Provider Quarterly Services October 31,2020 1(Electronic ME Contract Manager Report (Period: 07/01/20-09/30/20) Submission via E-mail) January 30,2021 (Period: 10/01/20-12/31/20) April 30,2021 (Period: 01/01/21-03/31/21) July 31,2021 (Period: 04/01/21-06/30/21) Navigate Program October 31,2020 1(Electronic ME Contract Manager Quarterly (Period: 07/01/20-09/30/20) Submission via E-mail) Expenditure Report January 30,2021 (Period: 10/01/20-12/31/20) April 30,2021 (Period: 01/01/21-03/31/21) July 31,2021 (Period: 04/01/21-06/30/21) Reports Required for Information and Referral Services Providers Information and Due monthly, by the 30th of 1(Electronic ME Contract Manager Referrals Provider's every month following the Submission via E-mail) Network(Jewish month of service Community Services of South Florida, Inc.) Exhibit P-1, Information and Referral Monthly Progress Report Reports Required for the forensic Mental Health Services Program Appendix A, By the 10th of every month 1(Electronic Director of Adult System of Conditional Release following the reporting month Submission via E-mail) Care Report Weekly Statewide Weekly by 12:00 Noon every 1(Electronic Director of Adult System of Census Report Thursday Submission via E-mail) Care Appendix B, Monthly By the 10th of every month 1(Electronic Director of Adult System of Diversion Report following the reporting month Submission via E-mail) Care Quarterly SMHFT Due within thirty(30) 1(Electronic Director of Adult System of Visit Report calendar days of date of the Submission via E-mail) Care visit Staffing Report January 5,2021 1(Electronic Director of Adult System of (Period: 07/01/20-12/31/20) Submission via E-mail) Care July 5,2021 (Period: 01/01/21-06-30-21) Revised Exhibit C Page 16 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Reports Required for the Community Action Treatment Team(CAT Team)Program Weekly Census Weekly by 12:00 noon,every 1(Electronic Children's System of Care Report Monday Submission via E-mail) Manager Encrypted and Password Protected Monthly shall be submitted Electronically KIS, FASAMS,or other data Monthly Data electronically to the ME no system designated by the ME Required by DCF later than the 4th of each or the Department FASAMS PAM 155-2 month following the month of service Appendix 1-Persons By the 8th calendar day of the 1 (Electronic 1.Children's System of Care Served and month after the month of Submission via E-Mail) Manager Performance service 2.Contract Manager Measure Report Appendix 2- October 10,2020 1(Electronic 1.Children System of Care Quarterly (Period: 07/01/20-09/30/20) Submission via E-mail) Manager Supplemental Data January 10,2021 Report (Period: 10/01/20-12/31/20) 2.Contract Manager April 10,2021 (Period: 01/01/21-03/31/21) July 10,2021 (Period: 04/01/21-06/30/21) Appendix 3-CAT Monthly, by the eighth (8th) 1 1. ME Sr.Accountant(Fiscal Team Monthly calendar day Department) Invoice after the month of service 2.Children's System of Care Manager Invoice Review Submitted with the monthly 1 1. ME Sr.Accountant(Fiscal Supporting invoice,as appropriate, Department) Documentation and/or as requested by SFBHN 2.Children's System of Care (incidental expenses) staff Manager Reports Required for the Mobile Response Teams Monthly MRT Monthly by the 10th following 1(Electronic 1. ME Contract Manager Tracker the month of service Submission via E-mail) 2. ME Data Analysts -Encrypted, password protected Outreach Activities October 15,2020 1(Electronic 1. ME Contract Manager Log (Period: 07/01/20-09/30/20) Submission via E-mail) 2. ME Data Analysts January 15,2021 (Period: 10/01/20-12/31/20) April 15,2021 (Period: 01/01/21-03/31/21) July 15,2021 (Period: 04/01/21-06/30/21) Revised Exhibit C Page 17 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7 1 2020 Exhibit C Required Reports Reports Required for Family Intensive Treatment Team(FIT)Service Providers Weekly-Child Each Monday by close of 1(Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit Al) Monthly Progress By the 13th day of the month 1(Electronic 1. Contract Manager Report(Reporting following the month of Submission via E-mail) 2.Child Welfare Integration Template 17 is services Coordinator available at: https://www.myflfa milies.com/service- programs/samh/man aging-entiti es/2020- contract-docs.shtml Reports Required for the Families Engaged in Recovery and Safety(FERAS)Providers Weekly-Child Each Monday by close of 1(Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit U) Monthly-Child By the 15th day of the month 1(Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services Monthly-FERAS By the 8th day of the month 1(Electronic Child Welfare Integration Outreach Log following the month of Submission via E-mail) Coordinator services Reports Required for Child Welfare Specialty Program Provider Weekly-Child Each Monday by close of 1(Electronic Child Welfare Integration Welfare Program business following the week Submission via E-mail) Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday-Monday) of Exhibit J) Monthly-Child By the 13th day of the month 1(Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services Revised Exhibit C Page 18 of 19 Guidance/Care Center, Inc. Contract No. P-04 Thriving Mind South Florida (Contracting as South FloridaBehavioral Health Network, lnc.) 7/1/2020 Exhibit C Required Reports Monthly—Child By the 8th day of the month 1(Electronic Child Welfare Integration Welfare Specialty following the month of Submission via E-mail) Coordinator Program Outreach services Log Reports Required for Child Welfare Integration&Support Teams(CWIST) Monthly Family Monthly by the 5th for the 1(Electronic ME Child Welfare Navigator Tracker preceding month's services. Submission via E-mail) Integration Coordinator Monthly Behavioral Monthly by the 5th for the 1(Electronic ME Child Welfare Consultant Activity preceding month's services. Submission via E-mail) Integration Coordinator Log Reports Required for Network Providers Providing SA Treatment Services to Pregnant Women,Mother's and their Affected Families(OCA's:MS027 and MS081) Women's Special By the 8th day of the month One(1) Password, Data Analysts Appropriation Data following the month of protected and Reporting-Per services encrypted Electronic Exhibit AE Submission Supported Employment Report—Special Proviso Funded Clubhouses Supported October 10,2020 One(1) Password, ME Peer Services Manager Employment (Period: 07/01/20-09/30/20) protected and January 10,2021 encrypted Electronic (Period: 10/01/20-12/31/20) Submission April 10,2021 (Period: 01/01/21-03/31/21) July 10,2021 (Period: 04/01/21-06/30/21) Reports Required for Network Providers screening for Supplemental Security Income/Social Security Disability Insurance(SSI/SSDI)Outreach,Access,and Recovery(SOAR) Certificate of online Within ten (10) business days 1(Electronic SOAR Local Lead SOAR course of completion Submission via E-mail) completion Records review per October 15,2020 One(1) Password, SOAR Local Lead Exhibit AN,Section (Period: 07/01/20-09/30/20) protected and 11,c. Individual January 15,2021 encrypted Electronic Records Review and (Period: 10/01/20-12/31/20) Submission in Exhibit AN,Section April 15,2021 13.b.,Children's (Period: 01/01/21-03/31/21) SOAR July 15,2021 (Period: 04/01/21-06/30/21) Note:When a regular due date for a required report falls on a weekend or a legal holiday,the due date is extended to the next business day immediately following the weekend or holiday. Revised Exhibit C Page 19 of 19 Guidance/Care Center, Inc. Contract No. P-04 THRIVING MIND SOUTH FLOHICA" SCOPE OF WORK Attachment VI NAME IOF PROVIDER: Guidance Care Center Inc. NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: $150,000 "Regular" Prevention Prevention Partnership TYPE OF FUNDING: Services Grant (PPG) X COST ALLOCATED TO: (check both Children's Substance Adult Substance Abuse if approved for both covered services) use X Section I. DESCRIPTION OF SERVICES AND STRATEGIES FOR SERVICE DELIVERY DESCRIPTION OF SERVICES SUMMARY (include overall intention/purpose of program and service flow, brief description of program activities, target population to be served by the program services and how it was selected, how the services address cultural competency, the name (s)of the EBP (s)and how it (they) will be implemented, describe comprehensive programming, and the partners and coordination efforts): The Guidance/Care Center's (GCQ will provide the Project SUCCESS program using the Substance Abuse and Mental Health and Services Administration (SAMHSA) Center for Substance Abuse Prevention (CSAP) Project SUCCESS program recognized in the National Registry of Evidence-based Programs and Practices (NREPP). The program will be available and accessible to high risk youth ages 12-18 who have experimented with alcohol, are showing early danger signs and multiple risk factors for substance abuse and who attend Monroe County High Schools. Project SUCCESS relies primarily on Education as a strategy. Services include school wide activities targeting the entire school population and are designed to increase awareness of mental health and substance abuse issues, prevention education groups targeting all 91h graders, and individual counseling to those in need of additional supportive counseling. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20 year olds by 10% by meeting the following objectives: reducing alcohol use, increasing the perception of harm and risk in youth and enhancing positive, pro-social protective factors. Goal 2: Increase capacity by providing level 2 prevention programming for those at high risk; thereby eliminating service gaps for these students by providing the funding and resources necessary to ensure successful program implementation, continuity of care and partnership capacity countywide. GCC partners with the Monroe County School District and the Monroe County Coalition for the provision of these services. Page I of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 lom Specific primary Number of Category prevention Unduplica Activity/Program - (Universal programs, ted include whether Brief Description Indirect, practices in Participan the strategy is an Universal each of the six is (if EBP Direct, prevention duplicated Selective, strategies note) Indicated) (CSAP) School wide 9 months out of the school Universal Information 2,500 activities year Project SUCCESS staff Direct Dissemination will conduct activities designed to inform and increase awareness of varying targets of prevention services (suicide awareness, mental health and substance use awareness related to risk factors for substance use). 9th grade A prevention strategy which Selective Education 270 prevention consists of 4 topics taught in 4 education series to 8 sessions to all 9th graders enrolled in the district Screening A prevention strategy in which Selective Problem ID and 650 all students who are enrolled referral in the school are screened for prevention and other needs Student Assistance A prevention strategy in which Selective Problem ID and 750 students who are identified as referral needing other services are provided that service by Project SUCCESS staff or referred elsewhere for the needed service. One on one A prevention strategy in which Indicated Education 35 a student can receive up to 3 individual prevention sessions as need. Champions of Champions of Change Selective Alternatives 30 Change consists of high school students working under the direction of the Marathon High School Prevention Counselor to promote the goals of Prevention within the school Capacity Building A prevention strategy which Universal Education 430 includes presentations on Direct ATOD prevention and other relevant topics in both school and non- traditional settings. Page 2 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 Section II. TARGET POPULATION — RISK AND PROTECTIVE FACTORS TARGET POPULATION OR PARTICIPANTS (include numbers in tables and a narrative description of participant characteristics below): Description of participants to be served (describe criteria for program enrollment eligibility, geographic areas/ Neighborhoods (list zip codes), risk factors of the neighborhoods, description of the sites (school, church, park, etc.), as well as any other significant demographic information), specific cultural characteristics, and describe according to the Comprehensive Community Action Plan priorities: Youth alcohol use—Abuse by "legal' age individuals, Youth/Adult marijuana use, Prescription drug misuse/abuse, over the counter drugs misuse/abuse, other illicit drug use. Participants will be students at the 3 High Schools in Monroe County and Middle School students in Marathon. School wide activities and Prevention Education Groups are universal in nature while small groups and individual counseling are targeted at youth identified as at risk. At risk students might be identified by parents, teachers, and other community agencies or by themselves. Project SUCCESS is designed to be implemented in school settings. Each counselor has been provided with adequate space and access to student populations to fully implement the program as designed. GCC has made changes to its Prevention programming for the coming year in that most all grade levels will be covered. Apple a Day will cover K through grade 4,Alcohol Literacy and Teen Intervene will cover middle schools and Project SUCCESS will be in the high schools. The comparison of percentage of Monroe County youth and Florida Statewide youth who reported having used a list of 14 various drugs in their lifetimes reveals that percentages for Monroe County youth exceed those for the state in every category (FYSAS 2010). A significantly greater percentage of Monroe County High School students (40.9%) than statewide students (33.6%) witnessed gang members selling drugs. The ethnicity of these children breaks down as follows: 52.9% White, 33.8% Hispanic, 10.10% Black, 1.45% Asian and 2.88% Other. Risk factors: Favorable attitudes towards ATOD Perceptions of harm Community Norms Self-regulation Protective factors: Prosocial opportunities/activities RISK AND PROTECTIVE FACTORS TARGETED, AND PREVENTION SYSTEM OF CARE COMPREHENSIVE COMMUNITY ACTION PLAN (CCAP) GOALS Prevention Program/Strategy and Related System of Target Population Risk/Protective Factors Targeted Care/CCAP Goal Addressed School wide activities Favorable attitudes towards 1 & 2 ATOD Perceptions of harm Prosocial opportunities/activities Positive peer influence, Healthy behaviors Increased knowledge/awareness Page 3 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 9th Grade Prevention Education Favorable attitudes towards 1 & 2 ATOD Perceptions of harm Self-regulation Skill/competency Healthy Behaviors Increased knowledge/awareness Screening Screening to identify and broad range of risk factors 1 & 2 with the intent to mitigate those risk factors Student Assistance Favorable attitudes towards 1 & 2 ATOD Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self- Esteem Positive family communications Community values One on one Indicated Favorable attitudes towards 1 & 2 ATOD Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Champions of Change Favorable attitudes towards 1 & 2 ATOD Perceptions of harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self- Esteem Positive family communications Community values Capacity Building Favorable attitudes towards 1 & 2 ATOD Perceptions of harm Increased knowledge/awareness Community values Skill/competency Section III. SITE LOCATIONS AND INFORMATION* Page 4 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 Site Name Target Participants Zip (Check all that apply) Note whether school or Street Address city Code Child/ Parents Others community Youth Key West High School 2100 Flagler x Avenue Key West 33040 Coral Shores High 89901 Old Highway Tavernier 33070 x School I I I I Marathon Middle/High 350 Sombrero Marathon 33050 School I Road x TOTAL NUMBER TO BE SERVED 2,500 *Changes in sites/locations of services must adhere to contractual requirement procedures. Section IV. MAJOR REFERRAL SOURCES List the major referral sources for the services provided: Monroe County Public Schools Parents Self-referral I Other community agencies Section V. EVALUATION AND PERFORMANCE/OUTCOME MEASURES Describe how the program will evaluate the effectiveness of all prevention services to be implemented consistent with 65D-30.013(2), F.A.C., in collaboration with the Evaluation Team identified by SFBHN each year. The SFBHN Evaluation Team shall review the results of providers' program evaluation and all technical materials used by providers annually to ensure consistency with current research in the prevention field. Evaluation of the effectiveness of all Prevention services described shall take place with BSRI. GCC will do the following: Address the underage drinking goal from the Monroe County CCAP and common outcomes related to substance and other alcohol use and will measure them using the Monroe County FYSAS, and Alcohol Time Line Follow Back. GCC will use results from previous years' FYSAS as the baseline and utilize more results by 2017 during course of this project to define meaningful improvement and gauge GCC participant outcomes as they relate to the overall goals of the CCAP. Adhere to the Fidelity requirements of each program. Any problem areas in the classrooms or in the groups, will be discussed and addressed at weekly Supervision meetings. The effectiveness of all programs will be evaluated through the pre and post surveys and client satisfaction surveys. Random observations will be done by Prevention Coordinator and Research Assistant. All activities for Prevention will be consistent with the agency's Quality Assurance/Quality Improvement Plan. Activity Logs will be maintained for all Prevention activities and client charts will be maintained for Indicated Prevention Activities. Coordinate with the Evaluation Team regularly, attend meetings, and submit the —required documentation. Section VI. QUANTITY AND QUALITY PERFORMANCE MEASURES AND TASK LIST Page 5 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 Include all TMSF Prevention required performance assessment tools (e.g. information forms, pre- post surveys, satisfaction surveys, fidelity measures, onsite observation reports) and other required information pertaining to quality. Number Program Activity- EBP and Type of EBP %to Meet this Obsery Activities/Service Name and Description Outcome ation Recomm (include frequency, intensity, &duration of Particip and Visits sessions, as well as the number of cycles/cohorts ants - endedMeaningful by expected to be offered and tentative Annual SessionsImprovement Evalua schedule/timing) Goal or Hours Pre-Post tion Number served Activity Title: 91h Grade Prevention Education 270 4 to 8 85% Of 2 per qtr. Series sessions scheduled Activity Description:A prevention sessions and strategy which consists of 4 topics taught 85% of in 4 to 8 sessions to all 91h graders participant enrolled in the district pre/post- tests Frequency: Daily or over a 4 to 8 week period matched and Intensity. 50 mins. meeting Duration: 8 sessions outcomes Meaningful Improvement Satisfaction: 85% will demonstrate improvement in post test scores Activity Title: Recruitment/Screening 650 N/A 85% of NA Activity Description: All students referred participant or presenting for service will receive an s will have initial screening of risk and protective factors screening Frequency: one time tools Intensi : one session available Duration: Meaningful Improvement for audit Satisfaction: 85% of participants will have screening tools available for audit Activity Title: Intake/Assessment 50 mins. 85% of N Activity Description: Participants who participant A become enrolled in the program will s will complete a detailed intake of service have needs. assessme Frequency: once nt tools Intensity: one session available Duration: 50 minutes in their Meaningful Improvement Satisfaction: 85% of charts enrolled participants will have assessment tools available in their charts Activity Title: Champions of Change 30 N/A 85% of N Activity Description:All Champion of Change participant A participants will be pre and post tested for the pre/post knowledge, beliefs, attitudes and use of tests substances matched Frequency: twice and meeting Page 6 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 Intensity. once at the beginning of participation outcomes and once at the end Duration: 30 mins. Meaningful Improvement Satisfaction: 85% of participants will show improvement in post test scores Section VII. CAPACITY BUILDING AND COORDINATION List other funding sources your agency/organization has for prevention/youth development programming. Describe how the program will coordinate with other programs and services provided by funded agency/organization. Describe other programs funded that align with prevention goals. GCC currently receives funding from SFBHN Regular Prevention which supports An Apple A Day serving K through 4th grade, and Teen Intervene in the Middle Schools. GCC will also implement the Project SUCCESS PES curriculum in the Monroe County Middle Schools utilizing Regular Prevention Staff. Since Project SUCCESS focuses on High School students there is no overlap. Prevention staff participate in clinical staff meetings in each location and can make referrals for other services as needed. List other prevention programming and providers in sites mentioned in Section III of this document. Describe how the program will coordinate with other funded organizations' programs and services to avoid duplication of services. GCC is aware that the Florida Keys Children's Shelter operates Prevention services using the EBP All Stars and SNAP. GCC and FKCS are currently in the process of scheduling a meeting to build capacity and cross learn about each other's programs to coordinate services and avoid duplication. List the coalition(s) within the target service areas in which prevention services will be provided under this Scope. Describe how the program will coordinate with the coalition and share data/contribute to the ongoing Strategic Prevention Framework with the identified coalition(s). GCC works with the Monroe County Coalition by attending all meetings and coordinating activities county wide. MCC has been particularly helpful in supporting Project SUCCESS school wide activities by providing student hand-outs and incentives. GCC will coordinate and participate in MCC community events such as "No One's House Parent Information" and "Know the Law campaigns. Section Vill. ADDITIONAL PREVENTION REQUIREMENTS 1. Site Schedule A final site schedule, on the Site Schedule form, with dates, times, and location of services shall be submitted no later than August 31 of the fiscal year or when requested by the Contract Manager. Sites schedules must be approved by SFBHN, in writing, and will be based on county need and distribution of services to avoid duplication in any geographical area or school to maximize SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity in writing and submitted to the Contract Manager for review and approval by the Prevention Director.The Contract Manager will reply with approval. Page 7 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 The site schedules shall be submitted on the SFBHN Prevention Site Schedule format. 2. Memorandum of Understanding (MOU)With the Community Coalition To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition shall execute and /or maintain a memorandum of understanding (MOU)delineating the specific responsibilities of each. This MOU will be consistent with the strategies of the State of Florida Department of Children and Families' and the Managing Entity's (ME's) prevention strategy.The provider shall submit an executed copy of the MOU to the ME's Contract Manager within 30 days of the effective date of the contract (for newly executed MOUs)or within thirty(30)calendar days for renewed MOUs. 3. Memorandum of Understanding (MOU)With Sites To facilitate the coordination and delivery of services, all providers shall have executed Memoranda of Understanding (MOU) with the sites where services are being provided. All MOUs with the sites shall be current and up to date, outlining the terms of the agreement. 4. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work. 5. Meetings All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, BSRI, at regularly scheduled or specially called meetings when notified by the ME. The ME will make every attempt possible to schedule meetings with advanced notice; however, there may be meetings that may be called on short notice. These include, but are not limited to, Prevention provider meetings, meetings with Behavioral Science Research Institute, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, and other meetings as noticed by SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 6. Reports/Assignments and Special Reports/Assignments Providers are expected to submit reports as outlined in the contract. Prevention Partnership Grant (PPG) reporting is specifically described in the contract with dates for submission. Other reports will be requested by SFBHN. Special reports and assignments are requested from time to time to meet State/Local Department of Children and Families, State Block Grant,SFBHN, and other requirements and needs. Prevention providers are required to submit the reports in the format requested and by the timeline requested. These reports may be requested from different sources for different reasons. Requests generally come from SFBHN staff, including the Prevention Director, and may be requested verbally or in writing. There may be times when other collaborative partners request information and SFBHN will support these requests. 7. Training Page 8 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 The Scope of Work outlines the requirements for training to support the State Block Grant reporting requirements for workforce development as well as for strengthening the Prevention workforce. All providers shall attend scheduled training as required by the ME, meet the ME and the evaluation team, BSRI, for technical assistance and/or training, at regularly scheduled or specially called meetings when notified by the ME. 8. Report Cards Providers are required to comply with the measures on the Prevention Report Card. Grading for the measures will be according to compliance or lack thereof. 9. Data All providers are required to submit the program data monthly in the Performance Based Prevention System (PBPS)as required by the contract. The provider shall also: ■ Ensure that the data submitted clearly documents all program participants, programs, and strategies which occurred under this contract and consistent with the Scope of Work in the contract; ■ Ensure that all data submitted to PBPS is consistent with the data maintained in the provider's file and consistent with the Scope of Work in the contract; ■ Review the data submitted with the evaluation team, Behavioral Science Research Institute(BSRI), monthly to determine any discrepancies in the numbers related the evaluation and the Scope of Work and make corrections prior to submission for approval by the SFBHN Prevention Director; ■ Submit an email to the SFBHN Prevention Director and the designated SFBHN Data Analyst verifying that the data in the PBPS system has been checked and is correct and complete and may be used for Block Grant reporting and payment. There shall be a designated individual and one back up individual at the provider organization responsible for verifying the data and submitting the email. This will imply that the data has been reviewed and is ready for submission. o The email subject line shall read: PBPS Data Submission Verification o The body of the email shall read: (name of organization) is submitting the PPG Prevention data for the month of (name of the month) in PBPS and we assure that the data is complete and correct. Our organization's data may be used to report to the State for the Block Grant report. Our organization's data may be used to reconcile with the payments for this month. ■ Failure to submit any data, or correct any errors in the data which results in a rejection rate of ten percent (10%) or higher of the monthly data submitted, will require the provider to submit a corrective action plan describing how and when the missing data will be submitted or how and when the rejected will be corrected and resubmitted; and ■ In accordance with the provisions of s. 402.73(1), F. S., and Rule 65-29.001 F.A.C., corrective action plans may be required for non-compliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 10. Evaluation Page 9 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 Prevention providers shall work in collaboration with the evaluation team, Behavioral Science Research Institute (BSRI) by participating in meetings, training, and providing service data and other necessary identified data vital to the completion of the system-wide evaluation of the prevention services within the Strategic Prevention Framework. Data will be provided to BSRI in the BSRI data system, DOES, and in any other requested format. The data includes the numbers for outcome data and process data required that contributes to the evaluation of the Prevention System of Care. Prevention providers are required to participate in fidelity checks, meetings, training, and other fidelity activities related to the outcomes in the Scope of Work and for the larger Prevention System of Care evaluation. BSRI will report compliance and collaboration to SFBHN per the BSRI Scope of Work requirements. Page 10 of 10 Scope of Work Guidance/Care Center, Inc. Contract No. P-04 ATTACHMENT E PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a CONTRACTOR, supplier, subcontractor, or CONTRACTOR under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." I have read the above and state that neither Respondent's name) nor any Affiliate has been placed on the convicted vendor list within the last 36 months. (Signature) Date• 90L 1 TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of County of The foregoing instrument was acknowledged before me, by means opkehysical presence or ❑ online notarization, this day of 40 (month), au.. (year), by (name of officer or agent, title of officer or agent) of ., (name of entity). Personally Known Produced Identification: Type of ID and Number on ID (SEAL) Sin a of Nota Ntolary public�tgtu cal Plana g a nne t_.lohrisa My fi�t>rY kY41 1€srY t 175 5 Extaire % � Name of N ary (Typed, Stamped or Printed) Notary Public, State of Guidance Care Center-SAMH Contract FY21;page 15 ATTACHMENT F SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE (Company) "...warrants that he/it has not employed, retained or otherwise had act on his/her behalf any former County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee." (Signature) Date: .w�... �. TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of ftlaa- County of The foregoing instrument was acknowledged before me, by means o physical presence or ❑ online notarization, this day of (month), (year), by (name of officer or agent, title of officer or agent) of (,name of entity), Personally Known ----- .. Produced Identification: Type of ID and Number on ID.__,_., . (SEAL) jinati. of Notary E)P: ary Public State of Florida OL in ryanne L Johnson Name o Notary (Typed, Stamped or Printed) Commission GG 175345 ires 01/15/2022 Notary Public, State of Guidance Care Center-SAMH Contract FY21;page 16 ATTACHMENT G DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: 4 (Name of Business) 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business' policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. N—Y--� \b . (Signature) Date: __-._..._n TO BE COMPLETED BY NOTARY (in accordance with State notary requirements) State of County of The foregoing instrument was acknowledged before me, by means of physical presence or ❑ online notarization, this .__.._. ay of, „_ _,_,_.._, (month), _ (year), by (name of officer or agent, title of officer or agent) of (name of entity). Personally Known Produced Identification: Type of ID and Number on ID.........m,,, (SEAL) Notary Public State of Florida Signatur f Notary Maryanne L Johnson My Commission GG 175345 Expires o1H512o22 Name of otary (Typed, Stamped or Printed) Notary Public, State Guidance Care Center-SAMH Contract FY21;page 17 ATTACHMENT H FY2020 Annual Performance Report (For year October 1, 2020—September 30, 2021) AgencyName -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Point of Contact (POCK ---------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Phone/Email ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Grant Amount Per Section 8 of your contract, it is required that you fill out the entire form and answer every question. Narrative on the FY2021 Performance (i.e. successes, challenges, etc.): Questions: 1. Please list services and client information below for the program/activities funded by the Monroe County award. trth-st ,, -ru t t-:!',i1 s t�"17 '.ty{ ,t�.� #1(,as 41,)) 1 G ;) -k „r.r1 i,! r,. �\ vS v);N , ,\���;. I-.,i;it. is 3i�, {{ �. lt�}.,f�`\ii t\ra,yr ,S, -:+tt�l.>^l U t. l 2,, \�S\\ tt,l t,„{ 't .,, p12yttt}�tU � t�11 js 1„r\is, y S �1 i 1�'�}t3 2 )! i 1't.3 { _l 4h,tr.: �a ,.! i\, \).. t.I F .# r.t.- r., \.)3 a t{, i )\tttt,r. 1 1 �)�t\\\ \�.� � 011 2. What were the measurable outcomes (including numbers) accomplished in FY2021? Please base these outcomes on the services you identified in Question#1. 3. What number and percentage of your clients/participants were at or below the federal poverty level in FY2021; and/or 200%; and/or another standard used by your organization? 4. Were all the awarded funds used in FY2021? If not, please explain. 5. What is the number of FTEs working on the program(s) funded by the award in FY2021? Guidance Care Center-SAMH Contract FY21;page 18 6. Were the awarded funds used as match in FY2021? If so, please list matching sources. 7. What area of Monroe County did you serve in FY2021? 8. How many total FTEs in your organization? 9. Volunteers: hours of program service were contributed by volunteers in FY2021. 10. What was the CEO/Executive Director (or highest paid title) compensation in FY2021? (Please breakdown between salary and benefits.) 11. What is your organization's fiscal year? For the following questions, please use the number as reported on your FY2021 IRS Form 990. If your FY2021 IRS Form 990 is not yet prepared, please provide an estimate for the following questions. 12. What were your organization's total expenses in FY2021? 13. What was your organization's total revenue in FY2021? 14. What was the organization's total in grants and contracts for FY2021? 15. What was the organization's total donations and in-kind (fundraising) in FY2021? 16. What ercentage of your expenses are program service expenses' versus management and general expenses in FY2021 as reported on your IRS Form 990? 1Program service expenses are defined as expenses needed to run your programs. 2Management and general expenses encompass expenses such as human resources,salaries of those not working directly with programs, legal services, accounting services, insurance expenses,office management,auditing, and other centralized services. Guidance Care Center-SAMH Contract FY21;page 19