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Item B5 (SAMH) AGREEMENT This Agreement is made and entered into this 21st day of September 2022, 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 (ME225-12-27 and P- 03) 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 ONE MILLION ONE HUNDRED TWENTY- FOUR THOUSAND, FIVE HUNDRED THIRTY-FIVE AND NO/100 DOLLARS ($1,124,535.00) in fiscal year 2023. 3. TERM. This Agreement shall commence on October 1, 2022, and terminate September 30, 2023, 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. Guidance Care Center-SAMH Contract FY22 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 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. 5. 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. Records shall be retained for a period of ten (10) years from the termination of this agreement. 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 seven (7) 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, or were wrongfully retained by the PROVIDER, the PROVIDER shall repay the monies together with interest calculated pursuant to Sec. 55.03, Florida Statutes, running from the date the monies were paid by the COUNTY. 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; subcontract files (including proposals of successful and unsuccessful bidders, bid recaps, bidding instructions, bidders list, etc.); original estimates; estimating work sheets; correspondence; change order files (including documentation covering negotiated settlements); back charge logs and supporting documentation; 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 contractors' representatives. All records shall be kept for ten (10) years after Final Completion of the Project. The County Clerk possesses the independent authority to conduct an audit of Records, assets, and activities relating to this Project. If any auditor employed by the Monroe County or Guidance Care Center-SAMH Contract FY22 County Clerk determines that monies paid to Contractor pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Contractor shall repay the monies together with interest calculated pursuant to Section 55.03, F.S., running form the date, the monies were paid to Contractor. 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. S. PUBLIC ACCESS. The County and PROVIDER shall allow and permit reasonable access to, and inspection of, all documents, papers, letters, or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the County and PROVIDER in conjunction with this Agreement; and the County shall have the right to unilaterally cancel this Agreement upon violation of this provision by PROVIDER. This provision shall survive any termination or expiration of the contract. The PROVIDER is encouraged to consult with its advisors about Florida Public Records Law in order to comply with this provision. Pursuant to F.S. 119.0701 and the terms and conditions of this contract, the PROVIDER is required to: 1) Keep and maintain public records that would be required by the County to perform the service. 2) Upon receipt from the County's custodian of records, provide the County with a copy of the 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 this chapter or as otherwise provided by law. 3) 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 PROVIDER does not transfer the records to the County. 4) Upon completion of the contract, transfer, at no cost, to the County all public records in possession of the PROVIDER or keep and maintain public records that would be required by the County to perform the service. If the PROVIDER transfers all public records to the County upon completion of the contract, the PROVIDER shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the PROVIDER keeps and maintains public records upon completion of the contract, the PROVIDER shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the County, upon request from the County's custodian of records, in a format that is compatible with the information technology systems of the County. 5) A request to inspect or copy public records relating to a County contract must be made directly to the County, but if the County does not possess the requested records, the County shall immediately notify the PROVIDER of the request, and the PROVIDER must provide the records to the County or allow the records to be inspected or copied within a reasonable time. If the PROVIDER does not comply with the County's request for records, the County shall enforce the public records contract provisions in accordance with the contract, notwithstanding the County's option and right to unilaterally cancel this contract upon violation of this provision by the PROVIDER. A PROVIDER who fails to provide the public records to the County within a reasonable time may be subject to penalties under section119.10, Florida Statutes. The PROVIDER shall not transfer custody, release, alter, destroy, or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. IF THE PROVIDER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE PROVIDER'S DUTY TO PROVIDE PUBLIC RECORDS Guidance Care Center-SAMH Contract FY22 RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY AT PHONE# 305-292-3470 BRADLEY-BRIAN(@MONROECOUNTY-FL.GOV, MONROE COUNTY ATTORNEY'S OFFICE 1111 121H Street, SUITE 408, KEY WEST, FL 33040. 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 GUIDESTAR 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 ME225-12-27 and P-03); (j) All legally required licenses; (k) Any updates/amendments throughout the fiscal year to the South Florida Behavioral Network contract with Guidance/Care Center (ME225-12-27 and P-03); (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; (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. 10. 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 2021-2023 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, 2023. RESPONSIBILITIES 11. 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. Guidance Care Center-SAMH Contract FY22 12. 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. 15. 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 17. 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 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. 18. 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. 19. 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 Guidance Care Center-SAMH Contract FY22 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 20. 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. 21. 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, 16t" 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. 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. Guidance Care Center-SAMH Contract FY22 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 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. 32. 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. Guidance Care Center-SAMH Contract FY22 GENERAL 33. 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. NOTICE. 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 35. GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND FEES. 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. 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. Guidance Care Center-SAMH Contract FY22 38. 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 FY22 IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) BOARD OF COUNTY COMMISSIONERS ATTEST: KEVIN MADOK, CLERK OF MONROE COUNTY, FLORIDA By By As Deputy Clerk Mayor/Chairman Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profit corporation Wendy M . Ramos (Federal ID No. eQ01 I eel I I ) Witness By Witness Frank Rabbito, COO Guidance/Care Center, Inc., a Florida 501(c)(3) not-for-profit corporation Resolution WCGCC 2022-02 Guidance Care Center-SAMH Contract FY22 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 FY22 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 FY22 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) $ X,XXX.XX 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. Chief Executive Officer Attachments (supporting documentation) 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 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 Guidance Care Center-SAMH Contract FY22 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 (ME225- 12-27 and P-03). Guidance Care Center-SAMH Contract FY22 ATTACHMENT D Contractual Agreements ME225-12-27 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. d/b/a Thriving Mind South Florida P-03 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. Guidance Care Center-SAMH Contract FY22 ATTACHMENT D (Continued) Contractual Agreements ME225-12-27 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. d/b/a Thriving Mind South Florida Guidance Care Center-SAMH Contract FY22 4; .wain moo. THRIVING MIND PSOUI 19 FI..oHlDA- 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 0 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 vvuvw::hriy.ir7lmind.carq.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 1,2021. It shall end at midnight,local time in Miami-Dade County,Florida on June 30,2022. 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 41 st 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:EtaverasCaDthrivingmind.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 Standard Contract Pagel of 16 Guidance/Care Center,Inc. Contract No.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 $8,668,712.00,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 $7,223,927.00, subject to the delivery and billing for services. The remaining amount of $1,444,785.00, 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 or for 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 individual served 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 individual served 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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, the ME 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 for transition 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 NETWORK PROVIDER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119,F.S.,TO THE NETWORK PROVIDER'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,CONTACT THE ME's CUSTODIAN OF PUBLIC RECORDS AT 786-507-7458 OR BY EMAIL AT ;1liZOI[)IiZII IJIE;ZrEDSIFIE3II.II�OI[ZG, OR BY MAIL AT SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK D/B/A THRIVING MIND SOUTH FLORIDA, 7205 NW 19 STREET SUITE 200, MIAMI, FLORIDA 33126 OR CONTACT THE DEPARTMENT'S CUSTODIAN OF PUBLIC RECORDS AT 850-487-1111, OR BY EMAIL AT DCFCustodianCMYFLFAMILI ES.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 individual served 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 individuals served,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 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Standard Contract Page 5 of 16 Guidance/Care Center,Inc. Contract No.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 other than 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 individual served 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 individual served 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. 20. Individual served Risk Prevention Standard Contract Page 6 of 16 Guidance/Care Center,Inc. Contract No.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- a. If services to individuals served are to be provided under this Contract,the Network Provider and any subcontractors shall,in accordance with the individual served 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 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. 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: Maps://www.myFlfamilies.com/service- pragrams/individual-with-disabilitV.11«roviderss/ and sign the Attestation of Understanding. Direct service employees Standard Contract Page 7 of 16 Guidance/Care Center,Inc. Contract No.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 individuals served, 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 individuals served 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 individuals served 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 u rider 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. 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 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,_i_hrivingmind.,_prg. 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 Provider further agrees that neither the ME nor the Departme nt 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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, individuals served,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 individuals served 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.aov/ 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..ORIDA- 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 individual served 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 individual served or other confidential information.The Information Security Officer will ensure that any access to the ME or Department information systems or any individual served 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 individual served 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 individual served 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.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 individual served 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 individual served or other confidential information. Individual served 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 individual served 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 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. Standard Contract Page 13 of 16 Guidance/Care Center,Inc. Contract No.ME225-12-27 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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, individual served 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 49.c.shall be followed.In the event of a dispute regarding individual served 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 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.ME225-12-27 .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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;or, c. electronic signatures,whether digital or encrypted,have the same force and effect as manual signatures. 55. All Terms and Conditions Included This contract and it attachments,I,II,III,IV,&y and any exhibits referenced in said attachments,together with any documents incorporated by reference,including the ME prime contract(which can be found at r7tL.p;.�[uu.\nrw thrivi_n., mind.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,II,III,IV,y,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 Signature Page Follows Standard Contract Page 15 of 16 Guidance/Care Center,Inc. Contract No. ME225-12-27 THRIVING MIND SOUTti F 1,0 o110A- 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:The Guidance/Care Center,Inc., SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK,INC. a FL 501c3 not-for-profit corporation SIGNED SIGNED BY: ......... BY: NAME:Frank C.Rabbito,COO NAME: John W.Newcomer,M.D. TITLE:Chief Operations Officer TITLE: DATE: DATE: Federal Tax IDN(or SSN)59-1458324 Network Provider Fiscal Year Ending Date 6/30 Resolution WCGCC 2021-02 Standard Contract Page 16 of 16 Guidance/Care Center,Inc. Contract No.ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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) "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 account both in process and end of process indicators, in order to meet the valid requirements of Individuals Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 1 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, asSauadlhFllauiiWnuBehaviol all141cuPh7N41viwih Inc.) 7/0t/;xZ0121II. 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 must 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 served needs. (11) "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. (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. EBl are programs that have demonstrated effectiveness with established general izabiIity (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: htti)s://www.myflfamiIies.com/service-programs/samh/managing-entities/index.shtmI Note: Click on FY21-22 ME Templates and click on Guidance Document 1, Evidence Based Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 2 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iunI asSauadlh Fllauill W a Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 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. (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 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 (a) Guidance/Care Center,Inc. Page 3 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iun1 asSauadlh Fllauill W a Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. (26) "Mental Health Services" is defined pursuant to Chapter 394,67 (15), F.S. (27) "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, (28) "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. (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 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.myflfamiIies.com/service-programs/samh/managing-entities/index.shtmI Note: Click on FY21-22 ME Templates and click on Guidance Document 10, Prevention Services (33) "Prime Contract" is the contract between the Department of Children and Families and the ME. (34) "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. (35) "Projects for Assistance in Transition from Homelessness (PATH)" is a federal grant to Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 4 of 55 Contract No. ME225-12-27 (CIwiWirmau:1iun, as Sm011l Fllauill W a Beharviol all 141cuPh 7N41viwi h Inc.) 7t0Jl/Z0112:II. support homeless individuals with mental illnesses, who may also have co-occurring substance use and mental health treatment needs. (36) "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. (37) "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. (38) "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. (39) "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. (40) "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. (41) "SAMH" stands for the Substance Abuse and Mental Health Programs within the Department. (42) "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. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 5 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iun1 asSauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. (43) "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. (44) "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. (45) "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. (46) "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. (47) "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. (48) 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. (49) "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), TAW is a funding stream for providing substance use disorder services or mental health services to families receiving TAW cash assistance benefits. (50) "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. (51) "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 Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 6 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sm011l Fllauill kj a Beharviol all 141cuPh 7N41violl h Inc.) 7t0Jl/Z0112:II. 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 person-centered and family-focused recovery-oriented coordinated system of care (ROSC). A ROSC is a value-driven framework to guide transformation of a behavioral health system of care as described in Exhibit l Recovery Management Practices. 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 7 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7t0Jl/Z0112:II. 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 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 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 provided upon request to the ME's Director of Prevention Services Director. e. Minimum Programmatic Requirements The Network Provider must maintain the following minimum programmatic requirements: Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 8 of 55 Contract No. ME225-12-27 Fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. (1) System of Care The person-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. 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, communityand 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 competent; (h) Gender responsive; (i) Sexual orientation; and Q) Recovery-oriented and recovery-supported, 3. Individuals to be Served Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 9 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 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 08/02/2021, 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 licenses) until said licenses) 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 10 of 55 Contract No. ME225-12-27 Fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. FASAMS DCF Pamphlet 155-2. (8) The Network Provider must ensure that individuals discharged from state mental health 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) 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. (10) By 08/02/2021,the Network Provider must submit to the ME's Contract Manager an updated Civil Rights Compliance Checklist (Cl (11) By 08/02/2021, the Network Provider must submit to the ME's Contract Manager an updated Civil Rights Certificate (Cl signed a dated by the Network Provider's contract signer. (12) By 08/02/2021, 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. (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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 11 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, asSauadlhFllauiiWnuBehaviol all141cuPh7N41viwih Inc.) 7/0t/;xZ0121II. (g) Fraud, waste, abuse and other potential wrongdoing auditing, monitoring, and remediation procedures. (h) Evidence-based practices (El utilized by the agency and how these El are monitored to ensure fidelity to the model. (i) The Continuous Quality Improvement Initiatives identified in Section B.1.a.(23) below. (13) By 10/01/2021,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) 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. (15) 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 13.1.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 IVIE'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 rare 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. (16) 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), Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 12 of 55 Contract No. ME225-12-27 Fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7t0Jl/Z0112:II. (17) 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 including dates,times, names of people spoken to, and final disposition, i.e. date returned orjustification when not returning. (18) 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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 13 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iun, as Sauadlh Fllauill W a Beharviol all 141cuPh 7N41violl h Inc.) 7t0Jl/Z0112:II. (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. (19) 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: 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 systems) when notified and as directed by the ME. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 14 of 55 Contract No. ME225-12-27 Fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauii llama Beharviol all Jf eutufi 7N41violl h Inc.) 7t0Jl/Z0112:II. (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 individuals served 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. (20) 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. 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: Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 15 of 55 Contract No. ME225-12-27 Fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, asSauadlh1"lllauiiWnuBehaviol all141cuPh7N41viollh Inc.) 7t0Jl/Z0112:II. 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. (21) Continuous Quality Improvement Initiatives—Network Providers must comply with all of the provisions for the initiatives outlined below: (a) Recovery Management Practices The Network Provider must operate under the principles of a Recovery Oriented System of Care (ROSC) in accordance with the requirements of Exhibit Bill Recovery Management Practices. 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. A ROSC is inclusive of clinical services that are recovery-focused, evidence-based, developmentally appropriate, gender-sensitive, culturally competent, trauma-informed and integrated with a broad spectrum of non-clinical recovery support services.As such,the Trauma Informed Care, Cultural and Linguistic Competence, and Integration of Behavioral Health Services and Primary Care initiatives are components of ROSC and will remain as integral parts of ROSC. The Network Provider will work with the ME on the implementation of a Recovery Management system of care framework that aligns with the standards in Exhibit Bill The Network Provider agrees to conduct self-assessments annually, at minimum, or when directed by the ME, using the SAPT and RSA-R below, report the results to the ME when requested, and develop an action plan based on the results. The action plan should also include action steps toward implementation of the region-specific best practices as directed by the ME. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 16 of 55 Contract No. ME225-12-27 (;CIniuuu-muu:1in u�k^.uAauadhFllauiillamaBehauvilm allJlu tffil eAmoirh, finc,j 1/011IUZ0121. 1) The Network Service Providers must use, at minimum, the following tools to assess recovery-oriented activities: i. The Self-Assessment/Planning Tool for Implementing Recovery-Oriented Services (SAPT)available at: https://www.usf.edu/cbcs/mhlp/tac/documents/toolkits/self-assessment- tool-recovery-oriented-mental-health.pdf, ii. The Recovery Self-Assessment-R(RSA) available at: https://medicine.vale.edu/psychiatry//prch/tools/rec_selfassessment, and 2) A Network Provider who employs peers must: 1. Use the Recovery Capital Scale,available at https://facesandvoicesofrecovery.org/resource/recovery-capital-scale/, in the recovery planning process. ii. Provide standardized training on Recovery Management best practices in employee orientation and refresher training. iii. Adhere the terms and conditions pursuant to Exhibit AO, Peer Service. 3) As part of the ROSC initiative,The Network Provider must also: i. Identify at least two ROSC Champions who will attend trainings and meetings. The names of the ROSC 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. ii. Attend scheduled ROSC meetings, trainings and activities to ensure staff and agency become knowledgeable of ROSC. (b) Integration of Behavioral Health Services and Primary Health Care 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 principles within ROSC. The integration will be ensured through linkage from the behavioral health provider with the primary health care provider of the individual through an electronic health record Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 17 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iun, as Sauadlh Fllauill W a Beharviol all Jf eutufi 7N41viwi h Inc.) 7t0Jl/Z0112:II. 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 health and behavioral health needs. (c) 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 Trauma Informed Care (TIC) principles within ROSC. Progress on TIC should continue to be reported in the COI semi-annual update, and should include, at minimum, required trauma trainings for all staff upon hire, and annually thereafter. (d) 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: 1) 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; 2) 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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 18 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. (e) Integration of Behavioral Health and the Child Welfare System 1) 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 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. 2) 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: i. 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. ii. Attendance at scheduled CWI meetings including Integration Workgroup meetings to develop the process for identifying and responding to child-welfare involved families. iii. Attendance at trainings regarding CWI when notified by the ME. Attendance at applicable trainings will be documented in the Continuous Quality Improvement Updates iv. Participation in all CWI related activities to ensure staff and agency become knowledgeable of the Child Welfare system. v. Description of the process to monitor and ensure that requests for any requested Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 19 of 55 Contract No. ME225-12-27 (CIwiWirmdu:1iun, asSauadlhFllauiiWnuBehaviol all lfeutufilN41viollh Inc.) 7t0Jl/Z0112:II. 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. (f) Accreditation The Network Provider must take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2022,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. The Network Provider must participate in all implementation activities and Technical Assistance provided by DCF and the ME. (22) Continuous Quality Improvement Updates 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) ROSC Action Plan, including the scores from the SAPT and R-RSA. (b) Integration of Behavioral Health Services and Primary Care, including evidence of the implementation of integrated care, including warm hand-offs and the process to track and report referrals of individuals from behavioral health to primary care and from primary care to behavioral health services. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 20 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauill kj a Rehaviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. (c) Trauma Informed Care, including required trauma trainings for all staff upon hire, and annually thereafter. (d) Cultural and Linguistic Competence; (e) Identification of the evidence-based practices (EBPs) utilized by the agency and address how these EBPs are monitored to ensure fidelity to the model; (f) Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; (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; (23) 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 AC, 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 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 e linkages to a wide range of services and monitor outcome metrics. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 21 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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. (24) Transitional Voucher Program The Transitional Voucher project is a flexible, individual served-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 AC, and the Exhibit AV,Transitional Voucher Program. (25) 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 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 individuals) 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: httips://www.myflfamiIies.com/service-programs/samh/managing-entities/index.shtmI Note: Click on FY21-22 ME Templates and click on Reporting Template 9 — Local Match Calculation Form Attachment I l (a) Guidance/Care Center,Inc. Page 22 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, asSauadlhFllauiiliahBehaviol all lfeatffi7N41viollh Inc.) 7/0t/;xZ0121II. (26) 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. (27) 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. (28) 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. (29) 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/apps/vbs/adoc/F2551_ITN09H13GC1 Addend um10_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. (30) The Network Provider must meet with the ME's staff at regularly scheduled or any called meetings when notified by the ME. (31) 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. (32) Referrals and Case Management Services to Individuals Residing in Assisted Living Facilities with a Limited Mental Health License (a) 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. (b) 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). Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 23 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7t0Jl/Z0112:II. (c) 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: htti)://www.floridahealthfinder.gov/faciIitylocator/FaciIitySearch.asil (33) 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. (34) 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. (35) 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. (36) Community Person Served Satisfaction Survey(if applicable) The Network Provider must conduct satisfaction surveys of individuals served pursuant Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 24 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, asSm011lFllauiiWnuBehaviol all141cuPh7N41viwih Inc.) 7/0t/;xZ0121II. 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 will result in a corrective action and an imposed financial penalty as described in the Standard Contract. (37) Department-Sponsored Surveys The Network Provider must participate in any Department-sponsored satisfaction surveys. (38) Individual Served 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 2,2021. (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 SAW 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. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 25 of 55 Contract No. ME225-12-27 Fbdvb�g Mind SoonlhQwdta uCmnrwcdn�omgnutb0mdda Bobup�r�B�uDffi N�mor4Iu�) ��lZ02l 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 consent of the ME. The Network Provider must ensure that services are performed in accordance with applicable rules, statutes, and licensing standards. 1. 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' SAW Programmatic State and Federal Lavvs, 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. U. Professional Qualifications (1) The Network Provider must comply with applicable rules,statutes, requirements,and standards with regard to professional qualifications.See Exhibit F,SAW 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 11 screening set forth in Chapter 435, and s. 408.809 F.S., except as otherwise specified in s. 394.4572(1)/l F.S. For the purposes of this contract. "Mental health peoonne|" 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. C3\ Additionally, the Network Provider must provide employment screening for substance use personnel using the standards pursuant tn Chapter 397.4073' F.3.' (4) Network Providers who have programs for children are required to meet the requirements of s. 39.001(2). (a) and (b) F.5 c. 8ta?|ngChangos The Network Provider must notify the ME'sContract Manager, in writing within ten (1O) calendar days of staffing changes regarding the positions of Chief Executive OD1cor, Chief Financial OO1cor, Medical D|roctor, Clinical D|rnctor, IT Director, Dispute Resolution 0fOcer, Data Security Officer, and Single Point of Contact (section 504of the ADA) ' or any individuals with similar functions. d. Subcontractors Attachment | HCU2 (a) Guidance/Care Center,Inc. Page 26of55 Contract No. Mszzu'/z'z/ fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. (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 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 27 of 55 Contract No. ME225-12-27 tl;CIniauu-maa:1in asSauadhl°'lImillamaBehaavilm all Jl atffil eAmoirh, Vann:.) 1/011IUZ0121. 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, 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. (b) 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 Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 28 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauill kj a Beharviol all 141cuPh 7N41violl h Inc.) 7/0t/;xZ0121II. 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 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. 2. 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 I HCO2 (a) Guidance/Care Center,Inc. Page 29 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 dates) listed in Exhibit C, Required Reports. The Network Provider Inventory List form may be requested from ME Contract Manager. 3. 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, Pl as applicable, by the dates specified in Exhibit C, Required Reports. 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 Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 30 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 Individual Served 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 Individual Served,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 reporting system designated by the ME. Only error-free data as processed by KIS will be Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 31 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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. 4. 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 I HCO2 (a) Guidance/Care Center,Inc. Page 32 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iunI asSauadlh Fllauill W a Beharviol all Jf eutufi 7N41violl h Inc.) 7/0t/;xZ0121II. 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.myflfamilies.com/service-programs/samh/fasams/index.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. 5. 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 Florida. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 33 of 55 Contract No. ME225-12-27 Fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmau:1iun1 asSauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. (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, 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 plans)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 information within twenty-four (24) hours of the request unless otherwise specified in the ME's Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 34 of 55 Contract No. ME225-12-27 fhrl hi g Mind Soullh Ftoi hta (Cua Wrmuu:liunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 35 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. (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,SAW Programmatic State and Federal Laws, Rules, and Regulations. 6. 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 ME must be used to determine placement and level of care. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 36 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSm011l Fluii llama Beharviol all Jf eutufi 7N41violl h Inc.) 7/0t/;xZ0121II. (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 El 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 El improved performance and outcomes, expansion of the service array, and necessary infrastructure development, Ill 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 monitors) 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, the application of process improvement methods to improve the coordination of access and services that are culturally and linguistically appropriate. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 37 of 55 Contract No. ME225-12-27 fhrl hi g Mind Soullh Ftoi hta (Cua Wrmuu:liun1 asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. (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 policyworking agreement,system of care information,data reporting requirements and technical assistance. (b)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 determination(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 determination made by the ME is final and binding on all parties. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 38 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 2021-2022 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 SAW 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://guidancecarecenter.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 39 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41violl h Inc.) 7/0t/;xZ0121II. (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 module, the ME's designated acute care system database. Arrangements to license and access the KIS Express Acute Care module 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.myflfamilies.com/service-programs/samh/fasams/index.shtml 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 systems)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.myflfamilies.com/service-programs/samh/fasams/index.shtml Failure to comply with the reporting requirements constitutes a lack of compliance with contract provisions.The Network Provider may be assessed financial consequences for failure to perform pursuant to section 8.,of the Standard Contract. 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 40 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauill kj a Rehaviol all 141cuPh 7N41viwi h Inc.) 7t0Jl/Z0112:II. 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. 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)A.c.(11) F.S). No fee may be charged for such filing. 7. Medication-Assisted Treatment Services a. The Network Provider must discuss 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 shall discuss medication-assisted treatment using FDA-approved medications including but not limited to methadone, buprenorphine-based products, and naltrexone. c. For individuals with alcohol use disorders, the Network Service Provider shall discuss 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. e. The Network Provider is prohibited from automatic discharges or discontinuing medications as a consequence of continued substance use or positive drug tests, unless the combination of substances used is medically contraindicated. f. 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; Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 41 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, asSauadlhFllauiiWnuBehaviol all141cuPh7N41viwih Inc.) 7t0Jl/Z0112:II. 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 stopping is inconsistent with a licensed prescriber's recommendation or valid prescription. V. The Network Provider must prohibit caps or limits on the length of medication-assisted treatment, except for limits imposed by a documented lack of eligible public funds. vi. The Network Provider is prohibited from requiring mandatory counseling participation requirements and mandatory self-help group participation requirements imposed as a condition of initiating or continuing medications that treat substance use disorders, except those established by methadone providers and applied to individuals on methadone pursuant to section 65D-30.014(5)(o) and section 65D-30.014(5)(m), Florida Administrative Code. 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 (NALM) 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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 42 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iun, as Sauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. Ill 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 bejustified in writing and submitted to the ME's Contract Manager for review and approval. 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. Ill 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. Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 43 of 55 Contract No. ME225-12-27 (;CIniuuu-muu:1in u�k^.uAauadhFllauiillamaBehauvilm allJlu tffil eAmoirh, finc,j 1/011IUZ0121. In the event an incident has an immediate impact on the health or safety of an individual served, 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: Individual served initials, incident report tracking number from IRAS (if applicable), incident report category, date and time of incident, and follow-up action taken. b. All designated public and private Baker Act receiving facilities, all State Mental Health Treatment Facilities,and all licensed Addictions Receiving Facilities that provide for the evaluation,diagnosis, care, treatment, training, or hospitalization of persons who appear to have a mental illness or have been diagnosed as having a mental illness must report seclusion and restraint event data in accordance with the DCF Pamphlet 155-2, Version 12.03, Chapter 14, or the latest revision thereof. This chapter is posted on the DCF website at https://myflfamilies.com/service- programs/samh/samhis/pamphlet-155-2-v12.shtml 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 an Individual Served 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 Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 44 of 55 Contract No. ME225-12-27 fhu mu hoof Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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: htti)://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. 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 forthese 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 45 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (Cua Wruu:liunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. 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 11 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 11 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 46 of 55 Contract No. ME225-12-27 (CIwiWirmdu:1iun, as Sauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7t0Jl/Z0112:II. 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. (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." 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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 47 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (CIwiWirmdu:1iunI asSauadlh Fllauii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7/0t/;xZ0121II. (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.,. 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, (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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 48 of 55 Contract No. ME225-12-27 Fbdvb�g Mind SoonlhQwdta uCmnrmcdn�omgnutb0mdda Bobup�r�B�uDffi N�mor4Iu�) ��lZ02l The Network Provider must develop a sliding fee scale, that is updated annually, in conjunction with the Federal Poverty Guidelines and applies to |nU|v|Uua|o receiving services that are paid for by stato, hadora|. 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.O18' 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 |. 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 individuals served. 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 Individuals served if public funds provided under this contract will be used to purchase vehicles which will be used to transport individuals served. 20. National Provider Identifier(NP|) a. All Network Providers must obtain and use an NP|' a H|PAA standard unique health identifier for health care providers. b. An application for anNP| may be submitted online at: c. Additional information can be obtained from one of the following websites: M\The National Plan and Provider Enumeration System (NPPE3) located at: (2)Tho CMS NP| located at: 21. Ethical Conduct The Network Provider understands that performance under this contract involves the expenditure of public funds from both the state and federal govornmnnts, and that the acceptance nf such funds obligates the Network Provider to perform its services in accordance with the very highest standards of ethical conduct. No employee, U|rnctnr, 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 tn 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 tnSection 12.. nf the Standard Contract of this contract. The Network Provider understands that the ME contracts with the department, and as a subcontractnr, recognizes that the department is a public agency which is mandated to Attachment | HCU2 (a) Guidance/Care Center,Inc. Page 4Vof55 Contract No. Mszzu'/z'z/ fhrlvhi g Mind Soullh Ftoi hta (Cua Wrmuu:liunI asSauadlh Fluii llama Beharviol all Jf eutufi 7N41viwi h Inc.) 7t0Jl/Z0112:II. 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 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 (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. 23. 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 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 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 Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 50 of 55 Contract No. ME225-12-27 tl;CIniuuu-muu:1in u�k^.uAm011n Fllauiillama Rehauvilm all Jlu atuf l eAmoirh, finc,j 1/011IUZ0121. 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 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 Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 51 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (Cua Wruu:liunI asSauadlh Fllauill kj a Beharviol all 141cuPh 7N41viwi h Inc.) 7t0Jl/Z0112:II. 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 N e t wo r k 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 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 Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 52 of 55 Contract No. ME225-12-27 fhrlvhi g Mind Soullh Ftoi hta (Cua Wrmuu:liunI asSm011l FllauiiWnu Beharviol all 141cuPh 7N41viwi h Inc.) 7/0t/;xZ0121II. 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. 1 S-2.048, F.A.C., in accordance with Guidance 25—National Voter Registration Act Guidance, incorporated herein by reference; Ill As a Voter Registration Agency, the Network Provider 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 their 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. 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: httil//dos.myflorida.com/elections/for-voters/voter-registration/national-voter-registration- 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. Ill 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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 53 of 55 Contract No. ME225-12-27 tl;Curuauu-maa:lin asSauadhl°'lImilianaRehaavilm all Jl atffil eAmoirh, Vann:.) 1/011IUZ0121. 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. 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. Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 54 of 55 Contract No. ME225-12-27 1'uu n in'g N Ii111d S(�11111t111 17 11�P r 11da q'1",uM11 uil-av i11�g a ��uuuVu Fl11o111111➢m C«°u v 11 11 o 11111 v a tV tV '1'14 v k,l '/10ll12021 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 J, Child Welfare Specialty Program (CWSP) 10. Exhibit K, SAMH Pre-Authorization Utilization Management Roster 11. Exhibit L,Assisted Living Facilities with Limited Mental Health License 12. Exhibit N, Special Provisions for the Indigent Drug Program 13. Exhibit 0, Mental Health Residential Level II 14. Exhibit 0, Missing Children 15. Exhibit V, Special Provisions for the Forensic Services Program 16. Exhibit X, Special Provisions for Projects for Assistance in Transition from Homelessness (PATH) Services 17. Exhibit Y,Temporary Assistance for Needy Families (TANF) Funding Guidance 18. Exhibit AA, Motivational Support Specialist 19. Exhibit AC, Care Coordination Report Narrative and Chart 20. Exhibit Al, Family Intensive Treatment Team -Scope of Work 21. Exhibit AJ, Community Action Team 22. Exhibit AM, Return on Investment-Special Appropriations Projects for Fiscal Year 20218-22 23. Exhibit AN, Supplemental Security Income/Social Security Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR) 24. Exhibit AO, Peer Services 25. Exhibit AP, Mental Health Case Management 26. Exhibit AS, Central Receiving Facility 27. Exhibit AV, Transitional Voucher Program 28. Exhibit AY, Mobile Response Team (MRT) for Monroe County 29. Exhibit AX, Crisis Stabilization Unit ("CSU") Long-Acting Injectable Trend Report 30. Exhibit BD, State Opioid Response Discretionary Grant Services (2) Medication Assisted Treatment Services for Opioid Use Disorders and Evidence Based Treatment to Address Stimulant Misuse and Use Disorders 31. Exhibit BE, Tele-Behavioral Health Services For Services Provided to Children & Families Engaged in the Monroe County Scholl System-OCA MHTLH 32. Exhibit BF, Emergency COVID-19 Grant-OCA MHCOV 33. Exhibit BH, Recovery Management Practices Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 55 of 55 ME225-12-27 I III IV'I I ig '?d 11 ri d So i,ith I•• oii da (';l:ontrac,fling :, oiiiWi''i Ii:]ou ui1a li:3ei°,iavioii fli II NeMllh II Iiettwork, Ilinc.) 1/°1/202°II 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 ❑X Adult Mental Health-Severe&Persistent Mental Illness ❑ Adult Substance Abuse i] Adult Mental Health-Serious&Acute Episodes of Mental i] Children's Substance Abuse Illness i] 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 i] Children's Mental Health-At Risk of Emotional Disturbances ❑X Adult Substance Abuse 0 Children's Substance Abuse B. INDIVIDUAL SERVED/PARTICIPANT ELIGIBILITY 1. The Network Provider agrees that all individuals 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: httip://www.leg.state.fl.us/STATUTES/index.cfm?Apg_mode=Disiplay_Statute&URL=0300- 0399/0394/0394.html 2. Behavioral Health services must be provided to individuals 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 0), below. Individuals in categories (a) and (b) are specifically identified as individuals 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. ME225-12-27 i-Ilrii1iiSMiiing IIWiirid Soi.itlh If:Ioii iida (Contract ng :,Soi,di'i Ii:llou ucla li:3e1°uavo of fli II Near ilitih Network, Iluiiic.) 1/°1/202°II 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 individuals 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 I, 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. ME225-12-27 i-Ilrii1iiVuu°g Ilttluirid Soil.itllh Ii:Ioii iida (Contract ng w:,Soi,d:li'i Ii:llou ucp,a li:3e1°uavo of fli II Near ilitih (Network, Iluiiic.) 1/°1/202°II providing the services to eligible individuals until the dispute is resolved. The dispute resolution process is described in Paragraph 49, 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 individuals 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. ME225-12-27 (;Conflmat:„fing aaS Soi.if:lla If:Il ru ucla Ii:3ei°iiavio fll Il eallilla II lie wa°irk, Uric.) 71i/202II EXHIBIT B METHOD OF PAYMENT 1. PAYMENT CLAUSES 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 $7,918,712.00, 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 under 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 $8,668,712.00 of the total Contract amount, the ME will be required to pay$7,223,927.00 subject to the delivery and appropriate billing for services. The remaining amount of $1,444,785.00 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 Aftercare, Intervention, Outpatient, and Recovery Support Services (Substance Abuse) are Exhibit B Page 1 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„Hing aaS Soi.if:lla If:Il a ucla Ii:3ei°iiavio fll Il eallilla II lie wa`irk, Uric.) 71I/202 II 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$1,120,663.00 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 L 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 2of7 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hi1iVrig 'III IdSoi,ith I,• of IdU,'.4 (;Conflmat:„fingaaSSoi.if:lla If:Il uucla Ii:3ei°iiavio fll Il eallilla INietwork, Uric.) 7/I/202II 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 3of7 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„HingaaSSoi.if:lla If:Il uucla Ii:3ei°iiaviou fll Il eallilla II lie wa°irk, Uric.) 71i/20 II individual who has depleted other fund sources. b. Department funds may not reimburse services provided to: i. 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 a. 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. b. Requirements for all Medicaid-enrolled Network Service Providers, prior to invoicing the Managing Entity for any services provided to any Medicaid-enrolled recipients, the Network Exhibit B Page 4of7 Guidance/Care Center,Inc. Contract No. ME225-12-27 ..I..II,• I1IVIP.1g 'u"II I'•id So i,�.ith I„IIoI IdU,'.4 (u:;ontimacHng a S,Soiii.if:llI If:Il ru ucla Ii:3e1°uavioi fll Il ear ills Network, Uric.) 71 i/202 II Provider must maintain documentation for each individual served in a format that is easily accessible and retrievable for monitoring or auditing purposes by the ME or Department that it has: i. Submitted a prior authorization request for any Medicaid-covered services provided. ii. Appealed any denied prior authorizations. iii. Provided assistance to appeal a denial of eligibility or coverage. iv. Verified the provided service is not a covered service under Florida Medicaid, as defined In Chapter 59G-4, F.A.C.,or is not available through the individual's MMA Plan. V. In cases where the individuals Medicaid-covered service limit has been exhausted for mental health services, an appropriately licensed mental health professional has issued a written clinical determination that the individual continues to need the specific mental health treatment service provided. vi. In cases where the individual's Medicaid-covered service limit has been exhausted for substance use disorder treatment services a qualified professional as defined in Section 397.311, F.S., has issued a written clinical determination that the individual continues to need the specific service provided. 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 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, 2020—September 30, 2023, 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: htt.s://www.rn flfarr7ilis.corrtlservicF� ro rarrrslaccesslctocslTANF Paatt. rTf 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 Exhibit B Page 5of7 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„HingaaSSoi.iflllI If:Il uucla Ii:3ell°iiavio fll Il eallilla II Ile wa`irk, Uric.) 71V202II 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. 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-1 4.021(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 Exhibit B Page 6of7 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hi1iVrig 'III IdSoi,ith I,• of IdU,'.4 (;Confl-at:„HingaaSSoi.if:lla If:Il ruucla Ii:3eri°iiavio fll Il eallilla INietwork, Uric.) 71 V20 II 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, Temporary Assistance for Needy Families (TANF) Funding Guidance, 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: hl.t h[rn 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 website is found in the link below: r].tt.ps://www.rnyfloridacl'o.com/i:}ivision/AA/Merrios/dc faul t..ht.rr7 16. 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 7of7 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-at:„Hing aaS Soiii.if:lla If:ll a ucla Ii:3di°iiaario fll II ed l lla IINetwork, Uric.) 7/1/"a021 Exhibit C Require Reports Required R��orfs Dfi Ll t� 11fCc�pies nd tc� P ........, Res once 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 2021-2022 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 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarario fll Il earllilla II Network, Uric.) 7/1/2021 Exhibit C Require 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://fs16.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) Exhibit C Page 2of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (';Conflmat:„Hing aaS Soiii.ifliI If:ll a ucla Ii:3di°iiaario fli II ed llla IINetwork, Uric.) 7/1/"a021 Exhibit C Require 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 Court Ordered If the court ordered service is 1 (Electronic ME Adult System of Care Involuntary not available,submit copy of Submission via E-mail) Director Commitment, court order within one(1) Placements,Services, working day of receiving from Treatment the court if the service is not available Inventory Report ME Contract Manager 8/2/2021 1 (Electronic Submission via E-mail) Exhibit C Page 3of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiasario ill Il eallilla II Network, Uric.) 7/1/"021 Exhibit C Require Reports Attestation of 8/2/2021 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 Civil Rights 8/2/2021 1 (Electronic ME Contract Manager Compliance Checklist Submission via E-mail) (CF0946) Civil Rights 8/2/2021 1 (Electronic ME Contract Manager Certificate(CF707) Submission via E-mail) Client Trust Fund 8/2/2021 1 (Electronic ME Contract Manager Letter Submission via E-mail) Quality 8/2/2021 1 (Electronic 1. ME Contract Manager Assurance/Quality Submission via E-mail) Improvement Plan 2. ME Continuous Quality Improvement Manager Signed Florida 8/2/2021 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 Peer/ROSC 8/2/2021 1 (Electronic ME contract manager Champions, per Submission via E-mail) Exhibit AO. Peer Services Manager Attestation signed by 10/1/2021 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 Exhibit C Page 4of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-at:„HingaaSSoiii.il:lla If:ll uucla Ii:3di°iiavio fll II eallilla II Network, Uric.) 7/1/2021 Exhibit C Require Reports amendments made to this Contract. NVRA Voter July 6,2021 1 (Electronic 1. ME Voter Registration Registration Agencies (Period:04/01/21 -06/30/21) Submission via E-mail) Activities Coordinator Quarterly Activities October 5,2021 Report Form (DS- (Period:07/01/21 -09/30/21) 2. ME Contract Manager DE131;effective January 5,2022 01/2012 or latest (Period: 10/01/21 - 12/31/21) revision thereof, if April 5,2022 applicable (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) Quarterly Financial October 29,2021 1 (Electronic 1. ME VP of Finance Statements(Balance (Period:07/01/21 -09/30/21) Submission via E-mail) Sheet and Statement January 31,2022 2. ME Contract Manager of Activity) (Period: 10/01/21 - 12131121) April 29,2022 (Period:01/01122-03/31/22) July 29, 2022 (Period:04/01/22-06/30/22) Attestation indicating October 29,2021 1 (Electronic ME Contract Manager the filing of Form 941 (Period:07/01/21 -09/30/21) Submission via E-mail) and payment of any January 31,2022 taxes due to the IRS (Period: 10/01/21 - 12/31/21) have been paid. April 29,2022 (Period:01/01/22-03/31/22) July 29,2022 (Period:04/01/22-06/30/22) January 31,2022 1 (Electronic 1. ME Contract Manager Continuous Quality (Period:07/01/21 - 12/31/21) Submission via E-mail) Improvement July 29, 2022 2. ME Continuous Quality Updates (Period:01/01/22-06/30/22) Improvement Manager Ye 'f=Enid Flnanci l R port fo"N uffark pr i r der'`s:, f eju riri '�4iadit `f er`t#f hirfent l( 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 2.VP of Finance less than$750,000 in (federal)or 45(state) of the Federal Awards or in recipient's receipt of the audit State Awards during report,whichever occurs first, the fiscal year 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 5of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„HingaaSSoi.i):Ila If:Il uucla Ii:3di°iiaario fll Il eallilla IINetwork, Uric.) 7/1/2021 Exhibit C Require 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 (federal)or 45(state) 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 2.VP of Finance Actual Expenses& (federal)or 45(state) of the Revenues Schedule 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 2.VP of Finance Department of days(federal)or 45(state) of Children and Families the recipient's receipt of the form,available at the audit report,whichever following website: occurs first, directly to each of the following unless https://www.myflfa otherwise required by Florida milies.com/service- Statutes The schedule shall be programs/samh/man based on revenues and aging-entities/2020- expenditures recorded during contract-docs.shtml 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 2.VP of Finance days(federal)or 45(state) of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Exhibit C Page 6of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-art:„iron aaS Soi.ii:lla If:Il a ucla Ii:3di°iiavio fll Il earllilla IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports 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 2.VP of Finance Statement of Activity days(federal)or 45(state) 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. Y��r�E>'�d Firf�rici�l ft�p4rts fc�r'Nettu�rk;I�r� idr a Re�uirlig'Audits I�eP"�1tfa� hrfiri I� Correspondence Due 180 days after the end of 1 (Electronic 1. ME Contract Manag er ger from the Auditor the Network Provider's fiscal Submission via E-mail) showing proof of year or within 30 days 2.VP of Finance submission of the (federal)or 45(state)of the Audit Report and recipient's receipt of the audit Management Letter report,whichever occurs first, to the Network directly to each of the Provider. following unless otherwise 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 2.VP of Finance issued by the Auditor days(federal)or 45(state)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. Exhibit C Page 7 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„Hing aaS Soi.i):Ila If:Il a ucla Ii:3di°iiavio fll Il eallilla IINetwork, Uric.) 7/1/"ate µ) Exhibit C Require 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 2.VP of Finance schedules per (federal)or 45(state)of the Attachment II 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 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(federal)or 45(state)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 2.VP of Finance (federal)or 45(state)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, 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 2.VP of Finance Department of (federal)or 45(state)of the Children and Families recipient's receipt of the audit form,available at the report,whichever occurs first, following website: directly to each of the following unless otherwise Managing Entities- required by Florida Statutes Florida Department The schedule shall be based of Children and on revenues and expenditures Exhibit C Page 8of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (';Confl-art:„Hing aaS Soiii.if:lla If:ll a ucla Ii:3di°iiaario fll II eall l lla II Network, Uric.) 7/1/"021 Exhibit C Require Reports Families recorded during the state's m flfamilies.com 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 2.VP of Finance Actual Expenses& (federal)or 45(state)of the Revenues Schedule 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 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 2.VP of Finance (federal)or 45(state)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, r eports"R giu�r d"fc r'Childretili.f ht (H"It 'Pr uid Fs,;as Ir abf+ s Crisis Per Exhibit S- Monthly Census One 1 Encrypted 1. ME Contract Manager Children' ( ) yp g 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 Re cfrts""Re aired fc r 6 aufctra("`HeA h'NetWork°(0Net)Bra ider, Alternative Services Within 15 calendar days after One Encrypted 1. ME Contract Manager y yP ger 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 Exhibit C Page 9of21 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hiliVing Wind Soi,ith i"] i IdU,'JI (';Confl-arc Dire aaS oiii.rl:lla If:ll a ucla Ii:3di°iiavio rll II ed llla IINetwork, Ilu ic.) 7/1/2021 Exhibit C Require Reports Statement of September 111 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 Rdiw'r't `Regi urea fir Prfja t"faf"1sltne„in l ransrtirrrr f`rarrc Hctrif± lnt�(PATFI„Providr ,, PATH Monthlyb Monthly, y 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) PATH Annual Data No later than November 17th 1 (Electronic https://www.pathi)dx,org// Report into the PATH Submission via E-mail) Data Exchange(PDX) data system R frcfft/�,k`64 (ddf//Adiflt /h` Healtfi Fir iiid66;a ;applrc Assisted LivingProvider to Maintain the 1 Electronic Re u ( q estor Facility with a Report on file and submit Submission via E-mail) Limited Mental upon Request by ME staff Encrypted and Health License Client Password Protected Quarterly Report, per October 5,2021 Exhibit L (Period:07/01/21 -09/30/21) January 5,2022 (Period: 10101/21 - 12/31/21) April 5,2022 (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) IRcirt Required fcfr Fldrda Axerti "C�arttrtturtitt Trtfnri't`(F#CT Prdde'r 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 IV.H., Reports in service Exhibit AF 2. ME Director of the Adult System of Care Exhibit C Page 10 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„Hing aS Soi.ifliI If:Il a ucla Ii:3di°iiaario fli Il ed flila IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports FACT Report Monthly by the 7th of each 1 (Electronic 1. ME Contract Manager (Template 29)per month following the month of Submission via E-mail) Section IV.H, Reports service 2. ME Director of the Adult in Exhibit AF System of Care Link to Template 29: Guidance 29 Transitional Vouchers.pdf (mvflfamilies.com) FACT Enhancement October 5,2021 1 (Electronic Reconciliation Report (Period:07/01/21 -09/30/21) Submission via E-mail) 1. ME Contract Manager per Section IV.H., January 5,2022 Reports in Exhibit AF (Period: 10/01/21 - 12/31/21) 2. ME Director of the Adult April 5,2022 System of Care (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) Outcomes Measures October 5,2021 1 (Electronic per Section W.I., in (Period:07/01/21 -09/30/21) Submission via E-mail) 1. ME Contract Manager Exhibit AF January 5,2022 (Period: 10/01/21 - 12/31/21) 2. ME Director of the Adult April 5,2022 System of Care (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) I pc;rt""kequir6d for" Jai ii Dade."F4664","Atterti, (u (MI`yFA )I ris,idea ,",,,,,,, Daily Census Report Daily, by 10 00 am 1„ ,(Eleectrctr onic 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 Rp:iirt f2aulred 1111111111111111 forrensFc rotas Prduicr "" Monthly Report"for By 1Oth of each month 1 Mental Health Admin istrator I ndividuals on Office Conditional Release, if applicable Exhibit C Pagel 1 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiaario fll Il eallilla II Network, Uric.) 7/1/2021 Exhibit C Required Reports kp, rt Ad 1red 6f Ft ren tclUlultid sciplin r 7e tri Pr6vid i 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- orograms/samh/man aging-entities/2021- 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 Court Reports preceding months'services Submission via E-mail) Forensic Team at Community , Health of South Florida, Inc. Report Requifed ftif'Ci�Lnluoidf�brivefl­ EnrollAc rl f s ment/Member October 5,2021 1,(Electronic ME Contract Manage r ship Report (Period:07/01/21 -09/30/21) Submission via E-mail) January 5,2022 (Period: 10/01/21 - 12/31/21) April 5,2022 (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) f ports a gialr6 far ubifi c�b//Abd rvice l fi a def Report for HIV Early January 5,2022 1 (Electronic ME Contract Manager Intervention (Period:07/01/21 - 12/31/21) Submission via E-mail) Services,SAPT Block July 5,2022 Grant Set Aside (Period: 01/01/22-06-30-22) 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 Exhibit C Page 12 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarvio fll Il eallilla IINetwork, Uric.) 7/1/"021 Exhibit C Require Reports 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 I rt� equlr d fcxr tatd0,p,'I id R6 066 b[Stretl nary, rattt Provlddrs Monthly SOR Data Due monthly, by the 15th of 1 (Electronic ME Contract Manager Collection Report every month following the Submission via E-mail) Exhibit BD month of service Encrypted and Password Protected f2���rt�Requir��fcsr` 'Ca`ts�t�neAbuse,Pr" u�riftc5rr` ervicesF�rnuidrs ,,, MonthlyData Prevention service data shall Electronically PBPS,or other data y 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 In the BSRI database system ME's contracted day after the month of service or any other format evaluation entity- requested by BSRI BSRI Monthly Service Monthly,by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day after the month Department) of service Invoice Review Submitted with the monthly 1 ME Sr.Accountant(Fiscal Supporting invoice Department) Documentation- from PBPS in ajpeg format Exhibit C Page 13 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hiliVing Wind Soi,ith I"IIa i IdU,'JI (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarario fli Il gad flila IINetwork, Uric.) 7/1/2021 Exhibit C Require 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 8/31/2021 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 f�,�pvrf�rl���irrei�f"ci"r l�'reverit)c�rr"�artri�rs�ilp; rarif�'r� rcf�r�'` Monthly E-Mail Monthly,b the calendar 1 Electronic 1. ME Director or Prevention Y t" ( 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 Prevention Services As Required by the Evaluation 1 (Electronic In the BSRI database system Quarterly Reports Entity(BSRI) Submission via E-mail) or any other format (Fidelity to Evidence- requested by BSRI Based Practices)— Exhibit C Page 14 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hiliVing Wind Soi,ith i"] i IdU,'JI (;u:onfrart:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarario fll Il earllilla IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Program Status Report as Required by RFA#11 L2GN1. 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 8/31/2021 1 (Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services ko t R Wrd'd f ur"E ralu ti,rftri"t)ty,ftar Preventi Monthly Service Monthly by 20t�calendar day 1 (Electronic 1. ME Contract Manag er 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 29,2021 1 (Electronic 1. ME Contract Manager, Expenditure Report (Period:07/01/21 -09/30/21) Submission via E-mail) January 31,2022 2. ME VP of Finance, and (Period: 10/01/21 - 12/31/21) April 29,2022 3. ME Director of Prevention (Period:01/01/22-03/31/22) Services July 29,2022 (Period:04/01/22-06/30/22) f part;.I e tuli e for,rrtuid6r lie eivir7 p66Mr. fipr j fi ti ri ,,,, Quarterly Updates on October 12,2021 1 (Electronic 1. ME Contract Manager Return on (Period:07/01/21 -09/30/21) Submission via E-mail) Investment Report- January 10,2022 Per Exhibit AM (Period: 10/01/21 - 12/31/21) April 11,2022 (Period:01/01122-03/31/22) July 11, 2022 (Period:04/01/22-06/30/22) Reps rt R quf fc r the;NAAAat6 k6,4f4' Pri ti dor Quarterly Services October 29,2021 1 (Electronic ME Contract Manager Report (Period:07/01/21 -09/30/21) Submission via E-mail) January 31,2022 (Period: 10/01/21 - 12/31/21) April 29,2022 (Period:01/01/22-03/31/22) July 29,2022 (Period:04/01/22-06/30/22) Exhibit C Page 15 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hiliVing Wind Soi,ith i"] i IdU,'JI (';Confl-art:„Hing aaS Soiii.if:lla If:ll a ucla Ii:3di°iiarario fll II earllilla IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Navigate Program October 29,2021 1 (Electronic ME Contract Manager Quarterly (Period:07/01/21 -09/30/21) Submission via E-mail) Expenditure Report January 31,2022 (Period: 10/01/21 - 12/31/21) April 29,2022 (Period:01/01/22-03/31/22) July 29,2022 (Period:04/01/22-06/30/22) Ra�pbrt&R6qulfcd far the„2 1-1 Hit lfne,,,,, MonthlyOutreach Due monthly, b the 30th of .......1.,( . y Electronic 1. ME Contract Manager Log every month following the Submission via E-mail) 2. Children's System of month of service Care Manager 3. VP of Contracts& Procurement Information and Due monthly, by the 30th of 1 (Electronic ME Contract Manager Referral Monthly every month following the Submission via E-mail) Report month of service Exhibit P-1, Information and Referral Monthly Report. Follow-Up Pilot As negotiated 1 (Electronic 1. ME Contract Manager Project Report Submission via E-mail) 2.Children's System of Care Manager 3.VP of Contracts& Procurement Re 6rts Required fear they.'F6f6 ik I�(artt l He fth' ertiic Pr o r rrm 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 or as requested by any Report ME Staff Weekly Statewide Weekly by 12:00 Noon every 1 (Electronic Director of Adult System of Census Report Thursday Submission via E-mail) Care or as requested by any ME Staff 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 or as requested by any ME Staff 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 or as requested by any visit ME Staff Exhibit C Page 16 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiaario fll Il eallilla II Network, Uric.) 7/1/2021 Exhibit C Require Reports Staffing Report Weekly by 10:00 A.M.for the 1 (Electronic Director of Adult System of previous work week Submission via E-mail) Care or as requested by any ME Staff R2 port :Required fi r the,/Cttimmunity' on Tre4frrient`Tdam SAT 1 eafi�„prograrrr 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 Data Monthly shall be submitted Electronically KIS, FASAMS,or other data Required by DCF electronically to the ME no system designated by the ME FASAMS PAM 155-2 later than the 4th of each or the Department month following the month of service Appendix 1 -Persons By the 811 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 12,2021 1 (Electronic 1.Children System of Care Quarterly (Period:07/01/21 -09/30/21) Submission via E-mail) Manager Supplemental Data January 10,2022 Report (Period: 10/01/21 - 12/31/21) 2.Contract Manager April 11,2022 (Period:01/01/22-03/31/22) July 11,2022 (Period:04/01/22-06/30/22) Appendix 3-CAT Monthly,by the eighth (8th) 1 1. ME Sr.Accountant(Fiscal Team Monthly calendar day after the month Department) Invoice 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 Ftp6'r"t~�f�ec�uired for th%M��ile,Re�p+�rie,Teams Mobile Response Monthly b the 10 following 1 Electronic 1. ME Contract Manager Team Report the month of service Submission via E-mail) 2. ME VP of Behavioral -Encrypted, password Health Services protected 3. ME Data Analysts MRT Policies and October 1,2021 1 (Electronic 1. ME Contract Manager Procedures Submission via E-mail) 2. ME VP of Behavioral Health Services 3. ME Data Analysts Exhibit C Page 17 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 I hiliVing Wind Soi,ith i"] i IdU,'JI (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiaario fli Il ed flila IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Memorandum of October 1,2021 1 (Electronic 1. ME Contract Manager Understanding/ Submission via E-mail) 2. ME VP of Behavioral Agreement with the Health Services Local School District 3. ME Data Analysts Response protocols December 31,2021 1 (Electronic 1. ME Contract Manager with the following Submission via E-mail) 2. ME VP of Behavioral stakeholders: Health Services 3. ME Data Analysts • Local Police Departments • Department of Juvenile Justice • Southern Region Community-Based Care Lead Agency • Colleges and Universities Outreach Activities October 15,2021 1 (Electronic 1. ME Contract Manager Log (Period:07/01/21 -09/30/21) Submission via E-mail) 2. ME VP of Behavioral January 14,2022 Health Services (Period: 10/01/21 - 12/31/21) April 15,2022 (Period:01/01/22-03/31/22) July 15,2022 (Period:04/01/22-06/30/22) Re��if•tat'Required ft�r'E�mily fnta�hiu�T��,�fm �it 1`c�ft'rt(SIT)�erUlce Fr6Vlelers,,,, 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) Access Database By the 13th day of the month 1 (Electronic 1. Contract Manager Report following the month of Submission via E-mail) 2.Child Welfare Integration services Coordinator Exhibit C Page 18 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmvt:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiavio fll II eallilla II IIaMtwa°irk, Uric.) 7/1/2021 Exhibit C Required Reports R 'pch#s R jutrel for tic'6,,H1rn " d Iri"RtS�rer ; �d fiFet; , E12A ,,,f r6ulders 3r J!( ) WeeklyChild Each Monday by close of 1 (Electronic g- nic 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 10th 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 Recfr'tsRequire fi frhr�c( (% :If roll �secial#y;Frc 'fafri Proid "r"„" 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 18th day of the month 1 (Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services 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 Repi r qulred fi r Child w fii rito�4r tloh uppoft Terri '( tNIST) Monthly Family Monthly by the 5th for the 1 (Electronic MEChild 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 Repcirt Rewired for°Notarubffk'F{rculr Pftng A TI etrr er}/lce # c4nant 1tUv`i en,lthor' `ri Women's special By the 8t"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 Support ed.,rrtpf t R p6fft' penal P oV&,/d,funded Exhibit C Page 19 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Confl-acHngaaSSoi.if:lla If:Il uucla Ii:3di°iiarvio fll Il eallilla IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Supported October 12,2021 One(1) Password, ME Peer Services Manager Employment (Period:07/01/21 -09/30/21) protected and January 10,2022 encrypted Electronic (Period: 10/01/21 - 12/31/21) Submission April 11,2022 (Period:01/01/22-03/31/22) July 11,2022 (Period:04/01/22-06/30/22) rt �Rquir �frlo� ,,,JVicferf1th1 t� plN1t� ura,,Y� ctYnecditr,,,,,,,, C i abtlrty lrfsur nc ;,(5 (f5 17()Oiitre h;A ce s,and Recavery,( (AI) Certificate of onlineWithin ten (10) business days 1 (Electronic SOAR Local Lead SOAR course of completion Submission via E-mail) completion Records review per October 15,2021 One(1) Password, SOAR Local Lead Exhibit AN,Section (Period:07/01/21 -09/30/21) protected and 11,c. Individual January 14,2022 encrypted Electronic Records Review and (Period: 10/01/21 - 12131121) Submission in Exhibit AN,Section April 15,2022 13.b.,Children's (Period:01/01/22-03/31/22) SOAR July 15,2022 (Period:04/01/22-06/30/22) ri sT fa if i tt' h'Uniti;"kecrdivisrrf1a 6 0', "Cef e tii rw CSU Recidivism Rate October 15,2021 1 (Electronic VP of IT and Data Analytics Data Collection (Period:07/01/21 -09/30/21) Submission via E-mail) (Attachment I, January 14,2022 Section D.Special (Period: 10/01/21 - 12/31/21) Provisions) April 15,2022 (Period:01/01/22-03/31/22) July 15, 2022 (Period:04/01/22-06/30/22) Pea�r"Sup�Sirt- er�ri�es Peer Support By the 10'"day of the month One(1) Password, ME Peer Services Manager Employment Report following the month of protected and (Monthly, per Exhibit services encrypted Electronic AO) Submission Exhibit C Page 20 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmat:„HingaaSSoiii.ifliI If:ll uucla Ii:3ei°iiavio fli II eMllla II Ii wa`irk, Uric.) 7/1/2021 Exhibit C Require Reports Peer Support By the 10t"day of the month One(1) Password, ME Peer Services Manager Services Report following the month of protected and (Monthly, , per services encrypted Electronic Exhibit AO) Submission Per n Aftecatef �ces Outpatient Report By the 15th day of the month One(1) Password, Adult System of Care " (Monthly) following the month of protected and Department services encrypted Electronic Submission Department of October 15,2021 One(1) Password, Adult System of Care Corrections Referrals (Period:07/01/21 -09/30/21) protected and Department for Baker Act January 14,2022 encrypted Electronic Services(Quarterly) (Period: 10/01/21 - 12/31/21) Submission April 15,2022 (Period:01/01122-03/31/22) July 15,2022 (Period:04/01/22-06/30/22) 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 21 of 21 Guidance/Care Center,Inc. Contract No. ME225-12-27 11 11-11VIng Und Sou,ulflh II Ila,w lda (C,o1r -m hrgi'7 S South II I1 ida lily 11'1 !lvlclri III II IIeallth INetworl ,Uric.) 7/1/ 02"'1 EXHIBIT D Substance Abuse & Mental Health Required Performance Outcomes&Outputs Network Provider Name: Guidance/Care Center,Inc. Contract#: ME225-12-27 Date: 7/1/2021 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 21-22 Guidance Document 24,click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml. Note: Click on FY21-22 ME Templates and click on Guidance Document 24—Performance Measurement Manual Adults Community Mental Health a.MH003-Average annual days worked for pay for adults with severe 40 38 and persistent mental illness b. MH703- Percent of adults with serious mental illness who are 24% 22.8% competitively employed c. MH742 - Percent of adults with severe and persistent mental 90% 85.5% illnesses who live in stable housing environment d. MH743 - Percent of adults in forensic involvement who live in 67% 63.7% stable housing environment e. MH744-Percent of adults in mental health crisis who live in stable 86% 81.7% housing environment Adult Substance Abuse a. SAA73 - Percentage change in clients who are employed from 10% 9.5% admission to discharge b. SA754- Percent change in the number of adults arrested 30 days 15% 14.3% prior to admission versus 30 days prior to discharge c. SA755 - Percent of adults who successfully complete substance 51% 48.5% abuse treatment services d. SA756-Percent of adults with substance abuse who live in a stable 94% 89.3% housing environment at the time of discharge Children's Mental Health a. MH012 - Percent of school days seriously emotionally disturbed 86% 81.7% (SED)children attended b. MH377- Percent of children with emotional disturbances(ED)who 60.8% improve their level of functioning 64% c.MH378 - Percent of children with serious emotional disturbances 65% 61.8% (SED)who improve their level of functioning d. MH778- Percent of children with emotional disturbance (ED)who 95% 90.3% live in a stable housing environment e. MH779 - Percent of children with serious emotional disturbance 93% 88.4% (SED)who live in a stable housing environment f.MH780 - Percent of children at risk of emotional disturbance (ED) 96% 91.2% who live in a stable housing environment Children's Substance Abuse a. SA725 - Percent of children who successfully complete substance 48% 45.6% abuse treatment services b.SA751 - Percent change in the number of children arrested 30 days 20% 19.0% Exhibit D Guidance/Care Center,Inc. Page 1 of 3 Contract No. ME225-12-27 11 11-11VIng Mlnd Sou,ulflh II Ila,w lda (C,o1r urm hrgi'7 S South II I1 ida liar 11'1 !lvlclri III II Ilealltlh INetworl ,Uric.) 7/I F 02"'1 prior to admission versus 30 days prior to discharge c. SA752 - Percent of children with substance abuse who live in a 93% 88.4% stable housing environment at the time of discharge Table 1—Network Minimum Year to Date Service Provider Annual Target Acceptable Performance This Performance Performance Performance Period Measures Network Provider Compliance: Network Providers shall achieve a minimum of 95% of the annual target levels in Table 1.The measures shall be demonstrated on an annual basis but will be monitored by the ME monthly. For each measure where the Year-to-Date performance falls below the Minimum Acceptable Performance, the Network Provider will submit a brief narrative, at the request of the ME, describing each of the following elements: 1. Any specific challenges,obstacles,or other operational considerations which are identified as significant factors underlying the unsatisfactory level of performance. 2. Any extenuating circumstances beyond the Network Provider's scope which are identified as significant factors underlying the unsatisfactory level of performance. 3. Efforts the Network Provider has undertaken to support improved performance during this reporting period. 4. Efforts the Network Provider will undertake in the future to support improved performance during subsequent reporting periods. 5. Any region-wide guidance,capacity,training,or other logistical supports needed to support improved performance during subsequent reporting periods. Exhibit D Guidance/Care Center,Inc. Page 2 of 3 Contract No. ME225-12-27 11 rrlitring IN11111d Sou.ulllh II Ilarw lda (I";ouihrarriiiu°iK;q"is South II Ilorida IBplli nflclri III II IIeallth Network,Ilinc.) 7111/202 Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Year FY21-22 Service Category FY Target Residential Care 27 a� Outpatient Care 1655 a� Crisis Care 199 x State Hospital Discharges N/A Peer Support Services N/A Residential Care N/A c Outpatient Care 529 U Crisis Care 51 Residential Care N/A a Outpatient Care 524 a� U Detoxification 105 Women's Specific Services N/A V) +- Injecting Drug Users 73 a Peer Support Services 5 Residential Care N/A cc c Outpatient Care 220 N NC) Detoxification 0 N � � Q Prevention **Refer to Attachment IV,Scope of Work for the numbers served.** 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 3 of 3 Contract No. ME225-12-27 iii11 Ong IMv I'Id `;fw li c:i'ldt "1.0111 FJd,'i II Ui dt,>Sr11.11 1101 I,i.l � '1x.vloI' l I u'7l 111 Nr.;9;:1+oI,<' 11I I;.) 7,/11 011:" 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: F2-1 Federal Authority F2-1.1 Block Grants Regarding Mental Health and Substance Abuse F2-1.1.1 Block Grants for Community Mental Health Services 42 U,S,C. ss. 300x, et seq. F2-1.1.2 Block Grants for Prevention and Treatment of Substance Abuse 42 U.S.C. ss. 300x-21 et seq. 45 CFR Part 96, Subpart L F2-1.2 Department of Health And Human Services,General Administration, Block Grants 45 CFR Part, 96 F2-1.3 Charitable Choice Regulations Applicable to Substance Abuse Block Grant and PATH Grant 42 CFR Part 54 F2-1.4 Confidentiality Of Substance Use Disorder Patient Records 42 CFR Part 2 F2-1.5 Security and Privacy 45 CFR Part 164 F2-1.6 Supplemental Security Income for the Aged, Blind and Disabled 20 CFR Part 416 F2-1.7 Temporary Assistance to Needy Families(TANF) 42 U.S.C. ss. 601 - 619 45 CFR, Part 260 F2-1.8 Projects for Assistance in Transition from Homelessness(PATH) 42 U.S.C, ss, 290cc-21 —290cc-35 F2-1.9 Equal Opportunity for Individuals with Disabilities(Americans with Disabilities Act of 1990) 42 U.S.C. ss. 12101 - 12213 F2-1.10 Prevention of Trafficking(Trafficking Victims Protection Act of 2000) 22 U.S.C. s. 7104 2 CFR Part 175 F2-1.11 Governmentwide Requirements for Drug-Free Workplace(Financial Assistance) 2 CFR Part 182 2 CFR Part 382 Exhibit F Page 1 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conti actu ig as,Sccrutll°l li oii id li[:!eil,iiavtoi all II Nea flh II II^:^t: oii llk, Uric:.) 711120 t II 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. ME225-12-27 (;Conti rcc°:tou ig w;Sccrutll°l li oii id li[:!eil,iiavtoi III II Ne flh II II^:^t: oii llk, Uric:,)' 71112 2 II 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 F241 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. ME225-12-27 (;Conti rcc°:tou ig w;Sccrutll°l li oii id li[:!eiI,iiavtoi all II Nd.Mlllh II II^:^t: oii llk, Uric:,) 71 i/."1 1.II CFOP 155-47 Processing Referrals From The Department Of Corrections CFOP 215-6 Incident Reporting and Analysis System (IRAS) F242 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. 65I-42, F.A,C. Travel Expenses Ch. 69I-5, F.A.0 State Financial Assistance CFO's Memorandum No. 01 Contract and Grant Reviews and Related Payment Processing Requirements CFO's Memorandum No. 02 Reference Guide for State Expenditures Comptroller's Memorandum No. 04 Guidance on all Contractual Service Agreements Pursuant to Section 215.971, Florida Statutes CFO's Memorandum No. 20 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 F243 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. ME225-12-27 N O N r N N N N LLJ 000 � m c oco o � a — � O Z U - N C O � U v x 0 0 0 0 p o 0 � o 0 O N vl Vr O � O C W r ."C G O O C G O O C O O O C C 6, v1 O C n O V d 0 S A T w W o 0 0 o c c 0 W u A � W o v, C7 F 0 0 0 0 � N N o ooNm � m—�nra000�o �o t:o N �o r�o�nm o c o o INS C,� t�o�ct� oiocd�-raio�ri�o a,-i o a oaoo; c c o o iar �n va�ov� v; �n o N R A J w Yi 69 FR 5 n +f 69 h 59 69 69 69 69 fI9+A + 69 +"3 69'A A'+ 6Fi'r=69 + r#Y3 a4 b9 V3 . _• 5Fi s 69 � V3 ,mi b9 i 69 69 U zw - a y Y L y C�C y m a ro m. 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Gz y v 7 7:p c' ai v �' y N i+' C� •' = �' r�r, „ .°�3 � p � ��A �.� � `�° � p ar �$ ��� u c>:.� v �o�j o.a a m d �^ y �� N �C5 �.v� cam. �a�v a�m ° 7 u � �� �.?.a;a.� ❑ o'a = P O ❑V'� - F 4 O a H H i.y r G'3 N L L O N 1� vl Ln O r RN Ci Ci Ut.)QQ zzOOO C'x NCC FG r/�V]r/�F'I-IQQ .-.G-�F1117.V]L..�UUP�-IaaQq LY�l Qi�Q GQ FA Q�0.1 L.)y' ^J N 7 W ti N M 7 00 O •° CJ 1 O O O O 1 O=7 --�`--��--�M""�.-. �. N .�I N N N �.: M .;.... ,v' i!, a if, EXHIBIT H-FUNDING DETAIL July 2021 Provider:Guidance/care Center,Inc. Contract#:ME225-12-27 Amendment# ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Services MH001 $ 228,629 Residential Services MH001 Nun-Residential Services MH009 $ 915,082 Non-Residential Services MH009 S 470.000 Crisis and Bnker Act Services MHO18 $ 1L130,503 Crisis and Baker Act Services MHO18 S 15,677 Community Forensic Program MH072 $ 160,000 Special Appropriation-ICFH MHOBN S FACT Team MH073 $ - Purchased Residential Treatment(PATS) MH071 S - Indigent Drug Program MH076 '$ 50,564 Community Action Treatment(CAT)Team MHCAT S 750,000 Proviso Allocation-Citrus MHO94 $ Mobile Crisis Team MHMCT S 636,471 PATH Grant MHOPG $ 165,000 CSOC Grant Year 2 CSOC2 S TANF Services MHOTB $ - Specialty Programs SPLTY S Early Intervention-Psychotic Disorders MH026 $ Telehealth Behavioral Health Services MHTLH S 97,950 Forensic Hospital Multidisciplinary Team MHOFH $ - Cares Act-(CAT)Team MHCA2 S For Profit Sab-Recipeint-KeyWes[LIMA MHSFP $ Cares Act-Care C00rdivaL10n MHCAS S Supported Employment Services MHEMP $ 75,006 S Miami-Dade County Homeless Trust MHOU) $ S 10S Pilot Project MH021 $ S MDC-Central Receiving Facility MDCRF $ S Care Coordination MHOCN $ 83,130 Care Coordination MHOCN Cat ryForward MHOCF $ Carry Forward MHOCF S Cares Act-I&R Expansion MHCAS $ - Cares Act FACT Team MHCAF $ specialty Programs SPLTY $ Cares Act-Care Coordination MHCAS $ Emergency COVID-19 Gram MHCOV $ Forensic Transitional Beds MHFMH $ Telehealth Behavioral Health Services MHTLH $ Cries Act-SRT MHCAR $ TOTAL ADULT MENTAL HEALTH= $ 2,897,998 TOTAL CHILDREN MENTAL HEALTH= $ 1,970,09R ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Services MS003 $ - Residential Services MS003 S Non-Residential Services MS011 $ 523,791 Non-Residential Services MS011 S 253.773 Detox Services MS0^-1 $ 486,643 Detox Services MS021 S HIV Services MS023 $ HIV Services MS023 S Prevention Services MS025 $ - Prevention Services MS025 S 199.063 Women's Services MSO^-7 $ Prevention Partnership Grant MSOPP S Pregnant Women Project MS081 '$ - TANF Services MSOTB S FIT Team MS091 $ 200,000 Proviso Allocation-Here's Help MS903 TANF Services MSOTB $ Here's Help Opioid Training MS921 S Proviso Allocation-New Hope CORPS MS908 $ Functional Family Therapy-EBA MS911 S State Opioid Response Disc Grant-Hospital Bridge MSSOH $ - SOR-Prevention Year 2 MSSP2 S 25,000 Opioid Response Disc.Ree Comm Org-Year 3 MSRC3 $ - SOR-Prevention Year 3 MSSP3 S 75,000 Here's Help Opioid Training MS921 $ State Opioid Response Disc Grant-Child Welfare MSSOW S Community Based Services MSCBS $ 50,000 Specialty Programs SPLTY S Opioid Response Disc.Grant-GPRA MSSGP $ Cares Act-Care Coordination MSCAS S MDC-Central Receiving Facility MDCRF Care Coordination M50CN $ 32,651 Care Coordination MHOCN S Carry Forward MSOCF $ Carry Forvard MHOCF S SOR-MAT Year 2 MSSM2 $ 150,000 Opioid Response Disc.Grant-GERA Year 3 MSSG3 $ SOR-MAT Year 3 MSSM3 $ 450,000 State Opioid Response Disc Grunt-Child Welfare MSso W $ Specialty Programs SPLTY $ Opioid Response Disc.Rec Comm Ora Year 2 MSRC2 $ Cares Act-Care Coordination MSCAS $ TOTAL ADULT SUBSTANCE ABUSE $ 1,893,085 TOTAL CHILDREN SUBSTANCE ABUSE_ $ 552,836 FUNDS NOT REQUIRING MATCH: Drug Abuse Services $ 764,148 TOTAL ALL PROGRAMS= $ 7,223,927 Prevention $ _199,063 ON(OMPENSATED UNITS= $ 1,444,785 Demstitutionalization Project _ $ 228,629 TOTAL= $ 8,668,712 CMH Program_ _ _ $ 1,970,098 SOR Grant $ 700,000 TOTAL FUNDS REQUIRING MATCH= S 3,361,989 TOTAL FUNDS NOT REQUIRING MATCH $ 3,861,938 LOCAL MATCH REQUIRED= $ 1120,663 NOTES FY 2020-21 Adjustments: '2/5/20 All 1-time only funding including carry forward allocations ure withdrawn. SOR funding allocation for FY 2020-21 is allocated as follows: MSSM2466,692(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: MSSP2422,437(Ist quarter)and MSSP3-S67,310(3 quarters);subject to appropriation in the FY 20-21. '9/4/20$65,742 is added to MSSM2 for additional services to be utilized prior to 910/29,1-time only. '9/10/20 S252,000 is added to ASA-MS011 and S433,188 is reduced from ASA-MS091(adjustments with Village). 12/9/20 S100 075 is it from MSSM3 to MSSM2 to align with SFBHN SOR allocation;additionally,$175,000 is added to MSSM2 for additional SOR services,1-time only. $75,000 is reduced from MHEMP and replaced with MH009 to fund the same supported emplyment services. $301,092 is added to AMH-MHCOV to fund Emergency Cm id grant funded services to include Supported Housing and crisis services. $97,950 is added to AMH-MHTLH for Tele-health behavioral services. 12/22t20 $35,216 is added to MSSGP and S7,658 to MSSG3 for the GPRA data services,the GPRA data entry will be reimbursed at$60.00 per event. 12/2820 MHEMP&MH009 adjustments on 12/9/20 are reversed us the SOH is revised to reflect the Supported Housing services. FY 2021-22 Adjustments: 2/25/21 All the SOR allocations including GPRA and Prevention finding are withdrawn,as these allocations are not recurring. '6/10/21 SOR allocations are added based on tentative allocations for FY 201-22,OCA allocations may change once die approved Schedule of funds for the new year is received. Guidance/Care Center,Inc. Exhibit H Contract No. ME225-12-27 Page 1 of 1 N C N 7 ti n N N N N V W F � a O yj Z U N U C � U z O O V� Vi a n 7 Vi N K 69 6A 69 65 69 F � � � oo vi C C � N � O C F � � a z F M �I O a x � - 00 a En ss s4 6A U O a V m o N z M aC O 69 69 6R Efi 69 69 Yi F{}Ji`.r A 59 69 A 69 69 69 65 69 59 A 69 69 is fF A e9`Jm 69&n 69 Yi 69 FH 69 69 69 A 'A x y a Ir 40 F 'sue. v U a £ y Q Z d a o c a r mTas c U o a 71 � � o Ej x � 33 � � R � •� � � � .:. a . s � �7d o G G .R v,-c > % o ce CO n ° ❑ E" W x F, 7o '� •c y y) �j O 0 0 0t ci N aUC-) C-) °. .°. � 000 � a �Gv U v F .°rQQ L � CcN�� UUF. F; a �.dQ �GdQ0. 0. o� oaU N V N M 7 IO h 00 N N M 7 �rl V) W 7 If, 1: l- GO M 0 7 1 h O\ 0 7 W D\ C .-i N M 7 U) )O h 00 T O In In cc V M M W, V) M V) m � )D N U n N N U C (0 a 0 (con iIxU:1lllid 1� :)Oii1 n I id 1 I' h i ilnI,,A Ir�,�i11Pt N� NvoI k, iIIc.1 EXHIBIT I Motivational Support Program(MSP) Treatment Provider Protocols Network Provider: Guidance/Care Center, Inc. I. POLICY: It is the policy of South 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 to the ME Contract Manager. II. PURPOSE: The purpose of this program is to: • 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. III. 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: To access the Department's FY 21-22 Guidance Document 19, click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml Note: Click on FY21-22 ME Templates and click on Guidance Document 19, Integration with Child Welfare IV. 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-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. Exhibit I Guidance/Care Center,Inc. Page 1 of 6 Contract No. ME225-12-27 i vint,b IvliiId `,ou1l 1 c:I' �i t (con :1!IIg 1�SoIJi nI id 1 I'oP7mik, I,,A Ir�,�i11Pt "J,aNn oI k, iIIc.1 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. 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) at the designated MSP 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 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 individuals who show an indication of behavioral health needs. Enrollment for Individuals served are not included in Outreach services. I. QUALIFIED PROFESSIONAL-A physician or physician assistant licensed under Chapter 458 or 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. 464.012 who has a master's or doctoral degree in psychiatric nursing, holds a national advanced practice certification as a psychiatric mental health advanced practice nurse, and has 2 years of post-master's clinical experience under the supervision of a physician a professional licensed under Chapter 490 or 491, F.S., a professional as defined in s. 394.455(5), (7), (32), (35), or (36)notwithstanding any other provision of law, 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 a 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 Exhibit I Guidance/Care Center,Inc. Page 2 of 6 Contract No. ME225-12-27 ii vinq Vfli d'iou[hl nitiixu11i g 1.vSoii11t I nild I ', h� ,I loIr I loflIh IV!NvciI.h<, 1iI1c.1 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 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. 1. Urgent Referral Case MSP will 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 (CPIS) or with the Behavioral Health Clinical Consultant (CCS). Referral Source: A CPI Supervisor (CPIS), 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 or post commencement consultation. 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 or with 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 CCS or CPIS for an MSP referral to be submitted, the CPIS or CCS is to follow-up to ensure that the MSP referral has been completed. Referral Source: A CPI Supervisor (CPIS), 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 or post commencement consultation. 3. CBC Referrals MSP will offer a 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 I Guidance/Care Center,Inc. Page 3 of 6 Contract No. ME225-12-27 ii vinq IVfli d'iou[h 'isnitii,i,::iiil9a,,�`!"oifflh l �� ai ! I I:,� I].IvloIr I I lr� il i h I +lVvf i h;, III1c.1 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. 2. The treatment provider will ensure that an initial appointment takes place within seven (7) business days of the receipt of referral from MSS, regardless of the individual's ability to pay. 3. The treatment provider will ensure that the individual was financially assessed utilizing the sliding fee scale as specified 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. 5. The treatment provider must notify the MSS and submit a 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 (PI), and/or the CBC lead agency, Intensive Family Preservation Services ("IFPS"), Full Case Management Agencies("FCMA") Providers to participate in staff ing's as required. B. Substance Abuse Treatment Assessment 1. The treatment provider will complete and transfer the assessment tool to the MSS within twenty (20) calendar days of admission into outpatient substance abuse treatment. 2. The provider will complete and transfer the assessment tool to the MSS within five (5) calendar days of admission into residential substance abuse treatment. C. Mental Health Treatment Assessment 1, The treatment provider will complete a Bio-psychosocial assessment,upon completion of 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- psychosocial assessment to the MSS within one (1) business day of its completion. Exhibit I Guidance/Care Center,Inc. Page 4 of 6 Contract No. ME225-12-27 h111 ivii.q I HIId 1:o: Ill /I' d t 2. The treatment provider must link the individual to recommended services based on the needs identified in the Bio-psychosocial 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-Psychosocial 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 (2) 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. D. Drug Testing: The initial drug test is conducted by the DCF Protective Investigator (PI) prior to the referral to the MSP. Subsequent weekly random drug testing will 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 2 weeks of treatment. After the initial 2 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 closed. 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 closed with MSP, The MSP Monthly Treatment Summary Form found in Appendix 1 of this Exhibit. 1. The form must be submitted at the required intervals as specified above. 2. 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 I Guidance/Care Center,Inc. Page 5 of 6 Contract No. ME225-12-27 i i vi nq IVN'ld 'I a [h l ccI' d t (co xu:1111(j 1•�So Iffl7 I nI id! I HohP lv loI,,Il I Io' l I,I IV1woI I^;, Ili`t+:c.) Appendix 1 Motivational Support Program Monthly Progress Report Initial ❑ Monthly ❑ Network Provider(Agency Name): Date: Client Name: Social Security Number: DOB: ICD 10 Code DSM 5 Diagnosis Progress in Treatment (to include compliance with sessions, resistance): Frequency of UA Testing: Urinalysis Results: I, (Print Therapist Name), hereby attest that I will submit this completed form to the Motivational Support Program Specialist every 151h calendar day after the month of service, Therapist Signature and Title: Date: Exhibit I Guidance/Care Center,Inc. Page 6 of 6 Contract No. ME225-12-27 (con :1!IIg 1�S()IJ1 nI id 1 I'oP7mik, I,,A Ir�;�i1I N, Nn/oI <' iIIc.1 Exhibit J Child Welfare Specialty Program (CWSP) Network Provider: Guidance Care Center, Inc. A. OVERVIEW The Network Provider is contracted to operate Child Welfare Specialty Program ("CWSP") described in the approved Program Description, herein incorporated by reference, designed to provide intensive outpatient substance abuse and/or mental health services to individuals or families involved in the Child Welfare system. The goal of the program is to reduce re-entry into the child welfare system. For the provision of services, the Network Provider must adhere to the CWSP protocol, dated 09/30/2019, or the latest revision thereof. CWSP includes participation from the Department of Children and Families (DCF) Child Protective Investigator (CPI) Unit, Full Case Management Agencies (FCMA), Behavioral Health Providers, the Southern Region Lead Community-Based Care Provider, the ME contracted Motivational Support Program Network Provider, the Child Welfare Integration and Support Team ("CWIST") Network Provider, Behavioral Health Consultants,and the ME. B. METHOD OF PAYMENT The CWSP Program will be reimbursed by the ME using a Case Rate method of payment in accordance with subsection 65E-14.021(2), F.A.C. Refer to Exhibit B, Method of Payment C. REQUIRED REPORTS The Network Provider agrees to submit all of the following reports and documentation by the specified timelines and any ad hoc requests made by the ME. 1. Child Welfare Program Active Cases Weekly Report The Network Provide must submit the Child Welfare Program Active Cases Weekly Report every Monday by close of business, following the week of service. The report must be e-mailed 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 number of individuals pending an intake,who have been referred to the specific program and currently enrolled individuals assigned to each program, The Network Provider shall use the Child Welfare Programs Active Weekly Cases Report in the template provided in Appendix 1 of this Exhibit. 2. Child Welfare Monthly Tracker On a monthly basis, by the 18tn of every month, the Network Provider shall submit a tracker on the template provided by the Managing Entity with information from the preceding month. The report must be submitted electronically in a secured, password protected or encrypted format by Exhibit J Page 1 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 (con :1!IIg 1� :)OIJ1 nI ld i I'oP7m/!/ ..�I, Ir�,�i11Pt N, NvoI h<, iIIc.1 the dates and to the individuals specified in Exhibit C, Required Reports. Network provider shall submit request for payment for individuals that have received more than 30 days of services. 3. Florida's Safe Families Network(FSFN) Documentation The CWSP will assign one person on the CWSP team that is to be responsible for writing weekly SAMH notes in FSFN. The note will at minimum include the information detailed in Appendix 2, SAMH Weekly Note Template. 4. Child Welfare Specialty Program Outreach Log The Network Provider must submit the CWSP Outreach Log by the 8th of every month following the month of services as back up to the monthly invoice. The outreach log must include the following categories: a. Individual Name, b. Date of Birth, c. SSN, d. Date of Contact, and e. Staff Name performing the Outreach, and f. Notes The CWSP Outreach Log must be submitted in a secured, password protected,encrypted email to the ME's Child Welfare Integration Coordinator. D. TRAINING The Network Provider agrees to ensure that all CWSP staff participate in any training provided by the Department or the ME. Trainings include but are not limited to all technical assistance, child welfare champions trainings, FSFN training, etc. Exhibit J Page 2 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 ii vinq IVN'ld I c:I' d t (co IIIIxw�iing 1�So Iffl7 nI id! 1Hoh� lvio Ii I Io'flI,I VIwoI <' liII:.) APPENDIX Child Welfare Programs Active Cases Weekly Report REPORTING PERIOD: Child Welfare Specialty Program (CWSP) Exhibit J Page 3 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 �:1111(1 a � ": �i fflh ni ld l 1r,xil1h N�woi b,, 1117� I," '0 1 APPENDIX 2 SAMH WEEKLY NOTE TEMPLATE:WEEK ENDING ON DAY OF WEEKLY CASE CONFERENCE Evidence Based Modality Being Used: CL..IINIICAL.. #OF SESSIONS Stage of Change: NEEDED PER PROTOCOL THIS WEEK: Clinical Impressions in Session: #OF SESSIONS COMPLETED: Resistance or Cancellations: Resistance or Cancellations: PEER SUPPORT #OF SESSIONS NEEDED PER PROTOCOL THIS WEEK: Strength Based Observations: #OF SESSIONS COMPLETED: Resistance or Cancellations: CASE MANAGEMENT #OF FACE TO FACE NEEDED PER Referrals Made (Type,Agency, Date): PROTOCOL THIS WEEK: #OF FACE TO Referral Follow Up: FACE COMPLETED: Exhibit J Page 4 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 ) / a all o ) , � 2 0 3 ] a / ƒ\ \ � 2 CO) cc � � ¢ � c k � � � Q / ccc ) G Q = U / 2z � � - 2 � � \ O / k \ / \ ) k m - k \ : - � � 7 / &_2 ? § � ■ � ) a 6 CA « , P ) / U 00 \ \ \ 2) � I _ r � / hiiiviiIt:I IviiiI ouIlli oI'l da :��i�irxt�::iiit�.i,i Sol i1PI , i-jai i,J�i I:,� P7 I��� ni lih No Iik, Ilia. Exhibit L Assisted Living Facilities with Limited Mental Health License Authority: s. 394.4574, F.S. I. Network Providers that enter into a cooperative agreement with an Assisted 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: 1) 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-LMHL facilities. 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) In circumstances where the Network Provider determines that placement of a particular individual in an Assisted Living Facilities with a Limited Mental Health License is unsuitable, the Network Provider must document in the person's treatment plan or service plan the rationale for alternative placement in an ALF without a limited mental health license. 3) 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. 4) 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. If the mental health resident continues to decline services, they must be encouraged to do so in writing, unless that is also refused. Documentation of a 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. 5) 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 to drop-in centers, clubhouses and other services where available, 6) Ensure that a cooperative agreement to provide mental health services, including case management as required in s. 429,075 FS, is developed between the Network Provider and administrator of the ALF-LMHL. 7) Ensure that the cooperative agreement identifies, at a 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 at the ALF-LMHL. The ALF-LMHL administrators must also be given contact information for the managing entity, as appropriate. The cooperative agreement must contain a provision requiring the provider Exhibit L Guidance/Care Center,Inc. Page 1 of 3 Contract No. ME225-12-27 ii vinq IVfli d'iou[h l (,111 ia coitii,i,;lii�t ,1.;.•��ii1171::1�ai is.! I I:',, 17 �� i� i. it I I� ,��IIP� I"�I��t�r,r��ih:;, Illi�;. 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. 8) Ensure that the Cooperative Agreement is annually updated between the Network Provider and the ALF-LMHL Administrator. 9) 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, or ALF-LMHL Administrator. The plan should be individualized and should include information about support services and special needs. 10) The case manager must assist the mental health resident in carrying out the activities identified in the individual's community living support plan. 11) 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 to the ME for inspection. The record must be retained for at least two (2)years after the date of the most recent interaction. 12) Adequate and consistent monitoring and enforcement of community living support plans and cooperative agreements are conducted by the resident's case manager. 13) 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. 14) Ensure that the case management are delivered per the requirements of Exhibit AP Mental Health Case Management Standards, II. Attendance at Assisted Living Facility Public Meeting The Network Provider must attend the ME's Assisted Living Facility with Limited Mental Health License Public Meeting as scheduled by the ME. III. Required Report The Network Provider must maintain an ALF-LMHL Consumer 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 Exhibit C, Required Reports. The Network Provider must provide the ME with copies of the ALF-LMHL Consumer Report upon request. The report must include at least 20% sample of the records to ensure compliance. The ALF-LMHL Consumer Report must be submitted in a secured, password protected, or encrypted format. Exhibit L Guidance/Care Center,Inc. Page 2 of 3 Contract No. ME225-12-27 0 Z � S N } 0] � LL N M ry �l N N O N Z Z � m � rn � � o m U d m U LU � C L_ N `o 0 U 3 J N ¢ m 3 � s J N ' Q N E d W z = T o V O X m J ¢ wa 2 J LL Q d ac U � U � ti LL N w E C � N Z U J 4J E u N Z U U N o Q IM U J � L! J Q fn c N U U m c ° m ZLL C7 J J Q �i vint,b IvliiId `,ou1l 1 c:I' �i t (con :1!IIg a,�SoIJi nI ld i l�,�P7m/!/ 7I, I(�,�i11P: N,aNn/oi h�r�, I c.) 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, 2020, 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 (IDP) are used for eligible individuals. 1. Purpose The purpose of this guidance document is to: 1.1. Establish IDP administration procedures; 1.2. Provide written guidelines to the Managing Entities and IDP Providers; and 1.3. Establish Florida State Hospital's(IDP/FSH Warehouse) medication order guidelines and processes for receiving, storing, and shipping IDP medications. 2. Definitions 2.1. IDP Dispensing Unit: A pharmacy holding a current permit from the Florida Board of Pharmacy that dispenses medication for the IDP. 2.2. IDP/FSH Warehouse: A physical space located on the campus of Florida State Hospital (FSH) at Chattahoochee, Florida. This space is reserved for receiving, storing,and shipping IDP medications. 2.3. Inventory: A listing of medications available through the IDP/FSH Warehouse that agencies that participate in the IDP can use to order medications. An inventory is also known as a 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 or Psychotropic Medication: 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. Anxiolytics; 2.5.4. Mood stabilizers; and 2.5.5. Cerebral or psychomotor stimulants. 2.5.6. Other medications commonly used may include beta blockers,anticonvulsants, cognition enhancers,and opiate blockers. Exhibit N Pagel of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq I'vNnd 'I a [h I c:I' d t (co �:1111ij 1�So Iffl7 I nI ld 1 ;�ohP lvio Ii I Iofl I,I V„lwnI iIIc.°; 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 of medication. 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 to medications. 3. Program Administration 3.1. Managing Entities Responsibilities If Managing Entities receive funding under the IDP, they will: 3.1.1. Approve organizations requesting to become IDP providers.To be eligible, organizations must be under contract with the regional Managing Entity, 3.1.2. Each July, provide a list of approved IDP providers to the 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 EVNT(non-client specific file upload) contractors should submit a service using the IDP OCA(MH076)with the Incidental Expense covered service(28) 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 IDP providers use IDP funds for individuals who meet the criteria. 3.2. IDP Providers 3.2.1. IDP providers will: 3.2.1.1.Assess and enroll individuals in the IDP who meet the clinical and financial criteria established in Chapter 394, F.S. 3.2.1.1.1. To meet the clinical criteria individuals: 3.2.1.1.1.1. Must be a member of at least one of the 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. 3.2.1.2. Prioritize the purchase of Long Acting Injectables with IDP funding. 3.2.1.3. Explore and secure other sources of medication funding such as manufactures' Medication Assistant Program, Good Rx and others. 3.2.1.3.1.To meet the clinical criteria individuals: 3.2.1.3.1.1. Must be a member of at least one of the Department's priority populations; and 3.2.1.3.1.2. Must not reside in a state mental health treatment facility or an inpatient community unit. 3.2.1.3.2.To meet the financial eligibility criteria individuals: Exhibit N Page 2 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq I'vNnd 'I a [h I c:I' d t (co �:1111(j 1�So Iffl7 nI ld 1 Hoh� lvio Ii I Ioi11Pt V„lwr,l.^';, iIIc.) 3.2.1.3.2.1. Must have a net family income that is at or below 150 percent of the Federal Poverty Income Guidelines, as published annually in the Federal Register; 3.2.1.3.2.2. Must lack third-party insurance or other psychotropic medications funding sources; and 3.2.1.3.2.3. Must not participate in a program where other funding sources pay for psychotropic medications. If individuals have third party insurance for psychotropic medications but were temporarily denied benefits for these medications,they may receive IDP medications until such time as coverage or eligibility is reestablished. 3.2.1.4. Provide information to individuals and staff working with IDP individuals regarding adverse effects,side effects, possible allergic reactions, and instructions on what to do in case of an emergency; 3.2.1.5. 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: 3.2.1.5.1.The providers' IDP contact information including name, e-mail, and phone number; 3.2.1.5.2.The authorized person's name who approves the Supply Requisition (See Appendix 1); and 3.2.1.5.3.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. 3.2.1.6. Use the Supply Requisition (See Appendix 2)obtained via email from the IDP/FSH Warehouse to place orders: 3.2.1.6.1.Submit orders only as needed; 3.2.1.6.2.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; 3.2.1.6.3.Fax or e-mail the completed,signed, and approved Supply Requisition directly to the IDP/FSH Warehouse; and 3.2.1.6.4.Pay line of credit surpluses to IDP/FSH Warehouse before the Warehouse processes new orders. 3.2.1.7. Submit the last order and payment before May 15 of the fiscal year; 3.2.1.8. Review all orders for accuracy; 3.2.1.8.1.Review the medication with the Issue Document (See Appendix 3)to ensure accuracy; 3.2.1.8.2.If discrepancies are found, call the IDP/FSH Warehouse within 24 hours or email the Issue Document with corrections; and 3.2.1.8.3.Retain a copy of the Issue Document. Exhibit N Page 3 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq I'vNnd 'I a [h I c:I' d t (co IIilxU:1111(j 1�So Iffl7 I nI ld 1 ;�ohP lvio Ii I Ioi11Pt V„lwr,I k, i I I c.) 3.2.1.9. Ensure that IDP prescriptions meet the following conditions: 3.2.1.9.1.A prescription can be written for one year with four(90-day supply) refills. An appropriate prescription for a 90-day supply may be written with up to 3 refills. One prescription cannot cover more than a 90-day supply 3.2.1.9.2.Must be listed on the IDP Inventory; and 3.2.1.9.3.Must be filled at an IDP pharmacy. 3.2.1.10. Actively participate in Patient Assistance Programs(PAP) that provide psychiatric medications without cost; 3.2.1.11. Review updated video presentations for medication guidelines or read the adult medication guidelines available through the Florida Mental Health Institute (FMHI)of the University of South Florida's Medicaid Drug Therapy Management Program for Behavioral Health,found at http://flmedicaidbh.fmhi.usf.edu/. 3.2.1.12. Review and validate the IDP/FSH Warehouse monthly statements. 3.2.1.13. Address emergency situations, including but not limited to: 3.2.1.13.1. Order additional psychiatric medications from either the IDP/FSH Warehouse or a pharmacy of their choice (for urgent needs); and 3.2.1.13.2. Pay dispensing fees to IDP Dispensing Unit for individuals who cannot afford them. 3.2.1.14. Implement medication receiving, storage,and administrative procedures that meet the current State approved prescribing instructions pursuant to s. 465.035, F.S.; and 3.2.1.15. Contact via telephone or e-mail the IDP/FSH Warehouse to cancel backorders or portions of backorders; provide the Supply Requisition number. 3.2.2. IDP 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.Clearly mark the package as outdated. 3.2.2.2. Return overstocked medications: 3.2.2.2.1.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 a check to the IDP/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 IDP/FSH Warehouse Exhibit N Page 4 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq I've nd 'I a [h I c:I' d t (co �:1111(j 1�So Iffl7 I nI ld 1 ;�ohP lvio Ii I Iofl I,I V„lwnI iIIc.) The IDP/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 to the 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 IDP/FSH Warehouse accounting office will: 3.3.3.1. 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: 3.3.4.1. 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(s)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 at the IDP/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; 3.3.10.Submit copies of the Issue Documents to the pharmacies that receive the medication orders; 3.3.11.Not give 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 of Substance Abuse and Mental Health (SAMH) 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 IDP medications. 4. Contact Information Exhibit N Page 5 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq IVN'ld 'I a [h I c:I' d t (co IIilxU:1111(j 1�So Iffl7I nIld 1 ;�ohP lvio Ii I Io'flI,I V„1wr,I <' i`Ic.) For questions regarding IDP/FSH Warehouse contact: Katadra Dawkins Florida State Hospital Indigent Psychiatric Medication Program (IDP) Pharmacy Building 1235, Room 113 Chattahoochee Florida 32324 E-Mail: katadra.dawkins@myflfamilies.com Work No. (850) 663-7274 Fax No. (850) 663-7291 Exhibit N Page 6 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 Appendix 1 SIGNATURE AUTHORIZATION FORM V PAR7- 4���- � State of Florida Ron DeSantis Department of Children and Families Governor n Shevaun L. Harris r�rf�ANC,'- Secretary MYF'LFAMILIES.COM Dr. Richard Herstein Signature Authorization Chief Hospital Indigent Drug Program Administrator 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 families,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)663-7585 at least seven(7)days prior to the event. Deaf or hard of hearing individuals may call 1-800- 955-8771. �,rms>P�MNv ��'�,✓�PAPSPBYi����, 2012 F ACCREDITED GOVERNOR'S STERLING AWARD RECIPIENT Exhibit N Page 7 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq1VM'Id':iou[h ! t fflh id! I H�oP7.0 inI,rIl 1Ic' lI,I INS !h,i,voI hr�, 111Ic.1 Appendix 2 SUPPLY REQUISITION SUPPLY INVENTORY MANAGEMENT SYSTEM Supply Requisition Supply Use Only To Be Completed By Requester 1. c 5 Expansion 6.Other Cost 3.Organizational Code 4.Su T Code OW Accumulators 7.Grant S.Grant 9.External Gen-enal Ledger 10 Agency Requisition Year Unique Number m No 11.Stock Number 12 Quantity Unit Price Total Price 13.unitotlssue 14.Description $0.00 $0,00 $0,00 $0.00 $0,00 $0,00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Remarks: 15.Requestor's Signature 16.Date 17.Slgnalureof Approval 18.Date 19.Requeslor's Telephone Number(SubCom,If available) Filled By Date Received By Date Exhibit N Page 8 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 I Olnq VN'ld cI'kl l Appendix 3 ISSUE DOCUMENT TO CONFIRM EXAMPLE ISSUE DOCUMENT DELIVER TO FROM : DP - INDIGENT DRUG PROGRAM UNIT OF OBJECT REQUEST ISSUED BACK UNIT ro,PAL LOC CODE STOCK NUMBER ISSUE CODE ORDER PRICE 6';05-00f-0694-5 N11 311002 W 30 0 140867 tl G4Y"),60 IIAWN Rlt,)Ak.,DIA'ANOArE IWNIONll (FIAIJ)01-) IMI-AMPX5 NDC,M0049-0254 6505-005-1199-p BI M 10 0 (w J 104 63.16 MIRI'AZAIIIINE. 15-MG IAB(RUMERCINI)WBIL NI)CA0052-0105-30 6505-001-9,'0-8 BI- t44002 3 3 0 n57,6385 172.9.2 PFRPHFINA/INF-4-MG TAB(Tku A B-()N) 10041 H,NIX'#00 1 72-1668-6W BW 1 630-002-W 17-4 BT 344002 V 0 1 56 0 PFRIIIJIFNAZINFI� 16-M0 TAB(T"RII,Al,()N) MOAIIJ,10)('400172-4670-60,BIA 6505-005-1919-4 131 144(02 W 10 43,2502 432-50 /IPRASIDONFI�80-NIG,("AIIS(61-A)DON)60 kli.R B011 1,F NIX 00049-3990-60 6505-005-18 F6-0 B 1 3,44002 0 6 0 16.9200 22p 52 ZHIRASIL)RI)NL:.:2(h-%4(.8,('AIIS((it-'(,)t.)(.)N)60 FIER Fat T iLf?NDC:00019 3960 60 6505-005-23 S9-4 R 1 3.44002 8 8 0 0038S65 44 8 3 09 24 QUE I I AMNI: 17UMA 14 A I E XR�(SUROQ1 T11300NIG ]'ABS`S` 60/B0�141'1 6505-005-2144 40 B 144002 4 4 0 805J,200 312118 OF T I IAP NE 1JAIARA I L,XR St,J<OQI El,XRF 200,N46 I ABS 60/13 W505-00 1-.0 7 8-4 B 1' 34,1002 9 8 0 '2 1,4k7,158 2WA,1 V FN 1,AI A X I N I-F S I": N 50-NU i X R 8 AI`(1 J FT XO R) 10041 I'l,N[W 000008.083 6, SH - CONFIRM SUPPLIES SHIPPED DURING PHYSICAL INVENTORY OR SYSTEM DOWN-TINE Exhibit N Page 9 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 � i I Onq VNnd 1 cI' fflh id:I Hohmfln I,,,d l lofl I h N0woi k, 11 I 11 Appendix 4 ISSUE DOCUMENT TO REVERSE EXAMPLE ISSTJE DOCUM'F-NT DELIVER TO FROM : DP - INDIGENT DRUC; PROGRAM LOC CODE STOCK NTMER UNIT OF OBJECT' REQUEST ISSUED BACK UNIT TOTAL ISSUE CODE ORDER PR ICE 6,105-001•"0694-5 VI 34,1002 30 30 0 16 9867 t 909,60 f fM,()KRfDAI.DECANOA 1'1:.: WOMG/Ml 0 W I XW) NIX n00045-0254 65054)05-R3991 B 1 3 14002 M 10 (),,164 6j 16 M I Wlt�Z A P I N[,,: l 5-M G I A B(R EM E R 30/B'T li-N DC'10005 2-0105-30 6 3 0 S-(W I-3 9 19-8 W 344002 3 31 9 1 57,6'W 172,92 650-002-0 1 t 7-4 11k], 3141100-7 1 1 50,1179 1'NW 114 6:T1ttII WNAZ Nf`a 1 6A,40'I"1\11(I R I q A FON) 1004k 11,NDC00�72-1670,60,IAW 6935-005-18 9-4 111 344002 10 10 0 4 , ,50! 432 i0 Z11'R,kS1[)0NE:80-M6,(Af'S(61AOONp 60 I'LA W)II t+ NUC 00049-i990-00 6505-005-18 16-0 BT 344002 6 6 0 36,9200 22 l,52 Z111RASH)ONL 20-446,CAIIS(,(A ODONy 60 11FR 601TIf ND,""00f)49-3960-60 6505-005,2338-4 1'll 344002 9 8 D 1038 6544 83(N.34 Q(1F1 1APMT:1 FUNIARA 111a XW(sFR0(.'flA1'L,)300N4(; 1',\13s,60,/BO4`3dJ 6505-005-2344-9 W1 344002 4 4 0 805 6200 32-12 4 8 01 T,I MNNE 11 NIA RA]E'XR:SInKOOUIA,W.100%46"CABS,60/131 6303-001-W 4 R 1' 344002 8 8 0 25,075S 200,6 I3 N fl AI A X IN fl,U Sll: 1 30-MO X l<CA 1'0 N4"EX OR1 I 001BT1,NW 4 0008-ON ,6- SH - CONFIRM SUPPLIES SHIPPED DURING PHYSICAL INVENTORY OR SYSTEM DOWN-TIME, Exhibit N Page 10 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 111i'01')aI'vliIId of I iI /I' dt (((:��iilrxi�::1iit� EXHIBIT 0 Adult Mental Health Residential Level II Services The Network Provider is contracted to provide Mental Health Residential Level II services. Level II 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 II 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 level II,each individual shall receive services each week in accordance with subsection 65E-4, F.A.C. The Network Provider must adhere to the service, programmatic, and administrative requirements for mental health residential services pursuant to Chapter 65E-4, F.A.C., I. Criteria for Admission Individuals who enter Level II residential treatment facilities must meet the following minimum criteria: 1. Diagnosed as having a mental illness; 2. Age 18 or older; 3. Ambulatory or capable of self-transfer; 4. Able to participate in treatment programming and services; 5. Free of major medical conditions requiring ongoing 24 hours per day, 7 days per week nursing services; 6. Self-administers medication with staff supervision; 7. Does not exhibit chronic inappropriate behaviorwhich disrupts the facility's activities or is harmful to self or others; 8. Maintain personal hygiene and grooming with staff supervision; 9. Initiate and participates in social interaction with staff supervision; 10. Perform assigned household chores with staff supervision; and 11. Is capable of self-preservation in accordance with subparagraph 65E-4.016(17) (b) 2, F.A.C. 12. Additional 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 an individual needs to function in the facility's environment. II. Target Population 1. Pregnant women and women with dependent children; Exhibit O Page 1 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 �i vinq 1" 1iitd'itu [h 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. Individuals who are being discharged from a state treatment facility; 4. Individuals who are at risk of being admitted into a civil of forensic state Mental Health Treatment Facility; 5. Individuals 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. Individuals who are forensic individuals(have an incompetent to proceed or a not guilty by reason of insanity court order); 8. Individuals who are at risk of institutionalization or incarceration for mental health reasons; 9. Individuals who have had three (3) or more admissions to a crisis stabilization unit (CSU), short- term residential facility(SRT),or inpatient psychiatric unit, including mental health level I and II of the countyjail; 10. Individuals 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 individual on the Centralized Wait List for Residential Services. While the individual is on the wait list, the referral source will be responsible to continue obtaining an individual's 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 individual remains on the waitlist. 2) Interim Services: All individuals placed on the waitlist should be enrolled in services by the Exhibit O Page 2 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq 'flitd'iou[hl isnitii,u 11i ga,,vSoii11t I nild I I lofl I N„N11r,1.1k, 1iI1c.1 assessing Network Provider/referral source until residential placement is available. 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. IV. Technical Assistance 1. 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 to the program and assists in the elimination of barriers to discharge for individuals served in the program V. Initial Authorization 1. An initial authorization number for the period of 120 days is generated if the individual 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. VI. Continued Stay Criteria VI.A. In addition to meeting all the criteria outlined in Section I, Criteria for Admission, on a continuing basis, the following criteria must also be met: 1. 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 individual can return to the 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 individual's ability to return to a less intensive level of care. VI.B. Procedures for Continued Stay Request: The Network Provider must review the individual's information and determine the primary clinical reasoning for extending services at the same level of care. 1. The Network Provider must complete and submit the following to the ME for review and determination. Incomplete requests will automatically be denied. 1) Complete and sign the Adult Mental Health "Continued Stay Authorization Request Form 2)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's 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. Exhibit O Page 3 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq 'flitd'iou[hl 'isnitlixu::1in9a,,�`!"�� ifflt L ,, ai ! I I::,� 17,»loIr I I VII. Invoice Validation 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 individual for residential services. The invoice should reflect the period of time for which the individual's stay was authorized. 2. 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 II 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 O Page 4 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 I1�l Ving Wrid Soil, Ih i"]oI id (Coil Itimcsfllirig "oill�llli ll:lIoiiuda ii;3,cchavlic:)i4ii ih,,�flth IIWtwr:ull°Ik, Iluuc //I11?1?0 1 EXHIBIT 0 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. "Abducted" means that an individual who does not have care and custody of a child under the jurisdiction of a dependency court has taken the child and left the jurisdiction of the court or in some manner is avoiding the supervision ordered by the dependency court. b. "Absconded" means that an individual who has care and custody of a child under the jurisdiction of a dependency court has taken the child and left the jurisdiction of the court or in some manner is avoiding the supervision ordered by the dependency court. b. "Absconded" means that an individual who has care and custody of a child under thejurisdiction of a dependency court has taken the child and left the jurisdiction of the court or in some manner is avoiding the supervision ordered by the dependency court. c. "Child" means any unmarried person under the age of 18 years who has not been emancipated by order of the court. d. "Department" means the Department of Children and Families unless otherwise specified. e. "Designee" means a person, contractual network provider or other agency or entity named by the Department. f. "Exigent Circumstances" means 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. g. "Family Services Counselor" means 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. h. 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 Exhibit 0 Guidance/Care Center,Inc. Page 1 of 4 Contract No. ME225-12-27 (Coll Itila fliri&, Soil�illm Il:l]oii uda Ii:1ehllavlk)1141 II h,,�fltII II d:Awoi1k, Ilu°°ic) 7/II 0"l?'I reported as missing to a law enforcement agency. i. "Runaway" means a child who has left a relative placement, non-relative placement, shelter home, foster home, residential group home, any other placement alternative or their in-home placement without permission of the caregiver and who is determined to be missing. A child who has run away three or more times for the purposes is considered a "Habitual Runaway". 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 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 Exhibit O Guidance/Care Center,Inc. Page 2 of 4 Contract No. ME225-12-27 (Coll Itila fliri&, Soil�illm Il:l]oii uda II:1ehllavlk)1141 II h,,aftIII II d:Awoi1k, Ilu°°ic:) //II 0"l?'I 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 (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 Exhibit Q Guidance/Care Center,Inc. Page 3 of 4 Contract No. ME225-12-27 ffill Ming Wrid Soli p.h i"]oII Ilda (Coll Iti a flri&, Soil�lllm Il:l]oii uda li:1ehllavlk)11 1 II h,,aftl'I II dAwoi1k, Ilu°°ic) //II 0"l?'I 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 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. 3. Resources 1) Children and Families Operating Procedure No. 175-85 — Family Safety — Prevention, Reporting and Services to Missing Children: 175-85.doc(usf.edu) 2) Rule Chapter 65C-30, F.A.C.: 65C-30 : General Child Welfare Provisions - Florida Administrative Rules, Law, Code, Register-FAC, FAR, eRulemaking(flrules.orgl 3) Rule Chapter 65C-29, F,A,C,: 65C-29 : Protective Investigations- Florida Administrative Rules,Law,Code, Register-FAC, FAR,eRulemaking(flrules.ol Exhibit 0 Guidance/Care Center,Inc. Page 4 of 4 Contract No. ME225-12-27 ":1'1mu•m Two Wnd South Ftorliim7,a (1:'m)YOrmliimn,;as Southi 1'llm.u�ir°1da I111petw6wat 11v ddl lh l (Prh,Inc.) "7/II/'7,k112III 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, The Network Provider will not submit violations of conditional release affidavits/reports to the court prior to consultation with the Forensic Specialist. The Forensic Team, when appropriate, should discuss proposed violations of conditional release 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. ME225-12-27 ":1'1mu•m Two Wnd South Ftorliim7,a (1:'m)YOrmliimn,;as Southi 1'llm.u�ir°1da I111petw6wat 11v ddl lh l (Prh,Inc.) "7/II/'7,k112III (e) The Network Provider designee will complete and sign the Agency Agreement to Treat and return it to the Forensic Team within 72 hours of having received it. (f) 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. (g) 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. 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. (h) Conditional Release Monitoring —The Network Provider will ensure that individuals on conditional release order in Miami-Dade and Monroe Counties, including individuals transferred into the counties from other circuits are monitored. i. The Network Provider will ensure that individuals on conditional release are monitored and in compliance in accordance with the court order and department rules. Exhibit V Guidance/Care Center,Inc. Page 2 of 4 Contract No. ME225-12-27 ":1'1mu•m Two Wnd South Ftorliim1,a (1:'m)YOrmliimn,;as Southi 1'llm.u�ir°1da I111petw6wat 11v ddl lh l (Prh,Inc.) T/II/'1,k112III 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 maintain current copies of conditional release orders. (i) Resource 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. (j) 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 individuals 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 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 individuals on conditional release from other circuits in need of forensic mental health services placed by the ME. Statewide admission to 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 individuals on conditional release from other circuits in need of forensic mental health services placed by the ME pursuant Exhibit V Guidance/Care Center,Inc. Page 3 of 4 Contract No. ME225-12-27 ":1'1 H1,1um'Wnd South Ftorliim7,a (1:'m)YOrmliimn,;as Southi 1'llm.u�ir°1da I111petw6wat 11v ddl lh l (Prh,Inc.) "7/II/'7,k112III 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. ME225-12-27 ii vinq I'vNnd 'I a [h I c:I' d t (co �:1111ij 1�So Iffl7 I nI ld 1 ;�ohP lvio Ii I Iofl I,I V„lwnI iIIc.`1 Exhibit X Projects for Assistance in Transition from Homelessness(PATH) Authority: 42 U.S.C. s. 290cc-21 et. seq. 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. To access the Department's FY 21-22 Guidance Document 15, click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml Note: Click on FY21-22 ME Templates and click on Guidance Document Projects for Assistance in Transition from Homelessness(PATH)Service To be eligible for PATH, individuals must: • Be 18 years or older; • Have a serious mental illness or a serious mental illness and co-occurring substance use issue, and • Be homeless or at imminent risk of becoming homeless. The Network Provider must adhere to the following requirements: • Annually submit an application packet which includes a budget and an Intended Use Plan (IUP) for Managing Entity and Department review and approval, o The Department will provide a budget, an IUP template,and a due date. ■ The IUP must cover needs and services for the upcoming State fiscal year(7/1 — 6/30).The Network Providers shall detail how PATH programs collaborate with the local Continuum of Care (CoQ and the Coordinated Entry process, and include signed letters of support from the CoC Lead Agency. ■ The IUP 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. ■ If no significant changes to PATH programs are anticipated for the upcoming fiscal year, the PATH Director must submit a letter certifying that the response to the IUP has not changed. • Ensure that PATH funded case managers are trained in Housing Navigation to: o Provide individualized support by helping each PATH-enrolled individual develop a personalized service plan to address any barriers to obtaining and maintaining permanent housing. Exhibit X Pagel of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq IVN'ld 'I a [h I c:I' d t (co IIilxU:1111(j 1�So Iffl7I nIld 1 ;�ohP lvio Ii I Io'flI,I V„lwr,I <' li`Ic.) o Provide employment linkage, benefits establishment, linkage to community providers for substance use treatment, primary and mental health care,and all other services needed to assist individuals in reaching their recovery goals. o Perform community outreach to business owners, realtors, landlords, housing developers and other service providers to build strong relationships and identify new and existing opportunities to better assist individuals in accessing resources, employment,supportive services, and housing opportunities. • Review service plans every three months and the plan must include: o Community mental health services; o Coordination and referrals for needed services such as shelter,daily living activities, personal and benefits planning, transportation, habilitation and rehabilitation services, prevocational and employment services, and permanent housing; and o Assistance obtaining income and income support services, Supplemental Nutrition Assistance Program (SNAP) benefits,and Supplemental Security Income/Social Security Disability Insurance(SSI/SSDI). • 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. • Submit an annual report no later than November 17th via the PDX at https://pathpdx.samhsa.gov/account/login • Train designated staff on SSI/SSDI Outreach,Access,and Recovery(SOAR) using the SOAR Online Course, available at: https://soarworks.prainc.com/course/ssissdi-outreach-access-and- recovery-soar-online-traini nq. o In the event PATH staff do not provide SOAR services, PATH staff must link potentially eligible individuals to non-profit or advocacy organizations assisting with applications for Social Security benefits. • Enter SSI/SSDI application data into the SOAR Online Application Tracking (OAT) database at soartrack.prainc.com/, in accordance with Managing Entity Contract Guidance 9. • 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 IUP budget. o Calculating Match Example: $300,000 federal award Must provide $1 for every$3 in federal dollars Calculation: $300,000/3 =$100,000 match to be provided TOTAL PATH EXPENDITURES=$400,000 • Employ policies and procedures that ensure priority use of other available funding sources for services(i.e., Medicaid). • Include consideration of continuity of care needs specifically for people experiencing homelessness in disaster response plans. The Network Provider shall assess, at least annually, and amend as appropriate,their disaster response plan to ensure it continues to meet the service needs of the target population. Exhibit X Page 2 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 I VI' q vl 1d `ol1llll c: I" tit • Participate and collect consumer data in the Homeless Management Information System (HMIS) and establish plans for new hire training and continued training. • Adhere to the standards established in the Florida PATH Program Manual The State PATH Contact (SPC) reserves the right to exclude any entity seeking to apply for PATH Grant funding. The Managing Entity shall: • Review instructions and participate in training(s) on data entry into the Web Block Grant Application System (WebBGAS)data system and annually check for any changes that may have been updated since prior years. • 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. • Check each PATH Provider IUP and budget for accuracy,completeness, and adherence to the reporting requirements and submit to the SPC by the due date. • Upload PATH application documents and enter the data for each provider into WebBGAS once approved by the SPC. • Ensure budget costs charged to the grant are allowable as authorized under 45 CFR§ 75.403, and that housing expenses do not exceed the maximum 20 percent allowable per section 522(h) (42 U.S. Code§290cc-22), • 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. • Designate a lead staff responsible for managing, reviewing and ensuring accurate data input by PATH Provider's in PDX. • Encourage PATH 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 (01) plan as part of their larger OI plan provided that the PATH eligible population is considered. PATH Providers are encouraged to collect and use data to: o Identify the number of individuals to be served during the grant period; o Identify subpopulations(i.e., racial,ethnic,sexual, and gender minority groups) vulnerable to behavioral health disparities to be actively addressing; and o Identify methods for the development of policies and procedures to ensure adherence to the National Standards for Culturally and Linguistically Appropriate Services(CLAS) in Health and Health Care. • Assist PATH Providers in collaborating with local resources to link people with safe, affordable housing. • 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 Exhibit X Page 3 of b Guidance/Care Center,Inc. Contract No. ME225-12-27 ii vinq IVN'ld 'I a [h I c:I' d t (co IIilxU:1111(j 1�So Iffl7I nIld 1 ;�ohP lvio Ii I Io'flI,I V„lwr,I <' liII:.) following: a corrective action issue, adding a new or withdrawing of a PATH Provider, or changes in funding allocation. • 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 • Use Section 4 and Appendix F in the most current SPC Welcome Manual when conducting site visits. The manual is available in PDX. • Ensure both street outreach and case management are provided in each of the county(ies) served. 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. Exhibit X Page 4 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 �i vileq Vflit,t'iou[hl Inilci I Ir,,i11h IVlwni <' 11inc.) 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 is when: 1) The individual has been determined to be PATH eligible, 2) 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 ❑ There is an informed presumption that the individual has a serious mental illness because: ❑ He/she is experiencing or displaying symptoms of mental illness and is experiencing difficulty in functioning as a result of these symptoms that indicates severity, ❑ He/she has shared or has a known history of engagement with mental health services, ❑ He/she has symptoms and functioning that indicates there is a history of or expected tenure of significant mental health concerns AND ❑ He/she lacks any housing, OR ❑ His/her primary residence during the night is a supervised public or private facility that provides temporary living accommodations, OR ❑ He/she is a resident in temporary or transitional housing that caries time limits, OR ❑ He/she is in a doubled-up living arrangement where his/her name is not on the lease, OR ❑ He/she is living in a condemned building without a place to move, OR ❑ He/she is in arrears in rent/utility payments, OR ❑ He/she has received an eviction notice without a place to move, OR Exhibit X Page 5 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 �i vileq Vflnd':iou[hl Ini i(.! I 1r,,i11h IV:Nvni <' 11inc.) /1 ❑ 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 to go to alternatives like short-term shelters whose residents are considered to be homeless. Exhibit X Page 6 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 IIiIMIIq Vv I'Id smIUhl I c:I' cfi,' (corili,icUng as`:'cIJ ltlI aIidil I(a� IPtl"1+:NnoIk, IiIIc.) 0/,,,'0. /)0/11 Exhibit Y Temporary Assistance for Needy Families (TANF) Funding Guidance Temporary Assistance for Needy Families (TANF) is a federal block grant component which provides funding to states to help move recipients into work. In the context of the Department of Children and Families (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.TANF It is not a separate program; it is a funding stream. The Network Provider must adhere to the requirements listed in this exhibit. I. Authority TANF was authorized by Congress in 19961, and Florida enacted the program in Chapters 414 and 445, F.S. The Department has also developed a state plan, Temporary Assistance for Needy Families State Plan Renewal: October 1, 2020-September 30, 2023, available at: https://www.myflfami lies.com/service-programs/access/docs/TANF-Plan.pdf II. Eligibility A. For reimbursement of an individual's substance use disorder services or mental health services through the TANF funding stream, one of two eligibility standards apply: 1. The individual must meet TANF eligibility requirements; or 2. The individual must be at-risk for welfare dependency, as provided under s. 414.1585, F.S. B. Section 414.1585, F.S„ establishes the requirements for TANF funding to be used in SAMH for diversionary services. This is for families who are at-risk of welfare dependency due to a substance use disorder or mental health disorder. Additionally, a family must be at or below 200% of the federal poverty level, and must be one of the following: 1. A parent or relative caretakerwith one or more minor children living in the home; 2. A non-custodial parent with a court order to pay child support; 3. A pregnant woman; 4. A family whose children have been removed from the home by the Child Welfare Program (where the service is included or added to the active family reunification goals in the case plan); or 5. A Supplemental Security Income (SSI) recipient or a Social Security Disability Insurance (SSDI) recipient. See,the Personal Responsibility and Work Opportunity Act, Pub. L. 104-193,(1996). Revised Exhibit Y Pagel of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 I i i I M I I q Vv I'I d s m I Uhl I c:I' ci�:'i (corill,ucUng as`:'ctIJUI IidiV I(a� I,IV!NnoIk, IiIIc.) 0/,,,'0. /)0/11 TANF funds cannot be used to reimburse medical treatment services.' A family that receives TANF cash assistance payments, the amount of which is dependent on family size, must meet certain weekly work activity requirements. Sanctions apply to a family when it does not meet the work activity requirements. This is an important point to note, as sanctions will reduce the cash assistance payment available for a family. Substance use disorder services and mental health services are considered job search and job readiness assistance. Such assistance is time limited by federal law' Additionally, Florida law has adopted the following requirements relating to inclusion of substance use disorder services and mental health services as work activities: 1. A TANF recipient cannot claim more than 5 hours of outpatient services a week, up to a cap of 100 hours per year.' 2. A TANF recipient receiving services through out-of-home residential treatment may be exempted from the work requirement, when certified by a Florida-licensed physician, for 60 days,which maybe extended up to an additional 90 days.' III. Managing Entity Responsibilities and Expectations The Managing Entities are responsible for: 1. Acknowledging each new or renewed Participant via electronic submission prior to reimbursement approval for each Participant; 2. Providing technical assistance to Network Service Providers as needed; 3. Identifying outreach services, and promoting interagency collaboration for linkages in the community; 4. Overseeing all TANF SAMH requirements and invoice approvals; 5. Performing annual monitoring using the approved TANF monitoring tool, and following-up on the monitoring to ensure that corrective action plans are completed; 6. Documenting, investigating, and resolving complaints, with additional technical assistance, when needed; 7. Monitoring length of stay, for residential treatment, to ensure that TANF is used as an appropriate funding stream; and 8. Implementing new federal and state requirements related to the reauthorization of TANF legislation. IV. Network Service Provider Responsibilities and Expectations Network Service Providers that receive TANF as a funding stream must be required by contract to '42 U.S.C.s.608(6)(A). 3 42 U.S.C.s.607(d)(6).Job search and readiness activities may be counted as work activities for no more than 6 weeks a year,and no more than four consecutive weeks.42 U.S.C.s.607(c)(2)(A)(i). 4 S.414.065(4)(0, F.S. 5 S. 414 0655, F.S. Revised Exhibit Y Page 2 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 I i i I M I I q 'vl l I'I d s m I Uhl I c:I' ci�:'i l;corili,icUn is`:'cIJ It l I aI id 1 I(a�I,I IVaNn/oi hr�, IlIIc.) 0/,,,'0. 0/11 ensure Participants meet TANF eligibility requirements. It is the Provider's responsibility to determine if a Participant meets eligibility criteria by using the TANF SAMH EZ-1 Eligibility Form as a means of assisting the Participant with determining whether the Participant can be certified as TANF-eligible. Provider responsibilities and expectations further require that: 1. TANF, as a funding stream, only be used for client-specific services, 2. The Network Service Provider utilizing a notification procedure established by their Managing Entity must send a notification to the Managing Entity for confirmation of the Participants' involvement in the program. 3. All Participants are re-determined for TANF eligibility by the Network Provider and certified by the Participant's signature, reflecting their current status between July 1st and July 31st, or as directed by the Department. 4. The Network Service Provider must document the federally mandated income verification. Monthly income must be requested by the Provider and updated monthly in the Participant's case file.This only applies to the TANF diversion population. 5. Before any funds are released by the Managing Entity,each Network Service Provider certify the Participant's eligibility, as required by federal and state law; and 6. Any month in which TANF SAMH services are billed, a Network Service Provider submit the state-approved TANF SAMH Participant Log along with the monthly invoice. The total units of TANF SAMH billed services on the Participant Log must match the TANF services on the invoice. The Managing Entity must verify that every individual who receives services was a TANF SAMH-eligible Participant during the month covered by the invoice prior to payment of the invoice. V. Services Because TANF is a funding stream, not a program, both the Managing Entity and Network Service Provider must be able to demonstrate service utilization by funding source. As with any clinical service, the Participant's need should determine the type, intensity, and frequency of service provided. The service should also support the following Florida TANF macro goals: 1. To make sure that children are safe in their homes or the homes of relatives; and 2. To prepare Participants to enter the workforce and retain employment. If a Participant receives Medicaid, TANF SAMH funds shall not be used to reimburse Medicaid services. Rather TANF SAMH funds shall support Medicaid services. All SAMH services utilizing TANF funding must be client-specific. This is due to the eligibility requirements discussed previously in Section II. VI. Monitoring Managing Entities are responsible for monitoring all aspects of TANF as a funding stream. Each Managing Entity will use randomly selected files to review the progress notes and treatment plans for Revised Exhibit Y Page 3 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 I i i I M I I q 'vl l I'I d s m I Uhl I c:I' ci�:'i (corill,ucUng as`:'ct IJUI I id V I(a�I,I IV:Nn/oi hr�, 11IIc.) 0/,,,'0. /)0 11 evidence that Participants, in the Managing Entity's respective region, are pursuing TANF goals as part of the Participant's treatment. VII.TANF SAMH 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 $50.00 per day, b) Services to be Provided 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 of the incidental expenses should include: • Client Name • Number of Days(24 hours) per month in rental housing unit (Census Log) • The goal(s)for SAMH TANF • Description of treatment services received each month • Rental Receipt • Approving authority signature with date Revised Exhibit Y Page 4 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 l.hii1iiSMiiing IIWiirid Soi.itlh If:Ioii iida (Contimat:„Hing aS Soi.d:lh Ii: oii ucla li:3e1 uavioi fll Il ea lli Network, Ilri .) t/I12021 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. ME225-12-27 I-IlhiirviiSMiiing IIWiirid Soi.itlh Ii: oiii iida (Contimat:„Hing aS Soi.d:Ih Ii oii ucla li:3e1 uaviou fll Il ea lli INetwork, Uric.) t/I12021 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. Individual 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. 397.31](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 Individual and a further statement of possible needs based on the Individual'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. Individual'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 Individual 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. ME225-12-27 i-Ilrii1iiSMiiing IIWiirid Soi.itlh Ii:Ioii iida Contimat:„Hing aS Soi.d:lh ii:Ioii kVa li:3e1 uavioi fll Il eallilli Network, Uric.) 7111202 1 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. ME225-12-27 I-Ilrii1iiVuu°g IMuirid Soil.itllh If:Ioii iida (Contimat:„Hing aS Soi.d:lh Ii: oii ucla li:3e1 uavioi fll Il eallilli Network, Ilu ic.) 71112021 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 Individual'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 Individual's screening or case management monitoring process, and in those instances when it is necessary to verify use or abstinence for an Individual 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 Individuals' 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. ME225-12-27 (;Contrac ong aSSoi.ifliI Ii oii ucl li: 11 a roiirru ill Il i ollilli IlNetwork, Ilu ic.) 7/i/ 02"II ii. Funds spent on behalf of(Individual name); iii. Referral type (protective investigation/supervision); iv. Date of request; V. Description of Goods/Services requested; A 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. ME225-12-27 °trio h aaa n Mh1d Sou hi 1`111PHda Conilraaa ill ',,i °;c,Wh Florbil a Vta.tw, of al Ilda. atHi'141"iou k,1,11c. /0111./;MI2111. 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 impart 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 for which they will be referred. Exhibit AC Page 1 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 °trio h aaa n /h1d Saawhi 1`111pa°Wa Conilraaa ill ',,i °;c,Wh Florbil a Vta.tw, of al Ilia. atHi'141"iou k,1,11c. 7/0 111./;MI2111. Case management may be ongoing for those determined eligible for this service based on current standards. 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, physical health, 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 of well-being 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. Exhibit AC Page 2 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Ttno h aaa n /h1d Sou hi 1`111pa°ii a 1."onilraaa ilaaaa ',,i °;c,Wh 1'fl,rau-aila Vtaa<w,uiingal Ilia. ahh'14vhw,ilirk,Inc. 7/1U:11./;1N112111. 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. 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. 11. Care Coordination should incorporate a recovery oriented, strengths-based approach to an individual's pathway to recovery, II. PRIORITY POPULATIONS Pursuant to s. 394.9082(3)(c), F.S., the Department has defined several priority populations to potentially benefit from Care Coordination. Managing Entities and provider agencies are expected to utilize at least 50%of allocated funds in OCAs MHOCN and MSOCN to serve the following populations 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. c. Adults with three (3) or more evaluations at an acute care facility within 180 days, regardless of admission. 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. The Department has defined additional populations to benefit from Care Coordination using funds in OCAS MHCAS and MHCAS. Under OCA MHCAS: 1. Children and parents or caretakers in the child welfare system with behavioral health needs, including adolescents, as defined in s. 394.492, F.S. who require assistance in transitioning to services provided in the adult system of care. Exhibit AC Page 3 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Yh h aaa n /h1d Sou hi 1`111pa°ii a 1."onilraaa ilaaaa ',,i °;c,Wh 1'fl,rau-aila Vtaa<w,uiingal Ilia. ahh'14vhw,ilirk'Inc. 7/1U:11./;1N112111. 2. Children and adolescents with a mental health diagnosis, SUD, or co-occurring disorders who demonstrate high utilization. For the purposes of this document, high utilization is defined as: children and adolescents under 18 years of age with three (3) or more admissions into a crisis stabilization unit or an inpatient psychiatric hospital within 180 days, including: a. Children being discharged from Baker Act Receiving Facilities, Emergency Rooms,jails,or juvenile justice facilities at least one time, who are at risk of re-entry into these institutions or of high utilization for crisis stabilization. b. Children and adolescents who have recently resided in, or are currently awaiting admission to or discharge from, a treatment facility for children and adolescents as defined in s. 394.455, which includes facilities (hospital, community facility, public or private facility, or receiving or treatment facility) and residential facilities for mental health, or co-occurring disorders. c. Children and adolescents with three (3) or more evaluations at an acute care facility within 180 days, regardless of admission. 3. Children not currently receiving services by a CAT Team. Care Coordination under these OCAS cannot be provided to individuals enrolled in the following team- based services FACT, Coordinated Specialty Care for Early Mental Illness, CAT, FIT, Comprehensive Community Service Teams, Forensic Multidisciplinary Teams, and any other local multidisciplinary treatment teams that include case management. If necessary, Managing Entities and Network Service Providers may implement a time-limited transition plan for individuals in the process of connecting to a case manager or team-based services that includes case managers (excluding Dependency Case Management and medical case management). The transition must ensure Care Coordination may not exceed 90 days during which time both a case manager and a care coordinator may provide services to the same individual unless a longer duration is specifically approved by the Department. The transition plan shall be designed to ensure a warm hand-off and successful case management engagement. Under OCA MSCAS: 1. Families with infants experiencing or at risk for Neonatal Abstinence Syndrome or Substance Exposed Newborn. In addition to the priority population listed in section 11. 1, 11.2 and all others under additional OCA's above, the following populations have been identified as benefiting from Care Coordination and may be served: 2. 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): Exhibit AC Page 4 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 trio h aaa n Moaaal SaaWhi Flipfld a Conilraaa ing A,i ,';c, h Florbil a Vta.tw, of al Ilh atUl'40",11iou°fl•,]IInc. /011/;MI21111 I. 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 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 unit in thejail. 3. Individuals (youth and adults) referred by, or to, a Law Enforcement Agencies and followed by that Law Enforcement: a. Youth/Adult must meet the following criteria: i. Must be receiving ME SAMH funded services or be willing to accept Care Coordination services from an ME Network Provider. ii. Adults have a confirmed SPMI and/or Co-Occurring diagnosis (Diagnosis of PTSD alone is not eligible). Youth must have a confirmed SED diagnosis and obtain parental /caregiver/guardian consent. iii. Currently is in or has the potential to experience a state of crisis, substance abuse or dependence,and history of suicidal/homicidal ideation. b.Youth/Adult 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 dynamic, lack of support system, isolation, instability and/or recent traumatic event. 4. 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. Exhibit AC Page 5 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Ttrio oa n n domaml Sou hi Fliuo°ldla Ci moilaraam°iNng v, aiva�0a 1'brmu-oil°,a 1"rehi Olin al Ilda. atoll'14'hliilirk'111c. 7/1),111./;1N112111. 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, SLID, 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 parentswith 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 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. Exhibit AC Page 6 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Ttrio oa n n domaml Saawhi Fliuo°ldla Ci moilaraam°iNng v, aiva�0a 1'brmu-oil°,a 1"rehi Olin al Ilda. atHi'14vhliilirk,111c. 7/1),,:11./:1N112111. 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 4) Participate in team meeting and/or other weekly contacts with the Network Provider. 5) Monitor and support Network Provider's engagement,enrollment and timelyservice 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 caresettings; 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, Exhibit AC Page 7 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Ttrio oa n n domaml Saawhi Fliuo°ldla Ci moilaraam°iNng v, aiva�0a 1'brmu-oil°,a 1"rehi Olin al Ilda. atHi'14'hliilirk'111c. 7/1),111./;11,(112111. 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 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. Exhibit AC Page 8 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 "uou M 11111�1irbila Barhavloml Ilia. Uh'141mrrk,1111 " 7/0 11/;MI21111 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 In this phase, there is frequent problem-solving skills, supports prior to contact with the individual in the discharge. community,focusing on active In this phase,the team This phase, promotes the engagement with behavioral health increasingly encourages transfer from CTI to other services, and identifying and individuals to manage community supports, both addressing housing-related issues in problems independently after formal and informal and order to prevent future episodes of connecting them to termination of CTI services homelessness or housing instability. supportive services. occurs with a support A transition plan is implemented network safely in place. while providing emotional support. Activities CTI worker engages the individual. This CTI worker monitors the CTI worker provides includes making home visits orvisits in effectiveness of the support consultation but little direct the community including in shelters or network; service.The worker lets the on the street,introducing the individual solve their own individual to providers,and meeting Helps to modify network as problems.The worker with caregivers,helping the individual necessary; ensures key negotiate ground rules for caregivers/providers meet Continues case management relationships,mediating conflicts, and and agree on long term assess the potential of the individual's activities as necessary; support system. support system. Continues community-based Reinforces the roles of Focuses on urgent/basic needs such as visits; support network members; food, immediate medical care,shelter, Provides psychoeducation Develops and begins to set in warm clothing or blankets,access to about self-management and motion plan for long-term essential medications; successful navigation of the goals(e.g.employment, Accompanies individuals to community service systems and education,family providers;Forges connections to social Completes any Phase I reunification);May hold a service systems,and assists the activities that still need party or some other individual to apply for available resolutions. Less frequent ceremonial recognition of benefits as indicated(phone,food and successful transition out of nutrition benefits,Medicaid, Disability, meetings and provides social CTI services.A final meeting etc.); crisis interventions and is held to formally recognize troubleshooting. the end of interventions and relationship. Exhibit AC Page 9 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Thrblu g NfiuuullSaaudi Fliuu°ilaJ a Conil rau°fuuat % Sou M Ftii�irai1a Jletuavloml 11l Uh'1rehaauirk,1111c. 7/011./�2(1C2111. 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 10 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 °trio h aaa n Mh1d Saawhi 1`111PHda Conilraaa ill ',,i °;c,Wh Florbil a Vta.tw, of al Ilda. atHi'141"iou k,1,11c. /0111./;MI2111. 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 availableat_https://soarworks.samhsa.gov/course/ss1ssdi-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 h e a I t h 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. Exhibit AC Pagel 1 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 °trio h aaa n doaaal Saawhi Flipfldm 1."onilaraaa,lhig ia,i aiaa�0a 1'brau-oila Vtaa<w, in al Ilda. atHi'14vhliilirk,1,1i1c. /1),111./;1N112111. e. In depth discussion of high priority cases, usually between 4-8 individuals. Additionally, each individual should be discussed at minimum once a month. 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 in ch.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. VI I. 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,or project code, and using the following service modifier codes in the Modifier 2 field: Modifier Code Assigned OCA-Short Description DO MHOCN—Care Coordination DV MSOCN—Care Coordination SA AS MHCAS—Children's Care Coordination SA MSCAS—NAS/SEN Care Coordination 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. Exhibit AC Page 12 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 °trio h aaa n /h1d Sou hi 1`111pa°Wa Conilraaa ill ',,i °;c,Wh Florbil a Vta.tw, of al Ilia. atHi'141"iou k,1,11c. /0111./;MI2111. VI II. 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. IX. REPORTING REQUIREMENTS 1. Monthly Care Coordination Report: The Network Provider must submit Care Coordination Monthly using the DCF Template 21 by the 5t" 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. XI.RESOURCES Network Providers are encouraged to research the following list of promising practices in Care Coordination as examples of effective implementation. A. Recovery Support Bridgers/Navigators Certified Recovery Peer Specialists(CRPS)are utilized to assist individuals successfully transition back into the community following discharge from a SMHTF, CSU or Detox. The CRPS engages the individual while still inpatient and provides support and information on discharge options. They participate in discharge planning and assist the person in identifying community-based service and support needs and build self- directed recovery tools, such as a Wellness Recovery Action Plan (WRAP). The CRPS then supports the individual as they transition to the community. More information on WRAP may be accessed at: http://mentalheaIthrecovery.com/ B. Care Transition Programs' This intervention utilizes a Transition Coach to preferably meet an individual in the acute care setting to engage them and their family (as appropriate) and sets up in-home follow up visits and phone calls designated to increase self-management skills, personal goal attainment, and provide continuity Exhibit AC Page 13 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Thrblng NJodrullSnawhi Fliuu°ildxi Conn rau iiunii1 1% Scu M 1,'11ruflill a Behavilina1 111a. hh �41moirk,1111:r. 7/11:11./;xN112111. across the transition.' More information on the Care Transition Programs may be accessed at: http://caretransitions.org C. Medical Homes The Agency for Healthcare Research and Quality defines the medical home as a model of the organization of primary care that delivers the functions of primary health care with the following attributes: • Comprehensive Care— the medical home is accountable for meeting the individual's physical and mental health needs,which requires a team of care providers. • Patient-Centered—the medical home partnerswith patients and theirfamilies,respecting each person's unique needs, culture,values,and preferences, • Coordinated Care — the medical home coordinates care across all elements of the broader health system, including community services and supports. • Accessible Services — a medical home delivers services in shorter wait times, enhanced in- person hours,around-the-clock telephone or electronic access to a member of the care team. • Quality and Safety — a medical home uses evidence-based medicine and clinical decision support tools to guide shared decision making with patients and families, engaging in performance and improvement.' In Indiana,WellPoint Health Plan medical homes for persons with high-service use decreased emergency department utilization by 72% and decreased controlled substance prescriptions by 38% in the 6 months pre- and post-program. Medical homes for people with substance use issues can also be a key intervention for super-utilizer programs— in Michigan, an integrated medicine clinic addressing super-utilizers with mental health and substance abuse needs decreased emergency department visits by over 50%among highest utilizers. D. Behavioral Health Homes The SAMHSA— HRSA Center for Integrated Health Solutions has proposed a set of core clinical features of a behavioral health-based health home that serves people with mental health and substance use disorders,with the belief that application of these features will help organizations succeed as health homes. This resource may be accessed at: http://www.integration.samhsa.gov/clinical- practice/CIHS_Health_Homes_Core_CI inical_Features.pdf E. Reducing Avoidable Readmissions Effectively The RARE Campaign in Minnesota was established to improve the quality of care for persons transitioning across care systems and to reduce avoidable readmissions by 20%. Five areas were identified as a focus of these efforts: • Patient/Family Engagement and Activation, • Medication Management, • Comprehensive Transition Planning, • Care Transition Support, and • Transition Communication See,http://caretransitions.org/about-the-care-transitions-intervention/,site accessed October 14,2015 2 See,hftps://pcmh.ahrq.gov/page/defining-pomh,site accessed October 14,2015. Exhibit AC Page 14 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Thrb1ng NJonnullSnawhi Fliuu°ilrJlxi Conn rau iiunnily, 1% Stun h 1'hrifliila Behavillina1 111a, u1u1n �41NIoldi,1111c, 7/11:11./;1N112111. For more detail,the RARE Campaign published recommendations on actions to address the above areas of focus which can be accessed at: http://www.rarereadmissions.org/documents/Recommended Actions Mental Health.pdf F. Telehealth The use of technology presents another promising practice in coordinating care,specifically as it related to access. As an example, the Department of Veterans Affairs (VA) piloted a Care Coordination/home telehealth initiative that continually monitored veterans with chronic health conditions. Vital signs and other disease management data was transmitted to clinicians remotely located.The pilot reported reductions in hospital admissions and length of stay.3 G. Wraparound Wraparound is an intensive, individualized care planning and management process for individuals with complex needs,most typically children,youth,and their families.The Wraparound approach provides a structured, holistic, and highly individualized team planning process which includes meeting the needs of the entire family. The philosophy of care begins with the principal of"voice and choice",which stipulates the child and family perspective and drives the planning.The values further stipulate that care be community-based and culturally and linguistically competent. The staff to family ratio typically does not exceed one Wraparound facilitator to ten families. More information on Wraparound may be accessed at: http://nwi.pdx.edu/ 31OM(Institute of Medicine).2010.The healthcare Imperative:Lowering Costs and Improving Outcomes:Workshop Series Summary.Washington,DC:The National Academies Press Exhibit AC Page 15 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 T1au hluug ids,,Ihid Saudi 1"diuu h a d..wV ira,-aa doaa uaa Soua h 1't H111I a 11'CarduItvi'I a IIIIe"t1h'?ua Irk,III ar. 7/1U11./:220'21. 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 16 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 T1au hluug ids,,Ihid Saudi 1"diuu h t d..wV ira,-aa doaa uaa Soua h 1't'II'fl1d a 11'CarduItvi'I a°a IIIIe"t1h""?ua l Irk"III ar. 7/1U11./20'21. 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 17 of 18 Guidance/Care Center,Inc. Contract No. ME225-12-27 Z C) 04 04 CD LLJ ca Z] CD F t C, CID ev (7v Mit -,n 70 0 - 00 0 0 M: 0 c: 00 70 X w LLJ "o -o U— M -C Ln z� bD -C z 70 < M > -0 r, aS c 7U Q) 12) C: LD (3 0 0 0 ca 70 0 rD va N O 0 .t CO ca CL. 4 w .K', 0 0 0 'rl :5 —Iz a, ::3 Z3 0 W 0 ll� 0 7� r- 0 0 0 :3 w 0. 70 0 It C: I- CD 0 cu -5 M 0 M U m m C., 4. 1'1aH1,11112 %1hict 2;mIa h IIFlluai°hh� t crflirav Nau!U,aGs South Fllurhl,a 11whaavuaorat 11l rcatth"uvlw urk,fric., 71]1/2021 Exhibit Al Family Intensive Treatment(FIT) Model Guidelines and Requirements Requirement: Specific Appropriations within the General Appropriations Act Purpose: To ensure the implementation and administration of this proviso project and ensure that the Network Provider ("FIT Team Provider") adheres to the service delivery and reporting requirements described herein. I. Authority Annual Specific Appropriations 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." II. Program Goals The FIT Team model is designed to provide intensive services to families in the child welfare system with parental substance use. Upon successful completion,the family should have the skills and natural support system needed to maintain improvements made during services.The goals of the FIT Team model are to: 1. Provide early identification of at-risk families and immediate access to intensive substance use and co-occurring mental health treatment services for parent(s)/guardian(s) in the child welfare system with early engagement strategies, such as at case initiation or case transfer, when a child in the family has been determined to be "unsafe"; 2. Establish a team-based approach, including Clinicians, Case Managers and Recovery Peer Support Specialists, to planning and service delivery in coordination with Community-Based Care Lead Agencies,Child Welfare Professionals, Managing Entities and other providers of services; 3. Integrate evidence-based 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. Identify family-driven pathways to recovery and promote sustained recovery through cultural and gender-sensitive treatment and involvement in recovery-oriented services and supports; 5. Promote increased engagement and retention in treatment; 6. Provide 24/7 access for crisis management; 7. Facilitate concurrent planning between child welfare case planning and treatment plan goals, to integrate the family's strengths and needs with their dependency case plan; 8. Advocate for parents)/guardian(s)and assist in navigating the child welfare process; Exhibit Al Page 1 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1"11u•o'Two Wild s uaflV Florida C orih-HOuuu!U,nGs ,'�nu th FLuHuda 11whauvicr t 111u a tth N'Ovupuu-k,111c., 7a IL/2flII21111 9. Promote treatment completion and continued care through linkage to ongoing support services and natural supports; and 10. 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)/guardian(s) have a substance use disorder; 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 (FFA), 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. III. Eligibility FIT Team Provider shall accept families referred by the child protective investigator, child welfare case manager or Community-Based Care Lead Agency. Providers and stakeholders working with child welfare families, such as engagement programs and the dependency court system, can also refer eligible parent s)/guardian(s). The FIT Team Provider shall deliver services to parents)/guardian(s)who meet all the following criteria: 1. Are eligible for publicly funded 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 the criteria for a substance use disorder; 3. Have at least one child between the ages of 0 and 10 years old; and 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 and placed in-home or out-of-home; 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 eligible parent(s)/guardian(s)are willing to participate in the FIT Program or the caregiver is court ordered to participate in FIT services. In either case, enhanced efforts to engage and retain the caregiver(s) in treatment are expected as a critical element of the FIT program. The FIT Team Provider may serve families who exceed the financial eligibility while applying a sliding fee scale in accordance with 394.76 F.S. and Chapter 65E-14.018, F.A.C., if no other option for treatment at this level is available. Exhibit Al Page 2 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1'1aH1,1oa2 %1hict 2;auIa ti IIFlluai°li h1 tCcrfliirav duiqU,aGs South lulluHd a 11 haavuaorat 111a rcatth"uvlw urk,fric., 71]1/2021 While eligibility is based on at least one parent/guardian in the home meeting criteria,all members of the household may receive and benefit from FIT services and coordination. This allows for family-focused treatment and ensures that all members of the household are addressing any issues that may impact success from both a behavioral health and child welfare perspective. Each parent/guardian that meets the eligibility criteria is counted toward the performance measures. IV. FIT Staffing Requirements By providing a team-based approach to care, families receive FIT services from consistent and designated staff that have received the required training on the child welfare system and evidence- based programs. FIT staff work collaboratively to meet the needs of FIT families. Below are the essential roles of FIT team members who are considered the "core" team. Adjustments to staff credentials and maximum caseloads must be approved by the Managing Entity with agreement from the Department of Children and Families. This includes time-limited plans to address initial implementation of this staffing requirement and vacancies. 1. Program Manager - A Master's or Doctoral degree in behavioral health sciences, such as psychology, mental health counseling, social work, art therapy, or marriage and family therapy; an active license issued by the Florida Board of Clinical Social Work, Marriage and Family Therapy, Mental Health Counseling,or Psychology;and a minimum of three years working with adults with substance use disorders. 2. Behavioral Health Clinician-A Master's or Doctoral degree in behavioral health sciences,such as mental health counseling, social work, art therapy, psychology, or marriage and family therapy; and a minimum of two years of experience working with adults with substance use disorders, Behavioral Health Clinicians provide evidence-based therapeutic services and incorporate behavioral health goals with Caregiver Protective Capacities and parenting interventions. Clinician caseloads are clinically determined by the Program Manager but shall not exceed 15 clients. 3. Case Manager—at minimum a Bachelor's degree 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 or Master'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 child welfare case manager and the FIT program does not fund the child welfare case manager. FIT Case Managers assist clients with coordination of provider referrals and follow-up for other needed services.Case manager caseloads are determined by the Program Manager based on the needs of the individuals served, but shall not exceed 20 clients. 4. Recovery Peer Specialist - Certified by the Florida Certification Board; or an individual who has direct personal experience living in recovery from substance use conditions for at least 2 years with a minimum of one (1) year work experience as a Recovery Peer Specialist. Recovery Peer Specialists are allowed one year from the date of their employment to obtain certification through the Florida Certification Board. Recovery Peer Specialists provide support, assistance, Exhibit Al Page 3 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1'1aH1,11112 %1hict 2;mIa ti IIFlluai°li h1 t:oWiirav Nau!U,aGs South lulluHd a 11 haavuaorat 111a rcatth"uvlw urk,fric., 71]1/2021 and advocacy for the client. Recovery Peer Specialists caseloads are determined by the Program Manager based on the needs of the individuals served but shall not exceed 20 clients. V. FIT Programmatic Requirements The FIT Team Provider shall be trained in the use of evidence-based substance use treatment and parenting practices found effective for serving families in the child welfare system. 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)/guardian(s) to reach FIT Team Provider in case of emergency 24 hours a day, 7 days a week; 2. Recovery peer 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 welfare professionals; 5. Individualized treatment provided at the level of care that is recommended by ASAM or LOCUS placement criteria; 6. Document FIT activities and family's progress in Florida Safe Families Network(FSFN); 7. 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; 8. Group treatment to address substance use disorders, based on individual and family needs and preferences; 9. Trauma-informed treatment services for substance use disorders and co-occurring substance use and mental health disorders; 10. Therapeutic services and psychoeducation 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 treatment plan, including a Multi-Disciplinary Team(MDT)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; Exhibit Al Page 4 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1"11u•o'Two Wild s uaflV Florida C c rih-ai luuu!U,nGs ,'�nu th FLuHuda Behauvicr t Illu a tth N'Ovupu-k,111c., 7)IL/2flII21111 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. VI. Assessment: All assessment tools should be completed as appropriate in the first 30 days following enrollment to the FIT program. The FIT assessment process includes consideration of the assessment activities that are completed by child welfare professionals, as well as any known behavioral health treatment history, In addition to assessments from child welfare, the FIT Team Provider shall assess parental capacity, functioning, substance use and co-occurring mental health, family history, and trauma. Results of all assessments are included in the Biopsychosocial and inform treatment planning and interventions. American Society of Addiction Medicine (ASAM) or Level of Care Utilization System (LOCUS) Criteria: Complete the ASAM or LOCUS Criteria to address the parent s)/guardian(s)' needs, obstacles and liabilities, as well as the caregiver's strengths, assets, resources and support structure to determine level of care upon admission. Daily Living Activities (DLA-20): Alcohol-Drug Functional Assessment: Complete the DLA-20 to determine the caregiver's level of functioning.To effectively monitor changes in client functioning overtime,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:Alcohol-Drug shall be administered at discharge, except in the case of unplanned discharge and parent is unavailable. Caregiver Protective Capacities: Review the caregiver protective capacity ratings completed by the child protective investigator or child welfare case manager from the most recent Family Functioning Assessment. The FIT Team Provider will complete a baseline rating of the caregiver protective capacities based on information gathered during the assessment process and integrate the capacities into the treatment plan goals. This will be evaluated by the FIT team monthly in progress updates and during treatment plan reviews and at discharge. These ratings are not to replace the assessment of caregiver protective capacities completed by the child welfare professional, but to align language for more robust discussion of the parent(s)/guardian(s) progress. Biopsychosocial Assessment: The Biopsychosocial Assessment shall describe the biological, psychological, and social factors that may have contributed to the recipient's need for services. The evaluation synthesizes the results of all assessments administered and include a brief mental status exam, diagnostic/clinical impression and preliminary service recommendations based on those results and interview of the client and family. Refer to Chapter 65D-30, F.A.C. for further requirements of the Biopsychosocial Assessment. VII.Treatment Planning Process As part of the core competency of an Integrated Practice Model,it is imperative behavioral health providers support and address child welfare outcomes by enhancing caregiver protective capacities. Utilizing the identified diminished caregiver protective capacities and behavioral health needs,the team will be able to develop appropriate interventions to address family needs.This practice is in unison with the Child Welfare Practice Model which requires child welfare professionals to identify reunification criteria, objectively Exhibit Al Page 5 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1"11u•o'Two Wild sauaflV Florida C orih-HOuuu!U,nGs ,'�nu th FLuHuda Behauvicr t Illu a tth N'Ovupu-k,111c., 7a IL/2flII21111 evaluate the scaling of caregiver protective capacities, and assess behavioral changes in the parent/guardian toward enhancing their protective capacities. The FIT team participates in or coordinates MDT staffings, requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s),teacher(s), primary health provider(s),and other provider(s),following enrollment and at least every 30 days. The MDT is responsible for the development and ongoing evaluation of the treatment plan and/or case plan, including any alterations that may prove necessary. VIII.Transition and Discharge Successful transition planning begins at admission, is family-centered, and continues throughout the family's treatment. Families are apprised of the appropriate community resources available, linked to those services and are key participants in all phases of the transitional care planning process. Referral processes with community providers need to occur in a timely,systematic fashion prior to discharge.The process concludes with the coordination and implementation of services and transition to the least restrictive level of care. Completion of the DLA-20: Alcohol-Drug and rating of the caregiver protective capacities are completed seven calendar days prior to discharge from FIT services, except in the rase of unplanned discharge and parents are unavailable.An MDT staffing is held 30 calendar days prior to discharge from the FIT program and includes the FIT team, and requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s), teacher(s), primary health provider(s), and other provider(s). The discharge MDT staffing addresses the family's behavioral health, relapse prevention and recovery service needs such as Alcoholics Anonymous, Narcotics Anonymous, a faith-based group or other recovery supports; the physical health care needs for the parents and children; support services such as housing supports, supportive employment, financial benefits, etc.; and community services such as child care, early intervention programs, therapies, and community-based parenting programs. Fourteen calendar days prior to discharge,the FIT provider makes referrals to ensure linkage for necessary services and supports.A discharge summary is completed summarizing the family's needs and referrals to services and is provided to the family upon discharge.A copy of the discharge summary is provided to the child welfare professional within seven days of discharge. In the event of an unplanned discharge,the FIT team coordinates an MDT as soon as disengagement is identified to discuss strategies for re-engagement or plan for next steps following discharge. These steps must be documented in the discharge summary and provided to the child welfare professional within seven days of discharge. Discharge Definitions 1. COMPLETED TREATMENT: Discharged due to successful completion of treatment. 2. MOVED: Discharged due to moving outside of the FIT Team Provider service area and not enrolled in another service or program during the reporting period 3. JAIL/PRISON: Discharged due to incarceration. 4. DISENGAGED: Discharged due to disengagement (dropped out of treatment, lost contact, administrative discharge, left against medical advice, eloped, failed to return from leave, and individual choice) 5. TRANSFER TO ANOTHER FIT PROVIDER: Discharged due to transfer to another FIT Team Provider 6, TRANSFER TO ANOTHER PROGRAM OR SERVICE: Discharged due to transfer to another treatment program or type of service (including recommendations for other levels of care due to maximum Exhibit Al Page 6 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1'1arh'1oa2 %1hict 2;mIa ti IIFlluai°li h1 t crflirav duiqU,aGs South lulluHd a Behaavuaorat 112a rcatth"uvlw urk,1ric., 71]1/2021 benefit achieved at current level of care); If a higher level of care is recommended but client refuses and disengages,the discharge will be defined as disengaged. 7, DIED: Discharged due to client death 8. GOAL CHANGE: Discharged due to goal change in the child welfare case but the child welfare case remains open; This discharge definition is used when the permanency goal is changed and there is no longer a requirement to continue treatment. 9. COURT CLOSED: Discharged due to the child welfare case closed by the court. IX. FIT Process 1. At time of referral, the FIT Team Provider will: a. Review the referral to ensure it meets FIT eligibility criteria i. This can include staffing with the referral source ii. If the referral does not meet criteria,the FIT Team Provider will staff the case with the referral source and recommendations and linkage to appropriate services are made and documented b. Access the initial and/or ongoing FFA from the FSFN system, if completed c. Review the FFAs for the diminished caregiver protective capacities d. Contact child welfare professional to acknowledge receipt of the referral and receive any additional information e. Review case plan,when available f. Review FSFN for any prior investigations g. If FIT program is full, a waitlist is maintained. All referred families are contacted, given information about status on waitlist and provided referrals for interim services to meet any immediate needs.Weekly phone contact is maintained for all clients on FIT waitlist 2. Upon accepting a referral, the FIT Team Provider will: a. Assign the referral to FIT Team (Counselor,Case Manager and Recovery Peer Specialist) b. Contact the family as soon as possible (within two business days) to explain the Fit Team approach, answer questions about FIT and set up enrollment meeting c. Ensure that initial and recurring efforts to contact and engage the referred parents)/guardian(s) are documented d. Determine which FIT Team member(s)will participate in the enrollment meeting 3. Upon enrollment, the FIT Team Provider will: a. Meet with family and complete all consents required by provider agency b. Ensure that a release of information is completed for the child welfare professional and any other formal and informal providers and supports involved with the family Exhibit Al Page 7 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1'1nH1,11112 %1hict Sm I�tu IIFlluai°li h1 t crflirav Nau!U,aGs South lullun-d a 11 haavuaorat 111a rcatth"uvlw urk,Inc., 71]1/2021 c. Contact the child welfare professional to provide disposition of referral, schedule an MDT staffing,and arrange to be present at all Teaming activities,such as case planning conference, mediation,staffings, urgent/emergent staffing,or court hearings,etc. 4. Within the first 30 days after enrollment,the FIT Team Provider will: a. Complete required FIT initial assessments b. Complete a Biopsychosocial based on all child welfare information,results of FIT assessments, and interview with the parent/guardian and family c. Based on the clinical assessments and identified diminished caregiver protective capacities, a treatment plan is developed with the family, FIT team, the child welfare professional, and other providers involved with the family d. Begin substance use treatment to include relapse prevention planning utilizing an evidence- based model e. Coordinate specialized services; for example: joint home visits, in-home interventions, parenting programs, child services, peer services, incidental funding,etc. f. Evaluate family's need for housing or to apply for eligibility for food, cash and medical assistance or use of incidental funds g. Complete all required FSFN documentation, at a minimum a monthly progress notes and update at any critical juncture 5. During ongoing treatment, the FIT Team Provider will: a. Complete additional assessments as appropriate or required b. Participate in or coordinate frequent (at least monthly) MDT staffings, requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s), teacher(s), primary health provider(s),and other provider(s) c. Review treatment plans, FFA-Ongoing, Progress Updates, and scaling of caregiver protective capacities.Any section scaled as a "C" or"D" is included as an area of focus in the Treatment Plan d. Continue to evaluate family's need for housing or to apply for eligibility for food, cash and medical assistance or use of incidental funds e. Participate in Teaming activities,such as case planning conference, mediation, MDT staffings, urgent/emergent staffing,or court hearings, etc. f. Complete all required FSFN documentation, at a minimum a monthly progress notes and update at any critical juncture 6. During Continued Care, the FIT Team Provider will offer ongoing continued care services once clinical services are determined to be completed. This can be done through individual services Exhibit Al Page 8 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 U11u•o'Two Wild s uaflV Florida C orih-HOuuu!U,nGs ,'�nu th FLuHuda Behauvicr t Illu a tth N'Ovupu-k,111c., 7a IL/2flII21111 and/or attendance at an aftercare group and is typically provided by the FIT Case Manager or Recovery Peer Specialist, 7. During Transition and Discharge,the FIT Team Provider will: a. Complete updated assessments,such as the DLA-20:Alcohol-Drug and rating of the caregiver protective capacities b. Provide progress updates to inform the child welfare case manager's ongoing assessments of caregiver protective capacities c. Consult with the child welfare professional(s) to determine the appropriate time for child welfare case closure. This includes agreement that 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 I. Families may be transitioned if there is a goal change to Termination of Parental Rights (TPR), however the family does not have to be discharged at this time if actively engaged and expresses a desire for continued FIT services ii. Families may be transitioned at any time the family declines ongoing treatment with the FIT Team d. Participate in or coordinate an MDT staffing 30 calendar days prior to discharge to discuss case transition with the FIT team, requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s), teacher(s), primary health provider(s),and other provider(s),except in the case of unplanned discharge and the parents are unavailable e. Coordinate linkage with community resources to ensure any ongoing care/aftercare 14 calendar days prior to discharge, except in the case of unplanned discharge f. Assist with coordination of follow up services I. Complete discharge summary and provide to the child welfare professional within seven days of discharge ii. Complete all required FSFN documentation X. Incidental Expenses Per, 65E-14.021, the following use of incidentals are approved: "transportation, childcare, housing assistance, clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals and other incidentals as approved by the department or Managing Entity." Incidentals should only be used to cover "temporary expenses incurred to facilitate continuing treatment and community stabilization when no other resources are available" and must be"associated with a treatment plan goal," Priorto utilizing Incidentals,the FIT provider explores all other resources with the family,including eligibility for food, cash and medical assistance through the Department of Children and Families Automated Exhibit Al Page 9 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 Flua•klintw 1dhuit S u!afdu Florida Corflu-aa 1uuu as ,';uWh FLuHuda 11a ha vilin at 11lea tth NOvvm-Or,Inc. 7a IL/2flll21 Community Connection to Economic Self Sufficiency(ACCESS) program. More information on ACCESS can be found at http://www.myflorida.com/accessflorida/. XI. Third-Party Services Services provided by the core FIT Team staff and funded by FIT contract dollars cannot be billed to any third-party payers. 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 (including detoxification; residential; crisis stabilization; medication management; aftercare; or other specialized service), the FIT Team shall refer to the appropriate level of care or service provider. The FIT Team shall work in concert with any other providers,the individual and the family to integrate services into overall treatment and to monitor progress toward treatment goals. For services provided outside of the core FIT Team staff, the FIT Team Provider shall seek reimbursement for services provided to individuals from any third-party payer, when available, including: commercial insurers,TRICARE, Medicare, Health Maintenance Organizations, Managed Care Organizations(MCOs),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. The FIT Team Provider shall also seek reimbursement for any Medicaid reimbursable service from Medicaid (or MCOs) when an eligible individual is a Medicaid enrollee. Additionally, the FIT Team Provider shall assist families who may be eligible for Medicaid to complete the program's application process and assist with the required eligibility documentation, pursuant to Chapter 65E-14,014(2), F.A.C. The FIT Team remains responsible for immediate access to services for admitted individuals, regardless of payer. XII. Reporting and Performance Measures A. Access Database: The FIT Team Provider shall enter all client data in the Access database, export the data on a monthly basis and submit the report to the ME by the 13t" day of each month following service delivery. B. Service Targets: Annual Target: 1) The FIT Team at Guidance/Care Center shall serve 17 families per year. Monthly Target: 1) The FIT Team at Guidance/Care Center shall maintain a minimum of 5 families in treatment. In the event the FIT Team Provider fails to achieve the minimum performance measures, the Managing Entity may apply appropriate financial consequences. C. Programmatic Performance Measures and Methodologies The FIT Team Provider shall meet the following performance measures and: 1. Upon successful treatment completion, 95 percent of eligible parent(s)/guardian(s)served will be living in a stable housing environment: Exhibit Al Page 10 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1"11u•o'Two Wild s uaflV Florida C orih-HMI,b!U,nGs ,'nu th FLuHud"a Behauvicr t Illu a tth",'Owpu-k.111c., 7a IL/2flII21111 a. Stable housing is defined as: Independent Living(Alone,with Relatives,with Non-Relatives) or Dependent Living (with Relatives,with Non-Relatives). b. The numerator is the sum of the number of eligible parent(s)/guardian(s)discharged as Completed Treatment during the reporting period who are living in a stable housing environment. c. The denominator is the sum of the total number of eligible parent(s)/guardian(s)discharged as Completed Treatment during the reporting period. d. The percentage of eligible parent(s)/guardian(s)living in a stable housing environment at treatment completion should be equal to or greater than 95 percent. 2. Upon successful treatment completion, 95 percent of eligible parent(s)/guardian(s) served will have stable employment: a. Stable employment is defined as: Active military, overseas; Active military, USA; Full Time; Unpaid Family Worker(A family member who works at least 15 hours or more a week without pay in a family-operated enterprise. If an individual refuses to work because that are making money through illegal activities,the client must be coded as Unemployed); Part Time; Retired; Homemaker(Manages household for family members); Student; or Disabled. b. The numerator is the sum of the number of eligible parents)/guardian(s)discharged as Completed Treatment during the reporting period who have stable employment. c. The denominator is the sum of the total number of eligible parent(s)/guardian(s)discharged as Completed Treatment during the reporting period. d. The percentage of eligible parents)/guardian(s)with stable employment at treatment completion should be equal to or greater than 95 percent, 3. Upon successful treatment completion, 90 percent of eligible parents)/guardian(s)served will improve their level of functioning,as measured by the Daily Living Activities(DLA-20):Alcohol-Drug Functional Assessment. 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 eligible parent(s)/guardian(s) discharged as Completed Treatment during the reporting period with an overall functioning score that is higher than the initial recorded score. c. The denominator is the sum of the number of eligible parents)/guardian(s) discharged as Completed Treatment with more than one DLA-20 score during the reporting period. d. The percentage of eligible parents)/guardian(s)who improve their level of functioning at treatment completion should be equal to or greater than 90 percent. 4. Upon successful treatment completion, 90 percent of eligible parent(s)/guardian(s)served will improve their Caregiver Protective Capacities as rated by the FIT Team Provider. Exhibit Al Page 11 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1'1IHI'1111' %1hict Sm I�tu IIFlloii°li h1 t:(IIIu r aIIAh qU'as oidh KoHd a 11 hapvl orat 111a rcatth"uvlwurk,111c., t)II/2111121 a. Measure of improvement is based on improvements to the Caregiver Protective Capacities ratings. b. The numerator is the sum of the number of eligible parent(s)/guardian(s) discharged as Completed Treatment during the reporting period with Caregiver Protective Capacities that are higher than the initial recorded rating. c. The denominator is the sum of the number of eligible parent(s)/guardian(s) discharged as Completed Treatment with more than one Caregiver Protective Capacities rating during the reporting period. D. 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 FIT Team Provider shall use the reporting template provided in Appendix 1 of this Exhibit Al. XIII.Additional Resources 1, Florida's Center for Child Welfare Hosts online references and training videos that can be useful to members of the FIT team. Caregiver Protective Capacities htti)://centervideo.forest.usf.edu/video/summitl 7/focusandchange/Caregiver%20Protective%2 OCa pacity%2OReference.pdf FSFN Trainings FSFN 101 (08/18/2016): http://centervideo.forest.usf.edu/fsfn/fsfn101/start.htmI FSFN Basic Functionality for Child Welfare Partners (07/19/2017): http://centervideo.forest.usf,edu/video/center/fsfnfunction/start.html Additional FSFN el-earning Modules: http://centerforchildwelfare.fmhi.usf.edu/fsfnwebtrain.shtml Plans of Safe Care http://centervideo.forest.usf.edu/video/center/safecare/start.htmI http://centerforchildwelfare.fmhi.usf.edu/kb/subabuse/planofsafecaresustanceaffectedinfants. pdf Exhibit Al Page 12 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 1"11u•o'Two Wild s uaflV Florida C orih-HMI,b!U,nGs ,'nu th FLuHud"a 11whauvicr t 111u a tth",'Owpu-k.111c., 7a IL/2flII21111 Integrating Behavioral Health and The Child Welfare Practice Model: Finding a Common Language: http://centervideo.forest.usf.edu/familiesfirst20l7conf/integratingbh/start.html 2, National Center on Substance Abuse and Child Welfare (NCSACW) Tutorial for Substance Use Disorder Treatment Professionals https://ncsacw.samhsa.gov/tutorials/tutorial Desc.aspx?id=26 Module One: Primer on CW and Dependency Court Systems for Substance Use Disorder Treatment Professionals. Module Two: Engaging Child Welfare-Involved Families in Treatment Module Three: Effective Treatment for Child Welfare-Involved Families Module Four: Special Considerations for Children Whose Parents Have Substance Use Disorders Module Five: Collaborative Strategies to Effectively Serve Child Welfare Families Affected by Substance Use Disorders 3, Florida Certification Board Register and click Available Courses: Motivational Interviewing for Behavioral Health Professionals New Perspectives on Recovery Creating a Culture of Engagement in Behavioral Health Services Welcoming Services and Service Coordination for Women with Substance Use and Co-occurring Disorders Exhibit Al Page 13 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 I-11H1,1111'o %1 hict Sm I i t� Fluirl h1 Ccrfl ii-a vNiqU,as South FuHda 11whavlorat 111a atth Nvlwurk,fric. 71]1/2021 APPENDIX 1 Child Welfare Programs Active Cases Weekly Report REPORTING PERIOD: 14 ffil SO Family Intensive Treatment Team (FITT) Exhibit Al Page 14 of 14 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffi II""II Ming Wind rr"°se'Il.l hi I oii II d a (Coll iti a sflrig a Soil�lllI Il:lloii da Ii;1c.IhlavIk)1141 Ii h,,aIftl'I 111d:Awolil ", Ulric:) 7/1120,21 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 March 26, 2021 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 FY21-22 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 — CAT Return on Investment Report 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 81h of the month following services. o Appendix 2 and Appendix 3 — Quarterly submission to the Managing Entity 1011h of the month following the end of each state Fiscal Year Quarter. 0 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; 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; Revised Exhibit AJ Pagel of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffiII""Il llling Wind rr"°sC'Il.lhi I oii Ilea (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ilu°°ic) 7/112(),21 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 for the CAT Team 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; 5. Decrease substance use and abuse; 6. Decrease psychiatric hospitalizations; 7. Transition into age appropriate services; and Revised Exhibit AJ Page 2 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 1hII""II Alin Wind,"°^soli„ lhi I oii Ilea (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1e'hlIavlk)11 11 Ii h"aIftl'I 111d:Awolil ", Ulric:) 7/1120,21 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. Network Providers may serve families who exceed the financial eligibility while applying a sliding fee scale in accordance with 394.674 F.S. and Ch. 65E-14.018, F.A.C., if no other option for treatment at this level is available(i.e. rural areas). 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 Entity.CAT members work collaboratively to deliver the majority of behavioral health services,coordinate Revised Exhibit AJ Page 3 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffiII""Ilvlllin Wind rr"°sC'Il.lhi I oii Ilea (Coll itiac lllrig a Soil�illm Il:l]oii uda Ii;1c.IhlavIk)11 11 Ii h,,aIltllI Iltd:Awolil ", Ulric: ) 7/1120,21 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://tipstars.org/Home.asrx 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. http://www.pathwaysrtc.pdx.edu/about 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. https://nwi.pdx.edu/wraparound-basics 4. Florida Wraparound model and toolkits available for providers and Managing Entities http://www.socflorida.com/wraparound.shtml 5. Strengthening Family Support for Young People: Tip sheet for strengthening family support, https://www.pathwaysrtc.pdx.edu/pdf/pro'PTTC-FamilySupportTiPSheet.pdf Revised Exhibit AJ Page 4 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffi II""Il Ming Wind,"°^so ll„ l hi I oii II d a (Coll iti a sflrig a Soil�illm Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,a1ft1'I 111, Awolil ", Ulric:) 7/1120,21 6. Positive Youth Development (PYD), Resilience and Recovery: Actively focuses on building strengthens and enhancing healthy development. https://www.pathwaysrtc.odx.edu/pdf/DbCmtvBasedApproachesOg-201 1.l 7. Section 394.491, F.S. —Guiding principles for the child and adolescent mental health treatment and support system. http://www.leg.state.f1.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&lJ RL=0300-0399/0394/Sections/0394.491.html 8. 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, juvenilejustice,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. https://www.youthmovenational.org/mission-and-vision V. Serving Young Adults The CAT program serves young adults up to the age of twenty-one(21),which includes young adults ages eighteen (18) up to twenty (20) who 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 be shared. In 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. VII.Screening and Assessment Within 45 days of an individual's admission to services, the Network Service Provider must complete the North Carolina Family Assessment Scale for General Services and Reunification° (NCFAS-G+R) as the Revised Exhibit AJ Page 5 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffill""II Alin Wind,"°^soli„ lhi I oii Ilea (Coll itiasfllrig a Soil�illm Il:l]oii uda Ii:1c.hIavlk)11: 1 Ii h,,aIftI'I II , Awolil ", Ulric:) 7/112 0;,;21 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 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. Guidelines for Adolescent Depression in Primary Care (thereachinstitute.org) and 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,integration.samhsa.gov/clinical-practice/screening-tools • SAMHSA Co-occurring Center for Excellence—Integrated Screening and Assessment Integrated Treatment for Co-Occurring Disorders Evidence-Based Practices (EBP) KIT SAMHSA Publications and Digital Products • 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 Revised Exhibit AJ Page b of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffiu..uoaIing 11Wind Soll.utlhi II°"III ii IIda (Coll iti a sflrig a Soil ulllI Il:l]oii uda Ii;1c.hIaolk)11 11 Ii fualftl'I IlM, Awolil ", Ulric:) 7/1120,21 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://Iifeskills.casey.org// 5. Youth Efficacy/Empowerment Scale and Youth Participation in Planning Scale-Portland Research and Training Center(Pathways RTC): https://www.Pathwaysrtc.pdx.edu/pdf/DbCmtyBasedAnProaches09-2011.pdf b. 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/proj-3-amp See,http://www.aacap.orp/aacap/Policy State ments/2009/Family and Youth Participation in Clinical Decision Making.aspx Revised Exhibit AJ Page 7 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffiII""Il llling Wind rr"°se'Il.lhi I oii Ilea (Coll itiasflrig a Soil�illm Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,: 1t'I 111d::1Awolil ", Ilu°°ic) 7/1120,21 2. Family and Youth Participation in Clinical Decision Making. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/aacap/Policy_Statements/2009/Family_and_Youth_Partici pat ion_in_Cli nical_Decision_Making.aspxx 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 monitor the Wraparound plan to ensure effectiveness and to revise as needed to ensure the plan best matches the individual's and family's self-identified needs. https://nwi.pdx.edu/NWI-book/Chapters/SECTION-4.pdf 4. Florida Wraparound model and toolkits available for providers and Managing Entities htti)://www.socflorida.com/wrai3around.shtml IX. Plan of Care 1. Initial Plan of Care Within 30 days of an individual's admission to services, the Network Service Provider must complete an Initial Plan of Care to guide the provision of services by the CAT team.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; • Specify the CAT services and supports to be provided by CAT Team 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 of Care 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 i mplement 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 individual's assets and resources; • Be individualized and developmentally appropriate to age and functioning level; Revised Exhibit AJ Page 8 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 1hII""Ili11ling Wind rr"oIiuthi IlIoii Ilea (Coll itiac lllrig a Soil�illm Il:l]oii uda Ii;1e'hlIavlk)11 11 Ii h"alltllt II d:Awof 11", Ulric:) 7/1120,21 • Address needs in various life domains, as appropriate; • 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 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/amh/wraparound/docs/wraparound-approach-soc.pdf 2. Florida Wraparound model and toolkits available for providers and Managing Entities http://www.socflorida.com/wraparound.shtml 3. Achieve My Plan (AMP): Youth participation in planning — provides tools, tip sheets for professionals and youth https://www.pathwaysrtc.pdx.edu/p3c-achieve-myplan 4. 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.Pathways pdx.ed u/pdf/DbJ CFS-Walkei P-En ha cement-for-Wraparound-05-2017.pdf 5. Community-based Approaches for Supporting Positive Development in Youth and Young Adults: RTC Pathways https://www.pathwaysrtc.pdx.edu/pdf/obCmtyBasedApproachesO9-2011.pdf 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. 2 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 2Chapter 394.491,F.S.-Guiding principles for the child and adolescent mental health treatment and support system. http://www.Ieq.state.fl.us/statutes/index.cfm?App mode=Display Statute&Search String=&URL=0300-0399/0394/Sections/0394.491.html Revised Exhibit AJ Page 9 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ihil""Il llling Wind,"°^soll„ lhi I oii Ilea (Coll itiasflriga Soil�lllI II IIoIii da Ii;1c.hIavlk)11 11 Iih,,aIftl'I 111d::1Awolil ", Ilu°°ic) 7/112(),;21 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.I 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 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.pathwa\/srtc.pdx.edu/pathways-transition-training-collaborative 2. 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/pdf/pro'-S-AM P-what-is-peer- support.pdf 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 3Transition Youth with Serious Mental Illness:http://www.apa.org/abouVgr/issues/cvf/transition-youth.pdf Revised Exhibit AJ Page 10 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffi II""II Ming Wind rr"°se'Il.l hi I oii II d a (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ulric:) 7/1120,21 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. 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 Revised Exhibit AJ Page 11 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffi II""Il Ming Wind,"°^so ll„ l hi I oii II d a (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii 1uaIftl'I 111d:Awolil ", Ilu°ic: ) 7/1120,21 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 Individuals receiving services must attend an average of 80%percent of school days, according to the following methodology: a. 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. b. The numerator is the sum of the total number of school days attended for all individuals. c. 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. Revised Exhibit AJ Page 12 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 f f iu,.uMing 11Wind Soll.ulhi II°" oii IIda (Coll itiasflriga Soil ufllmIl:l]oiiudaIi;1c.hIaolk)11 11Iih,,alftl'IIldd:Awolil ", Ilu°°ic) 7/1120,;21 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. • "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: Revised Exhibit AJ Page 13 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffi ll""II Ming Wind,"°^so ll„ l hi I II oII II d a (Coll itiasfllrig a Soil�Illm Il:l]oii uda Ii:1e'hIIavlk)1141 Ii h"aIftI'I II , Awolil ", Ilu°°ic-) 7/112 0;,;21 • 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 parent/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 WAS 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 14 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 hi'N�ng %ind Soiu I �:]oii 11d a (Coll I lIiacflrig as soufl'I :�loii uda li;3'e'havlk)i-A II h,,aftlh Il toNvoi,11k, ricl) 71112021 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 Total Served Total Served Total Served Section D-2 Min _ per CAT CAT CAT 11t Month= 10 month 21d Month=20 CARES Act CARES Act CARES Act 31d Month=25 Funded Funded Funded Thereafter=35 4) MINIMUM PERFORMANCE MEASURES—Section XV 15 2 0 CD 0 W -V E E 0 X 0 a. M C3 IL M 0 M 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 CFARSIFARS 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 15 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 ThM9|Mg W|ridSmLth F|oii|d@ (Contracting as Smuti IF|oridl0ehAwioma| Hei |til Nehx10111k. |11111-1) 7/1/2 2 1 APPENDIX QUARTERLY SUPPLEMENTAL DATA REPORT CATPROGRAM Reporting From To Period At admission,number of participants at At admission, Discharge Options risk of out of home placement due to: number of Residential Total This Total SERVED WITH CARES ACT FUNDING, Child mental Juvenile at risk of out of Quarter Year to Date IF APPLICABLE Welfare health justice home involvement treatment commitment placement Total Total Served Served Numberof discharges removed from the home due CAT CAT to child welfare involvement CARES Act CARES Act Funded— Funded Number of discharges Total Total admitted to a residential Served Served mental health treatment center CAT CAT CARES Act CARES Act Funded— Funded Number of discharges Total Total committed to juvenile justice Served Served placement CAT CAT CARES Act CARES Act Funded— Funded Number of discharges living Total Total in the community Served Served CAT CAT CARES Act CARES Act Funded Funded Totals Use the space below to provide any discussion of details affecting the delivery of services and supplemental data. 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 Revised Exhibit AJ Page 16nf21 Guidance/Care Center,Inc. Contract No.Mszzu'/z'z/ ThM9|Mg Wind Sot F|oii|d@ (Contracting as Smuti IF|oridl0ehAwioma| Hei |til Nehx10111k. |11111-1) 7/1/2()2 1 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 17nf21 Guidance/Care Center,Inc. Contract No.Mszzu'/z'z/ lmii ilviiii,g Wind SoiluIh Il..]oiii id (Coil Itilacatouoc7 "7o u111m Il:l]oiiuda Ii;tcclhiavlk)i—A II1h,,aIltllh Iltot:Atoill1k, Uric-.) 7111,20,21 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 psychologist/psychiatrist 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 18 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 h it Ming II Wind SoiuI If::]oi ual a (Coll ouotpw:wso ullla II:IIoiiuda 1i:1chi 4i011-all II1k,'dift1h 1MAW0111lk, IIuu1:-1) 7/11202 APPENDIX 3 CAT Return on Investment Quarterly Report Network Service Provider: Managing Entity: South Florida Behavioral Health Network,Inc. Cumulative Fiscal Quarterly RO1 Report: Number of Clients, 4o#iaal Costs Per D,a' Total Costs Per Quarter Clients Served in CAT Clients Discharged from CAT Clients Discharged from CAT who Remain in Community The Clients discharged from CATuuere diverted from'. C6st Per Day Annualized Cast Avoided Diverted from Child Welfare $170 Diverted from Juvenile Justice $223 Diverted from Psychiatric $478.04 Residential(SIPP) Tcsttt Cost Avoidance ROt Differential(Total Cost Avoidance minut total Costs for the Quarter Return on Investment bliferentlat (Divided'by totat Costs for the Quarter) 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 19 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 I II Ilv 11 ling Wind Iind,"°^so ilu I h ]oII id a (Coil Iil1mc lllirig Soil�illI Il oiiuda Ii;,c.hIavlk)—tall II1h,,aIlillh 111uAAi oll°Ik, Ulric) 7/112 2 Appendix 3 Guidance Instructions for Calculating the RO1 Report 1) Days in Quarter: Provide total number of days for the reporting quarter 2)To calculate the"Actual Cost Per Day": Total Cost for the Quarter divided by Clients Served then divided by Days in Quarter 3)Total Cost for the Quarter: Should be"$187,500.00" PLEASE NOTE: $187,500.00 should be the standard cost per quarter of a$750,000.00 annual budget 4) Diverted from Child Welfare Cost Avoided: Number diverted from Child Welfare x Cost Per Day($170)x 365 5) Diverted from Juvenile Justice Cost Avoided: Number diverted from Juvenile Justice x Cost Per Day($223)x 180 6) Diverted from Psychiatric Residential (SIPP)Cost Avoided: Number diverted from Psychiatric Residential (SIPP)x Cost Per Day($487.42)for Q1 &Q21$478.04 for Q3&Q4)x 180 7)Total Cost Avoidance: Add up Cost Avoided totals for Child Welfare,Juvenile Justice and Psychiatric Residential(SIPP) 8) RO1 Differential: Total Cost Avoidance amount minus Total Cost for the Quarter 9) Return on Investment: RO1 Differential amount divided by Total Cost for the Quarter PLEASE NOTE THE FOLLOWING REMINDERS: 1) Providers must input"zeros" instead of simply leaving the field blank. 2) Providers must include cents. 3) For numbers that extend out beyond 2 spots after the decimal place, if the third number to the right of the decimal place is a 5,round the second number to the right of the decimal place up. For example, 1.125 would be rounded to 1.13. Screenshot of the CAT RO1 formula calculation: Revised Exhibit AJ Page 20 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 hillivin Il Wind SoiuI If::]oiu(ia (Coll n ou otp ws so ufl'l II:IIoii uda li:1chi,4i011FA II k,'ditIh IMAW0111lk, II11111.1) 7/112 2 w 9 c B 1., iterly*kepmt-AppemdlxTEormbExample Y 2 Day,in quarter 92 i dcwictdpeeaay Toul(mat fat thc quaatet a Up,sWvAdrCAT 47 1875M Ctien*,s It sch e ed Prom LW 17 d CFv166smnfgedfrun CAT erhake:utaknlnC'prnrnmq S' t 9 Chen'sd"mNrpei from CAT wttmremarnedm the csrimmlyuve1� Cost Pei Day ('astAvoidpd 9 Dwered from Chddtwdahee 7 i70 �fiy7.Cyi";.�5 '10 Mvw'ed from wfflllp yusto p 1:82 1E OtvtRed Aom Psy.hevrio Pf.-,rdpmtal pW 4si Owl ON, 14 m ,wq 7 � -(B&1"CISY"t9C I narc n 12 m"�' a1a°� IAreraaa¢ alrtp ^'" 7 aRerP2 Sd8"A2 rkerBA I " �m n 93 roa�lry�h oed _ ,., 'EotaifastAuroidamx aa�,u,. �=64'r�tAapit a anf Rol t3i4 wnliat (Total Cost AwWme 6mus,T'otsl Cost fm tht 14 Ayuaoteu =DBM Retu Ifits lomwomemd JR01 UftierU dhrlded dy the Mal Cast bar lie I kuartmp =014J)4 I t ra I i I"'Note::Based or rrtfrmru data/risk aasessmemtaittim,e ntadarsysikont"T 1 t Revised Exhibit AJ Page 21 of 21 Guidance/Care Center,Inc. Contract No.ME225-12-27 (;Conflma+:°Hing aS oi.if:lla If:Il a u11a Ii:3e have of fli Il eallllla II lie wa`irk, Uric.) 7/II/ 02II EXHIBIT AM Return on Investment for Special Projects funded for FY 2021-2022 I. The Network Provider has been awarded funding to provide the following services: Provider: Guidance/Care Center, Inc. a. Project: Supported Employment Amount: $75,000.00 From the funds in Specific Appropriation 362, recurring funds from the General Revenue Fund is provided for supported employment services for individuals with mental health disorders. b. Family Intensive Treatment (FIT) Amount: $200,000.00 From the funds in Specific Appropriation 364, General Revenue Fund is provided to implement the Family Intensive Treatment (FIT) team model 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. Funds shall be targeted to select communities with high rates of child abuse cases. II. The Network Provider shall submit the following reports: 1. No later than 10 days after the completion of each fiscal quarter, a return on investment report on Template 30 — Proviso Project Return on Investment Report. The template is available at the following link: https://www.myflfamil ies.com/service-programs/samh/managing-entities/2021-contract- docs.shtml Note: Click on FY21 22 ME Templates and click on Reporting Template 30 — Proviso Project Return on Investment Report 2, Supported Employment Report: No later than the 10 days after the completion of each fiscal year quarter, submit the Supported Employment Services Report using Template 31 —Clubhouse Supported Employment Report. The template is available at the following link: httgs://www.myflfamilies.com/service-programs/samh/managing-entities/2021-contract- docs.shtml Exhibit AM Page 1 of 2 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-INurvuSMiiil.g IIWiirid Soi.itlh If„Ioii iida Confl-at:„Hing aS Soiii,d:ll'a If:ll a ucl a li: cell°uaavioi ill II eaallilla Network, Uric.) 7 /,2021 Note: Click on FY21 22 ME Templates and click on Reporting Template 31 —Clubhouse Supported Employment Report. 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.ME225-12-27 I Ii riSM1l•llg WI'id oil,Ath I„II IIda (Cc)IIItil actuului,uf:llI Il ly a il,i Network, Uric'.) C/II/2021 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 Managers)/SOAR Processors) 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 Processors) 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://soarworks.prainc.com/content/soar-on I ine-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.ME225-12-27 1-Ilhii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida (Confl-aat:„Hing aS oiii,d:ll'a If:ll a ucl a li:3e1°uaav of fli II eaa11111a Network, Ilu ic.) 7/11/20 1 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://soartrack.prainc.com/login,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://soarworks.samhsa.gov/course/ssissdi-outreach-access-and-recovery-soar-online-training. 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.ME225-12-27 ..i hi lVlng 'td 1111'•id South I„IIoI Idd,'.4 (Contrat:„t ing&S Soii.ifli I cl II:' Il u:r rilr a ill II ear ills Network, Uric'.) 7/II 021 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://soarworks.prainc,com/course/soar-child-curriculum b. The annual SOAR application target will be measured by a combination of adult and children's cases.The Network Provider agrees to an annual target of 1 children's applications. C. 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 Exhibit AN Page 3 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 (;Conflma+:°Hing aS oiii,if:lll If:Il a u11a Ii:3e hav of fll Il eallilli II lie woirk, Uric.) 7/11/202°II 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. 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 RESPONSIBILITIES 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.myflfamilies.com/service-programs/samh/managing-entities/index.shtml Note: To access the form click on FY21-22 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.ME225-12-27 Phil II SM II Zing Ur id I„'RL iufl 1I Ioi IIda (u:c u Iu �uu ure cru�:Il° Ii:]ou ud Ii:3e1,iavtoi II II Nc. :fll flh Il 0woi <,, Uric:,) C/Il ?02 Exhibit AO Peer Services Peer Support Specialists (as defined in s. 397.311(30), F.S.) and Recovery Management practices (as described in Exhibit BH, Recovery Management Practices ) have become an integral part of recovery services. . 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 their 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, while working alongside the treatment team if applicable. 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]. The requirements in this exhibit applies to all Network Providers providing peer support services funded by this contract. NETWORK PROVIDER RESPONSIBILITIES 1. Employee Orientation for Peers: The Network Provider must provide standardized training on Recovery Management best practices in employee orientation and refresher trainings,as required by Exhibit BH, Recovery Management Practices. 2. Assessment Tools: Peers must use the Recovery Capital Scale available at https://facesandvo1cesofrecovery.org/resource/recovery-capital-scale/ in the recovery planning process. The ME may require the Network Provider to report aggregate scores derived from the collection of Recovery Capital Scale tool. This information may be used to determine baseline data for the development of future performance measures. 3, Attain Client Consent: Initiate peer support services after voluntary consent when there is reason to believe such services will help the individuals served recovery, build resilience, or assist the individual to live successfully in their community with greater purpose. 4, Educate Peer Staff Regarding Community Resources: Peer Specialist can greatly assist individuals if the specialist is familiar with appropriate community resources that can advance the individual's recovery. Peers should be well integrated into the community to assist individuals served with the development of natural supports, community activities and employment. 5, Peer Specialist Education,Trainings,Seminars,and Committees: Peer Specialists must be allowed time for attending trainings and seminars that advance the practice of peer support and further Exhibit AO Page 1 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing Ur id I,'RL iufl 1I Ioi IIda (Conti ac°:[orig as S()U 111 Ii oii id I['Ie1,iavtioi ll II Ne. :clldllh Il et:woii 11<, Uric,) 71 n1 0,21 their professional development. They should also be allowed and encouraged to join committee meetings where their lived experience can be valued. 6, Document Peer Services Provided: Peer services must be documented in each client's clinical file, for example, development of wellness plans, WRAP Plans, the goals of the individual served, progress notes, linkages, etc, These plans should be updated regularly in consultation with the client to review progress and evidenced by proper documentation in the client file. 7. 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. 8. 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. 9, Recovery Oriented: The peer must provide Recovery-Oriented care recognizing that each person must be the agent of and the central participant in their own recovery journey. All services and supports need to be organized to support the developmental stages of this process.Services should instill hope, be person-and family-centered,offer choice,elicit, and honor each person's potential for growth, build on a person's and family's strengths and interests, and attend to the overall quality of life, including health and wellness. These values can be the foundation for all services regardless of the service type. 10. Reporting Requirements: No later than the 10th of each month, the Network Provider must submit to the Managing Entity, the following monthly reports: A. Monthly Peer Support Employment Report -This report must be signed by the Peer Supervisor,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, Position Title(s) and Program Name for current vacancies d. Duration of current Peer Specialist vacancies, e. Name of the Peer Specialist f. Certification Status g. Role/Title h. Status(full-time vs. part-time) i. Program Name Exhibit AO Page 2 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 I I IVII"Ilallll"'g Wrid Solluflih "']oi"IIda Ii I]oii uda li:"e Il uaviloi4iI II Ne. :flI f IIh IIW:woid<,, Ilu.°uc') C/III?02 j. Number of persons served by each Peer Specialist, k. Maximum recommended caseload for the Peer, and I. Hours of Peer Supervision B. Monthly Peer Support Services Report — This report should be completed by the Peer Specialist and signed by the Peer Supervisor. a. Peer-to-Peer Contact b. Groups c. Treatment Team Staffing's d. Outside Agency Staffing's e. Trainings f. Outreach g. Trainings taken C. The Network Provider shall submit any ad-hoc reports requested by the ME. D. 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. 11. Peer/ROSC Champion: By 08/02/2021, the Network Provider must submit the name and contact information of at least two Integrated Peer/ROSC Champions who will attend trainings and meetings. The information must be submitted to the individuals and by the dates listed in Exhibit C, Required Reports. The identified Champions must be a Peer Specialist who is providing peer services. 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. a. Responsibilities of champion: i. Attendance at scheduled Peer/ROSC meetings including ROSC Steering Committee Workgroup meetings and peer or peer supervisor meetings conducted by the ME to continue the development and implementation of a recovery-oriented system of care, ii. Participation in all ROSC related activities to ensure staff and agency become knowledgeable of a Recovery-Oriented System of Care. iii. Participation in all Peer related activities to ensure staff and agency become knowledgeable of the role/supervision of peer supports. 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. I. MANAGING ENTITY RESPONSIBILITES Exhibit AO Page 3 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III ti' irig IdSoiufl 1I „Ioi Id4;'.4 (;CoInti acAIrig w,SccruH11 Ii IIoii ud a i[:IieII,iavtoi III II Nd.4lllh II IIO: rolr llk, Ilriic) 7/1/2021 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 4 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffi II""II Ming Wind,"°^so ll„ l hi I oii II d a (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ilu°°ic) 7/112(),21 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. ME225-12-27 ffiII""II Alin Wind,"°^soli„ lhi I oii Ilea (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ilu°°ic) 7/1120,21 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 orjob-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 I 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. ME225-12-27 ffi ll""II Ming Wind rr"°sC'Il.l hi I oii II d a (Coll itiasfllrig a Soil�Illm Il:l]oii uda Ii:1c.hIavlk)1141 II h,,aftI'I II d:Awoilll", Ilu°°ic) 7/1/20;,;21 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. ME225-12-27 ffiII""IIIIIIII IIIind rr"oIiuthi IlIoii Ilea (Coll itiasfllriga Soil�fllm II IIoIii da li;1ehllavlk)—A Iih,,aIftI'I Il d:Awolil ", Ilu°°ic-) 7/112 0;,;21 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. ME225-12-27 ihII""IIIIIIII IIIind rr"oIiuthi IlIoii Ilea (Coll itiasfllrig a Soil�Illm Il:l]oii uda Ii:1c.hIavlk)1141 II NuaftI II II d:Awoilll", Ilu°°ic) 7/1/20;,;21 (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. ME225-12-27 ffi ll""II Ming Wind rr"°sC'Il.l hi I oii II d a (Coll itiasfllriga Soil�fllm II IIoIii da Ii:1c.hIavlk)1141 Iih,,aIftI'I Il d:Awolil ", Ilu°°ic) 7/112 0;,;21 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) Caseload. 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. ME225-12-27 ffill Ming IIIInd rr"°soiu l""II I oii Ilea (Coll iti a sflrig a Soil�lllI Il:lloii uda li:lehllavlk)11141 Ii h,,aIftl'I 111u:Awolil ", Ilu°ic: ) 711120�1°1 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 2021-2030, (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 Pagel of 5 Guidance/Care Center,Inc. Contract No. ME225-12-27 LIh111aliIng 1174 rid SoiiuI Ii:]oii u(ia (Coll 1til ac irig as Soiu llm II oil uda 11:1c1haalk)11 11 Ii k"a1ftw'I 111o1:wol1l", Il11,11) 711120�11 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 forjail 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.The Network Provider must screen all individuals presenting at the CRF. Those individuals with positive screenings must result in a full biopsychosocial assessment to be completed at the CRF to generate referral and linkage to the appropriate level of care. Exhibit AS Page 2 of 5 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffiII""II Alin Wind,"°^soli„ lhi I oii Ilea (Coll itiasflritp a Soil�111m Il:l]oii uda li:lehllavlk)11141 1i 1ua1ft1'I 111u:Awolil ", Ilu°ic: ) 711120�21 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 • Medical needs • Current medications • Current substance use, and • Risk of harm to self and others 5. Mobile Response Team: The Network Provider must provide all individuals with information on how to access Mobile Response Team services. 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 Exhibit AS Page 3 of 5 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffi ll""II Ming Wind rr"°sC'Il.l hi I oii II d a (Coll itiasfllrig a Soil�illm Il:l]oii uda li:1ehllavlk)11: 1 Ii h,,aIftI'I Il u:Awolil ", Ulric:) 711120,21 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. 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 4111 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. Exhibit AS Page 4 of 5 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffi II""II Ming Wind,"°^so 11„.l hi I oii II d a (Coll iti a sflrig a' Soil�lllI Il:l]oii uda li;1e'hllavlk)11 1 1i h"aIftl'I 111u:Awr:olil ", Ulric:) 711120�21 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. 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 301h 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. ME225-12-27 l mii iMing 11Wind Soil.uI h Ii:]oiii id (Coil Iil ac fliri 7 "7o u111m II oiii uda Ii:3,cchavlic:)i4i1 Ii h,,r 111 h Ilydol:oaoi1k, Ilricr.) 7111,20 21 EXHIBIT AV TRANSITIONAL VOUCHER PROGRAM DISCUSSION: The purpose of this document is to provide guidance for the implementation and management of the Transitional Voucher project. This project provides care coordination and vouchers to purchase treatment and support services for adults transitioning from Florida Assertive Community Treatment(FACT)teams,acute crisis services,and institutional settings to independent community living; and individuals experiencing homelessness, at risk for homelessness, or receiving care coordination services.Vouchers may also be utilized to assist eligible individuals maintain their current level of care by achieving residential stability. I. GOALS 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. The project aims to: • Prevent recurrent hospitalization and incarceration, • Provide safe, affordable, and stable housing opportunities, • Maximize use of FACT resources and community supports, • Increase participant choice and self-determination in their treatment and support service selection; and • Improve community involvement and overall quality of life for program participants. Transitional Vouchers provide a participant with a monthly budget to be spent on allowable services pursuant to Rule 65E-14.021, F.A.C.This service is intended to support Care Coordination efforts outlined in Guidance 4—Care Coordination. To access the Department's FY 21-22 Guidance Document 4,click on the link below: ht.lps:�Iwww.rrlyflfar�rilies.coirllservice frrograrrls�samh�manacting cntil:ies�index.shtml Note: Click on FY21-22 ME Templates and click on Guidance Document 4, Care Coordination "Voucher" refers to any electronic or paper record documenting a Network Service Provider's agreement to pay a third party for allowable services provided to an eligible program participant. This project offers time-limited financial assistance to support consumer-driven services based on the person's needs assessment and care plan objectives. The use of vouchers requires shared decision making in planning and service determinations, emphasizing self- management. Care Coordinators provide options and choices such that the care plan reflects the individual's values and preferences. This project has two funding and implementation components. The first component targets FACT participants and individuals discharging from a state mental health treatment facility (SMHTF) back to Exhibit AV Page 1 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 lmii uouing Il Wind Soil.uIh Ii:]oiii id (CoiItilac fliri.p So u111m II oii uda Ii;3,cchavlic:)i4i1 Ii h,,� 111h Ilydol:oaoi1k, Ilu°ic) 7111,20,21 their regions; the second targets additional individuals in need of specialized community integration supports. II. FACT AND SMHTF TARGETS This component satisfies the terms of a settlement agreement entered into by the Department and Disability Rights Florida and amended on July 27, 2018.' The settlement agreement requires the Department to develop a project designed to more fully utilize existing FACT resources and create additional opportunities for community integration of individuals being discharged from SMHTFs.This component is intended to transition approximately 96 FACT participants each fiscal year to less intensive community-based services and supports, allowing persons referred from SMHTFs to fill the vacated slots, if appropriate. Other allowable options for individuals discharging from SMHTFs using Transitional Voucher funds are to adult family care homes with community-based services and directly into permanent supported housing with community-based services. Managing Entities and Network Service Providers shall select FACT participants determined to be clinically and functionally ready for lower levels of care ready to transition out of FACT services. Considerations for transition readiness include, at a minimum, the individual's choice, their ability to self-manage,and the availability of a natural support system.Transition is gradual, individualized and actively involves the participant and the next provider to ensure effective coordination and engagement. Each Network Service Provider FACT team shall accept individuals referred for discharge from SMHTFs to replace individuals selected to receive Transitional Voucher services. III. COMMUNITY INTEGRATION TARGETS Research indicates that a combination of long-term housing,treatment,and recovery support services leads to improved residential stability and reductions in substance use and psychiatric symptoms'. The Transitional Voucher project is intended to assist eligible individuals obtain and maintain accessible,affordable housing with supportive recovery services. Each Managing Entity shall approve individuals who meet Transitional Voucher eligibility requirements. Persons eligible for services under this component must be currently receiving Department-funded SAMH services pursuant to Chapters 394 and 397, F.S., and must meet one the following alternative characteristics: A. Experiencing homelessness, meaning an individual who lacks housing, including: 1. An individual whose primary overnight residence is a temporary accommodation provided by a supervised public or private facility,or 2. An individual who resides in transitional housing, or 3. An individual at risk for homelessness; for example: an individual whose only housing option is shelter due to lack of affordable housing opportunities. T.W.,P.M.and Disability Rights Florida v.Michael Carroll,Department of Children and Families(Case No.4:13-CV-457 RFUCAS)Settlement Agreement,Amended July 27,2018 2 Substance Abuse and Mental Health Services Administration,Leading Change:A Plan for SAMHSA's Roles and Actions 2011-2014.HHS Publication No.(SMA)11-4629.Rockville,MD:Substance Abuse and Mental Health Services Administration,2011. Exhibit AV Page 2 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffill""II Alin Wind rr"°sC'Il.lhi IIIoII Ilea (Coll itiasfllrig a Soil�illm Il:l]oii uda Ii:1c.hIavlk)11r 1 II h,,aftl'I II d:Awoilll", Illricr ) 7/I/r0;,;21 4. Vouchers may also be utilized to assist eligible individuals maintain their current level of care by achieving residential stability. Or B. Receiving Care Coordination services pursuant to Guidance 4. Or C. Participating in FACT teams and ready to transition to a lower level of care. Or D. Discharging from SMHTFs to adult family care homes or directly into permanent supported housing with community-based services. IV. 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:husin,g ?sfbhn.or U. All supports and 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. Exhibit AV Page 3 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III tf I I g Wind d S o Ii,.A t II i, o I id a 4,;Colifluacflirig � "�aviu llm Il oiii uda If: eh.wk:)i4il II h,,�flth IIWtwr:ui1k, Uric 7111,2021 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. V. 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. Each month requires new voucher request and ME approval, 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.: 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. Exhibit AV Page 4 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 lmii uouing Il nd Soil.uIh Ii:]oiii id (Coil Itil ac fliri g So u111m II oiii uda Ii:3,cchavlic:)i4i1 Ii h,,� 111 h II otwoi1k, Ilu°ic ) 7111,20 21 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. VI. 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. C. Establish accurate record keeping that reflects specific services offered to and provided for each participant. D. Approve Transitional Voucher invoices and expenditures for services provided by non-Network Service Providers. E. The Care Coordinator or Case Manager must maintain in the individuals' file a record of all individual expenses charged against the funds. F. 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. G. All Transitional Vouchers must be coded with the appropriate modifier: a) For Substance Abuse use modifier: DS b) For Mental Health use modifier: DM H. All invoices and supporting documentation must be submitted to the ME by the 8th 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 Exhibit AV Page 5 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffi II""II Ming Wind rr"°sC'Il.l hi I oii II d a (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ilu°ic: ) 7/1120,21 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, VII. 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 reasons) for denial. Should the ME Housing 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 Network Provider shall adhere to the requirements identified in the Department's Transitional Voucher Guidance Document 29, dated 7/1/2021 or the latest revision thereof, To access the Department's FY 21-21 Guidance Document 29, click on the link below: hl;l, ndex.shl:ml Note: Click on FY21-22 ME Templates and click on Guidance Document 29, Transitional Voucher Exhibit AV Page 6 of 6 Guidance/Care Center,Inc. Contract No. ME225-12-27 THRIVINCG MIND SOUTH FLORIDA exc a°.rN.atAod"real dnc r'd'1:cfl i d��pt6'r 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. ME225-12-27 THRIVING MIN O SOUTH FLORIDA exc a°.rr.atAod"real dnc r'd'1:cfl Onc'1 ti!saa DDStOIIC= US(, r')I-Cviclaurc` , 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. ME225-12-27 a� aad THRIVING MIND SOUTH FLORIDA A uwkvvork of "r r;iloi he,i'h aril subuturce it c pncmdo,s, 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. ME225-12-27 a� aad THRIVING MIND SOUTH FLORIDA A uwkvvork of "r r;iloi he,,k'h aril subuturce it c pncmdo,s, The assistance requested is for (please check one): ❑Housing Assistance ❑Childcare ❑Clothing ❑Transportation (Bus passes, bicycles, airfares) ❑Educational Services ❑Vocational Services ❑Medical Care(Medication,doctor visits) ❑Housing Subsidies (Utility bills,furniture, toiletries) ❑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 MSTRV Not approved by: Date: Reason not approved: Signature: Title: Appendix 2 of Exhibit AV Page 2 of 2 Guidance/Care Center,Inc. Contract No. ME225-12-27 l mii iV ii,g IIWind Soii.uI h Ii:]oiii id (Coil Iil ac fliri 7 u o ulllm II oii d,u Ii:tcchavlic:)i4i1 Ii h,,� Ill h IldobAtoil1k, IIu°ic) 111,201211 EXHIBIT AX CRISIS STABILIZATION UNIT("CSU") LONG-ACTING INJECTABLE TREND REPORT On a quarterly basis by the dates and to the individuals identified in the Exhibit C, Required Reports, the Network Provider shall submit a report for those consumers who are admitted into a CSU facility for treatment that captures long-acting injectable utilization upon discharge from the CSU. An important variable in this analysis is establishing the number/percentage of consumers who receive anti-psychotic drugs upon discharge and of those that do receive such medication,the number/percentage that receive a long-acting injectable. The elements to be reported to the ME are the following: 1. #of CSU admissions for the quarter 2. #of CSU discharges for the quarter 3, #/%of CSU discharges during that period that were prescribed an antipsychotic medication for use after discharge: # / % 4, #/%of CSU discharges during that period who were prescribed an antipsychotic medication as above and received the antipsychotic as a long-acting anti-psychotic injectable: # / % Exhibit AX Page 1 of 1 Guidance/Care Center,Inc. Contract No.ME225-12-27 Phil II SM II Zing II Irid I,'RL iufl 1I oii IIda Contl actJ11 ug as Souflh Ii 011 id Il:,3 IlwMioiir6i II Neau flh IIldl .utwoiirk, inc.)Il 711/2021 Exhibit AY Mobile Response Team(MRT)for Monroe County Purpose: To ensure the implementation and administration of Mobile Response Team(MRT)services and adherence to the service delivery and reporting requirements herein. Best practice considerations and resources are provided to support continuous improvement of the MRT program; however,these are not contractually required. A. Authority The Marjory Stoneman Douglas High School Public Safety Act, Ch. 2018-3, Laws of Florida, created a statewide network of MRTs. The Florida Legislature appropriated recurring funds to ensure reasonable access to MRT services in all Florida counties. In 2020, House Bill 945 amended s. 394.495, F.S.,to include MRTs in the child and adolescent array of services and outlined programmatic requirements included herein. B. Program Goals The goals of MRTs are to lessen trauma;conduct an independent assessment to determine if the individual may be safely diverted from emergency departments; prevent unnecessary psychiatric hospitalization; or divert from juvenile justice or criminal justice settings. MRTs are intended to provide on-demand crisis intervention services in any setting in which a behavioral health crisis occurs, including, but not limited to, homes, schools, the community, and emergency departments. Mobile response services must be available 24 hours a day, 7 days a week. Services are provided by a team of licensed professionals, master's level professionals, and paraprofessionals trained in crisis intervention skills. In addition to helping resolve the crisis, MRTs work with individuals and families to identify resources, provide linkages, and develop strategies for effectively dealing with potential future crises. Intervention is warranted when a crisis interferes with the ability to function and places the individual at risk of self-harm, harm to others, or disruption of services or living environment. The individual may present with an overt change in functioning or have difficulty coping with traumatic life events. Mobile Response Teams may coordinate in-person services with law enforcement to provide additional safety, when appropriate and necessary. Supporting the "no wrong door" model, MRTs provide warm hand-offs and referrals to other services in the community to meet the ongoing needs of the individual and will follow-up to determine that the appropriate linkage is made. When the situation warrants, MRTs will assist with the individual being received by a designated receiving facility or a licensed substance abuse provider for further evaluation. Peer support services can be an effective way to connect individuals and families experiencing behavioral health crises with resources,ensure they engage in services,and assist them navigate the system. It is not required that the MRT have an individual team member who is either credentialed as a Certified Recovery Peer Specialist or working toward credentialing, however it is encouraged. MRTs must be designed to address a wide variety of interventions, including: • Based on a clinical assessment, determine the need for further examination at a Designated Receiving Facility or licensed substance use provider; • Assess the individual for risk of suicidal and homicidal thoughts or behaviors; Exhibit AY Page 1 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III 11 111ng Wrid;".0 llflih ""]oi Ilda,'JI QContilac[frig as/(AAllh Ii 011 uda Ii:Jellravliu:14i II Nea flh II"Jetwo�i1k, Uric.) 7/1/02II • Assess the individual for mood disturbances such as depression, anxiety, delusional thoughts, or hallucinations that may contribute to and exacerbate the crisis; and, • Identify family or peer conflicts and other disruptive behaviors that are or may contribute to escalating the crisis. C. Eligibility MRTs provide immediate, onsite behavioral health crisis services at minimum to individuals who are 25 and younger who: 1. Have an emotional disturbance; or 2. Are experiencing a mental health or emotional crisis; or 3. Are experiencing escalating emotional or behavioral health reactions and symptoms that impact their ability to function typically within the family, living situation,or community environment; or, 4. Are served by the child welfare system and are experiencing or at high risk of placement instability. D. Managing Entity Responsibilities The Managing Entity shall: 1. Ensure statewide access to MRT services 24 hours a day, 7 days a week. 2. Collaborate with local law enforcement agencies and public schools, colleges and universities in the planning, development, evaluation, and selection processes for Network Service Provider subcontracts for MRTs; 3. Post contact information for all MRTs on the start page of the Managing Entity's public website; 4. Collaborate with local and county governments to ensure the process to access MRT services is addressed in county transportation plans and Behavioral Health Receiving System plans; 5. Monitor MRT Network Service Provider data quality, response process, customer satisfaction, community collaboration, and warm hand-offs to community service providers; 6. Notify the Department of changes to MRT providers, including the number of teams per provider or updates to MRT contact information; 7. Submit Reporting Template 28 Mobile Response Team Monthly Report to the Department no later than the 18th of the month following services; and 8. Include requirements in subcontracts with Network Service Providers providing MRT services to: a. Adhere to the criteria in Sections C, E, F and G herein, b. Participate in all MRT program conference calls, meetings, or other oversight events scheduled by the Department. c. Make Mobile Response Team services available 24 hours per day, 7 days a week statewide. d. Establish response protocols with local law enforcement agencies, local community-based care lead agencies, child protective investigators, the Department of Juvenile Justice, and local schools, including public K-12 schools,colleges, and universities. e. Have access to a licensed mental health professional, f. Have access to a board-certified or board-eligible psychiatrist or psychiatric nurse practitioner. Exhibit AY Page 2 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III ing 'III I id Soluflih ,:]Ol Ida,' (u:onii a([ou ig as souflh Ii Ilu 11 id li:tehzMoi 6i II Near iIII Ii'd(Awaulidik, inc.)II 7,n/0 1 g. Provide an array of crisis response services to eligible persons and their families, designed to address individual and family needs, including screening, standardized assessments, crisis de- escalation, safety planning, and linkage to community services as necessary to address the immediate crisis event and ongoing behavioral health needs. Screenings and assessments shall be completed for the presence of an emotional disturbance, serious emotional disturbance, substance use, or mental illness including depression and risk for suicide. h. Adhere to standards for informed consent and confidentiality compliance, pursuant to but not limited to 394,459(3), F.S., 394.4784, F.S., 394.495, F.S. and relevant state laws and federal regulations. i. Establish formal Memorandum of Understanding or agreements with the local school district(s) that identify roles and responsibilities of schools and MRTwhen responding to schools to provide services. This agreement must include requirements for obtaining parental consent when the MRT responds to children 13 or younger or with unlicensed mental health professionals. j. Require the MRT Provider to establish response protocols with local law enforcement agencies, local community-based care lead agencies, the child welfare system, and the Department of Juvenile Justice. k. Establish formal and informal partnerships with key entities providing behavioral health services and supports to eligible persons and their families to facilitate warm hand-offs for continuity of care. I. Coordinate with the Community-Based Care (CBC) Lead Agency in the Network Provider's area to provide MRT services to children served by the child welfare system who are experiencing a behavioral health crisis. E. MRT Network Provider Responsibilities The Network Provider must adhere to the following: 1. Adhere to the criteria in Sections C, E, F and G herein. 2. Participate in all MRT program conference calls, meetings, or other oversight events scheduled by the Department. 3. Make Mobile Response Team services available 24 hours per day, 7 days a week statewide. 4. Establish response protocols with local law enforcement agencies, local community-based care lead agencies, child protective investigators, the Department of Juvenile Justice, and local schools, including public K-12 schools, colleges, and universities, 5. Have access to a licensed mental health professional. 6. Have access to a board-certified or board-eligible psychiatrist or psychiatric nurse practitioner. 7. Provide an array of crisis response services to eligible persons and their families,designed to address individual and family needs, including screening, standardized assessments, crisis de-escalation, safety planning, and linkage to community services as necessary to address the immediate crisis event and ongoing behavioral health needs. Screenings and assessments shall be completed for the presence of an emotional disturbance, serious emotional disturbance, substance use, or mental illness including depression and risk for suicide. 8. The Mobile Response Teams telephone number must be displayed the number to their MRT on the start page of its public-facing website. Exhibit AY Page 3 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III11 Ming IIIIrid SG luflih ""]011 Ilda,'JI (Conti a([ou ig as souflh Ii:1011 id li:tehrMoi 6i II Ne aIIflh Ii'd(Awa ilk, inc.)II 7,n/0 1 9. Ensure that the local 2-1-1 provider(s),Jewish Community Services, has information on the MRT and how to refer individuals in need. 10. Triage new requests to determine the level of severity and prioritize new requests that meet the clinical threshold for an in-person response. 11. Ensure there is a process in place for informed consent and confidentiality compliance measures. 12. Provide in-person response to calls meeting the clinical threshold within 60 minutes after prioritization. In-person responses may be provided face-to-face or via telehealth. If requested,face- to-face responses must be provided. Respond in the location where the crisis is occurring when requested and determined safe. 13. Establish formal Memorandum of Understanding or agreements with the local school district(s), and charter schools or alternative schools that identify roles and responsibilities of schools and MRT when responding to schools to provide services. This agreement must include the following elements: 1) List school district(s), for the purpose of this contract the school district is Monroe County Public Schools, 2) If the Network Provider enters into agreements with charter schools and alternative schools, list the name of school(s), 3) Process for obtaining parental consent when the MRT responds to children 13 or younger or with unlicensed mental health professionals. 4) Process that addresses a timely and effective response to Monroe County Public Schools who are initiating a Baker Act with a student. 5) If the Network Provider enters into agreements with charter schools and/or alternative schools, a process that addresses timely and effective response to the charter school and alternative schools who are initiating a Baker Act with a student. a list the name of school(s). 14. Establish response protocols with local law enforcement agencies, local community-based care lead agencies, the child welfare system,and the Department of Juvenile Justice. 15. Establish formal and informal partnerships with key entities providing behavioral health services and supports to eligible persons and their families to facilitate warm hand-offs for continuity of care. 16. Provide behavioral health crisis-oriented services that are responsive to the needs of the child, adolescent, or young adult and his or her family. 17. Utilize evidence-based practices to deescalate and respond to behavioral health challenges and to reduce the potential for future crises. When evidence-based practices are not available, the MRT shall use approaches based on clinical judgement and within the scope of their practice. 18. Provide a warm handoff to referred services and brief care coordination by facilitating the transition to ongoing services for up to 72 hours. Warm handoff means that the MRT provider actively connects the individual to another service provider. 19. Coordinate with the CBCs to provide information about the MRT services to foster parents. 20. Report to the Managing Entity on the performance outputs in Section G. and the number of individuals who did not require an involuntary examination that were actively linked to the appropriate level of care with a community provider for ongoing behavioral health services. 21. Promote information sharing and the use of innovative technology. Exhibit AY Page 4 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I I II II IIIng Wrid;;:uoll flih "'Ioi Ilda,'JI (;Contilac[Jrig as/(AAllh li 011 uda li:tellravliu:14i II Nea flh II"Jetwo�rlk, Uric.) 7/1/02II F. MRT Service Components: The Network Provider's Mobile response services encompass an array of crisis interventions including: 1. Evaluation and assessment, 2. Development of safety or crisis plans, 3. Providing or facilitating stabilization services, 4. Supportive crisis counseling, 5. Education, 6. Development of coping skills, 7. Linkage to appropriate resources,and 8. Connecting individuals who need more intensive mental health and substance use services to the needed level of care, 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 assessments, follow- up consultation, and initial triage to determine if an in-person response is needed to individuals via video-teleconferencing systems, phones,and remote monitoring. MRT staff who are not actively responding to calls,either face-to-face or through telehealth must not have other duties and responsibilities within the Network Provider. An MRT's ability to successfully divert inpatient admissions depends on service availability.Staff who are not actively responding or providing follow-up services should be conducting outreach to community partners,key stakeholders,and the general public to educate the public on the availability of and how to access services. G. Performance Outputs The Network Provider shall meet the following targets for MRT services: 1. Average response time within 60 minutes. 2. A minimum of seven (7) formal outreach activities conducted annually. This may include activities such as presenting at School Board meetings, community health fairs, and community partner meetings. Targets for outreach activities may include detoxification programs, emergency departments, schools and colleges, community behavioral health providers, law enforcement and other first responders, child protective investigators, dependency case managers, parents, family and youth run organizations, Department of Juvenile Justice, group homes, foster care organizations, 2-1-1 and other social service type call centers, as well as community leaders such as county commissions and city government. 3. At a minimum, the MRT shall serve 180 unduplicated persons through June 301h. "Served" means the MRT has responded to an acute care crisis and engaged with the individual and, if applicable, their family and caregivers. Exhibit AY Page 5 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III 11 111ng Wrid SoII flip °"]oi Ilda,'JI QContilac[Jrig as/(AAllh Ii 011 uda Ii:,Jehavliu:i4i II Nea flh II"Jetwo�rlk, Uric.) 7/1/02II H. Service Data Service Data: Service Data must be submitted monthly by the 4th 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 14.0, or the latest revised edition thereof. I. Reporting Requirements 1. Monthly MRT Tracker: The Network Provider must submit MRT Monthly Tracker using template provided by the ME by the 101h 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)as described in Section G.,2.,Performance Outputs above.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. MRT Policies and Procedures: By October 1, 2021, the Network Provider must submit its MRT policies and procedures , At a minimum, the policies and procedures must address the following elements: a) Staffing; b) Service Array, including transition of services; c) Triage process; d) Response times; e) Informed Consent; f) Confidentiality; g) Information Sharing; h) Use of innovative technology(telehealth); i) Identification and referral process for children, adolescents, or young adults, including those who are high utilizers(defined in Exhibit AC, Care Coordination) and their families to the Care Coordination Team located at Community Health of South Florida ; j) Identification and referral process for adults, including referrals for high utilizers (defined in Exhibit AC, Care Coordination) to care coordination services; k) Outreach efforts plan, 4. Memorandum of Understanding or Agreements: 1) By October 1,2021,the Network Provider must submit a formal agreement or formalized plan with the Monroe County Public Schools that identify roles and responsibilities of schools and MRT when responding to schools to provide services. This agreement must include requirements for obtaining parental consent when the MRT responds to children 13 or younger or with unlicensed mental health professionals. Exhibit AY Page 6 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I I111 vllling lurid rr7ouflh "']oi"IIda (Gt.)11l1[11 a"flling as" (AAh i 0111da i:36iia kiu i i i Near flh "detwo ilk, lr°ic) 1/1/2021 2) By December 31,2021, the Network Provider must establish response protocols with the following stakeholders: a) Monroe County Sheriff's Office; b) Key West Police Departments; c) Department of Juvenile Justice d) Southern Region Community-Based Care Lead Agency that addresses situations where youth are served by the child welfare system and are experiencing or are at high risk of placement instability. e) Colleges and Universities 5. 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. J. 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 and/or Department staff at regularly scheduled or specially called meetings,calls, trainings,or other oversight events when scheduled by the ME and/or the Department. K. Best Practice Considerations and Guiding Principles: The System of Care values and principles are the foundation of MRTs. The core values include: • Strength-based — move the focus from the deficits of the individual and family to focusing on their strengths and resources related to the goal of recovery. This includes viewing the individual and family as resourceful and resilient. • Family-driven and youth-guided—recognize that families have the primary decision-making role in the care of their children. The individual's and family's preferences should guide care. • Community based with an optimal service array—provide services in the least restrictive setting possible, ideally in the community. Individuals should be able to obtain any behavioral health service they need in their home community. Peer support is an important component of services. • Trauma sensitive—respond to the impact of trauma, emphasizing physical, psychological, and emotional safety for both service providers and individuals; and create opportunities for individuals to rebuild a sense of control and empowerment. • Culturally and linguistically competent—be respectful of, and responsive to,the health, beliefs, practices, and cultural and linguistic needs of diverse individuals. "Culture" is a term that goes beyond race and ethnicity to include characteristics such as age, gender, sexual orientation, disability, religion, income level, education, geographical location. Cultural competence applies to organizations as well as individuals. Cultural Competence is a set of behaviors,attitudes, and Exhibit AY Page 7 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III 11 111ng Wrid SoII flip ""]oi Ilda,'JI QContilac[frig as/(AAllh If 011 uda li:,Jehavliu:i4i II Nea flh II"Jetwo�irk,, Uric.) 7/1/02II policies that come together in a system to work effectively in multicultural situations. Linguistic competence is the ability to communicate effectively in a way that can be easily understood by diverse audiences. • Coordinated — provide care coordination for individuals with serious behavioral health conditions with an emphasis on individualized services across providers and systems. At the system level, leverage resources by analyzing funding gaps, assessing the use of existing resources from all funding streams,and identifying strategies to close the funding gaps, including the options of blending and braiding of funding sources. • Outcome-focused — ensure that programmatic outcome data is accessible to mangers, stakeholders, and decision makers, and that the data is meaningful and useful to those individuals. Collect feedback from each individual and family regarding the service delivery to improve outcomes of care that inform, individualize,and improve provider service delivery. Research suggests that best practice is to provide continued crisis intervention and care coordination services as indicated for up to 72 hours. In addition to helping resolve the crisis, teams work with the individual and their families to identify and develop strategies for effectively dealing with potential future crises. MRTs facilitate "warm handoffs" to community services, and other supports. Facilitating a warm handoff means actively connecting an individual to another service provider. This process goes beyond simply providing a referral name, phone number, and appointment time. Particularly for individuals in crisis, it has been shown that a referral alone is not adequate. Warm handoffs are a transfer of care between two providers in the presence of the individual and their family. This can involve an introduction to the new service provider during a short meeting with the crisis counselor. It is important to explain the process the individual should follow, what to expect during their first appointment, and allow them to ask questions. For additional information and resources to implement or improve the use of warm handoffs, the Agency for Healthcare Research & Quality provide resources for clinicians,staff, and a Quick Start Guide'. 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 access to further evaluation at 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. In 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) published the National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit, This toolkit identifies minimum expectations and best practices for mobile crisis teams that are funded with Block Grant https://www.ahrq.qov/professionals/gual itypatient-safet\//Patient-family_ engagement/pfeprimarycare/interventions/warmhandoff.html. Exhibit AY Page 8 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III 11 111ng Wrid SoII flip °"]oii Ilda,'JI (Contil ac[Jii ig as/(AAllh Ii 011 uda li:tellr avlio11 i II Nea flh II"Jetwo�u lk, Uric.) 7/1/02 II Crisis Set-Aside funding. SAMHSA identifies the mobile response teams to respond in two person teams for safety reasons. The minimum expectations are: 1. Include a licensed and/or credentialed clinician capable to assessing the needs of individuals; 2. Respond where the person is and not restrict services to select locations within the region or particular days/times; and 3. Connect individuals to facility-based care as needed through warm hand-offs and coordinating transportation. The best practices include: 1. Incorporate peers within the mobile crisis team; 2. Respond without law enforcement accompaniment unless special circumstances warrant inclusion in order to support truejustice system diversion; 3. Implement real-time GPS technology in partnership with the region's crisis call center hub to support efficient connection to needed resources and tracking of engagement; and 4. Schedule outpatient follow-up appointments in a manner synonymous with a warm hand-off in order to support connection to ongoing care, The toolkit is available at: htti)s://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care- 02242020.pdf. Below are some exemplary models of MRTs developed in other states. State of New Jersey The Mobile Response and Stabilization Services(MRSS)System delivers mobile response services to children/youth/young adults experiencing escalating emotional and/or behavioral reactions and symptoms that impact the youth's ability to function typically(at baseline)within their family, living situation,school and/or community environments. Mobile response services are available 24 hours per day, 7 days a week, year-round, are delivered by MRSS staff and include both initial (within 1 hour) face-to-face intervention wherever the youth's need presents, and follow-up interventions, services and coordination for up to 72 hours subsequent to the initial intervention. If at the end of initial mobile response services, a youth continues to exhibit patterns of behavioral and emotional needs that require continued intervention and coordination to maintain typical functioning and prevent continued crisis reaction,a child/youth may be transitioned to Mobile Response Stabilization Management Services that can continue to serve the individual for up to eight weeks. More information may be found at: https://www.n'.qov/dcf/families/csc/mobile/. State of Massachusetts In Massachusetts, Mobile Crisis Intervention (MCI) is provided to youth (under the age of 21) by all emergency service program (ESP) providers. MCI provides a short-term service that is a mobile, on- Exhibit AY Page 9 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III 11 111ng Wrid SoII flip °"]oi Ilda,'JI (Contilac[frig as/(AAllh If 011 uda Ii:,Jehavliu:i4i II Nea flh II'Je wo�i1k, Uric.) 7/1/02II site, face-to-face therapeutic response to a youth experiencing a behavioral health crisis for the purpose of identifying, assessing, treating and stabilizing the situation and reducing immediate risk of danger to the youth or others consistent with the youth's risk management/safety plan, where one exists. This service is provided 24 hours a day, 7 days a week and includes: A crisis assessment; engagement in a crisis planning process that may result in the development/update of one or more crisis planning tools(e.g„Safety Plan;Advance Communication to Treatment Providers;Supplements to Advance Communication and Safety Plan, Companion Guide for Providers on the Crisis Planning Tools for Families) that contain information relevant to and chosen by the youth and family; up to 7 days of crisis intervention and stabilization services including on-site face-to-face therapeutic response, psychiatric consultation and urgent psychopharmacology intervention, as needed; and referrals and linkages to all medically necessary behavioral health services and supports, including access to appropriate services along the behavioral health continuum of care. More information may be found at: https://www.mass.gov/files/documents/2016/07/oi/l)s-mobile-crisis- intervention.pdf. Milwaukee County,Wisconsin Milwaukee County in Wisconsin has a nationally respected and effective crisis response model for children in their region. The program is called the Mobile Urgent Treatment Team (MUTT) and its primary focus is to keep children at home with families and out of hospitals. MUTT provides MRSS services for children and adolescents (up to age 18) and addresses a family's immediate concerns about their child by phone or by responding to them in the community or in their home. Services are available 24 hours a day, seven days a week. Once called, the MUTT team immediately travels to the location where a crisis may be occurring. The team assesses the situation, including the potential for danger that the child poses to himself or others. Based on the assessment, the team weighs intervention options, including keeping the child home (with adequate support services), temporary placement in a crisis group home or other emergency setting, or hospitalization in a psychiatric facility. The team can provide short-term case management services as necessary and frequently acts as a liaison between the family and available community services. For more information, please visit: https://county.milwaukee.gov/EN/DHHS/BHD/Childrens-Services. King County,Washington The Children's Crisis Outreach Response System (CCORS) in King County, Washington provides crisis outreach and stabilization services 24 hours a day, 7 days a week to all residents of King County regardless of income. Specific services include mobile crisis outreach, which consists of specially trained teams available to respond in the child or youth's natural environment to de-escalate the situation. The team conducts mental health and suicide risk assessments and works with the family to implement ongoing services and supports to prevent future crises. CCORS also provides non- emergency outreach appointments, available within 24-48 hours for families who are not in immediate crisis but require timely support and linkages to services. Crisis stabilization services in the form of in-home support are available for up to 8 weeks following the initial acute crisis. Intensive crisis stabilization services (90-day in-home support) and crisis stabilization beds are also Exhibit AY Page 10 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 II II1iVing Wrid;;:uoll flih "']oiIlda,'JI QContilac[frig as/(AAllh Ii 011 uda Ii:,Jeravliu:i4i II Nea flh II"Jetwo�rlk, Uric.) 7/1/02II available to specialty populations. More information may be found at: https://www.kingcq ounty.gov/depts/community-human-services/mental-health-substance- abuse/services/Youth/CrisisOutreach.aspx, Maine Behavioral Health Care Crisis Team After police respond to a call involving ajuvenile, the officer completes a police juvenile reporting form and sends it to the Maine Behavioral Healthcare crisis team. A clinician then calls the family to arrange an assessment, provide resources and services and provide later follow-up to ensure the family has engaged in referred services. The reporting form captures critical information for tracking and accountability. In addition,parents ofjuveniles in crisis use the form as a tool to convey concerns and record problem behavior to mental health professionals. With parental consent, they use the information to inform the school system and help prepare an appropriate response to the child's needs. The result is a program that recognizesjuveniles at risk at the earliest possible stage,captures relevant and useful information, secures an appropriate referral network and tracks results for mutual accountability. The results of the program were decisive-86 percent of the families reported that only one response was needed to receive the appropriate resources. More information may be found at: https://maineheaIth.org/services/behavioral-mental-health/mental-health-crisis-services. Central Ohio Brings together crisis intervention specialists, therapists, case managers and other staff members who pair up to visit teens and young adults in schools,jails, hospital emergency rooms and other places to connect them with mental health services. Initially contacted though the community crisis hotline, the flow with a 2-1-1 call that is triaged and sent to a helpline.Appropriate calls are sent to the behavioral health provider crisis staff who again triages and respond in-person with a secondary staff person,who may be a therapist or case manager. L. Additional Resources There are many resources available online related to mental health services. This is not meant to be an all-inclusive list, but rather a starting point for additional resources. The Substance Abuse and Mental Health Services Administration (SAMSHA) has a resource tool on screening for behavioral health risk in school, available at: https://www.samhsa.gov/sites/default/files/ready_set_go_review_mh_screening_in_schools_508, pdf The U.S. government has sponsored a Stop Bullying campaign with tips and information at: https://www.stopbullying.gov/ Zero Suicide is a commitment to suicide prevention in health and behavioral health care systems and is also a specific set of strategies and tools; a toolkit is available at: htti)://zerosuicide.edc.org/toolkit Exhibit AY Pagel 1 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 I III II IIII g 'w,alllllrid SoII flh ""]oi Ilda,'JI (;Contilac[Jrig as/(AAllh If::1011 uda 11:1ellravliu:14 II Near llh II"Jetwo�rlk, Uric.) 7/1/$02.II Department-sponsored webinars on mobile response services, provided at no cost to the provider by the Florida Certification Board, are accessible by creating a free account with the Florida Certification Board at: https://fIcertificationboard.org/education-training/continuing-education/ and searching for the title of the webinars below: • Introduction to Mobile Response Teams(2019) • Mobile Response Teams: Strengths-Based Crisis Planning (2019) • Mobile Response Teams: Crisis Assessment and Intervention (2019) • Building Partnerships with Local Resources for Crisis Response (2019) Exhibit AY Page 12 of 12 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing II II lid I,'RL iufl 1I Ioi IIda (Conti ac°:[ou urea as S()U 111 Ii]ou id I['Ie1,iavtoi III II Ne. :cll dllh Il etwoii 11<,, Ilriic:,) 71112021 EXHIBIT BD State Opioid Response Discretionary Grant Services (2) Medication Assisted Treatment Services for Opioid Use Disorders and Evidence Based Treatment to Address Stimulant Misuse and Use Disorders A. OVERVIEW The Network Provider is contracted to provide Medication-assisted treatment (MAT) services for the treatment of opioid use disorder and/or evidence-based treatment to address stimulant misuse and opioid use disorder associated with the State Opioid Response (SOR) Grant awarded by the Substance Abuse and Mental Health Services Administration. This document incorporates by reference all the requirements of the Florida's State Opioid Response(SOR)2 Grant Project Guidance on System Priorities, Permissible Uses, and Prohibited Uses updated 11.11.20 and/or any revised subsequent version. 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. This program also supports evidence-based treatment to address stimulant misuse and use disorder, including for cocaine and methamphetamines. 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/SERVICE ARRAY Indigent, uninsured, and underinsured individuals with opioid use disorders (or who are misusing opioids) who are or will be receiving methadone, buprenorphine, or naltrexone maintenance treatment, as well as individuals with stimulant use disorders (or who are misusing stimulants) can also have the following services paid for using SOR grant funds: • Aftercare • Assessment • Case Management • Crisis Support/Emergency • Day Care • Day Treatment • Incidental Expenses (excluding direct payments to individuals to enter into, or continue to participate in, prevention or treatment services) • Outreach(to identify and link individualswith opioid use disorders to medication-assisted treatment providers and to connect individuals with stimulant use disorders to treatment and recovery support services) • Intervention • Medical Services • Medication Assisted Treatment Exhibit BD Page 1 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing II II lid I,'RL iufl 1I Ioi IIda (Conti a([Jrig as S()UflIl If::]ou uda li['Ie1,iaviioi ll II Ne. :c flh 112etwoii 11<,, Uric) 71112021 • Outpatient • Information and Referral • In-Home and On-Site • Respite • Recovery Support • Supported Employment • Supportive Housing/Living • Residential I and 11-Individuals with opioid use disorders may only be served in Residential Levels I and 11 if they are inducted on methadone, buprenorphine, or naltrexone, unless the individual has declined medications after a thorough explanation of the benefits and risks of all three FDA-approved medications. The benefits explained must include clinical findings reported in SAMHSA's TIP 63 that "methadone, extended-release injectable naltrexone (XR-NTX), and buprenorphine were each found to be more effective in reducing illicit opioid use than no medication in randomized clinical trials, which are the _gold standard for demonstrating efficacy in clinical medicine. Methadone and buprenorphine treatment have also been associated with reduced risk of overdose death.'' This patient education and the patient declining medications must be documented in the medical record. All individuals in residential treatment must be reevaluated every 30 days to ensure they still meet level of care criteria. • Inpatient Detoxification and Outpatient Detoxification- Per the grant FOA, medical withdrawal (detoxification) is not the standard of care for opioid use disorders, is associated with a very high relapse rate, and significantly increases an individual's risk for opioid overdose and death if opioid use is resumed. Therefore, medical withdrawal (detoxification) when done in isolation is not an evidence-based practice for OUD, If medical withdrawal (detoxification) is performed on individuals with an opioid use disorder, it must be accompanied by injectable extended-release naltrexone (Vivitrol) to protect such individuals from opioid overdose when they relapse. 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, DATA COLLECTION Exhibit BD Page 2 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing Ur id I,'RL iufl 1I Ioi IIda (Conti a(:[ou ig as S()U 111 Ii]ou id a ['Ie1,iavtoi III II Ne. :clldllh Il et:woii 11<,, Ilriic:,) 71112021 FASAMS DATA: Providers must enter all individual served data into the ME's designated data system to capture services and activities rendered for all SOR individuals served. Specifically, providers must input the following data: • All individuals served must either have an opioid and/or stimulant use disorder or have an opioid or stimulant as their primary, secondary, or tertiary drug of choice, or both. Individuals served without an opioid or stimulant listed as a drug of choice do not qualify for SOR funding. • All services rendered. • All MAT modifiers (methadone, buprenorphine mono, buprenorphine combo, and injection or oral naltrexone). Note: All individuals with opioid use disorders receiving SOR funded services must have the MAT modifier attached to service events listed in the data system,even if the medication itself is not being provided by the same provider of the service being entered. • All other data requirements apply. GPRA DATA: The Government Performance and Results Modernization Act of 2010 (GPRA) is a federal mandate which requires all SAMHSA grantees to collect and report performance data using approved measurement tools. Providers of treatment and recovery support services(which are underlined in the Service Array section)will be required to collect data at five data collection points(baseline,6 months post-intake,discharge,3-months post-discharge,and 6-months post- discharge) using the CSAT GPRA. The target completion rate is 100%; meaning programs must attempt to follow-up with all individuals. However, SAMHSA expects the state to achieve a minimum 6-months post-intake follow-up rate of completion of 80%. Any interview that is not conducted via face-to-face or virtual interview, will not count towards compliance. Guidance for data collection is provided below. DATA ENTRY: Providers must enter all individual served data into the WITS system for all SOR individuals served. The WITS system feeds into SAMHSA's data entry system,SPARS to maintain timely reporting and accurate data to SAMHSA. Specifically, providers must input the following data: • All individuals served identified with having an opioid and/or stimulant use disorder (Note: All individuals served need to have an opioid/stimulant use disorder checked within the WITS system to qualify for funding. Checking unknown or don't know means the individual served does not qualify for SOR funding.) • Responses to all questions identified in the GPRA and Supplemental interviews. • All individuals served entered into FASAMS under OCA MSSM3 must be entered into WITS. • GPRA and GPRA Supplemental forms must be administered by program/clinical staff and questions must be asked as written with no deviation. The GPRA cannot be self- administered by the individual served. Due to social distancing restrictions regarding COVID-19,SAMHSA is allowing interviews to be conducted via virtual platforms. However, Exhibit BD Page 3 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing II II lid I,'RL iufl 1I Ioi IIda (u:on1i a(: ou urea as Sccruflll Ii:lloii id I['Ie1,iavtoi all II Ne. :cll dllh Il et:woii 11<, Ilriic:,) 71112021 once social distancing restrictions are lifted, and SAMHSA returns to conducting interviews via face-to-fact contact, updated guidance will be disseminated. • All individuals who receive SOR-funded covered services underlined in the Service Array section, must have completed GPRA and GPRA Supplemental forms for each of the 5 collection points. 0 6 months post-intake data should be collected on all individuals served, regardless of whether an individual drops out of the program prior to the 6 months.When a program cannot follow-up with an individual,the program must use the GPRA tool to report that the individual was not located. Furthermore, a individual served who is not located, does not count towards compliance. o A Discharge GPRA must be completed each time an individual is discharged/transferred from SOR funding. • All SOR 1 No Cost Extension (NCE) funds must be used before transferring individuals served over to SOR-II. Individuals served will have to be administratively discharged from SOR 1 before they can be transferred to SOR 2,and a new GPRA intake interview must be completed before individuals served can begin receiving SOR 2 funded services. • An administrative discharge out of SOR 1 program will be completed, not a discharge interview. The administrative discharge requires sections A,J & K of the GPRA form. The individual served will then be enrolled into the SOR II program,and a new intake interview for the individual served will be completed (only during their transition into SOR-II). Afterwards, the same requirements must be completed, GPRA and GPRA Supplemental forms,for each of the 5 collection points. • If a new individual served with an Opioid Use Disorder(OUD)enrolls into the SOR program funded with NICE, NCE funds must be used on the new individual served. If the individual served is discharged completely from the SOR program and will not be funded with SOR- II funds,then you will do a discharge interview. • If an individual is discharged from a treatment episode and the individual then returns to re-enroll in a new SOR-funded treatment episode, a new data collection timeline must be started. EX: An individual is discharged "Left on own against staff advice with satisfactory progress"at 4 months post intake with a baseline having been completed. Individual re- enrolls 2 months later.A new baseline MUST be completed and continued on a new data collection timeline (for 6 months post-intake, discharge, 3-months post-discharge,and 6- months post-discharge).With the previous GPRA timeline discontinued. • If an individual leaves SOR funding and is transferred within the same episode of care to another funding source they MUST complete a discharge at that time and GPRAs at subsequent data collection points. If the same individual returns(transferred back)within a certain time point to SOR funding they do not have to complete a new Baseline. Follow the guidance below for these situations: • If an individual is transferred to another funding source and is transferred back to SOR funding between 0-6 months post-intake they must continue the timeline and at 6 months post-baseline complete the 6 months post-baseline GPRA. • If an individual is transferred to another funding source between 0-6 months post-intake and is transferred back to SOR funding after 6 months post-intake they must start a new timeline with a Baseline tool, Exhibit BD Page 4 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing II Irid I,'RL iufl 1I Ioi IIda (u:onii a(:[ou ig as S()U 111 Ii]oii id I['Ie1,iavtoi all II Ne. :clldllh 1Net:wou°II<,, Ilriic:,) 71112021 EX: Individual served completes baseline, transferred to other funding source at 2 months post intake, completes discharge, transferred back at 7 months post intake, individual served must complete new baseline and start new timeline. 2. WINDOWS FOR GPRA ADMINISTRATION: • Intake/Baseline: o For residential facilities - GPRA intake/baseline interviews must be completed within 3 days after the individual enters the program. o For nonresidential programs - GPRA intake/baseline interviews must be completed within 4 days after the individual served enters the program. • Follow-up (post-intake and post-discharge): o The window period allowed for GPRA follow-up interviews is one month before the(3 or 6 month)anniversary date and up to two months after the(3 or 6 month) anniversary date. • Discharge: o Discharge interviews must be completed on the day of discharge, regardless of length of stay in the program(i.e. 1-day length of treatment still needs a discharge GPRA completed) o If an individual has not finished treatment,drops out,or is not present the day of discharge,the project will have 14 days after discharge to find the individual and conduct the in-person discharge interview. If the interview has not been conducted by day 15,conduct an administrative discharge. For an administrative discharge when the interview is not conducted, interviewers must complete the first four items in Section A (Individual served ID, Individual served Type, Contract/Grant ID, Interview Type), Section J (Discharge),and Section K(Services Received) and mark that the interview was not completed. REFUSALS: If individuals refuse to answer the GPRA questions,they cannot be denied treatment, but a GPRA still must be completed at each data collection point. • A"REFUSED" answer option is available for all individual served-based questions, please use these to complete the GPRA if an individual served refuses to answer any questions. • Interviewers must complete the first five items in Section A (Individual served ID, Individual served Type, Contract/Grant ID, Interview Type, Interview date), Section A: Behavioral Health Diagnosis, Section A Questions #1-3, Section A Planned Services, Section I (Follow-Up only), Section J (Discharge Only), and Section K: Services Received (Discharge only). UNABLE TO LOCATE/LOST TO FOLLOW-UP: If an individual cannot be located after multiple attempts, including but not limited to their collateral contact, they still need a GPRA completed. Interviewer must complete the first four items in Section A(Individual served ID, Individual served Type,Contract/Grant ID, Interview Type),follow prompts by marking "NO" in Interview Type and continue to Section I (follow-up) or (discharge) 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 301" of each month: • #of individuals screened Exhibit BD Page 5 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing II II lid I,'RL iufl 1I Ioi IIda (Conti a(:[Jrig as S()U 111 Ii]ou id a ['Ie1,iavtoi III II Ne. :clldllh Il etwou°II<,, Ilriic) 71112021 • #of individuals induced with buprenorphine in the ED/hospital prior to discharge • #of individuals referred to treatment providers • #of individuals linked to treatment providers 3. 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. 4. 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. PROHIBITED USES OF SOR GRANTS FUNDS: 1. DENIAL OF CARE. Funds may not be used by any 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. 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. 2. DATA Waiver Training. Procurement of DATA waiver training is not an allowable use of SOR funds as this training is offered free of charge from SAMHSA at pcssnow.org. No funding may be used to procure DATA waiver training by recipients or subrecipients of SOR funding. SOR funds shall not be utilized to provide incentives to any Health Care Professional for receipt of a DATA Waiver or any type of professional development training. 3. DIRECT PAYMENTS TO PERSONS SERVED. Funds may not be used to make direct payments to individuals to induce them to enter prevention or treatment services. At this time, under Florida law,SOR funds are also prohibited to provide contingency items of monetary value to individuals receiving services. 4. LIMITS ON DETOXIFICATION SERVICES. Funds may not be used to provide detoxification services unless it is part of the transition to extended release naltrexone(Vivitrol).As previously noted, SAMHSA has declared that, "Medical withdrawal (detoxification) is not the standard of care for opioid use disorders, is associated with a very high relapse rare,and significantly increases an individual's risk for opioid overdose and death if opioid use is resumed.Therefore, medical withdrawal(detoxification)when done in isolation is not an evidence-based practice for OUD. If medical withdrawal (detoxification) is performed, it must be accompanied by injectable extended-release naltrexone to protect such individuals from opioid overdose in relapse and improve treatment outcomes." 5. CONSTRUCTION: Funds may not be used to pay for the purchase or construction of any building or structure to house any part of the program. 6. EXECUTIVE SALARY LIMITS, Funds may not be used to pay the salary of an individual at a rate in excess of$197,300. Exhibit BD Page 6 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 Phil II SM II Zing II II lid I,'RL iufl 1I Ioi IIda (u:on1i a([ou urea as ()Ufll Ii]Icu id li['IeII°uaetoi aII II Ne. :cll dIIh Il et:woii 11<, Uric) 71112021 7. OTHER PAYER SOURCES: SOR funds shall not be utilized for services that can be supported through other accessible sources of funding such as other federal discretionary and formula grant funds, (e.g. HHS, CDC,CMS, HRSA,and SAMHSA), DOJ (OJP/BJA)and non-federal funds, 3rd party insurance, and sliding scale self-pay among others. 8. DATA WAIVER TRAINING: DATA waiver training is not an allowable use of SOR funds as this training is offered free of charge from SAMHSA at pcssnow.org.SOR funds shall not be utilized to provide incentives to any Health Care Professional for receipt of a Data Waiver or any type of Professional Development Training. 9. TREATMENT USING MEDICAL MARIJUANA: Grant funds may not be used, directly or indirectly, to purchase, prescribe, or provide marijuana or treatment using marijuana. Treatment in this context includes the treatment of opioid use disorder. Grant funds also cannot be provided to any individual who or organization that provides or permits marijuana use for the purposes of treating substance use or mental disorders. 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 15t" of each month with the preceding months services information.The report must be submitted electronically encrypted and password protected. Exhibit BD Page 7 of 7 Guidance/Care Center,Inc. Contract No. ME225-12-27 ffi II""Il Ming Wind rr"°se'Il.l hi I oii II d a (Coll itiasflrig a Soil�illm Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,a1ft1'I 111d:Awolil ", Ilu°°ic) 7/11201;21 Exhibit BE Tele- Behavioral Health Services For Services Provided to Children&Families Engaged in the Monroe County School System—OCA MHTLH A. PURPOSE The purpose of this funded project is to expand an integrated telecommunications technology platform used by the Network Provider for behavioral health services provided to children, adolescents and families engaged in the Monroe County Public School system. B. HISTORY/BACKGROUND OF FUNDING: In 2020,the Florida Legislature passed HB945,amending s. 394, F.S., requiring the implementation of a coordinated system of care which integrates services provided through providers funded by the state's child-serving systems and facilitating access by children and adolescents, as resources permit, to needed behavioral health treatment and services at any point of entry regardless of the time of year, intensity, or complexity of the need, and other systems with which such children and adolescents are involved,as well as treatment and services available through other systems for which they would qualify. C. ALLOWABLE COSTS/SERVICE ARRAY All covered services described in chapter. 65E-14.021, F.A.C., are allowable when delivered by telehealth platforms to otherwise eligible students and their families. Any technology and system implementation supports needed to address identified needs for behavioral telehealth services to students and their families engaged with the school system.This may include the purchase of equipment, software, licenses,training, hosting and maintenance, and technical support services needed for the selected telehealth platform. Any combination of behavioral telehealth services of technology and system implementation supports. D. FUNDING: The available funding for this project for Monroe County is $97,950, Refer to Exhibit G, Covered Services Funding by OCA and Exhibit H, Funding. Exhibit BE Page 1 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffiII""Il llling Wind rr"°se'Il.lhi I oii Ilea (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ulric:) 7/1120121 E. CLIENT ELIGIBILITY CRITERIA: 1, Children, adolescents and their families engaged in the Monroe County Public School system. 2. 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: I .I ....... d rr vv.Il .state.fl.us/51AIfU If1f::S/iiim�lex.cFim�7A irr�ode:::::IDiis Ila Stalt use UIRII..:::::C 3CC 03 9/0394/C394.Ihtimll ......................................................................................................................... F. REFERRALS: Referral Sources— Monroe County Public Schools and the Managing Entity. G. STAFFING PATTERN: The Network Provider has sixteen (16) counselors and therapists who are co-located in each public school and four charter schools at least one day per week. H. DESCRIPTION OF SERVICES Telehealth is the delivery of an evaluation, assessment, consultation, treatment planning,or other allowable service via non-public facing live videoconference between a licensed clinician and an individual. 1. The Network Provider has a long-standing partnership with Monroe County School District including being part of the district school mental health plan for the past 3 years. GCC is the contracted provider in the Keys for behavioral health services (which includes the use telehealth services) in and for the school system. This funding allows for expansion of behavioral health services to school aged children with various accommodations available to implement various types of behavioral health care. 2. The Network Provider uses various evidenced based practices including Apple A Day, Project Success, Wraparound, Cognitive behavioral therapy, and Sesame Street in Communities 3. Use of technology: The platform used for telehealth is Blue Jeans which is a free application that is HI PPA compliant that allows for face to face services from/to anywhere from any computer or smart phone. 4. The Network Provider outpatient offices are open Monday through Friday from 8 am to 5 pm excluding holidays. However, children's services are community based and offered with flexibility to meet the needs of the clients and families serviced. In addition, 24-hour crisis line is available to triage emergencies. Exhibit BE Page 2 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 ffiII""Il llling Wind rr"°sC'Il.lhi I oii Ilea (Coll iti a sflrig a Soil�lllI Il:l]oii uda Ii;1c.hIavlk)11 11 Ii h,,aIftl'I 111d:Awolil ", Ilu°°ic) 7/1120121 I. LICENSES: For licensable services to be provided with these 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 licenses) is suspended, revoked, expired or terminated, the ME shall suspend payment for services delivered by the Network Provider under such licenses) until said licenses) is reinstated. J. PRIVACY AND SECURITY/TELEHEALTH PLATFORM: 1. 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. 2. 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. 3. Telehealth Platform: The Network Provider must use a tele-behavioral health software platform that is HIPAA compliant and provides secure,encrypted, audio-video conferencing to communicate with consumers. The Managing Entity approved tele-behavioral health software platform for this project is Blue Jeans which is HIPAA compliant—staff can also use texting is also an option from work issued cell phones provided that that client has signed consent. K. DATA REPORTING AND COLLECTION REQUIREMENTS: 1, Service Data: Service Data must be submitted monthly by the 4th of every month following the month of service into the ME's designated data system and must comply with the requirements of the FASAMS DCF Pamphlet 155-2, 2. Monthly Tracker: The Network Provider must submit Referral Monthly Tracker using the template provided by the ME by the 10th of every month for data from the previous month to the ME's Contract Manager. Exhibit BE Page 3 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 h it Ming IIWind SoiuI Ii:]oii u(i a (Coll frig&:wSolullla II:I]oiiuda 11:1chiraoliu:11411 Iik,'dII111a 1MAW0111lk, IIuu1:-1) 711/202°"II 3. Return on Investment—At the discretion of the ME, the Network Provider may be required to submit quarterly return on investment reports. 4, Any adhoc reports requested by the ME, L. NUMBERS TO BE SERVED: Proposed number of clients/families to be served with this funding: 25 Refer to Exhibit D, Substance Abuse& Mental Health Required Performance Outcomes& Outputs,for a listing or all required performance measures applicable to this project. M. MEETINGS/TRAININGS: 1. The Network Provider will ensure that its staff is properly trained on the utilization of the telehealth platform, 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 BE Page 4 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 lmii iMing 11%n d Soil.ulllh Ii:]oiii id (Coil Iil ac fliri 7 "7o u111m II oiii uda Ii:3,c:havlic:)i4i1 Ii h,,: 111 h II otwoi1k, Uric:.) 7111,20,121 Exhibit BF Emergency COVID-19 Grant OCA: MHCOV I. PURPOSE: The Network Provider is contracted to provide behavioral health services for individuals who are indigent, uninsured, or underinsured and experiencing behavioral health effects as a result of COVID-19, II. BACKGROUND AND HISTORY OF THE FUNDING:The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $2M to the Florida Department of Children and Families ("Department") to address unmet behavioral health needs as a result of COVID-19 pandemic. III. ALLOWABLE COSTS/SERVICE ARRAY:All covered services described in ch. 65E-14.021, F.A.C.,are allowable except Prevention-Indicated; Prevention-Selective; Prevention-Universal Direct; Prevention-Universal Indirect; and Inpatient. IV. TARGET POPULATION: The Network Provide may enhance its existing service array, including telehealth, to serve individuals with serious emotional disturbance, serious mental illness, and substance use disorders whose symptoms are exacerbated due to COVID-19. V. FUNDING: Refer to Exhibit G, Covered Services Funding by OCA VI. Match: No match requirement VII. BUDGET RESTRICTIONS: These 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 o to pay the salary of an individual at a rate in excess of$189,000 3. to supplant (or replace) current funding of existing services 4, directly or indirectly, purchase, prescribe, or provide marijuana or treatment using marijuana o to pay for client expenses such as utilities, rent, phones, or food. Vill. REPORTING REQUIREMENTS Government Performance and Results Modernization Act of 2010 (GPRA): The Network Provider is required to complete the Government Performance and Results Modernization Act of 2010 (GPRA) is a federal mandate which requires all SAMHSA grantees to collect and report performance data using approved measurement tools. The Network Provider is required to collect data at five data collection points (baseline, 6 months post-intake, discharge, 3-months post-discharge, and 6-months post- discharge) using the Collection Tools for Substance Abuse Treatment (CSAT)GPRA.The target completion rate is 100%; meaning programs must attempt to follow-up with all individuals. However, SAMHSA Exhibit BF Page 1 of 2 Guidance/Care Center,Inc. Contract No. ME225-12-27 f f iu..uMing Il Wind Soi ulhi II°" oii IIda (Coll itiasfllriga Soil ufllm Il:l]oiiuda Ii:1c.hIavlk)1141 Iih,,alftl'I Ildd:Awolil ", Ilu°°ic) 7/1120;,;21 expects the state to achieve a minimum 6-months post-intake follow-up rate of completion of 80%. Any interview that is not conducted via face-to-face or virtual interview,will not count towards compliance. In addition to completing the GPRA tool, the Network Provider is required to submit client level data to the ME's data system the Department's Financial and Services Accountability Management System. Exhibit BF Page 2 of 2 Guidance/Care Center,Inc. Contract No. ME225-12-27 h'ii iOng I`vNnd °;r:(u i l ol, (6�t �UJf1il ac,P I1 c� 6ru I� 'I I� 0ii,J.l +16'I Vr01'x.m t N�f;>r"+rr.(Ib., li1: 71I/ 10,?I Exhibit BH Recovery Management Practices 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 participate in all implementation activities and Technical Assistance provided by DCF and the ME. The purpose of this document is to provide direction and recommendations for implementation of Recovery Management practices in Network Service Providers, These practices are accomplished using Florida's Recovery-Oriented System of Care(ROSC) Framework.This document provides best practice standards to transform delivery of care to one that focuses on sustainable wellness and recovery. I. DEFINITIONS A. Peer specialist:As defined in s. 397.31](30), F.S. B. Recovery: As defined in s. 397.311(37), F.S. Through key stakeholder engagement, SAMHSA developed the following working definition of recovery.' Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential, This definition describes recovery as a process, not an end state. Complete symptom remission is neither a prerequisite of recovery nor a necessary process outcome. Recovery can have many pathways including professional clinical treatment and use of medications; family, school, and faith-based supports; peer support and other approaches. Four major dimensions support a life in recovery: 1. Health: Learning to overcome, manage, or more successfully live with symptoms; and making health choices that support one's physical and emotional wellbeing. 2. Home: A safe,stable place to live. 3. Purpose: Meaningful daily activities such as, work, school, volunteer activities, or creative endeavors; an increased ability to lead a self-directed life; and meaningful engagement in society. 4. Community: Relationships and social networks providing support,friendship, love,and hope. C. Recovery Management (RM): A philosophical framework for organizing treatment services to provide pre- recovery identification and engagement, recovery initiation and stabilization, long-term recovery maintenance, and quality-of-life enhancement for individuals and families affected by behavioral health disorders.2 D. Recovery-Oriented: Recovery-Oriented care recognizes that each person must be the agent of and the central participant in their own recovery journey. All services and supports need to be organized to support the developmental stages of this process. Services should instill hope, be person-and family-centered,offer choice, elicit and honor each person's potential for growth, build on a person's and family's strengths and interests, and attend to the overall quality of life, including 1(Rccov 2010) 2 White,W.(2008).Recovery management and recovery-oriented systems of care.Chicago:Great Lakes Addiction Technology Transfer Center,Northeast Addiction Technology Transfer Center and Philadelphia Department of Behavioral Health and Mental Retardation Services. Exhibit BH Page 1 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 I Ong I` I I I 1d °;nu l l l l o r l 1 i�t l;i:oniI ac,UI1 <ta uru.iil I I 0I I,J.i I +.I I.JVltar;;.i� t N+.:i WO I,, Ill1 : 7 health and wellness.These values can be the foundation for all services regardless of the service type. E. Recovery-Oriented system of care (ROSC): A value-driven framework to guide transformation of a behavioral health system of care.The framework structures behavioral health systems to involve a network of clinical,nonclinical services,and supports that sustain long-term,community-based recovery. Formal and informal service networks are developed and mobilized to sustain long-term recovery for individuals and families impacted by behavioral health disorders. ROSC reflects variations in each community's vision, institutions, resources, and priorities. The "system" is not a treatment agency but a macro-level organization of a community, a state,or a nation. F. Recovery Capital:Recovery capital is the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery. G. Recovery Support:As defined ins 397.311(40), F.S. H. Support Services: As defined ins. 394,67(16)(c), F.S. II. ROSC TRANSFORMATION OVERVIEW Based on the Department's Florida Substance Abuse and Mental Health Plan Triennial State and Regional Master Plana, Florida's behavioral health, recovery-oriented transformation includes: A. Action-Oriented Priority Areas to Foster: 1. Collaborative Service Relationship indicated by a mutual service relationship between the provider and the service recipient that shift from a hierarchy model to the shared decision-making process and best practices that support the service recipients. 2. Cross-system Partnerships indicated by strategically leveraging resources and working across sectors to achieve common goals. 3. Community Integration indicated by assertively connecting service recipients to natural community-based resources to promote development of interest,skills,and supportive relationships. 4. Community Health and Wellness indicated by a focus on prevention, early intervention, wellness and increased recovery capital through targeted community education, strategic partnership development, and improved connections between system and local communities. 5. Peer-based Recovery Support indicated by increasing access to peer-based recovery support services. B. Goals of a Recovery-Oriented System of Care 1. Promote good quality of life, community health and wellness for all. 2. Prevent the development of behavioral health conditions. 3. Intervene earlier in the progression of illnesses. 4. Reduce the harm caused by substance use disorders and mental health conditions on individuals, families, and communities. 5. Provide the resources to assist people with behavioral health conditions to achieve and sustain their wellness and build meaningful lives for themselves in their communities. C. Best Practice Standards as defined in Table 1. a Florida Substance Abuse And Mental Health Plan,Triennial State And Regional Master Plan,Fiscal Years 2019-2022,Department of Children and Families,Office of Substance Abuse and Mental Health,May 30,2019 Exhibit BH Page 2 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 h'ii iOng I`vNnd °;nu l i l ol, (6�t UjI'IIIa,P II c> 6ru I� 'Ii � 01 diJ l '16i Vr01'x.m t N�f;V+r0Ib., li1: 111 1 D. Performance Arenas for Quality Improvement Monitoring 1. Meeting Basic Needs indicated by assessment, planning and delivery of all services to first address basic needs. 2. Comprehensive Services indicated by treatment and recovery supports that provide for a variety of treatment and recovery support modalities. 3. Medication Assisted Treatment where applicable indicated by the provision of information on psychotropic medication and medication-assisted treatment(MAT). 4. Strength Based Approach indicated by treatment delivery and planning that are fundamentally oriented toward individual's strengths rather than deficits. 5. Customization and Choice indicated by the planning and delivery of all services and supports are designed to address the unique circumstances, history, needs, expressed preferences, and capabilities of individuals receiving services. b. Opportunity to Engage in Self-Determination indicated by the level of involvement of the individual determining treatment approaches and other recovery-oriented services. 7. Network Supports and Community Engagement indicated by active efforts in the planning and delivery of services to involve environmental supports in the individual's treatment and overall recovery that promotes community integration. 8. Recovery Focus indicated by providing services that are centered on helping individuals to achieve recovery goals and ensuring ongoing and seamless connections with services and supports. E. Potential Practice Changes as described in Table 1. Exhibit BH Page 3 of 10 Guidance/Care Center,Inc. 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E y C o 12 — X 0 L 0] m . U) a m o - c 0 U U ca p- m m > o (n Z a) m Q Co m U li d >O.c U oa .. U o E O N N 0- N— 0 o s N voi io O aEi c a N E a) c c L c a) U U ._ E L.- m O U s c p r. ._ E L .- m a E V) C �' (�6 °) Q) y p O]m .N-. a) o T a)=0 Q) `` '7 a7 c o s 0 c m o s = m y m m o ca c E o u°) uy) io a) n 6 a) p (7 m E > - a) E o c E m n > m Q c .. E m m > Q CM E '> o E m a) m o w _ m w__ Z _0 a Q c p m a)= op Q _ _ _ - '•' W a) E m Q a) -o Q (n a (n E (n U) m o (n cn op Q N Q m -a m 0 L i l l Ong l'1g IVv I'I °;o: Il l i cIf t 6 t 01111,JJ,'i�IK'i 'VS'S(r LlIl1 0ii D6'IavioI ua 1l I No IIr1c') 7 2"1 III. IMPLEMENTATION A. MANANGING ENTITY RESPONSIBILITIES Each Managing Entity shall demonstrate progress toward implementation of a ROSC framework within its service areas.The Managing Entity shall: 1. Incorporate specific Best Practice Standards and Potential Practice Changes in Table 1 into Network Service Provider subcontracts and monitor compliance with the Performance Arenas for Quality Improvement Monitoring al igned with the specific standards and changes selected. 2. Facilitate development of ROSC concepts with community stakeholders incorporating the elements of the Florida Peer Services Handbook 2016,available at: https://www.myflfamiIies.com/service-programs/samh/publications/ 3. Support programmatic changes to include prevention and early intervention. 4. Promote adoption of sustainable recovery-oriented practices. 5. Analyze and align current Managing Entity administrative, fiscal, policy, monitoring, and evaluation functions with recovery-oriented concepts using the Best Practices Standards in Table 1. 6. Identify opportunities to promote the expansion of peer-based recovery support services and recovery communities, enhance the role of peers in the workforce,and support development of peer-run organizations in their network. 7. Require subcontracted Network Service Providers to use, at minimum, the following tools to assess recovery-oriented activities: a. The Self-Assessment/Planning Tool for Implementing Recovery-Oriented Services (SAPT) available at: https://www.usf.edu/cbcs/mhlp/tac/documents/toolkits/self-assessment-tool- recovery-oriented-mental-health.pdf, b. The Recovery Self-Assessment-R (RSA) available at: https://medicine.yale.edu/pssychiatr\//prch/tools/rec_selfassessment,and 8. Require subcontracted Network Service Providers who employ peers with direct recovery- support services to: a. Use the Recovery Capital Scale as a foundation to inform the recovery planning process available at: Providers- Recovery Oriented System of Care I Florida Department of Children and Families(myflfamilies.com) b. Receive standardized peer supervision training for peer supervisors. 9. Monitor Network Service Providers utilization of the Self-Assessment/Planning Tool (SAPT) and document areas of improvement from the SAPT and the Recovery-Oriented Quality Improvement process available at: Managing Entities- Recovery Oriented System of Care I Florida Department of Children and Families(mvflfamilies.com) 10. Provide standardized training on Recovery Management best practices in employee orientation and refresher training. Exhibit BH Page 7 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 it 1fll'1g V ll'1d °)f:wll l cc l"Iti t I'1.oI'I11 ac,I, II4i< sl so,dl i 101 i,i B I=78 i0I. 11 I Ua 1l I Ne[v',roI", Uric') 7/1 10 1F,� 11. Include the Department's local Recovery-Oriented Quality Improvement Specialist (ROOIS) in Managing Entity Quality Improvement monitoring to: 1) Conduct Recovery-Oriented Quality Improvement monitoring of Network Service Providers, 2) Provide follow-up training and technical assistance on enhance recovery management approaches and practices to Network Service Providers and provide technical assistance in collaboration with the Department to any Network Service Providers with a cumulative average score of less than 4.0 across all recovery domains, and 3) Provide training and technical assistance to expand peer-based recovery services in Network Service Providers and Recovery Community Organizations. 12. Include findings from the recovery-oriented QI Monitoring Tool in Network Service Provider monitoring reports and shall include all elements of the site visit, facility tour, policy and procedure review, person served interviews, surveys, clinical chart scoring outcomes, staff interviews, and where applicable, review of peer specialist staff job description(s). Reports shall be submitted to the Network Service Provider within 30 days of the site visit. IV. RESOURCES Managing Entities and Network Service Providers are encouraged to research the following recovery- oriented promising practices as examples of effective implementation: Recovery Support Bridger's/Navigators-Certified Recovery Peer Specialists(CRPS) are utilized to assist individuals successfully transition back into the community following discharge from a SMHTF,CSU or Detox. The CRPS engages the individual while still inpatient and provides support and information on discharge options.They participate in discharge planning and assist the person in identifying community-based service and support needs and build self-directed recovery tools,such as a Wellness Recovery Action Plan (WRAP). The CRPS then supports the individual as they transition to the community. More information on WRAP may be accessed at: http://mental heal threcovery.com/ Care Transition Programs®-This intervention utilizes a Transition Coach to preferably meet an individual in the acute care setting to engage them and their family (as appropriate) and sets up in- home follow up visits and phone calls designated to increase self-management skills, personal goal attainment, and provide continuity across the transition.' More information on the Care Transition Programs may be accessed at: http://caretransitions.org// Behavioral Health Homes-The SAMHSA—HRSA Center for Integrated Health Solutions has proposed a set of core clinical features of a behavioral health-based health home that serves people with mental health and substance use disorders,with the belief that application of these features will help organizations succeed as health homes. This resource may be accessed at: http://www.integration.samhsa.gov/clinical-practice/CIHS Health Homes Core_Clinical_Features.gdf Reducing Avoidable Readmissions Effectively-The RARE Campaign in Minnesota was established to improve the quality of care for persons transitioning across care systems and to reduce avoidable a See,http://caretransitions.org/about-the-care-transitions-intervention/,site accessed October 14,2015. Exhibit BH Page 8 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 I it lllll'1g IMv I'1d °;r;w i rcc�flt6 t 01111,7dCJ IK'l ' S1S011ill l 01i,i i B6P7avloI� tl I u,7l1lt Nr:l;vrrc,I.l;, Uric' ���rU �(:11"I readmissions by 20%. Five areas were identified as a focus of these efforts: • Patient/Family Engagement and Activation, • Medication Management, • Comprehensive Transition Planning, • Care Transition Support, and • Transition Communication For more detail,the RARE Campaign published recommendations on actions to address the above areas of focus which can be accessed at: http://www.rarereadmissions.org/documents/Recommended_Actions_Mental_Health.gdf Telehealth-Technology presents another promising practice in coordinating care,specifically related to access. For example, the Department of Veterans Affairs piloted a care coordination/home telehealth initiative that continually monitored veterans with chronic health conditions. Vital signs and other disease management data was transmitted to clinicians remotely located. The pilot reported reductions in hospital admissions and length of stay.' Wraparound-Wraparound is an intensive, individualized care planning and management process for individuals with complex needs, most typically children,youth, and their families.The Wraparound approach provides a structured, holistic and highly individualized team planning process which includes meeting the needs of the entire family.The philosophy of care begins with the principal of"voice and choice",which stipulates the child and family perspective and drives the planning.The values further stipulate that care be community-based and culturally and linguistically competent. The staff to family ratio typically does not exceed one Wraparound facilitator to ten families. More information on Wraparound may be accessed at: htti)://nwi.pdx.edu/, Related Articles: • Philadelphia Behavioral Health Services Transformation Practice Guidelines for Recovery and Resilience Oriented Treatment • Philadelphia Dept. of Behavioral Health and Intellectual Disabilities Services and Achara Consulting Inc. (2017). Peer Support Toolkit. Philadelphia, PA: DBHIDS • Davidson, L.; Tondora, J.; Ridgway, P.; & Rowe, M. (2012). Inventory of transformation characteristics for recovery-oriented systems of care. New Haven, CT: Yale University Program for Recovery and Community Health. • Winarski, J., Dow., M, Hendry, P., & Robinson, P. (2018). Self-Assessment/Planning Tool for Implementing Recovery-Oriented Services (SAPT)Adapted for Florida's Recovery Oriented System of Care Initiative(ROSC).Tampa,FL: Louis de la Parte Florida Mental Health Institute, University of South Florida. • Recovery concept finds common ground in mental health and addiction, Co-occurrences Newsletter of the Minnesota Co-Occurring State Incentive Grant Project • Recovery in Mental Health &Addiction, Davidson and White, Recovery to Practice Issue No. 14 IOM(Institute of Medicine).2010.The healthcare Imperative:Lowering Costs and Improving Outcomes:Workshop Series Summary.Washington,DC:The National Academies Press Exhibit BH Page 9 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 iI 1fll'1g IV ll'1d °)fwll i c: flti t l'1.oI'I11 aci 1I I4j<i>sor ,l l i 101 is i B ']8V,)Ia 1l I Ua�l It Ne[v"/oI 1", Uric') 7/1 10 1F,� • Kelly,J. & White, W. (Late 2010) Addiction recovery management: Theory, science and practice. New York: Springer Science. • Monographs published by Great Lakes ATTC,available at http://www.williamwhitepapers.com/: o Recovery Management o Peer-based Addiction Recovery Support: History, Theory, Practice, and Scientific Evaluation o Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices o Practice Guidelines for Resilience and Recovery Oriented Treatment, Philadelphia Department of Behavioral Health and Intellectual Disability Services Relevant Websites: http://www.williamwhitepaDers.com/ http://www.acharaconsulting.com/ http://www.acharaconsuIting.com/peer-support-toolkit/ https://www.samhsa.gov/brss-tacs https://inaps.membercl icks.net/assets/docs/RTP%20Next%20Steps%20Manua1.pdf https://store.samhsa.gov/sites/default/files/d7/priv/pepl 2-recdef.pdf Exhibit BH Page 10 of 10 Guidance/Care Center,Inc. Contract No. ME225-12-27 Hirn inl Mind "rol9llli i"IoI I,I n g,1sS i ! II 11�zn rhl C,tIIViOT,`l :IIVCKI W l'11;,IrIc 7"I/i02,'I. ATTACHMENT II Financial and Audit Compliance The administration of resources awarded by the Department of Children & Families, through the Managing Entity,to the Network 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. 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 CIF 1120,Effective March 10,2021,(CF-1120-2021) Attachment II Page 1 of 3 Guidance/Care Center,Inc. Contract No. ME225-12-27 i on ravI�n ra^, Sot h Il 11� id Il�ctI vNor� LI:IItc,IIll wor1,;,I r 1 7 /202.'I. 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) B. Department of Children & Families (1 electronic copy and management letter, if issued) Office of the Inspector General CIF 1120,Effective March 10,2021,(CF-1120-2021) Attachment II Page 2 of 3 Guidance/Care Center,Inc. Contract No. ME225-12-27 Hirn inl Mind "rol9llli i"IoI I,I n g,1sS i ! II 11�zn rhl C,tIIViOT,`l :IIVCKI W l'11;,IrIc 7"I/i02,'I. Single Audit Unit The Centre, Suite 400-1 2415 Monroe Street Tallahassee, Florida 32303 Email address: HQW.IG.Single.AuditC 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: https://harvester.census.gov/facweb/ and other Federal agencies and pass-through entities in accordance with 2 CFR §200.512. D. Copies of reporting packages required by Part 11 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 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, CIF 1120,Effective March 10,2021,(CF-1120-2021) Attachment II Page 3 of 3 Guidance/Care Center,Inc. Contract No. ME225-12-27 riviving Mind SOLIth Florida as South Florida Behavioral Health Netwwk, lnij 0710112021 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 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-LILL, "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,,%)00,000 for each such failure. Signature Date Frank C. Rabbito, COO ME225-12-27 _-.....------- -- Name of Authorized Individual Apiptication or Contract Number Guidance/Care Center, Inc. Name of Organization 3000 41st Street, Ocean,Marathon,FL 33050 Address of Organization CF 1123,PDF 03/96 Attachment III Page 1 of 1 THRIVING MIND u O4JTH iF6.ORIW ATTACHMENT IV SCOPE OF WORK NAME OF PROVIDER: Guidance Care Center NAME OF PREVENTION PROGRAM: Power of Prevention AMOUNT OF CONTRACT AWARD: $199,063.00 "Regular" Prevention TYPE OF FUNDING: Prevention Block Partnership SOR Grant Services Grant PPG XX COST ALLOCATED TO: (check both Children's Substance Abuse Adult Substance Abuse if approved for both covered services) 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(8) Evidence- Based Practices: (1) Facilitated at Schools or Community Sites: (1) An Apple A Day©(Elementary K-4), (2) Project SUCCESS Prevention Education Series (PES) (Middle School), (3) Teen Intervene (Middle & High School). (2) Virtual Online Self-Guided Courses - Partnered with Monroe County Coalition (MCC): (4)AlcoholEdu, (5) Prescription Drug Safety, (6) Nicotine 101, (7) Marijuana Wise, and (8) Alcohol Wise. 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. Guidance/Care Center,Inc. Scope of Work Contract No. ME225-12-27 Page 1 of 11 2 IOM Specific Category primary Number of Activity/Program - (Universal prevention Unduplicate include whether Indirect, programs, d Brief Description practices in the strategy is an Universal Participants EBP Direct, each the six (if duplicated Selective, prevention ntion note) Indicated) strategies (CSAP) An Apple A Day© Classroom education Selective Education 400 Youth Elementary EBP teaching inner strength protective & risk factors and resilience to resist ATOD Project SUCCESS Classroom education Selective Education 100 Youth Middle School EBP addressing challenges of adolescence, risk of ATOD, relationships & refusal skills Teen Intervene One-on-One early Indicated Education 10 Youth High & Middle intervention for youth deemed School EBP high risk for or reporting alcohol/drug use referred by school counselor, coach, or as self-referred Problem ID: An Support to youth and families Selective Problem #will be Apple A Day© who need additional services Identification tracked EBP, Project and Referral SUCCESS EBP & Teen Intervene EBP Virtual EBP's Online interactive education Selective Education 200 Youth Courses: Alcohol courses ATOD pre/post Edu, Prescription completion Drug Safety, Nicotine 101, Marijuana Wise, Alcohol Wise Community Face to Face anti-ATOD Universal Information 600 Youth & Activities, Events messages through school- Direct Dissemination Adults (including any based assemblies, fairs), workshops, health fairs, Drives, and community events or Workshops meetings for youth Summer: An Apple School and summer camp Selective Alternative 25 Youth A Day© EBP & participants will participate in Project SUCCESS alternative activities ATOD to EBP reinforce skills as well as risks & protective factors Community Community Norms, Prosocial Universal Information 75 Adults Capacity Building — Activities, Opportunities for Direct Dissemination Adults Prosocial Involvement Scope of Work Guidance/Care Center,Inc. Page 2 of 11 Contract No. ME225-12-27 3 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. Also serving County Health Fairs, Family Relief Programs, and Food Banks 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. Educational priorities in accordance with the Monroe County CCAP are Youth Alcohol Use/Abuse, Youth Drug Use/Abuse. 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 Education - Favorable Attitudes Towards ATOD, Peer Norms, 1, 2, 3 AlcoholEdu, Prescription Drug Peer Perceptions, Perceptions of Harm, Increased Safety, Nicotine 101, Marijuana Knowledge and Awareness, Boundaries, Family Wise, Alcohol Wise, An Apple A Management&Adult Role Models. Day, Project SUCCESS, &Teen Intervene Community Activities, Events, 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, Project Linkage to Community Resources, Family SUCCESS & Teen Intervene Management. Community Capacity Building — Community Norms, Pro-social Activities, 3 Adults Opportunities for Pro-social Involvement Other Program/Strategy and Related Risk/Protective Factors Targeted Coalition Target Population CCAP Goal Addressed Scope of Work Guidance/Care Center,Inc. Page 3 of 11 Contract No. ME225-12-27 4 Community Activities, Events, Community Norms, Pro-social Activities, MCC— 1, 2, Drives, and Workshops & Opportunities for Pro-social Involvement 3 Community Capacity Building Section III. SITE LOCATIONS AND INFORMATION* Site Name Target Participants Zip Check all that apply) Note whether school or Street Address City Code Child/ communit Youth Parents Others Community Partner County Wide Monroe ALL X X Sites Covering 110 Miles Count Key Largo Middle 104801 Overseas Key Largo 33037 X School Hwy Plantation Key Middle 100 Lake Rd Tavernier 33070 X School Coral Shores High 89901 Old Hwy Tavernier 33070 X School Ocean Studies 92295 Overseas Tavernier 33070 X Charter School Hwy Treasure Village 86731 Overseas Islamorada 33036 X Montessori School Hwy Stanley Switlik Middle 3400 Overseas Marathon 33050 X School Hwy Marathon Middle/High 350 Sombrero Rd Marathon 33050 X School Sugarloaf School 255 Crane Blvd Sugarloaf 33042 X Gerald Adams 855 W College Rd Key West 33040 X Elementary School Poinciana Elementary 1407 Kennedy Dr Key West 33040 X School Sigsbee Charter School 939 Felton Rd Key West 33040 X Horace O'Bryant School 1105 Leon Street Key West 33040 X May Sands Montessori 1400 United Street Key West 33040 X School Key West High School 2100 Flagler Ave Key West 33050 j X _F_ TOTAL NUMBER TO BE SERVED 1,420 *Changes in sites/locations of services must adhere to contractual requirement procedures. Section IV. MAJOR REFERRAL SOURCES List the major referral sources for the servicesprovided: Scope of Work Guidance/Care Center,Inc. Page 4 of 11 Contract No. ME225-12-27 5 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 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/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 Timeline 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. Section VI. QUANTITY AND QUALITY PERFORMANCE MEASURES AND TASK LIST Include all Thriving Mind 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: Education—An Apple A Day 200 (8-10) 100%will 2 on site Activity Description: EBP Anti-ATOD youth sessio receive or virtual Curriculum ns services visits • Recruit sites/locations K—4t" and grade 85% of program Scope of Work Guidance/Care Center,Inc. Page 5 of 11 Contract No. ME225-12-27 6 • Create Memorandums of completers Understanding/Affiliation will show agreements for each site. decreased • Meet with staff for curriculum favorable scheduling of educational sessions in attitudes, the site. and • Curriculum preparation- print learning increased materials, prepare PowerPoint perceptions presentations. of harm, • Youth registration- create participant and data record sheet at initiation of first increased session. prosocial • Complete registration, pre/posttest, skills. 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 1x 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 summer. Meaningful Improvement Satisfaction:90% of program completers demonstrate satisfaction with program services Activity Title: Education- Project SUCCESS PES 100 (6-8) 100%will 2 on Activity Description: EBP Anti-ATOD Curriculum youth Sessions receive site or • Recruit sites/locations services virtual • Create Memorandums of Understanding 6tn-8th and visits /Affiliation agreements for each site. grade 85/o of • Meet with staff for curriculum scheduling of program educational sessions in the site. completers will show • Curriculum preparation- print learning decreased materials, prepare PowerPoint presentations. favorable • Youth registration- create participant data attitudes, record sheet at initiation of first session. and • Complete registration, pre/posttest, satisfaction increased • Enter all outcome data in the BSRI D.O.E.S perceptions system. of harm, • Update participant information in database. and • Conduct weekly curriculum sessions. increased• Update weekly attendance. prosocial • Enter participant or event data in PBPS data Scope of Work Guidance/Care Center,Inc. Page 6 of 11 Contract No. ME225-12-27 7 collection system. • Provide follow up information as needed. Frequency: Education 1x 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 youth (3-5) 100%will Activity Description: EBP Anti-ATOD Sessions receive Curriculum 6tn-12tn services • Recruit sites/locations grade and • Create Memorandums of 85% of Understanding/Affiliation agreements for each site. program • Meet with staff for curriculum completers scheduling of educational sessions in will show t decreased he site. • Curriculum preparation- print learning favorable materials, prepare PowerPoint attitudes, presentations. and • Youth registration- create participant increased data record sheet at initiation of first perceptions session. of harm, • Complete registration, pre/posttest, and satisfaction increased • Enter all outcome data in the BSRI prosocial D.O.E.S system. skills. • 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 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: Education -Virtual Online Courses: 100 As 100%will AlcoholEdu, Prescription Drug Safety, Nicotine youth needed receive 101, Marijuana Wise, &Alcohol Wise services Activity Description:Online interactive 6th_12th and ATOD education courses. 85% of Scope of Work Guidance/Care Center,Inc. Page 7 of 11 Contract No. ME225-12-27 8 • Recruit sites/locations grade program • Get Parent approval completers • Meet with staff for curriculum scheduling of will show educational sessions in the site. decreased • Youth registration- create participant data favorable record sheet at initiation of first session. attitudes, • Complete registration, pre/posttest, satisfaction and • Enter all outcome data in the BSRI D.O.E.S increased system. perceptions Update participant information in database. of harm, • and • Enter participant or event data in PBPS data increased collection system. prosocial • Provide follow up information as needed. skills. Frequency: Education as needed to complete course. Intensity: 1 or 3 hours depending on course Duration: As needed to complete the course Meaningful Improvement Satisfaction:90% of program completers demonstrate satisfaction with ro ram services Activity Title: Capacity Building/ATOD 75 As 100% of Presentations adults needed individuals Activity Description ATOD prevention receive materials presentations to adults in both school All ages and/or and non-traditional settings. As well as information for site personnel, other community key stakeholders including parents, teachers, and coaches. Frequency: One-time presentation Intensity:As Needed Duration: Year-Round scheduled with school faculty/administration and community partners. Activity Title: Community Activities, Fairs, 600 As 100% of Drives, and Workshops/ATOD youth & needed individuals Activity Description: Face to Face anti- adult receive ATOD messages and providing materials materials through school based anti- All ages and/or ATOD assemblies, workshops, health information fairs, 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. Scope of Work Guidance/Care Center,Inc. Page 8 of 11 Contract No. ME225-12-27 9 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 need additional prevention services are identified via problem ID and referral strategies and are referred into Teen Intervene program. This will be noted in BSRI data tracking 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 coordinates with The Florida Keys Children's Shelter who provide services in Monroe County. They provide the EBP All Stars. We have meetings regarding the schools we are in, so we are not duplicating services. 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 partners with MCC on (5) EBP's AlcoholEdu, Prescription Drug Safety, Nicotine 101, Marijuana Wise, and Alcohol Wise. GCC and the MCC partnered in implementing these (5) 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 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. Two (2) site schedule changes may be made in the contract year. The site schedules shall be submitted on the SFBHN Prevention Site Schedule format. 2. Memorandum of Understanding WOU) 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. Scope of Work Guidance/Care Center,Inc. Page 9 of 11 Contract No. ME225-12-27 10 3. Memorandum of Understanding NOW 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 Survev 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. 9. Data Scope of Work Guidance/Care Center,Inc. Page 10 of 11 Contract No. ME225-12-27 11 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. 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. Scope of Work Guidance/Care Center,Inc. Page 11 of 11 Contract No. ME225-12-27 THRIVING MIND SDUTH NLURIOA" Attachment V SCOPE OF WORK State Opioid Response SOR NAME OF PROVIDER: Guidance/Care Center NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: MSSP2 $25,000.00 MSSP3 $75,000.00 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 9th graders, and individual counseling to those in need of additional supportive counseling. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20-year old 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 Attachment V Guidance/Care Center,Inc. Scope of Work—State Opioid Response(SOR) Contract No. ME225-12-27 Page 1 of 10 IOM Specific Category primary Number of ctivity/Program - (Universal prevention Unduplicate include whether Indirect, programs, d Brief Description practices in the strategy is an Universal 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 arouas 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 ID 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 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 Planpriorities: Youth Attachment V Scope of Work—State Opioid Response(SOR) Page 2 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 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 Attachment V Scope of Work—State Opioid Response(SOR) Page 3 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 7" Grade Prevention Education Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation 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* Attachment V Scope of Work—State Opioid Response(SOR) Page 4 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 Site Name Target Participants Zip Check all that apply) Note whether school or Street Address City Code Child/ communit Youth Parents Others 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 servicesprovided: 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 Attachment V Scope of Work—State Opioid Response(SOR) Page 5 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 Westcare Team. 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 T and e of EBP % to Meet this Obsery Activities/Service Name and Description yp 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% N/A 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 o Activity Description:. 7th 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. Attachment V Scope of Work—State Opioid Response(SOR) Page 6 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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. 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 visits session 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 41" 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). Attachment V Scope of Work—State Opioid Response(SOR) Page 7 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 VIII. 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. 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 Attachment V Scope of Work—State Opioid Response(SOR) Page 8 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 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. Attachment V Scope of Work—State Opioid Response(SOR) Page 9 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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. 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 Attachment V Scope of Work—State Opioid Response(SOR) Page 10 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 Amendment#1 Contract No. ME225-12-27 10/01/2021 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. ME225-12-27. PREAMBLE: This amendment addresses the following revisions to the contract: • $53,394.00 is added to Adult Mental Health, OCA MHOCF, to be applied for OCA MH001,to fund a Residential Level 1 bed for one month; one-time only; • 13,162,00 is added to Children's Mental Health, OCA MHTLH; • $5,000.00 is reduced from MSSP3, and $50,525.00 is added to MSSP4; • $100,00.00 is reduced from MSSM2, $350,000 is reduced from MSSM3, and $500,000.00 is added to MSSM4; • $60,000.00 is reduced from Adult Mental Health, OCA MHOCN based on funding Care Coordination on a team-based approach; • $75,000.00 is added to OCA MHEMP to fund Supported Employment/Clubhouse Services; • $325,035.00 is added to Adult Mental Health, OCA MHCCS to fund the MRT Expansion Services; • $2,372.00 is added to Adult Mental Health, OCA MHOPG to align with the ME's Schedule of funds • Adds OCA MHOCF; • Adds OCA MHCCS; • Revises Exhibits; • Removes Exhibit Q, Missing Children; • Revises contract language. As a result, this amendment revises the Standard Contract; Attachment 1; Exhibit B, Method of Payment; Exhibit C, Required Reports; Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes & Outputs; Exhibit G, Covered Services Funding by OCA; Exhibit H, Funding Detail, and Local Match; Exhibit N, Indigent Drug Program; Exhibit Al, Family Intensive Treatment (FIT) Model Guidelines and Requirements; Exhibit AY, Mobile Response Team (MRT) for Monroe County; and Exhibit BH, Recovery Management Practices. 1. Page 2 of 16,Standard Contract, Paragraph 5,Contract Amount, is hereby amended to read: 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 $9,412,996.00, 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 $7,844,163.00, subject to the delivery and billing for services. The remaining amount of $1,568,833.00, 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. Page 1 of 7 Amendment#1 Contract No. ME225-12-27 10/01/2021 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. Page 10 of 16, Standard Contract, Paragraph 32. Sponsorship or Financial Support, is hereby amended to read: 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 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 and for 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. 3. Page 15 of 16, Standard Contract, Paragraph 54. Electronic Signature, is hereby amended to read: 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; or, c. electronic signatures, whether digital or encrypted, have the same force and effect as manual signatures. 4. Page 10 of 55, Attachment 1, Section B, Manner of Service, Paragraph 1) a.(4), is hereby amended to read: (4) The Network Provider must adhere to treatment group size limitations not to exceed fifteen (15) individuals per group for any clinical therapy service provided, with the exception of Outpatient Group services. For Outpatient Group services funded under this contract, the Network Provider must adhere to the group size limitations outlined in the current Medicaid Handbook. In addition to other programmatic documentation requirements, service documentation to evidence group activities must include the following: Data Elements: 1. Service Documentation-Group Sign in Sheet 2. Recipient name and identification number or, if non-recipient, participant's name, address, and relation to recipient; 3. Staff name and identification number 4. Service date; 5. Start time 6. Duration; Page 2 of 7 Amendment#1 Contract No. ME225-12-27 10/01/2021 7, Covered Service; 8. Service (Brief description of type of group); 9, Group Indicator; and 10. Program (AMH,ASA, CMH,CSA) Audit Documentation-Recipient Service or Non-Recipient Chart: 1. Recipient name and identification number or if non-recipient, participant's name, address, and relation to recipient; 2. Staff name and identification number 3. Service date 4. Clinical diagnosis; 5. Start time; 6. Duration; and 7. Services(Group progress note) 5. Page 54 of 55, Section E, List of Exhibits, is hereby amended to remove Exhibit 0, Missing Children, and renumber as follows: 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 J, Child Welfare Specialty Program (CWSP) 10. Exhibit K, SAMH Pre-Authorization Utilization Management Roster 11. Exhibit L,Assisted Living Facilities with Limited Mental Health License 12. Exhibit N, Special Provisions for the Indigent Drug Program 13. Exhibit 0, Mental Health Residential Level II 14. Exhibit V, Special Provisions for the Forensic Services Program 15. Exhibit X, Special Provisions for Projects for Assistance in Transition from Homelessness (PATH) Services 16. Exhibit AA, Motivational Support Specialist 17. Exhibit AC, Care Coordination Report Narrative and Chart 18. Exhibit Al, Family Intensive Treatment Team -Scope of Work 19. Exhibit AJ, Community Action Team 20. Exhibit AM, Return on Investment-Special Appropriations Projects for Fiscal Year 20218-22 21. Exhibit AN, Supplemental Security Income/Social Security Insurance (SSI/SSDI) Outreach, Page 3 of 7 Amendment#1 Contract No. ME225-12-27 10/01/2021 Access, and Recovery(SOAR) 22. Exhibit AO, Peer Services 23. Exhibit AP, Mental Health Case Management 24. Exhibit AS, Central Receiving Facility 25. Exhibit AV, Transitional Voucher Program 26. Exhibit AY, Mobile Response Team (MRT)for Monroe County 27. Exhibit AX, Crisis Stabilization Unit("CSU") Long-Acting Injectable Trend Report 28. Exhibit BD, State Opioid Response Discretionary Grant Services (2) Medication Assisted Treatment Services for Opioid Use Disorders and Evidence Based Treatment to Address Stimulant Misuse and Use Disorders 29. Exhibit BE, Tele-Behavioral Health Services For Services Provided to Children & Families Engaged in the Monroe County Scholl System—OCA MHTLH 30. Exhibit BF, Emergency COVID-19 Grant—OCA MHCOV 31. Exhibit BH, Recovery Management Practices 6. Pages 1 and 2 of 7, Exhibit B, Method of Payment, Payment Clauses, Paragraphs 1. a., e., and 4.a. are hereby amended to read: 1. PAYMENT CLAUSES 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 $8,662,996.00, subject to the availability of funds and satisfactory performance of all terms by the Network Provider. e. The total contract amount for services purchased through this contract is$9,412,996.00 of the total Contract amount, the ME will be required to pay $7,844,163.00 subject to the delivery and appropriate billing for services. The remaining amount of $1,568,833.00 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. 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$1,121,729.00 as indicated in Exhibit H, Funding Detail and Local Match Plan. Page 4 of 7 Amendment#1 Contract No. ME225-12-27 10/01/2021 7. Page 19 of 21, Exhibit C, Required Reports, is hereby amended to read: S kmplaiuerft;llre peclai P10ik tisc Supported October 12 2021 One (1) Password, ME Peer Services Manager Employment (Period:07/01/21 -09/30/21) protected and And January 10,2022 encrypted Electronic ME Conti-act Manager Template 30 (Period: 10/01/21 - 12/31/21) Submission And April 11,2022 Template 31 (Period:01/01/22-03/31/22) July 11,2022 (Period:04/01/22-06/30/22) 8. Pages 1 — 3, Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes & Outputs, are hereby deleted in their entirety, and Pages 1 —3, Revised Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes & Outputs, are inserted in lieu thereof and attached hereto. 9. Pages 1 - 4, Exhibit G, Covered Services by OCA, are hereby deleted in their entirety, and Pages 1 — 4, Revised Exhibit G,Covered Services by OCA, are inserted in lieu thereof and attached hereto. 10. Page 1 of 1, Exhibit H, Funding Detail, is hereby deleted in its entirety and Page 1 of 1, Revised Exhibit H, Funding Detail, is inserted in lieu thereof and attached hereto. 11. Page 1 of 1, Local Match Plan, is hereby deleted in its entirety and Page 1 of 1, Revised Local Match Plan, is inserted in lieu thereof and attached hereto. 12. Page 1 of 10, Exhibit N, Indigent Psychiatric Medication Program, known as the Indigent Drug Program (IDP), Preamble, is hereby amended to read: The Network Provider must follow the guidelines established in this document and by the Florida Department of Children and Families defined in Guidance 13, Indigent Psychiatric: Medication Program, known as the Indigent Drug Prograrn (IDP), dated July 1, 2021, or the latest revision thereof, herein incorporated by reference, 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 (IDP) are used for eligible individuals. 13. Page 1 of 10, Exhibit Al, Family Intensive Treatment (FIT) Model Guidelines and Requirements, Section 1, Authority, is hereby amended to read: I. Authority Annual Specific Appropriations 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 Department's Guidance 18, Family Intensive Treatment (FIT) Model Guidelines and Requirements, dated July 1, 2021, or the latest revision thereof, herein incorporated by reference, provides the guidance on the requirements of the FIT program. Page 5 of 7 Amendment#1 Contract No. ME225-12-27 10/01/2021 14. Page 1 of 12, Exhibit AY, Mobile Response Team (MRT) for Monroe County, Section A, Authority, is hereby amended to read: The Marjory Stoneman Douglas High School Public Safety Act, Ch. 2018-3, Laws of Florida, created a statewide network of MRTs. The Florida Legislature appropriated recurring funds to ensure reasonable access to MRT services in all Florida counties. In 2020, House Bill 945 amended s. 394.495, F.S., to include MRTs in the child and adolescent array of services and outlined programmatic requirements included herein and in the Departments Guidance 34, Mobile Response Team (MRT), dated July 1, 2021, or the latest revision thereof, herein incorporated by reference, 15. Page 1 of 10, Exhibit BH, Recovery Management Practices, the preamble is hereby amended to read: 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 participate in all implementation activities and Technical Assistance provided by DCF and the ME. The purpose of this document is to provide direction and recommendations for implementation of Recovery Management practices in Network Service Providers in accordance with the guidelines is this document and in the Department's Guidance Document 35, Recovery Management Practices, dated July 1, 2021, or the latest revision thereof, herein incorporated by reference. These practices are accomplished using Florida's Recovery-Oriented System of Care (ROSC) Framework. This document provides best practice standards to transform delivery of care to one that focuses on sustainable wellness and recovery. Remainder o f Page Left Blank Intentionally Page 6 of 7 Amendment#1 Contract No. ME225-12-27 10/01/2021 This amendment shall begin on October 1,2021. 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 sixteen (16) page amendment to be executed by their officials'thereunto duly authorized. THE GUIDANCE/CARE CENTER, INC.,a FL SOUTH FLORIDA BEHAVIORAL HEALTH 501c3 not-for-profit corporation NETWORK, INC. SIGNED SIGNED BY: t�E BY: NAME: Frank C. Rabbito NAME: John W. Newcomer, M.D. TITLE: Chief Operations Officer TITLE: President & Chief Executive Officer DATE: i.i of ii1 01 i' DATE: FEDERAL Tax ID#(or SSN): 59-1458324 Resolution WCGCC 2021-02 Page 7 of 7 11 11-11VIng Und./ow,ulflh II Ila,w lda (C"ollIhr�! limp as S P:.JI,n II IloI ida I13011h,!rrlio 111 Ile!III llI II\xAwc irk,IIIIIc.) 10/1/2021 EXHIBIT D Substance Abuse & Mental Health Required Performance Outcomes&Outputs Network Provider Name: Guidance/Care Center,Inc. Contract#: ME225-12-27 Date: 10/1/2021 Amendment#: 1 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 21-22 Guidance Document 24,click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml. Note: Click on FY21-22 ME Templates and click on Guidance Document 24—Performance Measurement Manual Adults Community Mental Health a.MH003-Average annual days worked for pay for adults with severe 40 38 and persistent mental illness b. MH703- Percent of adults with serious mental illness who are 24% 22.8% competitively employed c. MH742 - Percent of adults with severe and persistent mental 90% 85.5% illnesses who live in stable housing environment d. MH743-Percent of adults in forensic involvement who live instable 67% 63.7% housing environment e. MH744-Percent of adults in mental health crisis who live in stable 86% 81.7% housing environment Adult Substance Abuse a. SAA73 - Percentage change in clients who are employed from 10% 9.5% admission to discharge b. SA754- Percent change in the number of adults arrested 30 days 15% 14.3% prior to admission versus 30 days prior to discharge c. SA755 - Percent of adults who successfully complete substance 51% 48.5% abuse treatment services d. SA756-Percent of adults with substance abuse who live in a stable 94% 89.3% housing environment at the time of discharge Children's Mental Health a. MH012 - Percent of school days seriously emotionally disturbed 86% 81.7% (SED)children attended b. MH377- Percent of children with emotional disturbances(ED)who 60.8% improve their level of functioning 64% c.MH378 - Percent of children with serious emotional disturbances 65% 61.8% (SED)who improve their level of functioning d. MH778- Percent of children with emotional disturbance (ED) who 95% 90.3% live in a stable housing environment e. MH779 - Percent of children with serious emotional disturbance 93% 88.4% (SED)who live in a stable housing environment f.MH780-Percent of children at risk of emotional disturbance(ED)who 96% 91.2% live in a stable housing environment Children's Substance Abuse a. SA725 - Percent of children who successfully complete substance 48% 45.6% abuse treatment services Revised Exhibit D Guidance/Care Center,Inc. Page 1 of 3 Contract No. ME225-12-27 11 11-11VIng Ito nd.tow,ulflh II Ila,w lda (C"ollIhr�! iiinq as S P:.JI,n II IloI ida Il 011' !rrlio 111 Ile!III llI II\x�twc irk,IIII1c) I0/1/2021 b.SA751 - Percent change in the number of children arrested 30 days 20% 19.0% prior to admission versus 30 days prior to discharge c. SA752-Percent of children with substance abuse who live in a stable 93% 88.4% housing environment at the time of discharge Table 1 -Network Minimum Year to Date Service Provider Annual Target Acceptable Performance This Performance Performance Performance Period Measures Network Provider Compliance: Network Providers shall achieve a minimum of 95%of the annual target levels in Table 1.The measures shall be demonstrated on an annual basis but will be monitored by the ME monthly. For each measure where the Year-to-Date performance falls below the Minimum Acceptable Performance, the Network Provider will submit a brief narrative, at the request of the ME, describing each of the following elements: 1. Any specific challenges, obstacles,or other operational considerations which are identified as significant factors underlying the unsatisfactory level of performance. 2. Any extenuating circumstances beyond the Network Provider's scope which are identified as significant factors underlying the unsatisfactory level of performance. 3. Efforts the Network Provider has undertaken to support improved performance during this reporting period. 4. Efforts the Network Provider will undertake in the future to support improved performance during subsequent reporting periods. 5. Any region-wide guidance,capacity,training,or other logistical supports needed to support improved performance during subsequent reporting periods. Revised Exhibit D Guidance/Care Center,Inc. Page 2 of 3 Contract No. ME225-12-27 11 rrlitrui g k1lindSoullh II Ilow lda (coiiIhracfl III q a,S P:.s11°n II IlorkI„r Iitk)11I,nf!I!Ioin111 II114'u111fllI 112x^/w,:irk,III°Iu') 10/1/202"V Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Year FY21-22 Service Category FY Target Residential Care 30 a� Outpatient Care 1661 a� Crisis Care 199 x a State Hospital Discharges N/A Peer Support Services N/A Residential Care N/A c Outpatient Care 535 � x U Crisis Care 51 Residential Care N/A H a Outpatient Care 555 a� U Detoxification 135 Women's Specific Services N/A CN +- Injecting Drug Users 73 a Peer Support Services 5 Residential Care N/A c Outpatient Care 220 N N Detoxification 0 N � Q Prevention **Refer to Attachment IV, Scope of Work for the numbers served.** 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. Revised Exhibit D Guidance/Care Center,Inc. Page 3 of 3 Contract No. ME225-12-27 N O N O c com _ c c cO1v o N cco�n c o o N N N W ' O H - U (9 C O 0 0 U O T C C U C C C C U x Y P. U O O O Y N Y V P L z 0 z w V` R O O C O O C a U W c c o o c c o 0 O T P C C — O p tV G GC N1 OG°+ 00�n z z a� t7 0 c a ❑ = — Y Q c°i � � E F 4a��i �L �F� 7 Ei F ti Rh 'arU`y N� y y r' � G �.F � � F�F 'R' � v � � '�_O ? .L.^L-•. v W F" .v'- u � �' FF'C 4 Li � .... ox d=a � , �,p `�'•- ov o o c � kU� � J Z U :JawOC7 £ ,aN <UUU00 °°.°- z�OCCzcCrxc+:c+:v:v:v�F°¢Q��r�x0.'v LUUv:xo.a.a`W¢Qry¢ dQw oa mwmU¢ � •k W N C>' L O O O O J O.r�.....-.M.�r� d� I N J N N N •V �: ^.i M �••. °"V "I �" 'R�V:1/I . V1 � � � :. �° E Q N O N O C C N O G O C O G N O 1V N P N F � - N N LLJ U (9 ;a a � z U c � c x m — r o � c ? o d c x � � z e � z U O U = z 0 z w = � U � 7 o a wN b R A > ^ W s o W C U o F z 'r. W z z o c c c o c o - 0 0 0 o c o c o - - - S W W Q N GO Q b Q in N a O�l�M YJ C M V, � � � � � � z o z Q U � z U ti 79 b W A C a =-2-a� ;n? = oU o � c t?v:v1 0 :u.W�-,i:. Gz p v ,: 7 7 `v v v o ❑ o'r r`k., 47 r 2 �' T c t� ��OOC 'Yo:xc:w�'mvir�� ¢ ..sw'�.GCUUCiUw'c[ awaw¢¢`� 4 m w cgwwU¢ i�,. I" 7 Q V V iu�..� w' 'i v', 'in i, e ifi N O N O N N N N W O O G G C O C C T G C Y N C I N C�?�n C l� C (9 C c c c o c c U �n — a 0 0 o c o c o c c o c c vi o rn c G c C Y v\ D N— U' C C G Q T z w m V` R Z ,J O C U O C O C C O O C C C C C O O C U O O C C C O O F O vi C C O N r ti w G C C 7 7 � C C T C C C W W Q N GO Q b Q in N a O P l P VJ 00 O P O l� P O O O O M c� �M YJ 00 �D l�O W 00 O M V M O M. V, � � � � � � � z o z Q U � z U 72 'U ti C7 a a F v " s s. s. .F.I 7 7 `v v v c ❑ F'r r`Fr "47 Q o o c U'J v' c°�. R o r 2 �' T c t� <C Utt ��OOC 'Yo:xc:w�'mvir�� ¢ ..sw'�.GCUUCiUw'c[ awaw¢¢`� 4 m w cgwwU¢ F ~ ";i N O N O N N N N W O Z U (9 C O U o c c o c �c c c m �o c g c c N N T O b y Q T O\ N O C F F i U �d z r 0 z w 7 b R A > ^ W o w M co x U CF r'c W o � Y O 12 W W Q N GO Q b Q in N a O P M F. N l�M. 00 �D l�O W 00 O M V M O N C V, � � � � � � � '- 0� z o z Q U � z U ti 79 -a R o o F a 3 O on LQ� d`" vV, m vrA u a u ti F R a o a 7 7 `v v v o ❑ o'r r`kr 47 Q o 0 0 U'J v' c. R o r T¢.�c t� C 'Yo:xc:w�'mvir.-� ¢ ..sw'�.GCUUCiUw'c[ awaw¢¢`� 4 m w cgwwU¢ EXHIBIT H-FUNDING DETAIL October 2021 Provider:Cuidance/Care Center,Inc. Contract 4:ME225-12-27 Amendment 41 ADULT MENTAL HEALTH CHILDRE\MENTAL HEALTH FICA DESCRIPTION NEWOCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Rendential Services s MH001 $ ;�M, 9 Residential Services MH001 $ No R I ntial S e MH009 $ 915,082 N R'dential Sc­­ MH009 $ 4 g000 Crisis d Baker Act Services M tr l 8 $ 1 130,e03 Crisisand Baker Act Services MHOI S $ 15,G77 Faris Intervention Psychotic Disorders MH026 $ Purehased Residential Treatment(PRTS) MH071 $ � Commumty Forensic Program MH072 $ 160000 Special Appropriation WILL MHOBN $ .... Indigent Drag Program MH076 $ 50.564 Care Coordination MHOCN _$ Proviso Allocation-Citms MH094 $ Carry Forward MHOCF __$ _ Carry 3R.d t 1 Seri SUP I M H O I S CareCoordination MHOCN $ '3,1 Service, $ N R d ntiul S vices SUP 1 MH09S $ - Forencic Hospital Multidisciplinary Team MHOFH $ Crisis and Baker Act Services SUP I MH18,S $ FACT Team MHOFI $ Cmannuity Action Tmatomat(CAT)Team MHCAT $ 750.000 PATH Chant MHOPG $ I65000 Core Crisis Set Aside MHBG SUP 1 MHCCS $ TANF Services MHOTB $ Mobile Crisis Team MHMCT $ G36.471 Residential Services SUP I MFI $ Smcid,Prevention MHBG SUPI MHSP\ $ Nur-Residentarl Services SUP 1 M1109S $ T I he,dth Beluvioral Health Services MHTLH $ 111.112 Crisis and Baker Act Services SUP 1 MH18S $ CSOC Grant Year 2 CSOC2 $ � Expanding 211 Call MH211 $ Specialty Programs SPLTY $ Early Intervention Services MHBG SUPI MH26S $ $ � Core Crisis Set Aside MHBG SUPI MHCCS Emergency COVID-19 Grant Supplemerrrt MHCCS Short Term Residential Tieatment(SRT) MHCR2 $ $ ,� Su PPor ted Employment ymear t Services MHEMP $ 150,000, $p Fn T isitional Beds MHFMH $ Residential stabilitv Coord MHBG SLTI MHRES $ $ Emergency Cn%'[D-Sop l nental MHCCS 7 For Profit S b-Re p t key West HNLA MHSFP $ $ Sn d P do MHBG SUPI MHSPV $ $ Tel h lth 13,haxioml Health Servivec MHTLH $ $ MDC Central Recer,ingF cdAv MDCRF $ $ Specialty Programs SPLTY $ $ .. TOTAL ADULT MENTAL HEALTH= $ 3.201.337 TOTAL CHILDREN MENTAL HEALTH= $ 1,98,3,260 ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Services MS003 $ Residential Services M11003 $ 1 Nu R i1.Hal Services MSOII $ 523,791 Non-Residentod Secvioes MS011 $ 253,773,� Det Services MS021 $ 456,643 Detox Services MS021 $ HIV Services MS023 $ HIV Services MS023 $ Prevention Services MS025 $ Prevention Services MS025 $ 199063J W Services MS027 $ - Prevention Partnership Grant MSOPP $ Pregnant Women Project MS081 $ Care Coordination MSOCN _$ FIT Team MS091 $ 200,000 Carry Forward MSOCF $Care Coordination MSOCN $ 32.651 TAN FServices MS0T13 $Carry Forward MSOCF $ 115120 Residential Service,SUP MS03S $ TANF Service, MSOTB $ Nur-Re,idommlS icesSUP1 MS11S $ Residential Services SUP 1 MSO'+S 7 Detox Services SUP I NB21 S $ Nun Residential Services SUP 1 MS11S $ - Prevention Services SUP 1 MS25S $ - Det_Se rvices SUP I MS21 S 7 Proviso Allocation Here's Help MS903 $ Preeention Services SUP 1 MS25S 7 El Help Opioid Training MS921 $ Cue C d t I dgement MS92, $ NES.SEN Care CoordSAPT SUPI hISCS2 _$ Community Based Services MSCBS $ 50,000 Prevention Partnership P g SAPT SUPI MSPPS $ NES,SEN Care C 1 SAPT SUPI MSCS2 $ - S wide Prevention SAPT SUPI MSSPV $ - Opi d Response Disc.Rec Comm Ong-Year 2 MSRC> $ SOR Prevefition Years MSSP3 Opiod Response Disc Rec Comm Org fear 3 MSRC3 7 SOR Prevention Year 4 MSSP4 $ 125,525,� Opi d Response Dice Rae Comm Org Year4 MSRC4 7 Specialty Programs SPLTY $ Her iResponse Drsc Giant GPRA Year 3 MSSG3 $ $ SOR MAT Year 2 MSSM2 $ 50,000, $ SOR MAT I ear 3 MSSM3 $ 100,000 $ - SOR-MAT Year4 61hh M4 Suicide Prevention SAPT SUPI MSSPV $ _$ -.... Specialty Programs SPLTY $ ...$ TOTAL ADULT SUBSTANCE ABUSE_ $ 2,061,205 TOTAL CHILDREN SUBSTANCE ABUSE FUNDS NOT REQUIRING MATCH: Drag Abase Services_ _ $ _ 822499 TOTAL ALL PROGRAMS= $ 7,844.163 Prevention _ _ $ _ 344.588'.. UNCOMPENSATED UNITS= $ 1,568.833 Demstitationalization Protect _ $ _ '37 R,629 TOTAL= S 9,412.996 CMH Program $ 1,993 260 SOR Grant $.........650,000 TOTAL FUNDS REQUIRING MATCH= $ 3,665.197 TOTAL FUNDS NOT REQUIRING MATCH $ 4.178,976 LOCAL MATCH REQUIRED- $ 1,221,729 NOTES FY 2020-21 Adjustments: '2/520 All 1-time only fm(ling inchuding carry f rward allocations are withdrawn. SOR finding allocation for FY 2020-31 is allocated as follows:MSSM2-566,692(1st epe rter)and MSSM34200,075(3 gttaitem);subject to appropriation in the FY 20- 21. SOR Prevention finding allocation for FY 2020-21 is allocated as follows:MSSP2-$22,437(1st gaarted and MSSP3-S67,310(3 quarters);subject to appropriation in the FY 20-21. '9/420$65,742 is added to MSSM2 for additional services to be utilized prior to 9/3020,1-time only. 9/1020$252,000 is aikledto ASA-MSOl1 unl$433,188 is reduced fors ASA-MS091(u(Ijustments with Village). 12/9/20 $100,075 is transf red from MSSM3 to MSSM2 to align with SFBHN SUR allocation;additionally,$175,000 is added to MSSM2 for addiitonal SOR services,]-time only. $75,000 is reduced from MHEMP and replaced wttir MH009 to ford the same supportu{emplyment services. $301,092 is added toAMH-MHCOV to Load Emergency Covid grant fimded services to include Supported Housing and crisis services. $97,950 is added to AMH-MHTLH for Tete-heatHr behavioral services. 12/22220 $35216 is added to MSSGP and 57,658 to MSSG3 for the GPRA data sen-ices,the GPRA data entry will be mimh n,ed at 860.00 per event. 12/29/20 MHEMP&MH009 adjustments on 12/9/20 are reversed as the SOH is revised to reflect tire Supported Housing services. FY 2021-22 Adjmmrents: 2/2521 All the SOR allocations including GPRA and Prevention Finding are withdrawn,as these allocations am not recurring. 6/10/21 SOR allocations are added based on tentative allocations for FY 201-22,OCA allocations may clrmrge once the approved Schedule of fords for the new year is received 10/2/21 $53,394 is added to AMh-MHOcf(MH001)to fund a Res I bed for 9 months. 10/221 $119,120 is added to ASA-MSOCF(MS02H to expand 2 Detox buds for 9 m nibs,1-time only. $11 162 is added to CMH-MHTLH to align the fording allocation with the ME's SOT allocation. �$5 alien`vith the ME',SOF allocation and$50,525 is added to MSSP4.,000 is reduced from MSSP3 to $100,000 is reduced from MSSM2,$350,000 from MSSM3 and$500,000 is added to MSSM4 to align with SFBHN's SOF allocation. $60,000 is reduced from AMH-MHOCN based oil tuuding Care Coordination on a Team based approch. 10/21/20 SA Match calculations are mvised haled on prior year treatment data(%non-Alcohol Clients). 11/10/21 $75,000 is added to MHEMP to futd supported eanplym it/cttibliousSrvices $325,035 is added m AMH-MHCCS m fund the MRT Expansion cervices. $-7.372 is added to AMH_MHOPG to align with the ME's Schedule of foods allocation. Guidance/Care Center,Inc. Contract No. ME225-12-27 Revised Exhibit H Page 1 of 1 N O N ti O U N N N U LL1 N O Z (9 F", U z M �!1 EF f S4 EA S4 M h M O lC I� 7 M x o 0 c �. r� M y O 0. U _p p4 �l •�1i21 ^� Pr Q' 6A EP EF A S4 � O M V1 l0 � z M T 00 7 N 00 7 V^ 7 V1 N 07 O T N T V: 00 C T C l� T O O N O T n M OC O .-i 7 cl T V N N O ;n V9 5n e 6n EF. Et?fn h A A V9 s5 wF A 66�n 6n A 6S b9 n 6n w wl 6n Es ds 69 f 6n Yr 69 6n f 6n n W Hs a 6n Ad 64 O R o c a W W W Fz 7 o 0 o Y f) r a s ti F y .� �� Y �'o � Y L � .° � Ca W CQ �' ^ v' �, v � aF :S Y L R ❑ ❑ yy y > > 0i N N N ^' ` O O O y°� .�-i U N N i L i L O N 'li l� M •'F n fV N N dUUU�"� i-rrr _ � � OOOcCQ-' cCP.' �.' ✓lrnr%� � r. QQ .-iwcCc4C4rnUUcG �' 0. 0. 0. 0. Q' Q' QQ' 0.10. a) N V n if. T M I- oc NN N N N N N N 7 M M 7 7 7 7 7 7 Vl V: V] rl V W U C (0 a Amendment#2 Contract No. ME225-12-27 11/01/2021 As 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. ME225-12-27. PREAMBLE: This amendment addresses the following revisions to the contract: • $185,000.00 is added to Adult Mental Health, OCA MH09S, to provide Outpatient services; one-time only; • $120,000.00 is added to Children's Mental Health, OCA MH09S; to provide Outpatient Services; one-time only • $120,000.00 is added to Children's Substance Abuse, OCA MS11 S; to provide Outpatient Services; one-time only • $100,668.00 is added to Adult Mental Health, OCA MHMCT to expand the MRT services; one-time only; • $78,616.00 is added to MS21 S for two (2) additional Detox beds, effective 1/1/2022; one time only; • Increases Exhibit D, Network Service Provider Output Measures — Persons Served, as follows: 0 10 Adult Mental Health—Residential Care 0 94 Adult Mental Health—Outpatient Care 0 41 Adult Mental Health—Crisis Care 0 10 Children's Mental Health—Outpatient Care 0 7 Children's Mental Health—Crisis Care 0 5 Adult Substance Abuse—Detox 0 15 Children's Substance Abuse—Outpatient Care • Corrects Preamble of Amendment#1; • Adds OCA MH09S; • Adds OCA MS21 S; • Adds OCA MS11 S; • Revises exhibits; • Revises rates, retroactive to July 1, 2021. As a result, this amendment revises the Amendment #1, Preamble; Standard Contract; Exhibit B, Method of Payment; Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes & Outputs; Exhibit G, Covered Services Funding by OCA; Exhibit H, Funding Detail, and Local Match; and Exhibit AC, Care Coordination. 1. Page 1 of 16, Amendment #1, Preamble, is hereby amended to correct bullet point eight (8) to read as follows: PREAMBLE: This amendment addresses the following revisions to the contract: • $27,372.00 is added to Adult Mental Health, OCA MHOPG to align with the ME's Schedule of funds. 2. Page 2 of 16, Standard Contract, Paragraph 5, Contract Amount, as previously amended on page 1 of Amendment 1, is hereby amended to read: 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 $10,138,136.00, subject to the availability of funds and satisfactory Page 1 of 4 Amendment#2 Contract No. ME225-12-27 11/01/2021 performance of all terms by the Network Provider. Of the total Contract amount, the ME will be required to pay $8,448,447.00, subject to the delivery and billing for services. The remaining amount of $1,689,689.00, 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. 3. Pages 1 and 2 of 7, Exhibit B, Method of Payment, Payment Clauses, Paragraphs 1. a., e., and 4,a., as previously amended on page 4 of Amendment#1, are hereby amended to read: 1. PAYMENT CLAUSES 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 $9,399,136.00, subject to the availability of funds and satisfactory performance of all terms by the Network Provider. e. The total contract amount for services purchased through this contract is $10,138,136.00 of the total Contract amount, the ME will be required to pay$8,448,447.00 subject to the delivery and appropriate billing for services. The remaining amount of $1,689,689.00 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. 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$1,400,451.00 as indicated in Exhibit H, Funding Detail and Local Match Plan. 4. Pages 1 — 3, Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes & Outputs, as previously amended on page 5 of Amendment #1, are hereby deleted in their entirety, and Pages 1 — 3, Revised Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes&Outputs,are inserted in lieu thereof and attached hereto. Page 2 of 4 Amendment#2 Contract No. ME225-12-27 11/01/2021 5. Pages 1 - 4, Exhibit G, Covered Services by OCA, as previously amended on page 5 of Amendment #1, are hereby deleted in their entirety, and Pages 1 — 4, Revised Exhibit G, Covered Services by OCA, are inserted in lieu thereof and attached hereto. 6. Page 1 of 1, Exhibit H, Funding Detail, as previously amended on page 5 of Amendment 1, is hereby deleted in its entirety and Page 1 of 1, Revised Exhibit H, Funding Detail, is inserted in lieu thereof and attached hereto. 7. Page 1 of 1, Local Match Plan, as previously amended on page 5 of Amendment #1, is hereby deleted in its entirety and Page 1 of 1, Revised Local Match Plan, is inserted in lieu thereof and attached hereto. 8. Page 6 of 18, Exhibit AC, Section II, B. Priority Population, paragraph 5, is hereby amended to add: 5. Children and youth referred by Mobile Response Teams (MRT) that meet the following criteria: i. Youths that have come in contact (screening/assessment) with MRT services at least 2 times in 180 days. ii. Youth that have a combination of MRT contacts (screening/assessment) and one of the above children/youth criteria. 9. Page 7 of 18, Exhibit AC, Section II, B. Priority Population, is hereby amended to add: 7. Individuals released pursuant to v. State Mosher,where a judge did not issue a Conditional Release Order(CRO)and are no longer receiving Forensic Services, This amendment shall begin on November 1,2021. 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. Signature Page Follows Page 3 of 4 Amendment#2 Contract No. ME225-12-27 11/01/2021 IN WITNESS THEREOF, the parties hereto have caused this thirteen (13) page amendment to be executed by their officials'thereunto duly authorized. GUIDANCE/CARE CENTER, INC. SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK, INC. SIGNED ( � f . �� I � .�.__ SIGNED BY: BY: NAME: Frank Rabbito NAME: John W. Newcomer, M.D. TITLE: Chief Operations Officer TITLE: President &Chief Executive Officer 1/14/2022 DATE: DATE: FEDERAL Tax ID#(or SSN): 59-1458324 Resolution WCGCC 2021-02 Page 4 of 4 11 11-11VIng Und.tow,ulflh II Ila,w lda (C"oll irrm lieu igi as".,r:,oJIe II IloI Ida li,r ll i lvlu:lralll II IIealll1III INotuvork,Ilu c.) I I/1120211 EXHIBIT D Substance Abuse & Mental Health Required Performance Outcomes&Outputs Network Provider Name: Guidance/Care Center,Inc. Contract#: ME225-12-27 Date: 11/1/2021 Amendment#: 2 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 21-22 Guidance Document 24,click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml. Note: Click on FY21-22 ME Templates and click on Guidance Document 24—Performance Measurement Manual Adults Community Mental Health a.MH003-Average annual days worked for pay for adults with severe 40 38 and persistent mental illness b. MH703- Percent of adults with serious mental illness who are 24% 22.8% competitively employed c. MH742 - Percent of adults with severe and persistent mental 90% 85.5% illnesses who live in stable housing environment d. MH743-Percent of adults in forensic involvement who live instable 67% 63.7% housing environment e. MH744-Percent of adults in mental health crisis who live in stable 86% 81.7% housing environment Adult Substance Abuse a. SAA73 - Percentage change in clients who are employed from 10% 9.5% admission to discharge b. SA754- Percent change in the number of adults arrested 30 days 15% 14.3% prior to admission versus 30 days prior to discharge c. SA755 - Percent of adults who successfully complete substance 51% 48.5% abuse treatment services d. SA756-Percent of adults with substance abuse who live in a stable 94% 89.3% housing environment at the time of discharge Children's Mental Health a. MH012 - Percent of school days seriously emotionally disturbed 86% 81.7% (SED)children attended b. MH377- Percent of children with emotional disturbances(ED)who 60.8% improve their level of functioning 64% c.MH378 - Percent of children with serious emotional disturbances 65% 61.8% (SED)who improve their level of functioning d. MH778- Percent of children with emotional disturbance (ED)who 95% 90.3% live in a stable housing environment e. MH779 - Percent of children with serious emotional disturbance 93% 88.4% (SED)who live in a stable housing environment f.MH780-Percent of children at risk of emotional disturbance(ED)who 96% 91.2% live in a stable housing environment Children's Substance Abuse a. SA725 - Percent of children who successfully complete substance 48% 45.6% abuse treatment services Revised Exhibit D Guidance/Care Center,Inc. Page 1 of 3 Contract No.ME225-12-27 11 11.11VI g It4 nd.tow,ulflh II Ila,w lda (C"oll itrm h igi as".,r:,oJIe II IloI Ida li,r ll i lvlu:lralll II IIealll1III INotuvork,Ilu u:.) I I F 112021 b.SA751 - Percent change in the number of children arrested 30 days 20% 19.0% prior to admission versus 30 days prior to discharge c. SA752-Percent of children with substance abuse who live in a stable 93% 88.4% housing environment at the time of discharge Table 1 -Network Minimum Year to Date Service Provider Annual Target Acceptable Performance This Performance Performance Performance Period Measures Network Provider Compliance: Network Providers shall achieve a minimum of 95%of the annual target levels in Table 1.The measures shall be demonstrated on an annual basis but will be monitored by the ME monthly. For each measure where the Year-to-Date performance falls below the Minimum Acceptable Performance, the Network Provider will submit a brief narrative, at the request of the ME, describing each of the following elements: 1. Any specific challenges, obstacles,or other operational considerations which are identified as significant factors underlying the unsatisfactory level of performance. 2. Any extenuating circumstances beyond the Network Provider's scope which are identified as significant factors underlying the unsatisfactory level of performance. 3. Efforts the Network Provider has undertaken to support improved performance during this reporting period. 4. Efforts the Network Provider will undertake in the future to support improved performance during subsequent reporting periods. 5. Any region-wide guidance,capacity,training,or other logistical supports needed to support improved performance during subsequent reporting periods. Revised Exhibit D Guidance/Care Center,Inc. Page 2 of 3 Contract No.ME225-12-27 11 rrlitring N11111dSoullh II Ilarw lda ((°ouihrar fl rK;q"is South II Ilorida liBplli,!rrlclri III II IIeallth Network,Ilinc.) I IPII/202I Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Year FY21-22 Service Category FY Target Residential Care 40 a� Outpatient Care 1755 a� Crisis Care 240 x a State Hospital Discharges N/A Peer Support Services N/A 7V Residential Care N/A c Outpatient Care 545 � x U Crisis Care 58 Residential Care N/A H a Outpatient Care 555 a� U Detoxification 140 Women's Specific Services N/A CN +- Injecting Drug Users 73 a Peer Support Services 5 Residential Care N/A c Outpatient Care 235 N N Detoxification 0 N � Q Prevention **Refer to Attachment IV, Scope of Work for the numbers served.** 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. Revised Exhibit D Guidance/Care Center,Inc. Page 3 of 3 Contract No.ME225-12-27 V G O O C C G N V O O O C O G M O G G G A O O G G O N 4 c o c a c S N N N N o o c LLJ x O Z U (9 o c o c O x — — U L o c c U z } M. D o c c o o c G c o o c c c o o c c c o c o c o o c c c o z � - c o z M c c M o m V c c o S � O N z z 0 z It- 7 a w V` R O O C O O C a O — C p V O ^OJ C C W c c o o c c o 0 c c - o p Fi �n n�nry �cavN�n avo.- .. wno ry � ry � n n ca o c c roc z z W vi�v?v y v3 n s5 sF se n sn ss� 55�+s va va vj � .`x n sri,,11 a� z ,pZ m a W �y F W � � !� � " "=C7 m > > � � :c °x ^o"°�o vy.�✓'W ] z a C9 'S ❑ oo �a.� ti � oti _ .,c.. 7 ❑ra L] ' o 0 7d,F F; a E-, y I. v a Ewe. i�. Gzy. z U c�wc:OC7 R p C7 w Q o 0 0,� U I. cyi t. <0��oo ��� pee =aazzsU�F�a¢��xxavvUxceaaaa¢a ¢ awro 'arowv¢ N U L O O O O �, O.r�.....-.M.�r� ..1� I N i"V N N N .�„�: i:..i M �.�.�,. •1"�'S V;1!i i ie'. 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C O C C N G O C G O O — � M O i N N N N LLJ Inz Z c c c c o coc c � o c c c o 0 oc c U o - c� N 0 0 o c o coc c o c c vi o�n c o c c o c o c O OC OC G G C m O O O G G G � G � t` t` z 0 z a Wm V` R Z — J U O C O C C O O C C C C C C O O C U O O C C C O O C F O vi C C C O N r ti w C C C 7 7 � O C G G O C C C O C C O C o°i vi ri �i ri �co��eri � odd.: - d •• �� d o d ?�'.y O1 Q1 M In O 00 N�N�N T N N n b \O n n N In M VOi n R c�C z o ,zy U r U V `E° � F, v •� '`'� C C � v d �'a L � E i. 'L W .°..Fi U^, .: i m v v v W a'd•r `� b 'p•O p' � d -f P4 '° ti •a O'L' G F°i N U cart _ ° ti w K a c C 4 C7 = :_''a.? E.. W _ v,.+ ❑ ❑ v`:� L, E .� a w.� c. b ,�. x F" W Cq� z F c ,� o o o _ W o CC �3� al ° � ��.'i.L' 'L' N: ? F �'F M 'a `•' v m i O i R etl d .� a a C ° c� O G O O 7 O i '�'a� � m p " n•C•C 7 3 a` ai m y F F o "�'Q o 0 0 V u m m co. cam. E RN <UUUooS ��OOCao xc cmv ��a�ad =a�aUUUcecC iwo.d�c t ¢ mwamw�d a N o 07 N N r a x a e r oo a o• m o �o ° N N :�NNN N N N N N O N W O y Z U N C U �i o c o 0 o c � 7 z m U C� J v v z 0 v ' c� v 'o a x w � R p � a W o o O yC�c C a O mo � v CF r'c _ W 0 c c o Y P .�+ N 00 O O\ 00 00 Q V.V1 O O O 1� V1 Q b O� 00 l, z o t C7= U p¢ m Ez U L) c a a0. aO C7 i O K o S U :a ? > c _-.�k"-��✓.q p'C Nr aW a'- c "off='cc og a �. ..N. i =S '^�Q V m F I. y,'C O Ti'6 i y ,ij;r V_`�,�� � i L ^F ❑ C U W — ° �w K a c C i.-aa� �.. W.°z7 _ ox`�'.> ❑ a �... o, w.� ��a p z x o CC F R N E ✓ v= v d a= `c Gt C a o y v y z.'a i. ;n? oCi o cta� i. ^I N C U U U(� ❑ Q'7 C 7 Gi 0.i 0.'�fn VI V1 r ¢4 i--i s Rai'S�i fX U,U U 2'F'r-i SI L� Qa Q�I 00'-I N N M IA.2 N ; , �� Ne"\b r NN00 +" t� h� O•1" ( f� O ti 7 �ry b I' O —M ti N ,y.. v'.� in �f� �G EXHIBIT H-FUNDING DETAIL No,a[b 2021 Provider:Goidance/Care Center,Ina. Contract#:ME225-12-27 Amendment#Z ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRLLTION NEW OCA AMOUNT OCADESCRI TION NEW OCA AMOUNT Residential Seniucs lllml 6,,9 Residential Services MI1001 $ NmrRe,ideir 1 S viw, MHOD9 $ 215.082 Nun Residential S­iccs MII009 $ 4 0 O00 Crisis and Baker Act Services MHO18 $ „1,13U 5031 Crisis and Baker Act Services MIIOIS Early lnterve¢tion-Psychotic Disorders M11016 S Purchased Residential Treatment TRTS) MI1071 Community Forensic Program NRIO72 $ 16000�„ Special Appropriation-1CFH M110BN $ Indigent Drag Program MH076 $ 50,564 Care Coordination hM1HOC'N $ Proviso Allocation-Citrus hIHO94 S _ Carry Forward MBOCF $ Carry Forwnrd MHOCF $ 53,394 Residential Services SUP 1 MHO1S $ Care Coordination MHOC'N $ 23,130 Non Residential Services SUP t N-IH09S $ 120.000 Forensic Hospital Multidisciplinary Team MHOFH 8 Crisis and Baker Act Services SUP 1 MHISS $ FACT Team MHr1PT 8 Commrnity Action Treatrnent(CST)Tearn MHCAT S 600.000„ PATH Grant MHOPG $ 165.000 Core Crisis Set Aside MHBG SUP] MHCCS $ TANF Services MHOTB S Mobile Crisis Tear, MHMCT $ 6'6.471 Residential Services SUP t MH01S S Suicide Prevention MHBGSUPI MSSPV $ Non Residential Services SUP 1 MHO9S $ 18�.000 Telehealth Behavioral Health Services MHTLH $ I11i112 Crisis and Baker Act Services SUP t MH1SS S CSOC Grunt Yeaz-2 CSOC2 $ Ezpnndiag211 Call M11211 S ,,, Spa alty Programs SPLTY $ Early line, 9t,iccs MSBG SUP M1126S S $ Core Criers Set AsideMHBG SUPL MHCCS $ 325,035 $ Eacrgcncy COVID-19 Grant Supplcma,rel MIICOS S $ Short Term Residential Treatrent CSRT) MHCR2 S $ Supported Employmc,t Saviccs MIIEMP $ ... I50,000„ $ .... Porcnsic Transitional Bel, MHEMH S Rcsdchal stability Cooid MHBC SUP] MARES S - $~ Emagarcy COViD Suppinncntal hHiSCS S For Profit SulrRa;ipc d Kcy West ilMA MIISPP S - $~ S'eidc P--tion MHBG SUPI MIISPV S - $ Tcichcalth Bel-io,al Harp],Set,was MIITLIi S $ MDC-C-nal Rcccv,g Facility MDCRP S - $ 5pccialty Programs SPLTY S $ Commu,ty Acti ,Trcatnc,t(CAT)Tram MHCAT M Iilc Crisis Tcam MHMCT R 100,668 R TOTALAIICLTMENTM.HEM.TH= $ 3,637,005 TOTAL CHILDREN MENTAL HEALTH= $ 1,953,260 ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABASE OCADENCRI TION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Setsices MS003 S R al S i _, ,,.. Icnti umecs MS003 NrnrRwdcnt 1 S viuvs MND]] � 523 791 Nun Rasidorrhal Smiccs M5011 253,'3 Dctux Soniucs MS021 $ 486 643 D rt Set,ices MS021 MS023 S JHV Scrvi $ Ii1V Sc i,cs cvs MS023 M Pre,artion Su iecs S025 S P- t n$crviax MS025 $ 199063 Wumcn's Scrvioes MN027 S Prc,cntiun Pnrtnavhip Grant MSOPP Pregnant Women Project MSON S Ca re Coordination MSOCN FIT Team MS091 Crory Fro watt] MSOCF $ Care Coordination MSOCN $ 32651 IANF Services MSOTB $ C rry Poiv arJ MSOCT $ 118 120 Residential Services SUP 1 MS03S $ TANF Services MSOTB S Non Residential Services SUP 1 VISM S $ 120,000„ Residential Services SUP t MS03S S_ _ Detox S_ices SUP t MS21S $_ Ne'Residential Services SUP t MSl lS S - Prevention Seances SUP 1 MS25S $ Detox Services SUP I MS21S $ 8.616 Proviso Allocation Here's Help MS903 $ Prevention Services SUP t MS25S 8 Here's Help Opic id Traning MS921 $ Care Coordination Aidgement MS923 S NES/SEN Care Coord SATE SUP] MSC'S2 $ Commrniry Based Services MSCBS $ 50.000 Prevention Partnership Prog SATE SUPL MSPPS $ NES'SEN Care Coord SATE SUPL MSCS2 S - Suicide Prevention SATE SUPL MSSPV $ - Opioid Response Disc Rec Comm Org-Year h(SRC2 S SOR Preveihion Year MSSP3 $ 20000 Opioid Response Disc Rec Comm Org-Year3 MSRC3 S SOR Pre-lion Year MSSP4 $ 12�i525 Opioid Response Disc Fee Comm Org-Yeaz'4 h(SRC4 S Specialty l*rogruns SPLTY $ Opioid Response Disc.Grant-GPRA Year MSSG3 S $ SOR-MAT Year MSSM2 SOR-IVLST Year MSSM3 $,,,,, SOR-NEAT Year MSSM4 Suicide Prevention SAVE SUP] MSSPV S Specialry Prognuns SPLTY S $ TOTAL ADULT SUBSTANCE ABUSE- $ 2 139 821 TOTAL CHILDREN SUBSTANCE ABUSE_ $ 71R,3fi1 FUNDS NOT REQUIRING MATCH: Druv Abirse Services $ 920,615 TOTAL ALL PROGRAMS- S 8.448,447 Preve¢h0n $ 344,588 UNCOMPENSATED UNITS- S 1.689 ie) Deitutitnnonalrzanu¢Project _ $_ 3-R,6-9 TOTAL H = X 10,13R,13fi CM Program $ _1953,260 SOR Grant It _ 650,000 TOTAL FUNDS REQUIRING MATCH- $ 4,201--54 TOTAL FUNDS NOT REQUIRING MATCH $ 4,247.092 LOCAL MATCH REQUIRED= S 1.400.451 NOTES FY 2020-21 Adjustmcnts� 9i4/20$65,742 is added to MSSM2 fur additional setviccs h,he utilizul prior to 9/30/20,1-time only. 9/10/20 S252,000 is added to ASA-MS011 and S433,188 is reduced from ASA-MS091(adi-tints with Village). 12920 $100.77 hansfcmJ from MSSM3 h,MSSM2 t align with SPBII�SOR allocation,additionally,$175,000 is aJJod m MSSM f ddiihmal SOR_nr cs,1-time only. S75,000 is reduce]fium MIIEMP and replaced vrith Mit009 ro fund the same suppurtcul cmplylnent scrvic.:s. 5301,092 is added to AMII-MSCOV to fund Eincrgcncy Cuvid grant funded scn ices to include Supported Housing and crisis scrviccs. 597,950 is add,]h,AMIt-MIITLIi for Tcle-health hchaviomI scrviccs. 122220 $35,216 is added to MSS(?and$7,658 to MSSG3 for the GPRA darn scn ieas,the GPRA data entry will he reimbursed at S60.00 per c,cot. 1228/20 MHEMP&MI1009 adjustmcnn o,12/9/20 are reversal as the SOIL is revisal to,,E,t the Supported Housing scrviccs. PY n 2021-22 Ad atmerk, 225/21 All the SOR allowtiona including GPRA and Prevention finding are withdrawn as these allocations arc not recurring. '6/10i21 SOR allowtionn are added based 9n matativc ahocations for FY 201-22,OCA allocations may change once the approval Schcdulc offends fro the new year is rcncircd. IO2/21 $53,391 is added to AMh-MI10ef(MIt00H u,hand a Rix 1 bad 1 9 months. 102/2I$118,120 is added is,ASA-MSOCF(MS021)to nvpand 2 Detox bads for 9 months,1-time only. S,3 I3,162 iv added to CMIi-MITTLH to align the funding allocntion with the MIT,SOP allocation. S5,000 is reduced from MSSP3 to align with the ME's SOP allocation and S50,>55 is added to MSSP4. S 100,000 is reduced from MSSM2,S350,000 from MSSM3 and S500,000 is add,]in MSSM4 to ali6,with SFBHN's SOP allocation. $60,000 is reduced from AMIt-MIiOCN hased on funding Care Coordination on a I-,based aI proch. 10 2120 SA Match calculi&ins arc revised based o i prier yw tre atment eatment do.P non-Alesdol Clients). 11,10/21 $75,000 is added h,MIiEMP to fond supportal cniply tentclnbhonsc Sava S325,035 is added to AMH_MHCCS to rind the MRT/9S8 Expansion services. S2 7,372 is added 10 AMH-MHOPG to align with the ME's Schedule of finds allocation. 11/24/21$185,000 is added to AMH-MH09S,$120,000 to CMH-MH09S and$120,000 t0 CSA_MS11S for the provision of Outpatient type of services,nmi-recurring, 12,15'2021$100,668 is added to AMH-MHMCT to expand the MRT services. 1222/21$78,616 is added t0 MS21S t0 add 2 let-beds effective 1,1/2022, Guidance/Care Center,Inc. Contract No.ME225-12-27 Revised Exhibit H Page 1 cf 1 N O N y U O N N LO N V W H O � Z (9 c o 0 o c M .O EF !P. 64 EA �A N 01 v 7 V V clh Z h h M cl� � N zol V O O O O EA �A al M C CU r1 a O 71 0 bbO M N l0 O C O c-11 l— GO h N GO C G1 a9 Ge 7 v kn v ll� V'I fV iG Q� V] N V1 7 C rl W � C N N V: Q�. Gl O O O Vi Y O VI M N kn .• 1G O = [h [- M r 00 Ol O W � G7 W! O GO N 71 N N 7 V Q V9 69 5n n 6n EF. Et?fA h A A J3 6n w. A Yr�n 6o b9 6S b9 o 69 w 6F 6n Es os Ji 5A En3 E o fn 6s 65 V4 6n A 6n'A l 69 d3 H A N3 A Jn a 6? y R � V .may W C U o y S o - > A o ❑ > > > s Li v m + m c a U o ° � .� - a o ° o Q y ° c :S Y L R � ❑ ❑ � yy y '� '� '3 0i � N N N � � ^' Q �� '� � Q O O yO y°� .�-i U CU.1 L L L i O N Vl l� M 7 r � O N Q `7UU�` � i-rrr - � � OOG � �' CC0.: �-' ✓][n rL QQ .-iwd. �. ai V] L7UF. 0. ^^. W O.QQQQ0� 0� 2 GU c U a� m m m m In 7 7 7 7 Vi If, Vi Vl V: Vl Vl Vl Vl \OLi �O V N U C (9 Amendment#3 Contract No. ME225-12-27 6/30/2022 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. ME225-12-27. PREAMBLE: This amendment extends the contract end date to June 30, 2023, revises contract language, revises a number of contract exhibits and/or attachments, removes Exhibit K, SAMH Pre-Authorization utilization Management Roster, adds a number of contract exhibits and/or attachments, allocates funding for fiscal year 2022-2023, as detailed in the Exhibit G, Covered Service Funding by OCA and Exhibit H, Funding Detail. As a result, this amendment revises the Standard Contract; Attachment 1; Exhibit B, Method of Payment; Exhibit C, Required Reports; Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes & Outputs; Exhibit F, State and Federal Laws, Rules and Regulations; Exhibit G, Covered Services Funding by OCA; Exhibit H, Funding Detail, and Local Match; Exhibit I, Motivational Support Program; Exhibit N, Indigent Psychiatric Medication Program (IDP); Exhibit V, Forensic Services Program; Exhibit AC, Care Coordination; Al, Family Intensive Treatment; AJ, Community Action Team; Exhibit AN, Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach, Access, and Recovery (Soar); Exhibit AO, Peer Services; Exhibit AP, Mental Health Case Management Standards; Exhibit AV, Transitional Voucher Program; Exhibit AY, Mobile Response Team for Monroe County; Exhibit BE, Tele-Behavioral Health Services; and Exhibit BH Recovery Management Practices, 1. Page 1 of 16,Standard Contract, Paragraph 3,Contract Amount, is hereby amended to read: This contract shall begin on July 1,2021. It shall end at midnight, local time in Miami-Dade County, Florida on June 30,2023, subject to the survival of terms of Section 52. 2. Page 2 of 16, Standard Contract, Paragraph 5, Contract Amount, as previously amended on Page 1 of Amendment#2, is hereby amended to read: 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 $19,964,443.00, 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 $16,637,036.00, subject to the delivery and billing for services. The remaining amount of $3,327,407.00, 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. 3. Page 13 of 16, Standard Contract Section 42, Unauthorized Aliens and Employment Eligibility Verification (E-Verify), is hereby amended to read: Page 1 of 5 Amendment#3 Contract No. ME225-12-27 6/30/2022 42. Unauthorized Aliens and Employment Eligibility Verification (E-Verify)—Federal and State Requirements a, 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. b. 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 448.095, Florida Statutes. The Network Provider must submit an affidavit by the date and to the individual identified in Exhibit C, Required Reports, attesting that it does not and shall not employ, contract with, or subcontract with an unauthorized alien, in accordance with section 448.095, Florida Statutes. 4. Page 15 of 16, Standard Contract Section 55, All Terms and Conditions Included, as previously amended on Page 2 of Amendment#1, is hereby amended to read: This contract and it attachments, I, II, III, IV, V, VI & VII and any exhibits referenced in said attachments, together with any documents incorporated by reference, including the ME prime contract (which can be found at htt ://www.thrivingmir�d.c�rq), 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 VII, 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. 5. Pages 1 - 55, Attachment 1, HCO2(a), dated 07/01/2021, as previously amended on Page 2 of Amendment #1, are hereby deleted in their entirety, and Pages 1 — 56, Revised Attachment 1, dated 7/01/2022, are inserted and attached hereto. 6. Pages 1 —7, Exhibit B, Method of Payment for FY2022-23, are hereby inserted and attached hereto, 7. Pages 1 -24, Exhibit C, Required Reports for FY 2022-23, are hereby inserted and attached hereto. Page 2 of 5 Amendment#3 Contract No. ME225-12-27 6/30/2022 8. Pages 1 - 3, Exhibit D, Substance Abuse & Mental Health Required Performance Outcomes and Outputs for FY 2022-23,are hereby inserted and attached hereto. 9. Pages 1 -4, Exhibit F, SAMH Programmatic State and Federal Laws, Rules, and Regulations, dated 7/1/2021, are hereby deleted in their entirety, and Pages 1 - 4, Revised Exhibit F, SAMH Programmatic State and Federal Laws, Rules, and Regulations, dated 7/1/2022, are inserted and attached hereto. 10. Pages 1 - 4, Exhibit G, Covered Services Funding by OCA for FY 2022-23, are hereby inserted and attached hereto. 11. Page 1 of 1, Exhibit H, Funding Detail for FY 2022-23, is hereby inserted and attached hereto. 12. Page 1 of 1, Local Match Plan for FY 2022-23, is hereby inserted and attached hereto. 13. Page 1 -6. Exhibit I, Motivational Support Program (MSP), are deleted in their entirety, and Page 1 - 6, Revised Exhibit I, Motivational Support Program (MSP), are hereby inserted and attached hereto. 14. Pages 1 - 10, Exhibit N, Indigent Psychiatric Medication Program, known as the Indigent Drug Program, (IDP), dated 7/1/2021, as previously deleted on Page 5 of Amendment 1 are hereby deleted in their entirety, and Pages 1 - 4, Revised Exhibit N, Indigent Psychiatric Medication Program, known as the Indigent Drug Program, (IDP) dated 7/1/2022, are inserted and attached hereto. 15. Pages 1 - 4, Exhibit V, Forensic Services Program, dated 7/1/2021, are hereby deleted in their entirety, and Pages 1 - 4, Revised Exhibit V, Forensic Services Program, dated 7/1/2022, are inserted and attached hereto. 16. Pages 1 of 18, Exhibit AC, Care Coordination, dated 7/1/2021, as previously amended on Page 3 of Amendment#2, are hereby deleted in their entirety, and Pages 1 -18, Revised Exhibit AC, Care Coordination, dated 7/1/2022, are hereby inserted and attached hereto. 17. Pages 1 -10, Exhibit Al, Family Intensive Treatment (FIT) Model Guidelines, dated 7/1/2021, as previously amendment on Page 5 of Amendment#1, are hereby deleted in their entirety, and Pages 1 - 14, Revised Exhibit Al Family Intensive Treatment (FIT) Model Guidelines, dated 7/1/2022, are hereby inserted and attached hereto. 18. Pages 1 -21, Exhibit AJ, Community Action Treatment (CAT)Team, are deleted in their entirety, and Page 1 -20, Revised, Exhibit AJ, Community Action Treatment (CAT) Team, are hereby inserted and attached hereto. 19. Pages 1 -7, Exhibit AN, Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach,Access, and Recovery (SOAR), for FY 2022-23, are hereby inserted and attached hereto. 20. Pages 1 -4, Exhibit AO, Peer Services, dated 7/1/2021, are hereby deleted in their entirety, and Pages 1 -4, Revised Exhibit AO, Peer Services, dated 7/1/2022, are inserted and attached hereto. Page 3 of 5 Amendment#3 Contract No. ME225-12-27 6/30/2022 21. Pages 1 —6, Exhibit AP, Mental Health Case Management Standards, dated 7/1/2021, are hereby deleted in their entirety, and Pages 1 —6, Revised Exhibit AP, Mental Health Case Management Standards, dated 7/1/2022, are inserted and attached hereto. 22. Pages 1 —10, Exhibit AV, Transitional Voucher Program, dated 7/1/2021, are hereby deleted in their entirety, and Pages 1 —10, Revised Exhibit AV,Transitional Voucher Program, dated 7/1/2022, are inserted and attached hereto. 23. Pages 1 —12, Exhibit AY, Mobile Response Team (MRT) for Monroe County, dated 7/1/2021, as previously amended on Page 6 of Amendment #1 are hereby deleted in their entirety, and Pages 1 — 12, Exhibit AY, Revised Mobile Response Team (MRT) for Monroe County, date 7/1/2022, are inserted and attached hereto. 24. Pages 1 —4, Exhibit BE, for FY 2022-23,are hereby inserted and attached hereto. 25. Pages 1 —10, Exhibit BH, Recovery Management Practices, dated 7/1/2021, as previously amened on Page 6 of Amendment#1, are hereby deleted in their entirety, and Pages 1 — 10, Revised Exhibit BH, Recovery Management Practices, dated 7/1/2022, as previously amended on Page 5 of Amendment#1, are inserted and attached hereto. 26. Pages 1 —12,Attachment VI, Prevention Scope of Work,for FY 2022-2023,are hereby inserted and attached hereto. 27. Page 1 —10, Attachment VII, State Opioid Response (SOR), Scope of Work, for FY 2022- 2023 are hereby inserted and attached hereto. This amendment shall begin on June 30, 2022. 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. Signature Page Follows Page 4 of 5 Amendment#3 Contract No. ME225-12-27 6/30/2022 This amendment is hereby made a part of the contract. IN WITNESS THEREOF, the parties hereto have caused this two hundred forty-six (246) page amendment to be executed by their officials' thereunto duly authorized. GUIDANCE/CARE CENTER, INC. SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK, INC. SIGNED e SIGNED BY: BY: NAME: Frank C. Rabbito NAME: John W. Newcomer, M.D. TITLE: Coo TITLE: President &Chief Executive Officer DATE: 6�6 i i 1 DATE: FEDERAL Tax ID#(or SSN): 59-145832 Resolution WCGCC 2022-02 Page 5 of 5 f➢rl iiuo7 Mind soullh floi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 REVISED 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) "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 account both in process and end of process indicators, in order to meet the valid requirements of Individuals Served. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 1 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) atOV;xZ0122 (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 must 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 served needs. (11) "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. (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 general izabiIity (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.myflfamiIies.com/service-programs/samh/managing-entities/index.shtmI Note: Click on FY22-23 ME Templates and click on Guidance Document 1, Evidence Based Guidelines Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 2 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) atOV;xZ0122 (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 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. (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 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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 3 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/it/;xZ0122 (27) "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, (28) "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. (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 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: httgs://www.myflfamiIies.com/service-programs/samh/managing-entities/index.shtmI Note: Click on FY22-23 ME Templates and click on Guidance Document 10, Prevention Services (33) "Prime Contract" is the contract between the Department of Children and Families and the ME. (34) "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. (35) "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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 4 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7t01JI/;xZ0122 substance use and mental health treatment needs. (36) "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. (37) "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. (38) "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. (39) "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. (40) "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. (41) "SAMH" stands for the Substance Abuse and Mental Health Programs within the Department, (42) "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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 5 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/it/;xZ0122 (43) "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. (44) "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. (45) "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. (46) "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. (47) "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. (48) 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. (49) "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. (50) "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. (51) "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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 6 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) /fliIl;xZ0122 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 person-centered and family-focused recovery-oriented coordinated system of care (ROSC). A ROSC is a value-driven framework to guide transformation of a behavioral health system of care as described in Exhibit BH, Recovery Management Practices. 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 7 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) /fliIl;xZ0122 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 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 and community-based s (2) Services and supports for persons with behavioral health disorders. (3) 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. (4) Integrate the Child Welfare and behavioral health systems. (5) 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. (6) 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 provided upon request to the ME's Director of Prevention Services Director. e. Minimum Programmatic Requirements The Network Provider must maintain the following minimum programmatic requirements: Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 8 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) atOV;xZ0122 (1) System of Care The person-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, 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, communityand 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 competent; (h) Gender responsive; (i) Sexual orientation; and Q) Recovery-oriented and recovery-supported, 3. Individuals to be Served See Exhibit A, Individuals/Participants to be Served Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 9 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/it/;xZ0122 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 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 fifteen (15) individuals per group for any clinical therapy service provided, with the exception of Outpatient Group services. For Outpatient Group services funded under this contract, the Network Provider must adhere to the group size limitations outlined in the current Medicaid Handbook. In addition to other programmatic documentation requirements, service documentation to evidence group activities must include the following: 1. Data Elements: a) Service Documentation-Group Sign in Sheet b) Recipient name and identification number or, if non-recipient, participant's name, address, and relation to recipient; c) Staff name and identification number d) Service date; e) Start time f) Duration; g) Covered Service; h) Service (Brief description of type of group); i) Group Indicator; and j) Program (AMH, ASA, CMH, CSA) Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 10 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) atOV;xZ0122 2. Audit Documentation-Recipient Service or Non-Recipient Chart: a) Recipient name and identification number or if non-recipient, participant's name, address, and relation to recipient; b) Staff name and identification number c) Service date d) Clinical diagnosis; e) Start time; f) Duration; and g) Services(Group progress note) (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 08/03/2022, 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 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) 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. (10) By 08/03/2022„ the Network Provider must submit to the ME's Contract Manager an Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 11 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 updated Civil Rights Compliance Checklist (CF0946). (11) By 08/03/2022, 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. (12) By 08/03/2022, 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. (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.(22) below. (13) By 08/03/2022, the Network Provider must submit its action plan on a template provided by the ME based on the results of the most recently completed Self-Assessment/Planning Tool for Implementing Recovery-Oriented Services (SAPT) and the Recovery Self-Assessment-R (RSA- R.) as required in Section B, 1.a (22) (a), Recovery Management Practices. The action plan will outline tasks and objectives that the Network Provider must address during the fiscal year that were identified in the self-assessments as needing improvement. (14) By 10/03/2022,the Network Provider must submit an attestation signed by the CEO/Executive Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 12 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (Cw0iiwmae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 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. (15) 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. (16) 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 13.1.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 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. (17) 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). (18) 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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 13 of 56 Contract No. ME225-12-27 F➢rl iiuo7 Mind soullh Ftoi°hia (CuM 0irae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) /fliIl;xZ0122 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 including dates,times, names of people spoken to, and final disposition, i.e. date returned orjustification when not returning. (19) 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. (20) 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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 14 of 56 Contract No. ME225-12-27 f➢uu•lvh�7 Mind Souilh floii°iia a q'u",aa 0ir aar'fling a Sw with Pla"uii da «°havla ii olll fl i aPh '111"114,hioii k,Inca /10ll120C22 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: 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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 15 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) /flit/;M122 access to care, but also includes processes to promote continuous improvement to manage resources. (e) The Network Provider will offer individuals served 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. (21) 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. 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, Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 16 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/it/;xZ0122 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. (22) Continuous Quality Improvement Initiatives—Network Providers must comply with all of the provisions for the initiatives outlined below: (a) Recovery Management Practices The Network Provider must operate under the principles of a Recovery Oriented System of Care (ROSC) in accordance with the requirements of Exhibit BH, Recovery Management Practices. 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. A ROSC is inclusive of clinical services that are recovery-focused, evidence-based, developmentally appropriate, gender-sensitive, culturally competent, trauma-informed and integrated with a broad spectrum of non-clinical recovery support services.As such,the Trauma Informed Care, Cultural and Linguistic Competence, and Integration of Behavioral Health Services and Primary Care initiatives are components of ROSC and will remain as integral parts of ROSC. The Network Provider will work with the ME on the implementation of a Recovery Management system of care framework that aligns with the standards in Exhibit BH. The Network Provider agrees to conduct self-assessments annually, at minimum, or when directed by the ME, using the SAPT and RSA-R below, report the results to the ME when requested, and develop an action plan based on the results. The action plan should also include action steps toward implementation of the region-specific best practices as directed by the ME. 1) The Network Service Providers must use, at minimum, the following tools to assess recovery-oriented activities: i. The Self-Assessment/Planning Tool for Implementing Recovery-Oriented Services(SAPT)available at: https://www.usf.edu/cbcs/mhIp/tac/documents/toolkits/self-assessment- tool-recovery-oriented-mental-health.pdf, ii. The Recovery Self-Assessment-R(RSA) available at: https://medicine.vale.edu/pssychiatry/prch/tools/rec_selfassessment, and Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 17 of 56 Contract No. ME225-12-27 (;Curo0uwae'fling m,i SwflVu F110111ikh ar0 Av!Iuoi d 1:1[1vaPh 4111hAvioll k,Ririe°,) 1r'01IU;Z0122 2) A Network Provider who employs peers must: i. Use the Recovery Capital Scale,available at https://facesandvoicesofrecovery.org/resource/recovery-capital-scale/ , in the recovery planning process. ii. Provide standardized training on Recovery Management best practices in employee orientation and refresher training, iii. Adhere the terms and conditions pursuant to Exhibit AO, Peer Service. 3) As part of the ROSC initiative,The Network Provider must also: i. Identify at least two ROSC Champions who will attend trainings and meetings. The names of the ROSC 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. ii. Attend scheduled ROSC meetings, trainings and activities to ensure staff and agency become knowledgeable of ROSC. (b) Integration of Behavioral Health Services and Primary Health Care 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 principles within ROSC. The integration will be ensured through linkage from the behavioral health provider with the primary health care provider of the individual 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 health and behavioral health needs. (c) 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 18 of 56 Contract No. ME225-12-27 (;Curo0uwae'fling m,i SwflVu F110111ikh ar0 Av!Iuoi at 1:1[1vaPh 4111hAvioll k,Ririe°,) 1r'01IU;Z0122 Providers will be implementing Trauma Informed Care (TIC) principles within ROSC. Progress on TIC should continue to be reported in the CQI semi-annual update, and should include, at minimum, required trauma trainings for all staff upon hire, and annually thereafter. (d) 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: 1) 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; 2) 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. (e) Integration of Behavioral Health and the Child Welfare System 1) 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 19 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) /fliIl;xZ0122 of the eligibility criteria please refer to the approved COST Protocols and Family Intensive Treatment Team Protocols, herein incorporated by reference, and available upon request to the MEs Contract Manager. 2) 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: i. 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. ii. Attendance at scheduled CWI meetings including Integration Workgroup meetings to develop the process for identifying and responding to child-welfare involved families. iii. Attendance at trainings regarding CWI when notified by the ME. Attendance at applicable trainings will be documented in the Continuous Quality Improvement Updates iv. Participation in all CWI related activities to ensure staff and agency become knowledgeable of the Child Welfare system, v. 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. (f) Accreditation The Network Provider must take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2023,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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 20 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 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. The Network Provider must participate in all implementation activities and Technical Assistance provided by DCF and the ME. (23) Continuous Quality Improvement Updates 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) ROSC Action Plan, including the scores from the SAPT and R-RSA. (b) Integration of Behavioral Health Services and Primary Care, including evidence of the implementation of integrated care, including warm hand-offs and the process to track and report referrals of individuals from behavioral health to primary care and from primary care to behavioral health services. (c) Trauma Informed Care, including required trauma trainings for all staff upon hire, and annually thereafter. (d) Cultural and Linguistic Competence; (e) Identification of the evidence-based practices (EBPs) utilized by the agency and address how these EBPs are monitored to ensure fidelity to the model; ( Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; (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; Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 21 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) atOV;xZ0122 (24) 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 AC, 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 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 e 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. (25) Transitional Voucher Program The Transitional Voucher project is a flexible, individual served-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 AC, and the Exhibit AV,Transitional Voucher Program. (26) Financial Audit Reports Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 22 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 (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 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 individuals) 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.myflfamiIies.com/service-programs/samh/managing-entities/index.shtmI Note: Click on FY22-23 ME Templates and click on Reporting Template 9 — Local Match Calculation Form (27) 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. (28) 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. (29) 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. (30) 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/apps/vbs/adoc/F2551_ITN09H13GC1 Addendum10_CFOP2158.pdf Approval from the Department through the ME is mandatory for all research conducted by any Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 23 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 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. (31) The Network Provider must meet with the ME's staff at regularly scheduled or any called meetings when notified by the ME. (32) 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. (33) Referrals and Case Management Services to Individuals Residing in Assisted Living Facilities with a Limited Mental Health License (a) 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. (b) 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), (c) 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 (34) 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. (35) 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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 24 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) atOV;xZ0122 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 A0, Peer Services. (36) 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. (37) Community Person 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 will result in a corrective action and an imposed financial penalty as described in the Standard Contract. (38) Department-Sponsored Surveys The Network Provider must participate in any Department-sponsored satisfaction surveys. (39) Individual Served 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 2,2022. (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). Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 25 of 56 Contract No. ME225-12-27 rbrlvb�g Mjodsoonlh flwd8a �m0raefling m,i Swfltii F11011 kht Beh Av!I oinitB���Avioll k,III w.) 1/01lZ0122 (c) Any Network Provider assuming responsibility for administration of the personal property and/or funds of individuals served must fn||om/ the Department's Accounting Procedures Manual 7 APM. b. 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 rnpa|U, plus applicable interest,within one(1)week of the determination. k8 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 tn the ME upon request. A4 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 app|icub|e, rules, statutes, licensing standards and policies and procedures. The Network Provider agrees to abide bv 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 consent of the ME. The Network Provider must ensure that services are performed in accordance with applicable rules, statutes, and licensing standards. 1. Staffing Requirements a. Staffing Levels (D 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. (%) The Network Provider must engage|n recruitment efforts tn 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,8AK8H Programmatic State and Federal Laws, Rules,and Regulations. (2) The Network Provider must provide employment screening for all mental health personnel Revised Attachment | HCO2 (x) Guidance/Care Center,Inc. Page 26of56 Contract No. Mszzu'/z'z/ f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) /fliIl;xZ0122 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 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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 27 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind souuifh floirhia (CuM 0ir ae'fling m,i SwflVu f110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 (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 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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 28 of 56 Contract No. ME225-12-27 (;Curo0uwae'fling m,i SwflVu F110111ikh ar0 Av!Iuoi d 1:1[1vaPh 4111hAvioll k,Ririe°,) 1r'01IU;Z0122 (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,orany 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: (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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 29 of 56 Contract No. ME225-12-27 f➢rl hi 'g Mind soullh floirhia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/it/;xZ0122 2. 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 VI, Prevention Scope of Work and Attachment VII, 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. 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. 3. 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 VI, Prevention Scope of Work and Attachment VII, 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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 30 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (Cw0iiwmae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Inc.) 7/flit/;xZ0122 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 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: Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 31 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 (a) To establish a unique Individual Served 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 Individual Served,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 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. 4. 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 VI,Prevention Scope of Work and Attachment VI I, Prevention Scope of Work—State Opioid Response. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 32 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/it/;xZ0122 (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. G. 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.myflfamilies.com/service-programs/samh/fasams/index.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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 33 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM 0irae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) /fliIl;xZ0122 5. 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 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, 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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 34 of 56 Contract No. ME225-12-27 (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 (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 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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 35 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (Cw0iiwmae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/it/;xZ0122 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. (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. 6. 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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 36 of 56 Contract No. ME225-12-27 F➢rl iiuo7 Mind soullh Ftoi°hia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) atOV;xZ0122 (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 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 monitors) 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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 37 of 56 Contract No. ME225-12-27 (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 (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, 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 policyworking agreement,system of care information,data reporting requirements and technical assistance. (b)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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 38 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d 1111vaPh k,Ririe.) 7/it/;xZ0122 d. Managing Entity Determinations The ME has exclusive authority to make the following determinations) and to set the procedures that the Network Provider must follow in obtaining the required determination(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 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 2022-2023 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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 39 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) /flit/;xZ0122 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://ban\/anhealth.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://guidancecarecenter.org/ 3. Acute Care Service Utilization Reporting for Public Receiving Facilities, Detoxification and Addiction Receiving Facilities: (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 module, the ME's designated acute care system database. Arrangements to license and access the KIS Express Acute Care module 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.myflfamilies.com/service-programs/samh/fasams/index.shtml 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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 40 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7t01JI/;xZ0122 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.myflfamilies.com/service-programs/samh/fasams/index.shtml Failure to comply with the reporting requirements constitutes a lack of compliance with contract provisions.The Network Provider may be assessed financial consequences for failure to perform pursuant to section 8.,of the Standard Contract. 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. 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.(II) F.S). No fee may be charged for such filing. 7. Medication-Assisted Treatment Services a. The Network Provider must discuss 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 shall discuss medication-assisted treatment using FDA-approved medications including but not limited to methadone, buprenorphine-based products, and naltrexone, c. For individuals with alcohol use disorders, the Network Service Provider shall discuss 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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 41 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) atOV;xZ0122 e. The Network Provider is prohibited from automatic discharges or discontinuing medications as a consequence of continued substance use or positive drug tests, unless the combination of substances used is medically contraindicated. f. 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 stopping is inconsistent with a licensed prescriber's recommendation or valid prescription. V. The Network Provider must prohibit caps or limits on the length of medication-assisted treatment, except for limits imposed by a documented lack of eligible public funds. vi. The Network Provider is prohibited from requiring mandatory counseling participation requirements and mandatory self-help group participation requirements imposed as a condition of initiating or continuing medications that treat substance use disorders, except those established by methadone providers and applied to individuals on methadone pursuant to section 65D-30.014(5)(o) and section 65D-30.014(5)(m), Florida Administrative Code. 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 42 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh fioirhia (CuM 0ir ae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) 7/flit/;xZ0122 their families. The strategies, activities, and services must be consistent with the local community ME-approved local Needs Assessment Logic Model (NALM) 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 VI, Prevention Scope of Work and Attachment VI I, Prevention 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 VI,Prevention Scope of Work and Attachment VI I,Prevention 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. 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. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 43 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 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 an individual served, 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: Individual served initials, incident report tracking number from IRAS (if applicable), incident report category, date and time of incident, and follow-up action taken. b. All designated public and private Baker Act receiving facilities, all State Mental Health Treatment Facilities,and all licensed Addictions Receiving Facilities that provide for the evaluation,diagnosis, care, treatment, training, or hospitalization of persons who appear to have a mental illness or have been diagnosed as having a mental illness must report seclusion and restraint event data in accordance with the DCF Pamphlet 155-2, Version 12.03, Chapter 14, or the latest revision thereof. This chapter is posted on the DCF website at https://myflfamilies.com/service- programs/samh/samhis/pamphlet-155-2-v12.shtml 11. Mandatory Reporting Requirements a. The Network Provider and any subcontractor must comply with and inform its employees of the Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 44 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 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 an Individual Served 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 httgs://www.myflfamilies.com/admin/ig/riptfraudl,shtml or by completing a Notification/Investigation Request (form CF 1934) and emailing the request to the Office of Inspector General at IG.ComplaintsCmyflfamilies.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.f1.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. 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 45 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (Cw0iiwmae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Inc.) atOV;xZ0122 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. (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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 46 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d 1111vaPh k,Ririe.) atOV;xZ0122 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 (1) 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. (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." Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 47 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/flit/;xZ0122 (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,,, 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. (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, Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 48 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/it/;xZ0122 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)]. (s) SAMHSA grant funds may not be used to purchase, prescribe,or provide marijuana or treatment using marijuana. 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 individuals served. 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 Individuals served if public funds provided under this contract will be used to purchase vehicles which will be used to transport individuals served. 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. b. An application for an NPI may be submitted online at: https://hmsa.com/portal/provider/zav_pel.ph.NAT.500.htm Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 49 of 56 Contract No. ME225-12-27 (;Curo0uwae'fling m,i SwflVu F110111ikh ar0 Av!Iuoi at 1:1[1vaPh 4111hAvioll k,Ririe°,) 1r'01IU;Z0122 c. Additional information can be obtained from one of the following websites: (1)The National Plan and Provider Enumeration System (NPPES) located at: https://nppes.cros.hhs.gov/NPPES/Welcome.do (2)The CMS NPI located at: https://www.cros.gov/Regulations-and-Guidance/Administrative- Simplification/NationalProvldentStand/ 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 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 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 (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. 23. 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 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 be part of the Contract Manager's file. Documents incorporated by reference in this contract are available in the ME Contract Manager's file. Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 50 of 56 Contract No. ME225-12-27 (CuM0irae'fling°a SwflVu F110111iida arOa'vl of d flvaYh k,Ririe.) 7/it/;xZ0122 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 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 51 of 56 Contract No. ME225-12-27 (;Curo0uwae'fling m,i SwflVu F110111ikh ar0 Av!Iuoi at 1:1[1vaPh 4111hAvioll k,Ririe°,) 1r'01IU;Z0122 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 N e t wo r k 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 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. Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 52 of 56 Contract No. ME225-12-27 f➢rl iiuo7 Mind soullh floi°hia (Cw0iiwmae'fling°a SwflVu F110111iida arOa'vl of all flvaYh k,Inc.) atOV;xZ0122 (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. 1 S-2.048, F.A.C., in accordance with Guidance 25—National Voter Registration Act Guidance, incorporated herein by reference; b. As a Voter Registration Agency, the Network Provider 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 their 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. 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 Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 53 of 56 Contract No. ME225-12-27 (;Curo0uwae'fling m,i SwflVu F110111ikh ar0 Av!Iuoi at 1:1[1vaPh 4111hAvioll k,Ririe°,) 1r'01IU;Z0122 18). f. The Department of State has published all form referenced herein, along with online training and additional guidance to implement NVRA at: httg://dos.myflorida.com/elections/for-voters/voter-registration/national-voter-registration- 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. 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 Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 54 of 56 Contract No. ME225-12-27 (Cw0iiwmae'fling°a wfltu F110111iida arOa'vl of all flvaYh k,Inc.) /fliIl;xZ0122 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 D,Substance Abuse and Mental Health Required Performance outcomes and Outputs for FY 2022-2023 6. Exhibit F, State and Federal Laws, Rules and Regulations 7. Exhibit G, Covered Service Funding by OCA 8. Exhibit G, Covered Service Funding by OCA for FY 2022-2023 9. Exhibit H, Funding Detail & Local Match Plan 10. Exhibit H, Funding Detail & Local Match Plan for FY 2022-2023 11. Exhibit I, Motivational Support (MSP) Provider Protocols 12. Exhibit J, Child Welfare Specialty Program (CWSP) 13. Exhibit L,Assisted Living Facilities with Limited Mental Health License 14. Exhibit N, Special Provisions for the Indigent Drug Program 15. Exhibit 0, Mental Health Residential Level II Revised Attachment 1 HCO2 (a) Guidance/Care Center,Inc. Page 55 of 56 Contract No.ME225-12-27 al<'➢uu•lvh�7 Mind Souilh 17twii°iia a q'",aa 0ir aar'fling a Sw with Pla"uii da «°havla ii olll fl i aPh '111"114,hioii k,Inca /10ll120C22 16. Exhibit 0, Mental Health Residential Level II 17. Exhibit V,Special Provisions for Forensic Services Program 18. Exhibit X, Special Provisions for Projects for Assistance in Transition from Homelessness (PATH) Services 19. Exhibit AA, Motivational Support Specialist 20. Exhibit AC, Care Coordination Services 21. Exhibit Al, Family Intensive Treatment Team -Scope of Work 22. Exhibit AJ, Community Action Team 23. Exhibit AM, Return on Investment-Special Appropriations Projects for Fiscal Year 2021-22 24. Exhibit AN, Supplemental Security Income/Social Security Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR) 25. Exhibit AN, Supplemental Security Income/Social Security Insurance (SSI/SSDI) Outreach, Access, and Recovery (SOAR) for Fiscal Year 2022-2023 26. Exhibit AO, Peer Services 27. Exhibit AP, Mental Health Case Management 28. Exhibit AS, Central Receiving Facility 29. Exhibit AV, Transitional Voucher Program 30. Exhibit AY, Mobile Response Team (MRT) for Monroe County 31. Exhibit AX, Crisis Stabilization Unit 32. Exhibit BD, State Opioid Response Discretionary Grant Services (2) Medication Assisted Treatment Services for Opioid Use Disorders and Evidence Based Treatment to Address Stimulant Misuse and use Disorders 33. Exhibit BE, Tele-Behavioral Health Services for Services Provided to Children & Families Engaged in the Monroe County School System—OCA MHTLH 34. Exhibit BE, Tele-Behavioral Health Services for Services Provided to Children & Families Engaged in the Monroe County School System —OCA MHTLH for Fiscal Year 2022-2023 35. Exhibit BH, Recovery Management Practices Revised Attachment I HCO2 (a) Guidance/Care Center,Inc. Page 56 of 56 Contract No. ME225-12-27 l-IlriiliiSMiiil.g IIWiirid Soi.utlh Ii:Ioii iida (Con raat:„fing aS Soiii.d:lla If:ll ru ucl a Ii:3ell°uavioi fll II e allilla Network, Uric.) 7111/2022 EXHIBIT B For Fiscal Year 2022-2023 METHOD OF PAYMENT 1. PAYMENT CLAUSES 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 $9,076,307.00, 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 under OCA (Identify 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 (N/A), 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 $9,826,307.00 of the total Contract amount, the ME will be required to pay$8,188,589.00 subject to the delivery and appropriate billing for services. The remaining amount of $1,637,718.00 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 Pagel of 7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 i-Ilhii1iiSMiiil.g IIWiirid Soi.utlh Ii:Ioii iida (Confl-aat:„Hing aS Soiii.d:lla If:ll ru ucl a Ii:3e1°uaav of fll II eaallilla Network, Uric.) 7111/2022 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$1,446,028.00 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 2of7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 i-Ilhii1iiSMiiil.g IIWiirid Soi.utlh Ii:Ioii iida Confl-aat:„fing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uavioi fll II eaallilla Network, Uric.) 7111/2022 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 3of7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 i-Ilhii1iiSMiiil.g IIWiirid Soi.utlh Ii:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uavioi fll II eaallilla Network, Uric.) 71II/20 individual who has depleted other fund sources. b. Department funds may not reimburse services provided to: i. 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 a. 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. b. Requirements for all Medicaid-enrolled Network Service Providers, prior to invoicing the Managing Entity for any services provided to any Medicaid-enrolled recipients, the Network Exhibit B Page 4of7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 I Iii iSM1l•llg 'u"IIII'id oil,A h I„II IIda (;Gonfl actune&S Soiii,if:ll'I If:llrru ucla li['I 11°°uavioirai II ear ills Network, Uric'.) 7111/2022 Provider must maintain documentation for each individual served in a format that is easily accessible and retrievable for monitoring or auditing purposes by the ME or Department that it has: i. Submitted a prior authorization request for any Medicaid-covered services provided. ii. Appealed any denied prior authorizations. iii. Provided assistance to appeal a denial of eligibility or coverage. iv. Verified the provided service is not a covered service under Florida Medicaid, as defined In Chapter 59G-4, F.A.C.,or is not available through the individual's MMA Plan. V. In cases where the individuals Medicaid-covered service limit has been exhausted for mental health services, an appropriately licensed mental health professional has issued a written clinical determination that the individual continues to need the specific mental health treatment service provided. vi. In cases where the individual's Medicaid-covered service limit has been exhausted for substance use disorder treatment services a qualified professional as defined in Section 397.311, F.S., has issued a written clinical determination that the individual continues to need the specific service provided. 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 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, 2020—September 30, 2023, 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: htt.s://uvww.rn flFarr7ilir.s.cr�rrtlserviice ro rarrrs/acresslclor:sCTANF Plart. r1f 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 Exhibit B Page 5of7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 I-Ilhii1iiSMiiil.g IIWiirid Soi.utlh Ii:Ioii iida (Confl-et:„Hing aS Soiii.d:lla If:ll ru ucl a Ii:3e1°uaavioi fll II eaallilla Network, Uric.) 7111/2022 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. 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 Exhibit B Page 6of7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 l-Ilhii1iiSMiiil.g IIWirid Soi.utlh Ii:Ioii iida Confl-aat:„Hing aS Soiii,d:ll'a If:llrru ucl a Ii:3e1°uavioi fll II eaallilla Network, Uric.) 711/2022 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, Temporary Assistance for Needy Families (TANF) Funding Guidance, 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: hl.t h[rn 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 website is found in the link below: r].tt.ps://www.rnyfloridacl'o.com/i:)ivisiort/AA/MerT1os/defaul t.rtt.rrI 16. 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 7of7 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No. ME225-12-27 Ph iiirvii SM ii il.g IIWi il.d So i.itllh If: oiii iida (Conflmat:„Hing aS oiii.d:ll If:ll a ucla li:3e1°uavioi fll II ea Hilt Network, Ilu ic.) C1 I1/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Requ'ir�d It ��rf .. Due"D�te ctf Ci�p���,,, nd to. ResP once 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 As requested by the Contract 1 (Electronic 1. ME Contract Manager Assurance Reviews, Manager or other SFBHN staff Submission via E-mail) Monitoring Reports, Surveys and 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 2021-2022 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 Inserted 06/30/2022 Page 1 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h iiirvii SM ii il.g Wind So i.itllh If: oiii iida Confl-aat:„frog raS Soiii.d:lla If:ll a ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 (1) Events that have immediate impacts on the health or safety of an ME Continuous ME Continuous Quality individual served, has Quality Improvement Improvement Manager and potential media impact, Manager and the ME the ME Contract Manager or involves employee- Contract Manager related incidents of criminal activity,the Network Provider must notify the ME Continuous Submission through Submission through IRAS Quality Improvement IRAS Manager and the ME Contract Manager immediately upon discovery. (2) Within 24 hours of occurrence, in 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. Exhibit C Inserted 06/30/2022 Page 2 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h iiirvii SM ii il.g Wind So i.itllh If: oiii iida Confl-aat:„Hing aS Soiii,d:ll'a If:ll a ucl a li:3e1°uaav of fll II eaallilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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://fs16.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) 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, Resource Monthly,with the monthly 1 1. ME Sr.Accountant(Fiscal Management Roster invoice by the eighth (8th) Department) for Substance Abuse calendar day and Mental Health after the month 2. ME ASOC Manager Residential Level II of service Services 3. ME CSOC Manager 4, ME Contract Manager Exhibit AC, Monthly Monthly by the 5th calendar 1 1. ME Care Coordinator Care Coordination day after the month of service Report Narrative and 2. ME Contract Manager Chart Final Invoice 1 ME Sr.Accountant(Fiscal By July 20 of each fiscal year Department) and/or 20 days after contract end date Exhibit C Inserted 06/30/2022 Page 3 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h iiirvii SM ii il.g Wind So i.itllh If: oiii iida (Confl-aat:„Hing aS oiii.d:lla If:ll a ucl a li:3e1°uaav of ill II eaallllla Network, Ilu ic.) C1 I1/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Designation of Within 5 working days of 1 (Electronic ME Contact Manager Dispute Resolution contract execution Submission via E-mail) Officer Court Ordered If the court ordered service is 1 (Electronic 1. ME Adult System of Care Involuntary not available,submit copy of Submission via E-mail) Manager Commitment, court order within one(1) Placements,Services, working day of receiving from 2. ME Contract Manager Treatment the court if the service is not available Affidavit of 08/03/2022 ME Contract Manager Employment 1 (Electronic Eligibility in Submission via E-mail) accordance with 448,095, FS Inventory Report ME Contract Manager 8/3/2022 1 (Electronic Submission via E-mail) Attestation of 8/3/2022 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 Civil Rights 8/3/2022 1 (Electronic ME Contract Manager Compliance Checklist Submission via E-mail) (CF0946) Civil Rights 8/3/2022 1 (Electronic ME Contract Manager Certificate(CF707) Submission via E-mail) Client Trust Fund 8/3/2022 1 (Electronic ME Contract Manager Letter Submission via E-mail) Quality 8/3/2022 1 (Electronic 1. ME Contract Manager Assurance/Quality Submission via E-mail) Improvement Plan 2. ME Continuous Quality Improvement Manager Exhibit C Inserted 06/30/2022 Page 4 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr iirvii SM ii il.g Wind So i.itllh If:I oii iida Confl-at:„Hing raS Soiii,d:ll'a If:ll a ucl a li:3e1°uav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Action Plans for the: August 3,2022 1 (Electronic 1. ME Contract Manager Submission via E-mail) 1, Self- 2. COI Specialist Assessment/Planni Peer Services Manager ng Tool for Implementing Recovery Oriented Services(SAPT) 2.Recovery Self- Assessment-R (RSA) Signed Florida 8/3/2022 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 Peer/ROSC 8/3/2022 1 (Electronic 1. ME contract manager Champions, per Submission via E-mail) Exhibit AO. 2. Peer Services Manager Attestation signed by 10/3/2022 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. NVRA Voter July 6, 2022 1 (Electronic 1. ME Voter Registration Registration Agencies (Period:04/01/22-06/30/22) Submission via E-mail) Activities Coordinator Quarterly Activities October 5,2022 Report Form (DS- (Period:07/01/22-09/30/22) 2. ME Contract Manager DE131;effective January 5,2023 01/2012 or latest (Period: 10/01/22- 12/31/22) revision thereof, if April 5,2023 applicable (Period:01/01/23-03/31/23) July 5,2023 (Period:04/01/23-06/30/23) Exhibit C Inserted 06/30/2022 Page 5 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr iirvii SM ii ii.g IIWi ii.d So i.itllh If:I oii iida Confl-aat:„Hing raS Soiii.d:lla If:ll a ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Quarterly Financial October 31,2022 1 (Electronic 1. ME VP of Finance Statements(Balance (Period:07/01/22-09/30/22) Submission via E-mail) Sheet and Statement January 31,2023 2. ME Contract Manager of Activity) (Period: 10/01/22- 12/31/22) April 28,2023 (Period:01/01/23-03/31/23) July 31,2023 (Period:04/01/23-06/30/23) Attestation indicating October 31,2022 1 (Electronic ME Contract Manager the filing of Form 941 (Period:07/01/22-09/30/22) Submission via E-mail) and payment of any January 31,2023 taxes due to the IRS (Period: 10/01/22- 12/31/22) have been paid. April 28, 2023 (Period:01/01/23-03/31/23) July 31, 2023 (Period:04/01 January 31,2023 1 (Electronic 1. ME Contract Manager Continuous Quality (Period:07/01/22- 12/31/23) Submission via E-mail) Improvement July 31,2023 2. ME Continuous Quality Updates (Period:01/01/23-06/30/23) Improvement Manager Ye r�Et d Ftn tcta�Rt or ;ft r Netucii rk f rav d rA �ethg'Aud'it ;Pet`'AttAthi rit jl 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 2.VP of Finance less than$750,000 in (federal)or 45(state) of the Federal Awards or in recipient's receipt of the audit State Awards during report,whichever occurs first, the fiscal year 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 (federal)or 45 (state) 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 Exhibit C Inserted 06/30/2022 Page 6 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 Ph iiirvii SM ii ii.g IIWi ii.d So i.itllh If: oiii iida Confl-at:„Hing aS Soiii.d:ll If:ll a ucla li:3e1°uavioi fll II eallilli Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 2.VP of Finance Actual Expenses& (federal)or 45(state) of the Revenues Schedule 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 2.VP of Finance Department of days(federal)or 45(state) of Children and Families the recipient's receipt of the form,available at the audit report,whichever following website: occurs first, directly to each of the following unless https://www.myflfa otherwise required by Florida milies.com/service- Statutes The schedule shall be programs/samh/man based on revenues and aging-entities/2020- expenditures recorded during contract-docs.shtml 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 2.VP of Finance days(federal)or 45(state) 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. Exhibit C Inserted 06/30/2022 Page 7 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr iirvii SM ii il.g Wind So i.itllh If: oiii iida (Conflmat:„frog aS oiii.d:ll If:ll a ucla li:3e1°uavioi fll II eallilli Network, Uric.) 71I1/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 2.VP of Finance Statement of Activity days(federal)or 45(state) 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. Y ar�Erid Firf (1 i (k����RrOAdW`I e4iair4+4udit ttacfi rmd 011 Correspondence Due 180 days after the end of 1 (Electronic 1. ME Contract Manag er from the Auditor the Network Provider's fiscal Submission via E-mail) showing proof of year or within 30 days 2.VP of Finance submission of the (federal)or 45(state)of the Audit Report and recipient's receipt of the audit Management Letter report,whichever occurs first, to the Network directly to each of the Provider. following unless otherwise 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 2.VP of Finance issued by the Auditor days(federal)or 45 (state)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. Exhibit C Inserted 06/30/2022 Page 8 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i hiirviiSMiiii.g IIWiirid Soi.itllh If:Ioii iida Confl-aat:„frog raS Soiii.d:lla If:ll a ucl a li:3e1°uaavioi fll II eaallilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 2.VP of Finance schedules per (federal)or 45 (state)of the Attachment II 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 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(federal)or 45(state)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 2.VP of Finance (federal)or 45(state)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. 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 2.VP of Finance Department of (federal)or 45(state)of the Children and Families recipient's receipt of the audit form,available at the report,whichever occurs first, Exhibit C Inserted 06/30/2022 Page 9 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h ii1ii SM ii il.g Wind So i.itllh If:I oii iida Confl-at:„frog aS Soiii.d:lla If:ll a ucl a li:3e1°uav of fll II eaallilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 following website: directly to each of the following unless otherwise Managing Entities- required by Florida Statutes Florida Department The schedule shall be based of Children and on revenues and expenditures Families recorded during the state's (myflfamilies.com) 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 2.VP of Finance Actual Expenses& (federal)or 45(state)of the Revenues Schedule 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 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 2.VP of Finance (federal)or 45(state)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. Rep�ar't�"t�epuir�d`f�r�hil�irerf's;;Nl�rs�a(H�althPr��rid��s";his„� I"rcable Children's Crisis Per Exhibit S- Monthly Census One(1) Encrypted 1. M 9E 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 Re*c6ets Requifd for Behaufc'ra("He aftf`iUetutrrk{ ;Nt) ravicle Exhibit C Inserted 06/30/2022 Page 10 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h ii1ii SM ii il.g IIWi il.d So i.itllh If:I oii iida Confl-at:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uaav of fll II eaallilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 st 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 fte. o:f£',R quir dfd'r Proje #`fi r`% x t nee iii 1 f a rs �tibrt'............ PATH Monthly Monthly,by the 5th calendar 1 (Electro nic Report(generated day after the month of service Submission via E-mail) 1. ME Contract Manager from the HMIS 2. ME Housing Coordinator system) PATH Monthly Client Monthly by the 10th calendar 1 (Electronic Tracker day after the month of service Submission via E-mail- 1. ME Contract Manager Encrypted and 2. ME Housing Coordinator Password Protected) PATH Annual Data No later than November 17th 1 (Electronic httos://www.pathpdx,org/ Report into the PATH Submission via E-mail) Data Exchange(PDX) data system R pc�its R (aiP d.fiat Adult Merff'114, 06 'at`, k e„ Assisted Living Provider to Maintain the 1 (Electronic Requester ( nic 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 Password Protected Quarterly Report, per October 5,2022 Exhibit L (Period:07/01/22-09/30/22) January 5,2023 (Period: 10/01/22- 12/31/22) April 5,2023 (Period:01/01/23-03/31/23) July 5,2023 (Period:04/01/23-06/30/23) Repaft R quir'etf fc�h'Flr rid 'A r ertitie`Ce f fh(ari ty Tr eht 0%CT)I",ovidors;';,,, Exhibit C Inserted 06/30/2022 Page 11 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr ii1ii SM ii il.g Wind So i.itllh If:I oii iida (Confl-at:„Hing raga oiii.d:lla If:ll a ucl a Ii:3e1'iaav of fll II e allllla Network, Ilu ic.) 71I1/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Contact Information Within thirty(30)calendar 1 (Electronic 1. ME Contract Manager for the: days of contract execution. Submission via E-mail) 1. Psychiatrist or Psychiatric APRN 2. Administrative Supervisor Vacant Position(s) Monthly by the 15th of each 1 (Electronic Report month following the month of Submission via E-mail) 1. ME Contract Manager service 2. ME Adult System of Care Specialist FACT Report October 14,2022 1 (Electronic 1. ME Contract Manager (Template 29) (Period:07/01/22-09/30/22) Submission via E-mail) January 13,2023 2. ME Adult System of Care Link to Template 29: (Period: 10/01/22- 12/31/22) Specialist April 14,2023 Guidance 29 (Period:01/01/23-03/31/23) Transitional July 14,2023 Vouchers.pdf (Period:04/01/23-06/30/23) (myflfamilies.com) FACT Monthly Monthly by the 15th of each 1 (Electronic 1. ME Contract Manager Progress Report month following the month of Submission via E-mail) service 2. ME Adult System of Care Specialist Outcomes Measures October 14,2022 1 (Electronic (Period:07/01/22-09/30/22) Submission via E-mail) 1. ME Contract Manager January 13,2023 (Period: 10/01/22- 12131122) 2. ME Adult System of Care April 14,2023 Specialist (Period:01/01/23-03/31/23) July 14,2023 (Period:04/01/23-06/30/23) Re 'ff R qu rigid fc r`IS/I't mi pads Fc rens'fc" ft fff e,(MMAC)!rct tilers Daily Census Report Daily, by 10 00 am 1 (Electronic 1. Regional Forensic Monday- Friday Submission via E-mail) Coordinator 2. ME Contract Manager 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 Exhibit C Inserted 06/30/2022 Page 12 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h iiirvii SM ii il.g Wind So i.itllh If: oiii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uaavioi fll II eaallilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 Adult System of Care Specialist I £',p�rt�'ftequfre(t f(5f FtSC`�CS�iC,` �rU�C�', f�r'�1%IC��r(�i�������������� Monthly Report for By 1� .........,, Oth of each month 1 1. Mental Health Individuals on Administrator Office Conditional Release, 2. ME Contract Manager if applicable F �c�rt l�el�uir�d far E=�rensitx Multidt�t±i�alirr�i�r Te�i'h'"�rb'vider ......... ....,,,, Monthly Forensic By 10th of each month for the 1 (Electronic 1 ME Adult System of Multidisciplinary preceding months'services Submission via E-mail) Care Specialist Team Report—DCF Template 25: https://www.myflfa 2. ME Contract Manager milies.com/service- programs/samh/man aging-entities/2021- contract-docs.shtml Monthly Vacant By 10th of each month for the 1 (Electronic 1. ME Adult System of Position(s) Reports preceding months'services Submission via E-mail) Care Specialist 2. ME Contract Manager Monthly Court By 10th of each month for the 1 (Electronic 1. Court Reports preceding months'services Submission via E-mail) 2. Forensic Team at Community Health of South Florida, Inc. 3. ME Adult System of Care Specialist 4. ME Contract Manager 1140 fft Required fit'r C snsCirri r ar�uen gerrefe .... Enrollment/Member October 5,2022 1 (Electronic ME Contract Manager ship Report (Period:07/01/22-09/30/22) Submission via E-mail) January 5,2023 (Period: 10/01/22- 12/31/22) April 5,2023 (Period:01/01/23-03/31/23) July 5,2023 (Period:04/01/23-06/30/23) Exhibit C Inserted 06/30/2022 Page 13 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilrii1iiSMiiil.g IIWiirid Soi.itllh If:Ioii iida Conflmat:„Hing aS Soi.d:ll If:Il a ucla li:3e1°uavioi fll Il eallilli Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 k6ports rui es Pr&ider Report for HIV Early January 6,2023 1 (Electronic ME Contract Manager Intervention (Period:07/01/22- 12/31/22) Submission via E-mail) Services,SAPT Block July 5,2023 Grant Set Aside (Period: 01/01/23-06-30-23) 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 , Rprt : eutrdcr` tat ; picid Rr 'cri ; '[(scret'icna'r' rnfrcttrlders Monthly SOR Data Due monthly, by the 15th of 1 (Electronic ME Contract Manager Collection Report every month following the Submission via E-mail) Exhibit BD month of service Encrypted and Password Protected Re is rt required fbr ub taflc '//Abuse„Preuerffitiri' rufc6 W6/Viler Exhibit C Inserted 06/30/2022 Page 14 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h ii1ii SM ii il.g Wind So i.itllh If:I oii iida Confl-at:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uav of fli II eaallilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 In the BSRI database system ME's contracted day after the month of service or any other format evaluation entity- requested by BSRI BSRI Monthly Service Monthly,by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day after the month Department) of service Invoice Review Submitted with the monthly 1 ME Sr.Accountant(Fiscal Supporting invoice Department) Documentation- from PBPS in ajpeg 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 Final Annual Site 8/31/2022 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 frart 'Rac�uird fair Ireucntln Iartrirhip Grant l'r""ctticfer Exhibit C Inserted 06/30/2022 Page 15 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i h iiirvii SM ii il.g Wind So i.itllh If: oiii iida Confl-at:„Hing raS Soiii.d:lla If:ll a ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Monthly E-Mail Monthly,by the 411 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 Prevention Services As Required by the Evaluation 1 (Electronic In the BSRI database system Quarterly Reports Entity(BSRI) Submission via E-mail) or any other format (Fidelity to Evidence- requested by BSRI Based Practices)— Program Status Report as Required by RFA#11 L2GN1. 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 8/31/2022 1 (Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services Reports R//j6,iF d f Enttt�far Rrea rrtion/'56'&es' 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) Exhibit C Inserted 06/30/2022 Page 16 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i hiiirviiSMiiil.g IIWiirid Soi.itllh If: oiii iida (Confl-at:„Hing aS oiii.d:ll If:ll a ucla li:3e1°uavioi fll II ea flili Network, Ilu ic.) C1 I1/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Quarterly October 31,2022 1 (Electronic 1. ME Contract Manager, Expenditure Report (Period:07/01/22-09/30/22) Submission via E-mail) January 31,2023 2. ME VP of Finance,and (Period: 10/01/22- 12/31/22) April 28,2023 3. ME Director of Prevention (Period:01/01/23-03/31/23) Services July 31,2023 (Period:04/01/23-06/30/23) Exhibit C Inserted 06/30/2022 Page 17 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr iirvii SM ii il.g IIWi il.d So i.itllh If: oiii iida Confl-aacHng aSSoii.dh If:ll ru ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Re p6 is Required for Prd d'd/ Reca�ii rit 8p ific #pp ripr tii�rrs Quarterly Updates on October 12,2022 1 (Electronic 1. ME Contract Manager Return on (Period:07/01/22-09/30/22) Submission via E-mail) Investment Report- January 10,2023 Per Exhibit AM (Period: 10/01/22- 12/31/22) April 11,2023 (Period:01/01/23-03/31/23) July 11,2023 (Period:04/01/23-06/30/23) R pcsft&//[q 66d to,/ Ctif tg Arts raffi'rouider Quarterly Services October 31,2022 1 (Electronic ME Contract Manager Report (Period:07/01/22-09/30/22) Submission via E-mail) January 31,2023 (Period: 10/01/22- 12/31/22) April 28, 2023 (Period:01/01/23-03/31/23) July 31, 2023 (Period:04/01/23-06/30/23) Navigate Program October 31,2022 1 (Electronic ME Contract Manager Quarterly (Period:07/01/22-09/30/22) Submission via E-mail) Expenditure Report January 31,2023 (Period: 10/01/22- 12/31/22) April 28,2023 (Period:01/01/23-03/31/23) July 31,2023 (Period:04/01/23-06/30/23) klop uired fbr the, 1 f//Hl pfke:e, Monthly Outreach Due monthly, b the 30th of .......1.,( . y Electronic 1. ME Contract Manager Log every month following the Submission via E-mail) 2. Children's System of month of service Care Manager 3. VP of Contracts& Procurement Exhibit P-1, 2-1-1- Due monthly, by the 30th of 1 (Electronic ME Contract Manager Monthly Call Volume every month following the Submission via E-mail) Report . month of service Exhibit C Inserted 06/30/2022 Page 18 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr iirvii SM ii ii.g IIWi ii.d So i.itllh If: oiii iida Confl-at:„Hing raga oiii.d:lla If:ll a ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Follow-Up on 1 (Electronic 1. ME Contract Manager Referrals Pilot Due monthly, by the 30th of Submission via E-mail) 2.Children's System of Care Project Report every month following the Manager month of service 3.VP of Contracts& Procurement Updated Resource October 31, 2022 1 (Electronic 1. ME Contract Manager Manual/Directory Submission via E-mail) 2.Children's System of Care Manager 3.VP of Contracts& Procurement Report s'R juts d fdr"thy F i ri i ;IVl+ ntal �#h , vice f ragra Appendix A, By the 1 Oth of every month 1�(Electronic 1. ME Adult System of Care Conditional Release following the reporting month Submission via E-mail) Specialist Report 2. ME Contract Manager Weekly Statewide Weekly by 12:00 Noon every 1 (Electronic 1. ME Adult System of Census Report Thursday Submission via E-mail) Care Specialist 2. ME Contract Manager Appendix B, Monthly By the 10th of every month 1 (Electronic 1. ME Adult System of Diversion Report following the reporting month Submission via E-mail) Care Specialist 2. ME Contract Manager Quarterly SMHFT Due within thirty(30) 1 (Electronic 1. ME Adult System of Visit Report calendar days of date of the Submission via E-mail) Care Specialist visit 2. ME Contract Manager Staffing Report Weekly by 10:00 A.M.for the 1 (Electronic 1. ME Adult System of previous work week Submission via E-mail) Care Specialist 2. ME Contract Manager 12��isi`t~�R��uirea`i fir th� i�rnrr�un�ty„ kYi�n Treafrrf;�ntTcat�(SAT 1'�a�rri�,Prc��r >i� Weekly Census Weekly b 12:00 noon,ever 1 Electronic 1 IVIE's Children's y y ( Report Monday Submission via E-mail) System of Care Encrypted and Manager Password Protected 2. ME's Contract Manager Exhibit C Inserted 06/30/2022 Page 19 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilr ii1ii SM ii il.g Wind So i.itllh If:I oii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uavioi fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Monthly Data Monthly shall be submitted Electronically KIS, FASAMS,or other data Required by DCF electronically to the ME no system designated by the ME FASAMS PAM 155-2 later than the 4th of each or the Department month following the month of service Appendix 1 -Persons By the 811 calendar day of the 1 (Electronic 1. ME's Children's System of Served and month after the month of Submission via E-Mail) Care Manager Performance service 2. ME's Contract Manager Measure Report Appendix 2- October 12,2022 1 (Electronic 1. ME's Children System of Quarterly (Period:07/01/22-09/30/22) Submission via E-mail) Care Manager Supplemental Data January 10,2023 Report (Period: 10/01/22- 12/31/22) 2. ME's Contract Manager April 11, 2023 (Period:01/01/23-03/31/23) July 11, 2023 (Period:04/01/23-06/30/23) Appendix 3-CAT Monthly,by the eighth (8th) 1 1. ME Sr.Accountant(Fiscal Team Monthly calendar day after the month Department) Invoice of service 2. ME's 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. ME's Children's System of (incidental expenses) staff Care Manager nrt 'Re4ureci for'fh ;McstfRef'nib Tefr( Mobile Response Monthly b the 10 following 1 Electronic 1. ME Contract Manag er y to ( 9 Team Report the month of service Submission via E-mail) 2. ME VP of Behavioral -Encrypted, password Health Services protected 3. ME Data Analysts MRT Policies and October 1,2022 1 (Electronic 1. ME Contract Manager Procedures Submission via E-mail) 2. ME VP of Behavioral Health Services 3. ME Data Analysts Memorandum of October 1,2022,or any 1 (Electronic 1. ME Contract Manager Understanding/ addendums Submission via E-mail) 2. ME VP of Behavioral Agreement with the Health Services Local School District 3. ME Data Analysts Exhibit C Inserted 06/30/2022 Page 20 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i.lhiirviiSMiiil.g IIMiiii ld Soi.utllh If:Iloi ilda Confl-aat:„Hing aS Soiii.d:lla If:ll ru ucl a Il:3e1°uav of fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Outreach Activities October 12,2022 1 (Electronic 1. ME Contract Manager Log (Period:07/01/22-09/30/22) Submission via E-mail) 2. ME VP of Behavioral January 10,2023 Health Services (Period: 10/01/22- 12/31/22) April 11,2023 (Period:01/01/23-03/31/23) July 11,2023 (Period:04/01/23-06/30/23) Vacant Position(s) Monthly by the 10th of each 1 (Electronic Report month following the month of Submission via E-mail) 1. ME Contract Manager service 2. ME Adult System of Care Specialist R"piift Requiredfcfr ramily;(riteh 'tue"Tmatt n"t 1`e r t(FITS eruice,prt uid r `,,, Weekly Child Each Monday by close of 1 Electronic ME's Child Welfare Welfare Program business following the week Submission via E-mail) Integration Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday- Monday) of Exhibit Al) Access Database By the 13th day of the month 1 (Electronic 1. Contract Manager Report following the month of Submission via E-mail) 2.Child Welfare Integration services Coordinator Ropcarts'`Rc{u t4(tslfare;`spelalf lro fFam"Croitr Weekly-Child Each Monday by close of 1 (Electronic 1. ME's Child Welfar e Welfare Program business following the week Submission via E-mail) Integration Coordinator Active Cases Weekly of services(a week is defined Report(Appendix 1 as Tuesday- Monday) of Exhibit J) 2. ME Contract Manager Monthly-Child By the 18th day of the month 1 (Electronic 1. ME's Child Welfare Welfare Monthly following the month of Submission via E-mail) Integration Coordinator Tracker services 2. ME Contract Manager Exhibit C Inserted 06/30/2022 Page 21 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.IlriirviiSMiiil.g IIWiirid Soi.itllh If: oiii iida Confl-aat:„Hing raS Soiii.d:lla If:ll a ucl a li:3e1°uaavioi fll II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Monthly—Child By the 8th day of the month 1 (Electronic 1. ME's Child Welfare Welfare Specialty following the month of Submission via E-mail) Integration Coordinator Program Outreach services Log 2. ME Contract Manager Ie`pahf Iqulhe%fc:r'Cf�'rfd Ie(far `Irrtegratlrr&` upp ..: �5ft"Iert1 (CIT) . , Monthly Family Monthly by the 5th for the 1 (Electronic 1. ME Child Welfare Navigator Tracker preceding month's services. Submission via E-mail) Integration Coordinator 2. ME Contract Manager Monthly Behavioral Monthly by the 5th for the 1 (Electronic 1. ME Child Welfare Consultant Activity preceding month's services. Submission via E-mail) Integration Coordinator Log 2. ME Contract Manager Rer£ RegCitr1 fair Nfuur Rresuider lr c� rdlh Trea����� 0 Brut es i s pry in n#}�Jomerti,lltlofhdr" arid their,4fFecf d Fa f i(ie 's 90,17 ahr�M cf s Women's special By the 81h day of the month One(1) Password, 1. Data Analysts Appropriation Data following the month of protected and Reporting- Per services encrypted Electronic Exhibit AE Submission 2. ME Contract Manager upparted"Errtp i� fnehf R�pc�rt,� p, ia(Pr� iaXe�urid � fiik�hti(ae� ,,,, ,,,,, ""` Supported October 12,2022 One(1) Password 1. ME Peer Services Employment (Period:07/01/22-09/30/22) protected and Manager January 10,2023 encrypted Electronic Template 30,Proviso (Period: 10/01/22- 12131122) Submission Project Return on April 11,2023 2. ME Contract Manager Investment (Period:01/01/23-03/31/23) And July 11, 2023 Template 31, (Period:04/01/23-06/30/23) Clubhouse Supported Employment Report I'll 1 ����a kelp,f��Req�rired fc�r�letuy�rk Pr oul�e�� � �erflrig fb� u��lefil���,�1 ecUraf�/fnc�trre/ ct�l�il �eurtty tikarlity ifisurc , ltl} ? treacEw,Acr` tid Rcctery{ tAR},, Certificate of online Within ten (10) business days 1 (Electronic 1 SOAR Local Lead SOAR course of completion Submission via E-mail) completion 2. ME Contract Manager Exhibit C Inserted 06/30/2022 Page 22 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 I.Ilrii1iiSMiiil.g IIWiirid Soi.itllh If:Ioii iida Confl-aat:„Hing raS Soiii,d:ll'a If:ll a ucl a li:3e1°uaav of fli II e allilla Network, Uric.) 711/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 Records review per October 12,2022 One(1) Password, 1. SOAR Local Lead Exhibit AN, (Period:07/01/22-09/30/22) protected and January 10,2023 encrypted Electronic (Period: 10/01/22- 12/31/22) Submission 2. ME Contract Manager April 11,2023 (Period:01/01/23-03/31/23) July 11,2023 (Period:04/01/23-06/30/23) Crisis taErlittnn Unf / iuisrfti It `17ta Cn(fdcfiran CSU Recidivism Rate October 12,2022 1 (Electronic 1 VP of IT and Data Data Collection (Period:07/01/22-09/30/22) Submission via E-mail) Analytics (Attachment I, January 10,2023 Section D.Special (Period: 1 0/01122- 1 2131122) 2. ME Contract Manager Provisions) April 11, 2023 (Period:01/01/23-03/31/23) July 11, 2023 (Period:04/01/23-06/30/23) ,,,,,, R aiIpIportlerVrces,,,,,,;,,,,, Peer Support By the 101"day of the month One(1) Password, 1. ME Peer Services Employment Report following the month of protected and Manager (Monthly, per Exhibit services encrypted Electronic AO) Submission 2. ME Contract Manager Peer Support By the 101"day of the month One(1) Password, 1. ME Peer Services Services Report following the month of protected and Manager (Monthly, , per services encrypted Electronic Exhibit AO) Submission 2. ME Contract Manager prison A tercare' er`urdes Outpatient Report By the 15th day of the month One(1) Password, 1. Adult System of p Care (Monthly) following the month of protected and Department services encrypted Electronic Submission 2. ME Contract Manager Department of October 12,2022 One(1) Password, 1. Adult System of Care Corrections Referrals (Period:07/01/22-09/30/22) protected and Department for Baker Act January 10,2023 encrypted Electronic Services(Quarterly) (Period: 10/01/22- 12/31/22) Submission April 11,2023 2. ME Contract Manager (Period:01/01/23-03/31/23) July 11,2023 (Period:04/01/23-06/30/23) Exhibit C Inserted 06/30/2022 Page 23 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 i-IlhiirviiSMiiil.g IIWiirid Soi.itllh If„Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li: cell°uaav of fll II eaallilla Network, Uric.) 71II/2022 Exhibit C Required Reports For Fiscal Year 2022-2023 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 Inserted 06/30/2022 Page 24 of 24 Guidance/Care Center,Inc. Contract No. ME225-12-27 11111 riving ItPlnrl.trn,dIIII Ilacw lda (C"oll irra th igi''IS".,r:,oJI1 II IloI Ida 111r ll i lvlclri III II IIealll1III INetworlA,Ilu u:.) 71112022 EXHIBIT D for Fiscal Year 2022-2023 Substance Abuse & Mental Health Required Performance Outcomes&Outputs Network Provider Name: Guidance/Care Center,Inc. Contract#: ME225-12-27 Date: 6/30/2022 Amendment#: 3 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 22-23 Guidance Document 24,click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml. Note: Click on FY22-23 ME Templates and click on Guidance Document 24—Performance Measurement Manual Adults Community Mental Health a.MH003-Average annual days worked for pay for adults with severe 40 38 and persistent mental illness b. MH703- Percent of adults with serious mental illness who are 24% 22.8% competitively employed c. MH742 - Percent of adults with severe and persistent mental 90% 85.5% illnesses who live in stable housing environment d. MH743 - Percent of adults in forensic involvement who live in 67% 63.7% stable housing environment e. MH744-Percent of adults in mental health crisis who live in stable 86% 81.7% housing environment Adult Substance Abuse a. SAA73 - Percentage change in clients who are employed from 10% 9.5% admission to discharge b. SA754- Percent change in the number of adults arrested 30 days 15% 14.3% prior to admission versus 30 days prior to discharge c. SA755 - Percent of adults who successfully complete substance 51% 48.5% abuse treatment services d. SA756-Percent of adults with substance abuse who live in a stable 940% 89.3% housing environment at the time of discharge Children's Mental Health a. MHO12 - Percent of school days seriously emotionally disturbed 86% 81.7% (SED)children attended b. MH377- Percent of children with emotional disturbances(ED)who 64% 60.8% improve their level of functioning c.MH378 - Percent of children with serious emotional disturbances 65% 61.8% (SED)who improve their level of functioning d. MH778- Percent of children with emotional disturbance (ED) who 95% 90.3% live in a stable housing environment e. MH779 - Percent of children with serious emotional disturbance 93% 88.4% (SED)who live in a stable housing environment f.MH780 - Percent of children at risk of emotional disturbance (ED) 96% 91.2% who live in a stable housing environment Children's Substance Abuse a. SA725 - Percent of children who successfully complete substance 48% 45.6% abuse treatment services b.SA751 - Percent change in the number of children arrested 30 days 20% 19.0% Exhibit D Pagel of 3 Guidance/Care Center,Inc. Inserted 6/30/2022 Contract No. ME225-12-27 11111 riving IVrinri.trn,dIIII Ilacw lda (C"ollihra thigi'7 S".,r:,oJI1 II IloI Ida Iitr lli lvlclri III II IIealll1III INetworl ,Iluu:.) 71112022 prior to admission versus 30 days prior to discharge c. SA752 - Percent of children with substance abuse who live in a 93% 88.4% stable housing environment at the time of discharge Table 1—Network Minimum Year to Date Service Provider Annual Target Acceptable Performance This Performance Performance Performance ! Period Measures Network Provider Compliance: Network Providers shall achieve a minimum of 95% of the annual target levels in Table 1.The measures shall be demonstrated on an annual basis but will be monitored by the ME monthly. For each measure where the Year-to-Date performance falls below the Minimum Acceptable Performance, the Network Provider will submit a brief narrative, at the request of the ME, describing each of the following elements: 1. Any specific challenges,obstacles,or other operational considerations which are identified as significant factors underlying the unsatisfactory level of performance. 2. Any extenuating circumstances beyond the Network Provider's scope which are identified as significant factors underlying the unsatisfactory level of performance. 3. Efforts the Network Provider has undertaken to support improved performance during this reporting period. 4. Efforts the Network Provider will undertake in the future to support improved performance during subsequent reporting periods. 5. Any region-wide guidance,capacity,training,or other logistical supports needed to support improved performance during subsequent reporting periods. Exhibit D Page 2 of 3 Guidance/Care Center,Inc. Inserted 6/30/2022 Contract No. ME225-12-27 11111 rlhili gI4lur1dS+aw. IV IIIlarwlda (couihrar thrK;q"Is"sou.stl°u II IlorkIa litarlli nflcliI,ry III II IIeahIIIII Network,Ilinc.) /2022 Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Year FY22-23 Service Category FY Target Residential Care 22 a� Outpatient Care 1752 a� Crisis Care 143 x State Hospital Discharges N/A Peer Support Services 150 Residential Care N/A c 'n Outpatient Care 529 U Crisis Care 440 Residential Care N/A !n a Outpatient Care 485 a� U Detoxification 140 Women's Specific Services N/A N +- Injecting Drug Users 94 a Peer Support Services 70 Residential Care N/A cc c Outpatient Care 190 N N Detoxification N/A N � � Q Prevention **Refer to Attachment V, Scope of Work for the numbers served.** 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 Page 3 of 3 Guidance/Care Center,Inc. Inserted 6/30/2022 Contract No. ME225-12-27 I': 0rtlI xii`1 lire<T')'SOLI I i I i(]a 1:�6'lavlor it Ie.'l I l I Ne3 two I I;, Ii ric 11,1 U 102 2 REVISED 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: F2-1 Federal Authority F2-1.1 Block Grants Regarding Mental Health and Substance Abuse F2-1.1.1 Block Grants for Community Mental Health Services 42 U,S,C.ss. 300x,et seq. F2-1.1.2 Block Grants for Prevention and Treatment of Substance Abuse 42 U,S,C.ss. 300x-21 et seq. 45 CFR Part 96, Subpart L F2-1.2 Department of Health And Human Services,General Administration, Block Grants 45 CFR Part. 96 F2-1.3 Charitable Choice Regulations Applicable to Substance Abuse Block Grant and PATH Grant 42 CFR Part 54 F2-1.4 Confidentiality Of Substance Use Disorder Patient Records 42 CFR Part 2 F2-1.5 Security and Privacy 45 CFR Part 164 F2-1.6 Supplemental Security Income for the Aged, Blind and Disabled 20 CFR Part 416 F2-1.7 Temporary Assistance to Needy Families(TANF) 42 U.S.C. ss. 601 -619 45 CFR, Part 260 F2-1.8 Projects for Assistance in Transition from Homelessness(PATH) 42 U.S.C. ss. 290cc-21 —290cc-35 F2-1.9 Equal Opportunity for Individuals with Disabilities(Americans with Disabilities Act of 1990) 42 U,S.C, ss. 12101 - 12213 F2-1.10 Prevention of Trafficking(Trafficking Victims Protection Act of 2000) 22 U.S.C. s. 7104 2 CFR Part 175 F2-1.11 Governmentwide Requirements for Drug-Free Workplace(Financial Assistance) 2 CFR Part 182 2 CFR Part 382 Revised Exhibit F Page 1 of 4 Guidance/Care Center,Inc. Contract No. ME225-12-27 (;Conflmac Dune aaS oi,it:llI If:Il a ucla Ii:3di°iiaario fli Il ed llla INietwa°urk, Ilu ic.) 7/I/ 0 a 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 Ch. 120, F.S. Administrative Procedures Act Ch. 287, F.S. Procurement of Personal Property and Services Revised Exhibit F Guidance/Care Center,Inc. page 2 of 4 Contract No. ME225-12-27 (;Conflmac Dune aaS oi,it:llI If:Il a ucla Ii:3di°iiaario fli Il ed flila INietvaaa`id(, Ilu ic.) 7/I/ 0 a 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; statewide travel management system 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 F2-4.1 Department of Children and Families Operating Procedures CFOP 155-10/175-40 Services for Children with Mental Health and Any Other 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) Revised Exhibit F Guidance/Care Center,Inc. page 3 of 4 Contract No. ME225-12-27 (;Confl-ac Dune aaS oi,it:llI If:Il a ucla Ii:3di°Iuaario fll Il eallilla Il llet aaa`urk, Ilu ic.) 7/1/ 0 a F242 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 CFO's Memorandum No. 01 Contract and Grant Reviews and Related Payment Processing Requirements CFO's Memorandum No. 02 Reference Guide for State Expenditures Comptroller's Memorandum No. 04 Guidance on all Contractual Service Agreements Pursuant to Section 215.971, Florida Statutes CFO's Memorandum No. 20 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, hitps://www.ecfr.gov/current/title-2/subtitle-A/chapter-I I/part-200 2 CFR, 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 CFR Part 200 45 CFR, Part 75 Uniform Administration Requirements, Cost Principles,and Audit Requirements for HHS Awards F243 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 Financial and Services Accountability Management System (FASAMS) Revised Exhibit F Guidance/Care Center,Inc. page 4 of 4 Contract No. ME225-12-27 N N O � 7 Y C � rr. x N N c c � N N � o W x � O Z 0 0 0 0 0 0 � - O z U 0 0 0 0 0 0 r L; - T z U T N O c9 0 0 0 0 vi o 0 p7 s - C7 z 0 z w x � o g a W O W o 0 o N c c o m 'x N cv W ci e�w raoe ra.a r7 n e�000 a ao oo� r n o 0 0 o,w x- y� z G ~ U a _ � b .. r F ;� .0 .�C, Z y �C: � ;� i a '��"� L c=� ' ��:J v � A'-•� � oN. .c� d'u E A �� a s rn U c 21 F U o C C o �F�F� W � `c � F F,72 F � > x � � i <UvJQo ��� z�OOC= xoe04;X �vF�Q��ixxa7e�UUxxzL 06P Qc � < moamamJQ N b r 00' ..., ��00 y u C�✓ O O O O �. `i O ti�.-..-..-.M�� :I i I N '�N N N •���� .�' i. y Q LL N N O N C` o c c i o o c cco c o c o N o c — ooc cco 0 0 — — N N W L O Z T U (9 C O x U r u ' z u � v ' C7 W z = W o [] v N c o a o _ c f T u O x y A W a ^v C W o 0 U F o c c c o o c c c o 0 z T 7 ry -S p �n nv,N �oay.N�naeo— oono ry N V� naa o � o �� cdv,vi ri vi �cccrre.i � od eC.; — c o;�� c d o wof oo�� 000 iv c�N—NRT n�o �o t�rv�v! m o � ao`� z G z ci W v v vj v3 ^,sr3 n c�sF se s v es s n *°l v,v>us � ,^,n cn !+ •, ,.a es us v, � v�; �•,3 f a n v va JD Lc 92 �, v °� � F a 3 yxo• .. �`- � � ti w n c� .. r<".> p o'y ��J c d W 5 N 4 'ram � � c�j y °' > > �^ °o °'� o� -c�'° - s;3 0 = ��,•E 2� T i � � � � o p^p � � C7 x o o d c W m c o o K o x o aci c R rii ••^•L�' o v s•L. °''G= o v W c v�v. o o c o F. 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J�^N N M.y v v'JC ... Y i.,'i b r W .�'.,,t_ •V ,:; f....W i p.,o. i� i f`�W a O� '4�.. .-;- i. u^ I., p.::"r i N rv'i Q L.L j'� O O O O� ':'3 O'-I R e- i--i M� '.1 i.A N['ti N N N "V" , :�"i M R.:.. •'V 'I �" R R�N�i"' +� N N O N C` O C C M O O G m r 0 C O �L O C C O N H N N c o o W O Z U U p u ' i� C7 z z a W o � o 0 A W a ^v C W i> O U c c o 0 0 0 W o c o 0 c c `c � o N cv �n nv,N �oay.N�naeo— oono ry N V� naa o � o �� cdv,vi ri vi �cccrre.i � od eC.; — c o;�� c d o wof oo�� 000 iv c�N—NRT n�o �o t�rv�v, M o � ao`� z G z ci W v v vj v3 ^,sr3 n c�sF se s v es s n *°l v,v>us � ,^,n cn !+ •, ,.a es us v, � v�; �•,3 f a n v va JD �, v °� � F a 3 yxo• .. �`- � � ti w n c� .. r<".> p o'y ��J c � o �� x o o d c W m c o o K o x � o � aci c R �rii�••^•L�' o v �s•L.��.�.� °''G= � o v W�� � c v�v. o o c o' F. �.E W w `oF- r� V m V L q E c0 y C i O N �J F F F C Y+ G a i L t uL dca > W 0.r~�. Gz` zU UaaOC7 NO G WL.•4 cC C.YFi Ca '� 7 L m rn n v� a c � ,dry <UUUoo ��OOCCwao: 'ajmv,v',� Qd..=xxxU���r�zaaaa�¢�¢ � amw amwU¢ 1 '.1 i.A... � Y i.,'i b r W .�'.,,t_ •V ,:; f....W i p.,o. i� i f`�W a O� '4�.. .-;- i. u^ I., p.::"r i N rv'i Q L.L j' O O O O ':'3 O'-I R e- i--i M N['ti N N N "V" "i M R.:.. •'V �" R R Nei +� EXHIBIT H-FUNDING DETAIL Jnfy 2o22 For FIE 2022-2023 Provider.Goid...UCarc Cculcr,Inc Gmtractk:ME225-12-27 Ameudmeut#3 ABEL'I MENIAL HEAL'IH CHILDREN MENTAL HEALTH OCA DESCRIPTION .NEW OCA AMOUNT OCA DESCRIPTION .NEW OCA AMOUNT Residemial Services MH001 S_ R:'d Cal Services MWEI S Nou-Rcsidcndal Scrviccs MH009 S 91 082 Non Residential Sluices NHI009 $ 470 000 Crisis and Baker Al,Seas Rcas MH018 S 1.136.503 Crisis and Baker Acl Services MHO1R $ 15.677 Early lmervention Pryhtic Disorder, MHO26 $ Purchased Residential Treatment(PRTS) MH071 Community Forcusio Program MH072 S 160 000 Sp—M Appropuation-1CPH MHOBN S - IndigentDrugPmgmm MH076 S 50.564 Gre Coordination MHOCN S - I'roi-i,o Allocation-Citrus MH094 $_ Cony Norviard MHOCF S Carry Torn-ard MHOGF $ Rcsidcutial Scrviccs SUP 1 MH01S S tdemial Services SUP I MH09S .000 $ 130 Care Coordination MHOCV $ Von-Ices' Toren.is Hospital Multidisciplinary Team MHOpH $ _ C':.and Baker.act Servt—SLP I MH18S S FACT Teem MHOFT $ - C tamp-Action Trcatmcnt(CAT)Tcam MHCAT $ 600,000 PATH Grant MHOPG 1 I6 00 0 C CN:is get A,ideMHBCi SUPI MHCCS 1 TANF Services MHOTB $ Mobile Crisis Team MH\ACT $ 636,471 Rcsid¢oI Scry ccs SLP I NHE1S g... ...• r t S -d P acntion MHBC SUPI NHTSPV S - Noo-l2:d ntial Services SHE I NIHO99 1 I8m 000 Telehealdt Behasioral Health Services MHTLH $ 1 LU, Cnsisoud Elk.Act Sc­ SLP1 MH18S $ GSOC Cmut Ycnr2 CSOC2 S - I'xpnirdiu€211 Cnh MH211 $ SpccinlN Pr t¢cuiu SPLTY S - Early Inte—tim Services MHB6 SUPI MH26S $ Jewish Connnuni"Seriices PI .ICSPI S - Core G i.Su.4side MHB6$IY1 \IHLLS 1 32e 03e Jevish ConnnunityS vices M_ .ICSP2 1 - Emcrgracy COVID-19 Giant SnpplcmcnW MHLOS $ Lormcct Families Yondr Serccit NBTCFY S - Shot1 Tctm Rwidcubal Tr,ativctrt(SRT) MHLIL: $ JCS C iris I,inc NBTICL S - SupportedEmplovmmtServices MHLMP . I50000,,. 1CS Surfside MHS1JR 1 Fotcnsic Ttattsitional Bcd, MHFMH $ S Rr,idemial stahilip C,iorI MHBC SUPI MHR2ES ...., Emer ency CO%D-Supplemental MH5CS $ 1 For Profit Sub-Rc..p,uu-Kcv NV-HlvL1 \HiSFY $ S ...................... ......... Suicide Preven Linn MHBC SUPI MHSPV $ S Teleh,Ilh Behavintal H III Service., MHTLH .., ...., S ., MDC-Ccnnsl Recciciug PaoiEty 1.-IDCRF $' S Specialty Pmnm-am, SPLTY ..,. S ...... Community Action Twat—L(CAT)Team MHCAT S_ I10.0110 S _ Mobil,Crisis T,atn MHMCT S 100.668 S CSOCC east Yeur2 CSOC'' $ S J i.sh Community Service.,PI ICSPI $ S Jcrviilr Gouvnw A S—,,,,P2 JLSP2 iilia,Youth S— MHOCN Conn- N .. .... JCS Crisi,Line MHJCL $ l ICS Swfsidc MHSUR $.... ......... S ......... TOTAL:ADULT MENTAL HEALTH= $ 3.560.4M TOTAL.CHILDREN MENTAL HEALTH= S 1.953,260 ADULT SUBS1'AVCEABUSE CHILDREN SUHS'IANCEAHCSE OCA DESCRIPTION .NEW OCA AMOUNT OCA DESCRIPTION .NEW OCA AMOUNT Kcsidrnlial Services \1 cO0i $_ 1<esidemial Services MS003 S Nou-Rcsidcndal Scrviccs MS011 S 523-91 Non Residential Sluices MSoll $ _53 77'+, Detox Services MS021 S,.... 48h.643 Detox Services MS021 S ....,. ...... HIV Services MS023 $ _ HIl'S—l" MS023 S _ Prcvcudn O6'Scry c,s NIS025 g Prevention Smiles MS025 $ 199 t � Kom S—icas mse-, $.. ....Pavenuon l'onnership Gram MSOPP S Ihegnanl\Yomen Project MS081 $_ Caire Coordination M90CV S PIT Taun NIS091 S 200000 Cenv M—d MSOCF S - CareCoordinat— MSOCV $ TAN Services MS(TB S earry Fen.-�rd MsocF $ Ke,ideneal ser"i«,SUP I Mso3s s TANG Sc—ccs MSOTB $ Van R—d—O Scrviccs SUP 1 MS 115 $ 120.000 .. ..... - ..:...... Residential Serrlca,SUP I MS039 $ D-,Services SUP I MS219 S Noo-Rl,iden,l Services SUP I M511S g.., P -u Scrviccs SLY 1 MS255 S - Dctox SLP1 M521S 5 78�615 Proviso Allocation-Hcrc's Hclp M5903 S -, Prevention S—i—SUPI M525S F - Here's Help Opioid Training MS921 1 Care Goordmanon hidgcmcnt NIS923 4' NES,SEN Carc Coord SAPT SUPI NISCS2 S Coau pity Bas,d Scrviccs MSGBS S 5000 0 Prwcmion Pvwcrship Pro€SAPT SLYI MSPPS S NES'SEN Care Chord SAPT SUPI MSC52 $ Suicide Prevention SAPT SUPI \1SSPV J Opio d R,ponsc Disc Rcc Goutm Ot Y car 2 MSRC2 Si SOR-Prevention Year3 SSP3 S Op io d R,ponsc Disc Rcc Goutm Ot€Year3 MSRC3 $ SOR Pr,vcndon Ycar4 MSSP4 $ 2b,241 Opio'd 12,ponce Disc R,l Comm Ore Year 4 MSRC4 R SOI2 Prevention Years MSSP5 OImid 12 Iponse Disc R,,Comm Ore Year 5 mmw, $ Sp ally Ptngran SPLTN 1 is - OpioidRC,PmuCD,c.Gratis-CPRA Pcu7 MSSu3 G t Families Yondr Serccn NBTCFY S r ,.... ....,. ...... SOR-MAT Year2 MSSM2 $ 1CS Crisis Line \1 H.ICL S SOR-M AT Year3 MS,h 1CS SurC'de \1H511R 1 - SOR-MAT Ycar4 MSSM4 S 162.500 S SOR-MAT Years MSSMS S 487.500 ..... S ...... Suicide Prevention SAPT SL PI MHSPV Spccimty Pro€run, SPLTY $.... ......... S ......... Connect 11111111 Y1OLh Screen MHCFY 9; JCS Crisi,Line MHJCL $ S JCS Swf,id MHSUR 8.... S LoTAL ADULTSUBS1'ANCE ABUSE= S 1,)99,(141) LoTAL CHILDREN SUBSTANCE ABUSE $ 685,799 FUNDS NOT REQUIRING MATCH: D vAbu,e Sen ice, _ S 1,129,911 TOTAL ALL PROGRAMS S R,18S,589 P rt _ S_ 227 304 UN(OMPENSATLD HELPS- S 1.637.71S D m[roivlliz uan Prul"t S_ z 8629 TOTAL=S 9,926,307 CNIH Progmns„ S 1,953,260 SORGraut S 162,500 TOTAL FUNDS RLQUIRING MATCH- $ 4335.084 TOTAL F UNDS NOT REQUIRING MATCH S 3.850.505 LOCAL MAICUT REQUIRED= S 1,466,02K MILES EY 2021-22 Adjustments: 2,25/21 All the SOR allocations wcludmg GPRA and Prvcndon finding arc withdrawn,as dies,nllocadous arc not rcmu'rwg. '6/10/21 SOR,,11 c,tions are ddd bard on trnLativz allocations[or NY 201-23,OCA allocation,may change once the approved 9dedula of lands for the new year is received. 102/21 S53,394 is added to AMh-MHOef(MHOOI)to find a Re,I bed for 9 months. 10/221 S118,120 i,add d to ASA-MSOCL(NIS021)to expand 2 Dclox beds for 9 mondns.1-1une only. ali S13,162 is added w CMH-MHTLH to as the landing allocation with the ME,SON allocation. S5.000 is rduccd from MSSP3 to aE€n with the ME',SOF allocation and S50.525 i,addd H MSSP4. ,100.000 is reduced From MSSM2,S350,000 film MSSMS and 5500,000 is added w MSSM410 align with SFBHV',SOp allocation. 560,000 Rs redurzd front.AMH-MHOCN haeaI im funding Care Coordination on a Team based spp,,,6. 1021/20 SA March uk,flhui ,arc rcvis,d t d au prior y,,,r ircatmcnt dtn L.n Al,oO l Client,). 11/10/21$-5,000 i,added to M H L MP to Fund supported empl)men I.bhouse Services S325,0'5 i,added w AMH-MHCCS to mud the NIRT/9 RR Expan,ion....ices. 521,172 i,add to AMH-MHOPG malign with the ME,Schdulr of fund,allocation. 11/24/21$195,0'0 is addd to.4MH-MH09S,S 120,000 to CMH-MH095 and$120.000 to CSA-MS I I S for the proiision of Outpatient type of semi..,,non.recurring. 12/152021 W1,,668 i,added to AMH-MHMCT to,xpatnd the MRT se,,c 12'22 21 S78,616 i,addad to MS21 S m add 2 dtox bed,effective I s1'022. W'-'6/22 S32,563 is rcdu,cd from MSSP4 to align widn dnc ME's S,hcdulc of U.d,Allocation. FV 2022-23 adju,ln O,: 1/7/2 MSSM2,MSSMS allocations are sridtdras+n;MSSM4 and MSSMS allncatinn.,art made hardon projected udlication. MHOCN&MSOGN bud€cis arc removed as dtc Lam Coordination sovicls arc findcd ou a Tram approach. All,arty C nvard alloca. are removed a,they is-ere n>n-recurring budgets. MSSP3 bndgct i,.l—d,MSSP4;u,d MSSP5 n11—mOl ,mad,bold on pr O,d n[ilizadon. All the supplemental BIo1c Gratis adocadon,arc rrnlloe.td,nbj,ot to nvailbilip-offiunds Guidance/Care Center,Inc. E.!LbaH Contract No. ME225-12-27 Page I of I I,ertd 6/302022 N N O N T n N N N W Z � U �4 N z C c c Go O O O N N O O O O O r� Vt V•, to -. � 1. EP. E9 64 E9 EA N O O 7 U fi �i U � 0 F o � M z � _z C — N U O C O O 0 :C vs� ss s1 z N z NNN rotz -r a co m1-tv, v, o c o o ZN tV V V1 Vi 7 \D rl '-I b r O N C, O. c\ 00 if O 00 N 7\ N ... N 7 G1 Y Q N Q Y A W W'A 69`A W Gn W W �n f1!3 W. 56 b4 y5'A 65 b9 z9 W Z4 W& f dO-A A A-A 6n Hn'A f3 66 W 69 69 P w V) P 69 A 59 59 w a 5n Q U U p y m �'B � � o.�C � � •'•� " >>i a a c c > K a ? c o o a a o v o t a� � > cl U y a R rn -r. o a s7 .� •= s u•a o m m P? ✓: rn c o 0 o o.c U °s c c o u �+ wCOwwwUUwn. O _ J c o 0 :C Y L a a a a "'� _ _ •�O. Y N N N a 7, '�• y� = Q� co 0 7 y U L L L i 0 N Vi r M n .c c N N U 11177 a0 7 V1 00 r� - - - 'rw, IrlwlO N N N N N N N N M M M M M M�7 7 7 7 V/ V1 1() Vl Vl 1n VI Vi 1n Vl D V W U C (0 a 7 M 0 N O N N N O N } LL O LL REVISED EXHIBIT I Motivational Support Program (MSP) Treatment Provider Protocols Network Provider: Guidance/Care Center, Inc. I. POLICY: It is the policy of South 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 to the ME Contract Manager. II. PURPOSE: The purpose of this program is to: • 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. III. 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: To access the Department's FY 22-23 Guidance Document 19,click on the link below: htti)s://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml Note: Click on FY22-23 ME Templates and click on Guidance Document 19, Integration with Child Welfare IV. 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-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 Revised Exhibit Guidance/Care Center,Inc. Page 1 of 6 Contract No.ME225-12-27 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. 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) at the designated MSP 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 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 individuals who show an indication of behavioral health needs. Enrollment for Individuals served are not included in Outreach services. I. QUALIFIED PROFESSIONAL-A physician or physician assistant licensed under Chapter 458 or 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, 464.012 who has a master's or doctoral degree in psychiatric nursing, holds a national advanced practice certification as a psychiatric mental health advanced practice nurse, and has 2 years of post-master's clinical experience under the supervision of a physician a professional licensed under Chapter 490 or 491, F.S., a professional as defined in s. 394.455(5), (7), (32), (35), or (36)notwithstanding any other provision of law, 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 a 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 of a qualified professional, but only within the scope of their certification. Revised Exhibit Guidance/Care Center,Inc. Page 2 of 6 Contract No.ME225-12-27 0,',.n[i'trAJily<i,:,so�,I[h I oI id. J 1pchavioix1l I le ililI Nctwoi*, Ilriic,1 20:! 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 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. 1. Urgent Referral Case MSP will 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 (CPIS) or with the Behavioral Health Clinical Consultant (CCS). Referral Source: A CPI Supervisor (CPIS), 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 or post commencement consultation. 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 or with 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 CCS or CPIS for an MSP referral to be submitted, the CPIS or CCS is to follow-up to ensure that the MSP referral has been completed. Referral Source: A CPI Supervisor (CPIS), 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 or post commencement consultation. 3. CBC Referrals MSP will offer a 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) VI. PROCEDURES Revised Exhibit Guidance/Care Center,Inc. Page 3 of 6 Contract No.ME225-12-27 l h i,Nv ng c:11 la I'pcP7avloiN IIeNilt NA,Woi'k 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. 2. The treatment provider will ensure that an initial appointment takes place within seven (7) business days of the receipt of referral from MSS, regardless of the individual's ability to pay. 3. The treatment provider will ensure that the individual was financially assessed utilizing the sliding fee scale as specified 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. 5. The treatment provider must notify the MSS and submit a 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 (PI), and/or the CBC lead agency, Intensive Family Preservation Services ("IFPS"), 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 (20) calendar days of admission into outpatient substance abuse treatment. 2. The provider will complete and transfer the assessment tool to the MSS within five (5) calendar days of admission into residential substance abuse treatment. C. Mental Health Treatment Assessment 1. The treatment provider will complete a Bio-psychosocial assessment, upon completion of 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- psychosocial assessment to the MSS within one (1) business day of its completion. 2. The treatment provider must link the individual to recommended services based on the needs identified in the Bio-psychosocial 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. Revised Exhibit Guidance/Care Center,Inc. Page 4 of 6 Contract No.ME225-12-27 l h i,Nv ng I've nd ,-::tw[h c:11 la I'pcP7avloiN IIeNUI N�AWoi'lk, 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-Psychosocial 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 (2) 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. D. Drug Testing: The initial drug test is conducted by the DCF Protective Investigator (PI) prior to the referral to the MSP. Subsequent weekly random drug testing will 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 2 weeks of treatment. After the initial 2 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 closed. 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 closed with MSP. The MSP Monthly Treatment Summary Form found in Appendix 1 of this Exhibit. 1. The form must be submitted at the required intervals as specified above. 2. 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. F. Motivation Support Program form Monroe County Flow Chart The Network Provider shall follow the process delineated in the Guidance/Care Center, Inc. Motivational Support Program for Monroe County Flow Chart, dated February 8, 2022, incorporated herein by reference.The Network Provider will submit any revisions to the flow chart within ten (10)calendar days to the ME Contract Manager. Appendix 1 Motivational Support Program Monthly Progress Report Initial ❑ Revised Exhibit Guidance/Care Center,Inc. Page 5 of 6 Contract No.ME225-12-27 iI' Ong I`vN'Id �i a [h I c:11 i:t �'Coinh"i cU I'ly a< ')' :or ,I[h l oI' d. i 1pchavloixtl I le'dill N�Awr i*' Ih"ic") 7/1/ "0 1' Monthly ❑ Network Provider(Agency Name): Date: Client Name: Social Security Number: DOB: ICD 10 Code DSM 5 Diagnosis Progress in Treatment (to include compliance with sessions, resistance): Frequency of UA Testing: Urinalysis Results: I, (Print Therapist Name), hereby attest that I will submit this completed form to the Motivational Support Program Specialist every 151h calendar day after the month of service. Therapist Signature and Title: Date: Revised Exhibit Guidance/Care Center,Inc. Page 6 of 6 Contract No.ME225-12-27 ]'Iiiirl ung Mundi sol"Ithi F' o uda Iun� 6Ilig as " aniiILh FIciluud..l 11,haVl� rur:d U k,,ailII:ii I`,ekva::irk, tnmc 7/1 /2022', REVISED 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 Guidance Document 13, Indigent Psychiatric Medication Program, known as the Indigent Drug Program, dated July 1, 2022, 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 are used for eligible individuals. 1. Purpose The purpose of this guidance document is to: 1.1. Establish IDP administration procedures; 1.2. Provide written guidelines to the Managing Entities and IDP Providers; and 1.3. Establish medication order guidelines. 2. Definitions 2.1. IDP Pharmacy: A pharmacy holding a current permit pursuant to s. 449.01 F.S.from the Florida Board of Pharmacy that dispenses medication for the IDP. 2.2. Formulary: A listing of medications available in Order Express through Cardinal Health for IDP participating pharmacies to select the medications to order. 2.3. 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. 2.4. Psychiatric or Psychotropic Medication: Any drug prescribed with the primary intent to stabilize or improve mood, mental status, behavioral symptomatology,or mental illness. The medications the following major categories: 2.4.1. Antipsychotics; 2.4.2. Antidepressants; 2.4.3. Anxiolytics; 2.4.4. Mood stabilizers; and 2.4.5. Cerebral or psychomotor stimulants. 2.4.6. Other medications commonly used may include beta blockers, anticonvulsants, cognition enhancers,and opiate blockers. 2.5. 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 of medication. 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 to medications. Guidance/Care Center,Inc. Revised Exhibit N Contract No.ME225-12-27 1 of 4 1"1116 un kfin i sol"Ithi F, aorudo as "SoiilLh V"fMtda BcVuaVMu 11-�d U k,,a tl:u. I`,ehrra:;rk, Inc 7/1 2022, 3. Program Administration 3.1. Managing Entities If Managing Entities receive funding under the I DP,they will: 3.1.1. Approve organizations requesting to become IDP providers. To be eligible,organizations must be under contract with the regional Managing Entity. 3.1.2. Provide updates to the list of approved IDP providers to the Department's Office of Substance Abuse and Mental Health (SAMH) Regional Office, 3.1.3. Report bulk purchases into FASAMS. Using the EVNT(non-client specific file upload)contractors should submit a service using the IDP OCA(MH076)with the Incidental Expense covered service(28) 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 IDP providers use IDP funds for individuals who meet the criteria. 3.2. IDP Providers 3.2.1. IDP providers will: 3.2.1.1. Assess and enroll individuals in the IDP who meet the clinical and financial criteria established in ch, 394, F.S, 3.2.1.1.1. To meet the clinical criteria individuals: 3.2.1.1.1.1. Must be a member of at least one of the 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 a net family income that is at or below 150 percent of the Federal Poverty Income Guidelines, as published annually in the Federal Register; 3.2.1.1.2.2. Must lack third-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. If individuals have third party insurance for psychotropic medications but were temporarily denied benefits for these medications,they may receive IDP medications until such time as coverage or eligibility is reestablished. Guidance/Care Center,Inc. Revised Exhibit N Contract No.ME225-12-27 2of4 t"1inu urn Iund Sol"10,11 Fk)rida as Scil III Lh V"fou t&i baatI 1:u. I"Ml��d� r����i IM, I I I c 7/1 2102,:2 3.2.1.2. Provide information to individuals and staff working with IDP individuals regarding adverse effects,side effects, possible allergic reactions, and instructions on what to do in case of an emergency; 3.2.1.3. Maintain a copy of the IDP pharmacy license and permit issued in accordance with s.499.01 F.S. 3.2.1.4. Actively participate in Patient Assistance Programs (PAP)that provide psychiatric medications without cost; 3.2.1.5. Ensure that IDP prescriptions meet the following conditions: 3.2.1.5.1. An appropriate prescription for a 90-day supply may be written with up to 3 refills. One prescription cannot cover more than a 90-day supply; 3.2.1.5.2. Must be listed on the IDP Formulary; and 3.2.1.5.3. Must be filled at an IDP pharmacy. 3.2.1.6. Ensure participating pharmacies have an IDP account with Cardinal Health: 3.2.1.6.1. Complete a Cardinal Account Spreadsheet including contact information for the provider and participating pharmacies; and 3.2.1.6.2. Include a copy of the participating pharmacys license, 3.2.1.7. Ensure participating pharmacies order and receive IDP medication using the Cardinal Health account: 3.2.1.7.1. Select the IDP medication from"on formulary"available in Order Express; and 3.2.1.7.2. Click on"Mark as Ready" button to finalize the order. 3.2.1.8. Review a copy of the invoice sent via email and have participating pharmacies notify Florida State Hospital of discrepancies within 24 of receiving the invoice. 3.2.1.9. Track IDP balance using the invoices. 3.2.1.10. Address emergency situations, including but not limited to: 3.2.1.10.1. Order additional psychiatric medications from Cardinal;or a pharmacy of their choice(for urgent needs); and 3.2.1.10.2. Pay dispensing fees to IDP pharmacy for individuals who cannot afford to pay the fee. 3.2.1.11. Implement medication receiving, storage, and administrative procedures that meet the current State approved prescribing instructions pursuant to Chapter 465, 3.3. Florida State Hospital The Florida State Hospital will: 3.3.1. Setup the formulary available in Order Express. 3.3.2. Check available funds and notify the provider of outstanding balances. Guidance/Care Center,Inc. Revised Exhibit N Contract No.ME225-12-27 3of4 1'hinvung l fund Sol"10,11 l'kvuda as Scil III Lh V"fou t&i t 3eVua Rio°rail U k ailI1f i. I"Ml��d� r����i iM, I I I c 7/1 2102,:2 3.3.3. Review the orders and make changes if necessary, 3.3.4. Submit the orders and email a copy of the order confirmation to the pharmacies and providers. 3.3.5. Ensure SAMH Regional Offices have a Group Mail Box to receive copies of invoices. 3.4. Additional Resources 3.4.1.the Florida Medicaid Drug Therapy Management Program for Behavioral Health: http://www.medicaidmentaIhealth.org Guidance/Care Center,Inc. Revised Exhibit N Contract No.ME225-12-27 4of4 rh ilv hu g Mind scadl 14"I11orkla (;Co nfu mAih ^,wollflh Florida Pwtiav°ni,at 1f1f mIIUVi Inc.) //;I1/2022 REVISED EXHIBIT V 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, DCF Guidance 6, Outpatient Forensic Mental Health Services, DCF Guidance 7,State Mental Health Treatment Facility Admission and Discharge Processes, 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. The Network Provider will not submit violations of conditional release affidavits/reports to the court prior to consultation with the Forensic Specialist. The Forensic Team, when appropriate, should discuss proposed violations of conditional release with the ME's Forensic Coordinator, except in cases of physical aggression by the individual in question. Revised Exhibit V Guidance/Care Center,Inc. Page 1 of 4 Contract No.ME225-12-27 fhrllvhu g Mind scadil Flolld'a (1C'o nfamaaAiian; ^.iwauldh Florida Cnehavun °all MmIIUVi 7,e4ma rh,Inc.) t/1./2111122 (e) The Network Provider designee will complete and sign the Agency Agreement to Treat and return it to the Forensic Team within 72 hours of having received it. (f) 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. (g) 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. 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. (h) Conditional Release Monitoring —The Network Provider will ensure that individuals on conditional release order in Miami-Dade and Monroe Counties, including individuals transferred into the counties from other circuits are monitored. i. The Network Provider will ensure that individuals on conditional release are monitored and in compliance in accordance with the court order and department rules. Revised Exhibit V Guidance/Care Center,Inc. Page 2 of 4 Contract No.ME225-12-27 fhrllvhu g Mind scadil Flolld'a (1C'o nfamaaAiian; ^.iwauldh Florida Cnehavun °all MmIIUVi 7,e4ma rh,Inc.) M/2111122 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 maintain current copies of conditional release orders. (i) Resource 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. (j) 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 individuals 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 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 individuals on conditional release from other circuits in need of forensic mental health services placed by the ME. Statewide admission to 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 individuals on conditional release from other circuits in need of forensic mental health services placed by the ME pursuant Revised Exhibit V Guidance/Care Center,Inc. Page 3 of 4 Contract No.ME225-12-27 Fhrllvhu g Maaual Scadil Flolld'a (1C'o nfamaaAiian ^.iwauldh Florida Cnehavun °all MmIIUVi 7,e4ma rh,Inc.) M/2111122 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. Revised Exhibit V Guidance/Care Center,Inc. Page 4 of 4 Contract No.ME225-12-27 `I t lit h,111n2 INl nul"Shah IF111priid a C411 au1-aac° iIa 7�l,�S °wvWhi Plla rhla Barhavillw al ffva a000u "40"'itirk,>nnc, 071111 1/2 01 2 2 Revised 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 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. By definition, there is currently no equivalent,reimbursable service by Florida Medicaid or any other commercial insurance. 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 for which they will be referred. Revised Exhibit AC Page 1 of 18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t lit h,111n2)"')o nl"Shah IF111priid a C411 au1-aac° iIa 7�l,�S Case management may be ongoing for those determined eligible for this service based on current standards. 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, physical health, 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 of well-being 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. Revised Exhibit AC Page 2of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t11 r1la ha g ifiolonpl"Shah II°'ll lip a°iiII a C411o'I 1-a c�iIP g ils °;vtptlh Pllaaa-hb 01artaavilw al ffeaYh'1a",11iou°0„1u1c, 07/011/2(11122 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. 11. Care Coordination should incorporate a recovery oriented,strengths-based approach to an individual's pathway to recovery. II. PRIORITY POPULATIONS 1) Pursuant to s. 394.9082(3)(c), F.S., the Department has defined several priority populations to potentially benefit from Care Coordination. Managing Entities and provider agencies are expected to utilize at least 50%of allocated funds in OCAS MHOCN , MSOCN and MS11 S to serve the following populations A. 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: 1. Adults with three(3)or more acute care admissions within 180 days; or 2. Adults with acute care admissions that last 16 days or longer. 3. Adults with three (3) or more evaluations at an acute care facility within 180 days, regardless of admission. B. Adults with a SMI awaiting placement in a state mental health treatment facility (SMHTF)or awaiting discharge from a SMHTF back to the community. 2) The Department has defined additional populations to benefit from Care Coordination using funds in OCAS MHCAS and MHCAS. a) Under OCA MHCAS: A. Children and parents or caretakers in the child welfare system with behavioral health needs, including adolescents, as defined in s. 394.492, F.S. who require assistance in transitioning to services provided in the adult system of care. B. Children and adolescents with a mental health diagnosis, SUD, or co-occurring disorders who demonstrate high utilization. For the purposes of this document, high utilization is defined as: Revised Exhibit AC Page 3of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I ti h,111n2)"'find"1aaldh IFllipriid a 1."aonWaaa Oing as °;v utlh Pllorhl a 01arhavillw al ffe aYh'1a",11iou°fl•,:IlCu1c, 07/011/201122 children and adolescents under 18 years of age with three (3) or more admissions into a crisis stabilization unit or an inpatient psychiatric hospital within 180 days, including: 1. Children being discharged from Baker Act Receiving Facilities, Emergency Rooms,jails, or juvenile justice facilities at least one time, who are at risk of re-entry into these institutions or of high utilization for crisis stabilization. 2. Children and adolescents who have recently resided in, or are currently awaiting admission to or discharge from, a treatment facility for children and adolescents as defined in s. 394.455, which includes facilities (hospital, community facility, public or private facility, or receiving or treatment facility) and residential facilities for mental health, or co-occurring disorders. C. Children not currently receiving services by a Community Action Treatment ("CAT")Team. D. Children and adolescents who are assessed voluntarily without an admission to a Crisis Stabilization Unit two or more times within 180 days. b) Under OCA MSCAS: A. Families with infants experiencing or at risk for Neonatal Abstinence Syndrome or Substance Exposed Newborn. 3) In addition to the priority population listed in sections 1) A — B and 2) A. — D, , the following populations have been identified as benefiting from Care Coordination and may be served: A. Individuals referred, and enrolled in the Jail Diversion Program (JDP) who meet the following criteria: 1. Individuals must meet the following criteria (1 and 2): 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) 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 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 unit in thejail. Revised Exhibit AC Page 4of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I ii lvlja 2)"'find"1aaldh IFllipriid a 1."aonWaaa Oing as ,°wv utlh P'llaaHd a 01arhavililin at ffe aYh'1a",11iou°fl•,:IlCuac, 07/011/201122 C. Individuals (youth and adults) referred by, or to, a Law Enforcement Agencies and followed by that Law Enforcement: a. Youth/Adult must meet the following criteria: i. Must be receiving ME SAMH funded services or be willing to accept Care Coordination services from an ME Network Provider. ii. Adults have a confirmed SPMI and/or Co-Occurring diagnosis (Diagnosis of PTSD alone is not eligible). Youth must have a confirmed SED diagnosis and obtain parental /caregiver/guardian consent. iii. Currently is in or has the potential to experience a state of crisis, substance abuse or dependence,and history of suicidal/homicidal ideation. b.Youth/Adult 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 dynamic, lack of support system, isolation, instability and/or recent traumatic event. D. 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. E. Children and youth referred by Mobile Response Teams(MRT)that meet the following criteria: i. Youths that have come in contact(screening/assessment)with MRT services at least 2 times in 180 days. ii. Youth that have a combination of MRT contacts (screening/assessment) and one of the above children/youth criteria F. Adults being discharged,or no more than 30 days from discharge,from substance use and mental health Level II Residential Treatment program. 4) 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: A. 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, B. Individual requiring reentry services referred by the Prison Aftercare Program C. Individuals exiting higher levels of care such as residential level II treatment. Revised Exhibit AC Page 5of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t lit h,111n2)"'Io fl"Shah II°'ll11ua°iid a C411 au1-aac° iIa 7 '�S D. Caretakers and parents with a SMI,SUD,or co-occurring disorders involved with child welfare. E. 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 Department. F. Individuals may be identified by the ME's Care Coordination Team or through the ME's Network Providers. G. Individuals released pursuant to v, State Mosher, where a judge did not issue a Conditional Release Order(CRO) and are no longer receiving Forensic Services. H. Individuals served through Care Coordination must be ME-funded individuals. I. Persons with a SED, SMI, SUD, or co-occurring disorders who are exiting prison and are referred through the Prison Aftercare Program, or were released from prison through the Aftercare Program within the preceding 180 days and facing violations of post release supervision leading to further institutionalization (forensic hospitalization/prison) or incarceration. J. Care Coordination under these OCAS cannot be provided to individuals enrolled in the following team-based services FACT, Coordinated Specialty Care for Early Mental Illness/Navigate, Family Intensive Treatment (FIT), Comprehensive Community Service (CAT) Teams, Forensic Multidisciplinary Teams (FMT), and any other local multidisciplinary treatment teams that include case management; including Forensic Specialist Service Team contracted at Community Health of South Florida, Inc. K. If necessary, Managing Entities and Network Service Providers may implement a time-limited transition plan for individuals in the process of connecting to a case manager or team-based services that includes case managers(excluding Dependency Case Management and medical case management). The transition must ensure Care Coordination may not exceed 90 days during which time both a case manager and a care coordinator may provide services to the same individual unless a longer duration is specifically approved by the Department. The transition plan shall be designed to ensure a warm hand-off and successful case management engagement. III. IMPLEMENTATION A.Managing Entity Responsibilities The ME is responsible for system level care coordination and supporting Network Providers as they coordinate care at the person level, System level coordination includes the following activities: 1. 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 Collaborates with private receiving facilities to determine and/or confirm eligibility and referral process for those meeting criteria 2. Initiates referral to appropriate Network Provider and provides supporting documentation obtained through the data surveillance processor from private receiving facilities. 3. System level Care Coordinator activities include: Revised Exhibit AC Page 6of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t lit h,111n2 Nld nul So110h IF111priida C411�u1-ac° iII 7�l,�S a) Evaluates eligibility of individuals identified as meeting criteria; including determination if the person is enrollment in any program that will disqualify them from meeting criteria. b) Submit completed Care Coordination Referral Form c) Staff referrals and provides information as appropriate d) Tracks and ensures receipt of referral disposition within reasonable time frame: i. acknowledgement of receipt and approval 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 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, b. 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. Review NSP contracts to effectively track the correct implementation of CTI; with the ability to issue corrective action if determined that the model is not being properly implemented. 12. Ensure provider network adequacy and effectively manage resources. 13. Develop diversion strategies to prevent individuals who can be effectively treated in the community from entering SMHTFs. 14. 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. Revised Exhibit AC Page 7of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t lit h,111n2)"')o fl"Shah II°'ll11ua°iid a C411 au1-aac° iIa 7 '�S °wvWhi Plla rhla Barhavillw al ffva a000u "40"'itirk,>nnc, 071111 1/2 01 2 2 15. Provide technical assistance to Network Providers and assist in eliminating system barriers. 16. Work collaboratively with the Department to refine practice. 17. Implement a quality improvement process to establish a root cause analysis when Care Coordination fails. B.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 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 page left blank intentionally Revised Exhibit AC Page 8of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 I'Vaa°ao,ann7 Wnaa➢^w;oidh Florhta C poWu,,aa H nit ais SoaiAh II'lliriiLn Beha vili aaal ffeaYh"°�a:haaoirk,Inc, 017/011/2022 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 In this phase,there is frequent problem-solving skills. supports prior to contact with the individual in the discharge. community,focusing on active In this phase,the team This phase, promotes the engagement with behavioral health increasingly encourages transfer from CTI to other services, and identifying and individuals to manage community supports, both addressing housing-related issues in problems independently after formal and informal and order to prevent future episodes of connecting them to termination of CTI services homelessness or housing instability. supportive services. occurs with a support A transition plan is implemented network safely in place. while providing emotional support. Activities CTI worker engages the individual. This CTI worker monitors the CTI worker provides includes making home visits or visits in effectiveness of the support consultation but little direct the community including in shelters or network; service.The worker lets the on the street,introducing the individual solve their own individual to providers,and meeting Helps to modify network as problems.The worker with caregivers,helping the individual necessary; ensures key negotiate ground rules for caregivers/providers meet relationships,mediating conflicts, and Continues case management and agree on long term assess the potential of the individual's activities as necessary; support system. support system. Continues community-based y Reinforces the roles of Focuses on urgent/basic needs such as visits; support network members; food,immediate medical care,shelter, Provides psychoeducation Develops and begins to set in warm clothing or blankets,access to about self-management and motion plan for long-term essential medications; successful navigation of the goals(e.g.employment, Accompanies individuals to community service systems and education,family providers;Forges connections to social Completes any Phase I reunification); May hold a service systems,and assists the activities that still need party or some other individual to apply for available resolutions. Less frequent ceremonial recognition of benefits as indicated(phone,food and successful transition out of nutrition benefits,Medicaid, Disability, meetings and provides social CTI services.A final meeting etc.); crisis interventions and is held to formally recognize troubleshooting. the end of interventions and relationship. Revised Exhibit AC Page 9 of 18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I ti lvlja 2)"'find"1aaldh IFllipriid a 1."aonWaaa Oing as °;v utlh Pllorhl a 01arhavillw al ffe aYh'1a",11iou°fl•,:IlCu1c, 07/011/201122 C. 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 orjuvenilejustice,child welfare,primary care,behavioral healthcare,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.). Engagement should begin no earlier than 30 days from 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, 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 with submission back to the ME 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. Revised Exhibit AC Page 10 of 18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t lit h,111n2 Nlon l So110h IF111prida C411�u1-ac° iII 7�l,�S °wv�Whi Pllorhla Behavillwal ffv�aYh "10"'itirk,fire. 117/111i1/2022 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 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.samhsa.gov/course/ssissdi-outreach-access-and-recover\/-soar-onI ine-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. Collaborate 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 h e a I t h 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 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. Revised Exhibit AC Pagel 1 of 18 Guidance/Care Center,Inc. Contract No.ME225-12-27 `I t lit h,111n2)"')o fl So110h IF111priida C411 nu1-mlin�4�l,�S e. In depth discussion of high priority cases, usually between 4-8 individuals. Additionally, each individual should be discussed at minimum once a month, f. Plan for resolving barriers to implementation of CTI. g. Make a"To Do List"for upcoming week. D. 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 in ch. 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. E. 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,or project code, and using the following service modifier codes in the Modifier 2 field: Modifier Code Assigned OCA-Short Description DO MHOCN—Care Coordination DV MSOCN —Care Coordination SA AS I MHCAS—Children's Care Coordination SA I MSCAS—NAS/SEN Care Coordination 2. Only the covered services specified in this Exhibit in Section III, D,Care Coordination Covered Service may be reported using the modifier codes identified for Care Coordination. 3. 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. Revised Exhibit AC Page 12of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 °wvitflhii Pllaarkin 07arta,"i'uo,al ffva aYh "40"nou°k,>n,u1c, 0711111/7022 F. 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. G. REPORTING REQUIREMENTS 1. Monthly Care Coordination Monthly Reports(Narrative and Chart): The Network Provider must submit Care Coordination Monthly Reports using the Templates provided in this Exhibit by the 5t" 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. H. 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. I. RESOURCES Network Providers are encouraged to research the following list of promising practices in Care Coordination as examples of effective implementation. a. Recovery Support Bridgers/Navigators Certified Recovery Peer Specialists(CRPS)are utilized to assist individuals successfully transition back into the community following discharge from a SMHTF, CSU or Detox. The CRPS engages the individual while still inpatient and provides support and information on discharge options. They participate in discharge planning and assist the person in identifying community-based service and support needs and build self- directed recovery tools, such as a Wellness Recovery Action Plan (WRAP). The CRPS then supports the individual as they transition to the community. More information on WRAP may be accessed at: http://mentaIhealthrecovery.com/ b. Care Transition Programs" This intervention utilizes a Transition Coach to preferably meet an individual in the acute care setting to engage them and their family(as appropriate)and sets up in-home follow up visits and phone calls designated to increase self-management skills, personal goal attainment, and provide continuity Revised Exhibit AC Page 13of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 lI'llaa°ao,anag Wnaa➢^;oi 00a Fhwhta CuWt,aclhigy ais Saiiatl0a IFtnf°aalan Behavioral ffeaYtr 7�41moirk,Inc, 07111l11/202 across the transition.' More information on the Care Transition Programs may be accessed at: http://caretransitions.org c. Medical Homes The Agency for Healthcare Research and Quality defines the medical home as a model of the organization of primary care that delivers the functions of primary health care with the following attributes: i. Comprehensive Care—the medical home is accountable for meeting the individual's physical and mental health needs,which requires a team of care providers. ii. Patient-Centered—the medical home partners with patients and their families,respecting each person's unique needs,culture,values, and preferences. iii. Coordinated Care — the medical home coordinates care across all elements of the broader health system, including community services and supports. iv. Accessible Services — a medical home delivers services in shorter wait times, enhanced in- person hours,around-the-clock telephone or electronic access to a member of the care team. v. Quality and Safety — a medical home uses evidence-based medicine and clinical decision support tools to guide shared decision making with patients and families, engaging in performance and improvement.2 In Indiana, WellPoint Health Plan medical homes for persons with high-service use decreased emergency department utilization by 72%and decreased controlled substance prescriptions by 38% in the 6 months pre- and post-program. Medical homes for people with substance use issues can also be a key intervention for super-utilizer programs— in Michigan, an integrated medicine clinic addressing super-utilizers with mental health and substance abuse needs decreased emergency department visits by over 50%among highest utilizers. d. Behavioral Health Homes The SAMHSA — HRSA Center for Integrated Health Solutions has proposed a set of core clinical features of a behavioral health-based health home that serves people with mental health and substance use disorders, with the belief that application of these features will help organizations succeed as health homes. This resource may be accessed at: https://www.thenationaIcounci1.org/integrated-health-coe/resources/ e. Reducing Avoidable Readmissions Effectively The RARE Campaign in Minnesota was established to improve the quality of care for persons transitioning across care systems and to reduce avoidable readmissions by 20%. Five areas were identified as a focus of these efforts: i. Patient/Family Engagement and Activation, See,http://caretransitions.orgiabout-the-care-transitions-intervention/,site accessed October 14,2015 2 See,https://pcmh.ahrq.gov/page/defining-pcmh.site accessed October 14,2015. Revised Exhibit AC Page 14of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 lI'llaa°ao ba g Manaa➢^;oi 00a Fhwhta 1:puWu,,aa Hang ais Saiiatl0a II'unn°aalan Behavioral ffeaYtr 7�41aaaoir0a,Inc, 071111ID/2022 ii. Medication Management, iii. Comprehensive Transition Planning, iv. Care Transition Support, and v. Transition Communication For more detail,the RARE Campaign published recommendations on actions to address the above areas of focus which can be accessed at: https://www.rarereadmissions.org/areas/index.html f. Telehealth The use of technology presents another promising practice in coordinating care,specifically as it related to access, As an example, the Department of Veterans Affairs (VA) piloted a Care Coordination/home telehealth initiative that continually monitored veterans with chronic health conditions. Vital signs and other disease management data was transmitted to clinicians remotely located.The pilot reported reductions in hospital admissions and length of stay.' g. Wraparound Wraparound is an intensive, individualized care planning and management process for individuals with complex needs,most typically children,youth,and their families.The Wraparound approach provides a structured,holistic, and highly individualized team planning process which includes meeting the needs of the entire family. The philosophy of care begins with the principal of"voice and choice",which stipulates the child and family perspective and drives the planning.The values further stipulate that care be community-based and culturally and linguistically competent. The staff to family ratio typically does not exceed one Wraparound facilitator to ten families. More information on Wraparound may be accessed at: http://nw!.pdx.edu/ 1OM(Institute of Medicine).2010.The healthcare Imperative:Lowering Costs and Improving Outcomes:Workshop Series Summary.Washington,DC:The National Academies Press Revised Exhibit AC Page 15of18 Guidance/Care Center,Inc. Contract No.ME225-12-27 lI hHvhig Nflnd^waanintl0uIFllauohtaCpuuu0u•a Oonmt is "7oiu00n II'OonkLi 07urh»nvlonil 1fu aYh 741nnauir0r,Inc, 07/nilli1/20122 Exhibit AC Monthly Care Coordination Report-Narrative Region of Service: Circuits: Managing Entity: Report Period: Month/Year 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) Revised Exhibit AC Page 16 of 18 Guidance/Care Center,Inc. Contract No.ME225-12-27 ln'Vno°h;hig Nflnd^waanintl0u IFllauo hta C puuu0u•a Oonmt is "7oiu00n II'Oon°nm0un 07urhavi imil 1fu aYh"41nnauir0r,Inc, 07/nilli1/20122 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) Revised Exhibit AC Page 17 of 18 Guidance/Care Center,Inc. Contract No.ME225-12-27 LO clj o N LLJ o L) .................. aj aj aj u aj t (u u (u 4J < 00 4� . 0 0 X 00 I C) m LLI a) 'A cz aj -0 CA 5: .0a a . > tz Es Z� Ca) of u -4j lu aj Q) kx ID a, u 4j a) aj 1:5 cu o to tc, 47 M O aj L) bn tl: L) aj F.i 75 ...1 �4 7; 415, rj o a, 75 3 0 b w-I Cl. 10 Q, 'M P. x 0 M u Id a 'r.5 r TIh h iu g blind"lnuuah 14"IloHd a t.`onft na° hin as 5u111x h t'Ihi lli Itta Pn Ihaavim at 1[lpa altlla Nchl,wi ka Irma, / /211122 Revised Exhibit Al Family Intensive Treatment (FIT) Model Guidelines and Requirements Requirement: Specific Appropriations within the General Appropriations Act Purpose: To ensure the implementation and administration of this proviso project and ensure that the Network Provider ("FIT Team Provider") adheres to the service delivery and reporting requirements described herein and in Guidance 18, Family Intensive Treatment(FIT) Model Guidelines and Requirements,dated July 1,2022 or the latest revision thereof. I. Authority Annual Specific Appropriations 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." II. Program Goals The FIT Team model is designed to provide intensive services to families in the child welfare system with parental substance use. Upon successful completion,the family should have the skills and natural support system needed to maintain improvements made during services. The goals of the FIT Team model are to: 1. Provide early identification of at-risk families and immediate access to intensive substance use and co-occurring mental health treatment services for parent(s)/guardian(s) in the child welfare system with early engagement strategies, such as at case initiation or case transfer, when a child in the family has been determined to be"unsafe"; 2. Establish a team-based approach, including Clinicians, Case Managers and Recovery Peer Support Specialists, to planning and service delivery in coordination with Community-Based Care Lead Agencies, Child Welfare Professionals, Managing Entities and other providers of services; 3. Integrate evidence-based 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. Identify family-driven pathways to recovery and promote sustained recovery through cultural and gender-sensitive treatment and involvement in recovery-oriented services and supports; 5. Promote increased engagement and retention in treatment; 6. Provide 24/7 access for crisis management; 7. Facilitate concurrent planning between child welfare case planning and treatment plan goals, to integrate the family's strengths and needs with their dependency case plan; Revised Exhibit Al Page 1 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 llrhiug Mind Scadil 1,11,nuida "Is "S)Ixlln 1"hilidda Ca.Ihovuauu•nd ffeatffi N_e wii7u k,h1e, 7,1�./2,0121 8. Advocate for parent(s)/guardian(s)and assist in navigating the child welfare process; 9. Promote treatment completion and continued care through linkage to ongoing support services and natural supports; and 10. 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)/guardian(s) have a substance use disorder; 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 (FFA), 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. III. Eligibility FIT Team Provider shall accept families referred by the child protective investigator, child welfare case manager or Community-Based Care Lead Agency. Providers and stakeholders working with child welfare families, such as engagement programs and the dependency court system, can also refer eligible parent s)/guard!an(s), The FIT Team Provider shall deliver services to parent(s)/guardian(s) who meet all 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 the criteria for a substance use disorder: 3. Have at least one child between the ages of 0 and 10 years old; and 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 and placed in-home or out-of-home; 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 eligible parents)/guardian(s)are willing to participate in the FIT Program or the caregiver is court ordered to participate in FIT services. In either case, enhanced efforts to engage and retain the caregiver(s) in treatment are expected as a critical element of the FIT program. Revised Exhibit AI Page 2 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 HJr11,Wg Mind sonflil 14"Ila,nlida 1."mfl rnucH ng n auax�ln 1"hili d n ga.li'novioli nd N1a hh T^dow i 11 k,I ne, 7/11/2 11121 The FIT Team Provider may serve families who exceed the financial eligibility while applying a sliding fee scale in accordance with 394.76 F.S. and Chapter 65E-14.018, F.A.C., if no other option for treatment at this level is available. While eligibility is based on at least one parent/guardian in the home meeting criteria,all members of the household may receive and benefit from FIT services and coordination. This allows for family-focused treatment and ensures that all members of the household are addressing any issues that may impact success from both a behavioral health and child welfare perspective. Each parent/guardian that meets the eligibility criteria is counted toward the performance measures. IV. FIT Staffing Requirements By providing a team-based approach to care, families receive FIT services from consistent and designated staff that have received the required training on the child welfare system and evidence- based programs. FIT staff work collaboratively to meet the needs of FIT families. Below are the essential roles of FIT team members who are considered the "core" team. Adjustments to staff credentials and maximum caseloads must be approved by the Managing Entity with agreement from the Department of Children and Families. This includes time-limited plans to address initial implementation of this staffing requirement and vacancies. 1. Program Manager - A Master's or Doctoral degree in behavioral health sciences, such as psychology, mental health counseling, social work, art therapy, or marriage and family therapy; an active license issued by the Florida Board of Clinical Social Work,Marriage and Family Therapy, Mental Health Counseling,or Psychology;and a minimum of three years working with adults with substance use disorders, 2. Behavioral Health Clinician-A Master's or Doctoral degree in behavioral health sciences,such as mental health counseling, social work, art therapy, psychology, or marriage and family therapy; and a minimum of two years of experience working with adults with substance use disorders. Behavioral Health Clinicians provide evidence-based therapeutic services and incorporate behavioral health goals with Caregiver Protective Capacities and parenting interventions. Clinician caseloads are clinically determined by the Program Manager but shall not exceed 15 clients. 3. Case Manager—at minimum a Bachelor's degree 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 or Master'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 child welfare case manager and the FIT program does not fund the child welfare case manager. FIT Case Managers assist clients with coordination of provider referrals and follow-up for other needed services.Case manager caseloads are determined by the Program Manager based on the needs of the individuals served, but shall not exceed 20 clients. 4. Recovery Peer Specialist - Certified by the Florida Certification Board; or an individual who has direct personal experience living in recovery from substance use conditions for at least 2 years Revised Exhibit AI Page 3 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 Hj 11,W %firinl so n iu 14"I11ol da 1.oafl]rnucH ng n auax�ln 1"hilidd n ga.li'novioli nd N1a hh T^dow ill k,I ne, 7/11/2 11121 with a minimum of one (1) year work experience as a Recovery Peer Specialist. Recovery Peer Specialists are allowed one year from the date of their employment to obtain certification through the Florida Certification Board. Recovery Peer Specialists provide support, assistance, and advocacy for the client. Recovery Peer Specialists caseloads are determined by the Program Manager based on the needs of the individuals served but shall not exceed 20 clients. V. FIT Programmatic Requirements The FIT Team Provider shall be trained in the use of evidence-based substance use treatment and parenting practices found effective for serving families in the child welfare system. 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 parent(s)/guardian(s) to reach FIT Team Provider in case of emergency 24 hours a day, 7 days a week; 2. Recovery peer 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 welfare professionals; 5. Individualized treatment provided at the level of care that is recommended by ASAM or LOCUS placement criteria; 6. Document FIT activities and family's progress in Florida Safe Families Network(FSFN); 7. 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; 8. Group treatment to address substance use disorders, based on individual and family needs and preferences; 9. Trauma-informed treatment services for substance use disorders and co-occurring substance use and mental health disorders; 10. Therapeutic services and psychoeducation 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 treatment plan, including a Multi-Disciplinary Team (MDT)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; Revised Exhibit AI Page 4 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 fIb h iiu g hind"lon lu I"Ilotid a I.`onft liuun as 5u,u4xlln Flla idiil a Ce Ihovuauu•nd fkatffi Netm,oii lv,luaus, 7,1l/2,0121 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. VI. Assessment: All assessment tools should be completed as appropriate in the first 30 days following enrollment to the FIT program. The FIT assessment process includes consideration of the assessment activities that are completed by child welfare professionals, as well as any known behavioral health treatment history. In addition to assessments from child welfare, the FIT Team Provider shall assess parental capacity, functioning, substance use and co-occurring mental health, family history, and trauma. Results of all assessments are included in the Biopsychosocial and inform treatment planning and interventions. American Society of Addiction Medicine (ASAM) or Level of Care Utilization System (LOCUS) Criteria: Complete the ASAM or LOCUS Criteria to address the parent(s)/guardian(s)' needs, obstacles and liabilities, as well as the caregiver's strengths,assets, resources and support structure to determine level of care upon admission. Daily Living Activities (DLA-20): Alcohol-Drug Functional Assessment: Complete the DLA-20 to determine the caregiver's level of functioning.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:Alcohol-Drug shall be administered at discharge, except in the case of unplanned discharge and parent is unavailable. Caregiver Protective Capacities: Review the caregiver protective capacity ratings completed by the child protective investigator or child welfare case manager from the most recent Family Functioning Assessment. The FIT Team Provider will complete a baseline rating of the caregiver protective capacities based on information gathered during the assessment process and integrate the capacities into the treatment plan goals. This will be evaluated by the FIT team monthly in progress updates and during treatment plan reviews and at discharge. These ratings are not to replace the assessment of caregiver protective capacities completed by the child welfare professional, but to align language for more robust discussion of the parent(s)/guardian(s) progress. Biopsychosocial Assessment: The Biopsychosocial Assessment shall describe the biological, psychological, and social factors that may have contributed to the recipient's need for services. The evaluation synthesizes the results of all assessments administered and include a brief mental status exam, diagnostic/clinical impression and preliminary service recommendations based on those results and interview of the client and family. Refer to Chapter 65D-30, F.A.C. for further requirements of the Biopsychosocial Assessment. VII. Treatment Planning Process As part of the core competency of an Integrated Practice Model, it is imperative behavioral health providers support and address child welfare outcomes by enhancing caregiver protective capacities. Utilizing the Revised Exhibit AI Page 5 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 fIb h iiu g hind"lon lu I"Ilotid a I.`onft liuun as 5u,u4xlln Flla idiil a Ce Ihovuauu•nd fkatffi Netm,oii lv,luaus, 7,1l/2,0121 identified diminished caregiver protective capacities and behavioral health needs, the team will be able to develop appropriate interventions to address family needs.This practice is in unison with the Child Welfare Practice Model which requires child welfare professionals to identify reunification criteria, objectively evaluate the scaling of caregiver protective capacities, and assess behavioral changes in the parent/guardian toward enhancing their protective capacities. The FIT team participates in or coordinates MDT staffings, requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s),teacher(s), primary health provider(s),and other provider(s),following enrollment and at least every 30 days. The MDT is responsible for the development and ongoing evaluation of the treatment plan and/or case plan, including any alterations that may prove necessary. VIII.Transition and Discharge Successful transition planning begins at admission, is family-centered, and continues throughout the family's treatment. Families are apprised of the appropriate community resources available, linked to those services and are key participants in all phases of the transitional care planning process. Referral processes with community providers need to occur in a timely, systematic fashion prior to discharge. The process concludes with the coordination and implementation of services and transition to the least restrictive level of care. Completion of the DLA-20: Alcohol-Drug and rating of the caregiver protective capacities are completed seven calendar days prior to discharge from FIT services, except in the case of unplanned discharge and parents are unavailable.An MDT staffing is held 30 calendar days prior to discharge from the FIT program and includes the FIT team, and requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s), teacher(s), primary health provider(s), and other provider(s). The discharge MDT staffing addresses the family's behavioral health, relapse prevention and recovery service needs such as Alcoholics Anonymous, Narcotics Anonymous, a faith-based group or other recovery supports; the physical health care needs for the parents and children; support services such as housing supports, supportive employment, financial benefits, etc.; and community services such as child care, early intervention programs, therapies, and community-based parenting programs. Fourteen calendar days prior to discharge,the FIT provider makes referrals to ensure linkage for necessary services and supports.A discharge summary is completed summarizing the family's needs and referrals to services and is provided to the family upon discharge.A copy of the discharge summary is provided to the child welfare professional within seven days of discharge. In the event of an unplanned discharge, the FIT team coordinates an MDT as soon as disengagement is identified to discuss strategies for re-engagement or plan for next steps following discharge. These steps must be documented in the discharge summary and provided to the child welfare professional within seven days of discharge. Discharge Definitions 1. COMPLETED TREATMENT: Discharged due to successful completion of treatment. 2, MOVED: Discharged due to moving outside of the FIT Team Provider service area and not enrolled in another service or program during the reporting period 3, JAIL/PRISON: Discharged due to incarceration. 4, DISENGAGED: Discharged due to disengagement (dropped out of treatment, lost contact, administrative discharge, left against medical advice, eloped, failed to return from leave, and individual choice) 5, TRANSFER TO ANOTHER FIT PROVIDER: Discharged due to transfer to another FIT Team Provider Revised Exhibit AI Page 6 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 Hjr11'Wg Mind sonflil 14"Ila,nlida 1."mflirn'IcH ng n auax�ln 1"hilidd n ga.li'novioli nd N1a hh N-clw lii k'I ne, 7/11/2 11121 6, TRANSFER TO ANOTHER PROGRAM OR SERVICE: Discharged due to transfer to another treatment program or type of service (including recommendations for other levels of care due to maximum benefit achieved at current level of care); If a higher level of care is recommended but client refuses and disengages, the discharge will be defined as disengaged. 7, DIED: Discharged due to client death 8, GOAL CHANGE: Discharged due to goal change in the child welfare case but the child welfare case remains open; This discharge definition is used when the permanency goal is changed and there is no longer a requirement to continue treatment. 9. COURT CLOSED: Discharged due to the child welfare case closed by the court. IX. FIT Process 1. At time of referral,the FIT Team Provider will: a. Review the referral to ensure it meets FIT eligibility criteria I. This can include staffing with the referral source ii. If the referral does not meet criteria,the FIT Team Provider will staff the case with the referral source and recommendations and linkage to appropriate services are made and documented b. Access the initial and/or ongoing FFA from the FSFN system, if completed c. Review the FFAs for the diminished caregiver protective capacities d. Contact child welfare professional to acknowledge receipt of the referral and receive any additional information e. Review case plan,when available f. Review FSFN for any prior investigations g. If FIT program is full, a waitlist is maintained. All referred families are contacted, given information about status on waitlist and provided referrals for interim services to meet any immediate needs.Weekly phone contact is maintained for all clients on FIT waitlist 2. Upon accepting a referral, the FIT Team Provider will: a. Assign the referral to FIT Team (Counselor,Case Manager and Recovery Peer Specialist) b. Contact the family as soon as possible (within two business days) to explain the Fit Team approach, answer questions about FIT and set up enrollment meeting c. Ensure that initial and recurring efforts to contact and engage the referred parents)/guardian(s) are documented d. Determine which FIT Team member(s)will participate in the enrollment meeting 3. Upon enrollment, the FIT Team Provider will: a. Meet with family and complete all consents required by provider agency Revised Exhibit AI Page 7 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 HJr11,Wg Mind Sonflil 14"Ila,nlida 1."mfl rnucH ng n auax�ln 1"hilidd n ga.li'novioli nd N1a hh T^dow ill k,I ne, 7/11/2 11121 b. Ensure that a release of information is completed for the child welfare professional and any other formal and informal providers and supports involved with the family c. Contact the child welfare professional to provide disposition of referral, schedule an MDT staffing,and arrange to be present at all Teaming activities,such as case planning conference, mediation,staffings, urgent/emergent staffing,or court hearings, etc. 4. Within the first 30 days after enrollment, the FIT Team Provider will: a. Complete required FIT initial assessments b. Complete a Biopsychosocial based on all child welfare information,results of FIT assessments, and interview with the parent/guardian and family c. Based on the clinical assessments and identified diminished caregiver protective capacities,a treatment plan is developed with the family, FIT team, the child welfare professional, and other providers involved with the family d. Begin substance use treatment to include relapse prevention planning utilizing an evidence- based model e. Coordinate specialized services; for example: joint home visits, in-home interventions, parenting programs, child services, peer services, incidental funding, etc. f. Evaluate family's need for housing or to apply for eligibility for food, cash and medical assistance or use of incidental funds g. Complete all required FSFN documentation, at a minimum a monthly progress notes and update at any critical juncture 5. During ongoing treatment,the FIT Team Provider will: a. Complete additional assessments as appropriate or required b. Participate in or coordinate frequent (at least monthly) MDT staffings, requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s), teacher(s), primary health provider(s),and other provider(s) c. Review treatment plans, FFA-Ongoing, Progress Updates, and scaling of caregiver protective capacities.Any section scaled as a "C"or"D" is included as an area of focus in the Treatment Plan d. Continue to evaluate family's need for housing or to apply for eligibility for food, cash and medical assistance or use of incidental funds e. Participate in Teaming activities,such as case planning conference, mediation, MDT staffings, urgent/emergent staffing, or court hearings, etc. f. Complete all required FSFN documentation, at a minimum a monthly progress notes and update at any critical juncture Revised Exhibit AI Page 8 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 llrhiug Mind scadil 1,11,nuida(`m lV ulilug"Is "Sl)Ixlln l"hilidda Ca.Ihovuauu•nd ffeatffi N_e wii7�u k,h1e, 7,1�./2,0121 6. During Continued Care, the FIT Team Provider will offer ongoing continued care services once clinical services are determined to be completed. This can be done through individual services and/or attendance at an aftercare group and is typically provided by the FIT Case Manager or Recovery Peer Specialist, 7. During Transition and Discharge, the FIT Team Provider will: a. Complete updated assessments,such as the DLA-20: Alcohol-Drug and rating of the caregiver protective capacities b. Provide progress updates to inform the child welfare case manager's ongoing assessments of caregiver protective capacities c. Consult with the child welfare professionals) to determine the appropriate time for child welfare case closure. This includes agreement that 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 L Families may be transitioned if there is a goal change to Termination of Parental Rights (TPR), however the family does not have to be discharged at this time if actively engaged and expresses a desire for continued FIT services ii. Families may be transitioned at any time the family declines ongoing treatment with the FIT Team d. Participate in or coordinate an MDT staffing 30 calendar days prior to discharge to discuss case transition with the FIT team, requesting participation from child welfare professional(s), parent/guardian(s), and any other relevant parties such as caregiver(s), foster parent(s), mentor(s),teacher(s), primary health provider(s), and other provider(s), except in the case of unplanned discharge and the parents are unavailable e. Coordinate linkage with community resources to ensure any ongoing care/aftercare 14 calendar days prior to discharge, except in the case of unplanned discharge f. Assist with coordination of follow up services L Complete discharge summary and provide to the child welfare professional within seven days of discharge ii. Complete all required FSFN documentation X. Incidental Expenses Per, 65E-14.021, the following use of incidentals are approved: "transportation, childcare, housing assistance, clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals and other incidentals as approved by the department or Managing Entity." Incidentals should only be used to cover "temporary expenses incurred to facilitate continuing treatment and community stabilization when no other resources are available"and must be"associated with a treatment plan goal." Revised Exhibit AI Page 9 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 llrhiug Mind scadil 1,11,nuida "Is "S mxlln 1"hilidda Ca.Ihovuauu•nd ffeatffi N_e wii7�u k,h1e, 7,1�./2,0121 Prior tout ilizing Incidentals,the FIT provider explores all other resources with the family,including eligibility for food, cash and medical assistance through the Department of Children and Families Automated Community Connection to Economic Self Sufficiency(ACCESS) program. More information on ACCESS can be found at http://www.myflorida.com/accessflorida/. XI. Third-Party Services Services provided by the core FIT Team staff and funded by FIT contract dollars cannot be billed to any third-party payers. 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 (including detoxification; residential; crisis stabilization; medication management; aftercare; or other specialized service), the FIT Team shall refer to the appropriate level of care or service provider. The FIT Team shall work in concert with any other providers, the individual and the family to integrate services into overall treatment and to monitor progress toward treatment goals. For services provided outside of the core FIT Team staff,the FIT Team Provider shall seek reimbursement for services provided to individuals from any third-party payer, when available, including: commercial insurers,TRICARE, Medicare, Health Maintenance Organizations, Managed Care Organizations(MCOs),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. The FIT Team Provider shall also seek reimbursement for any Medicaid reimbursable service from Medicaid (or MCOs) when an eligible individual is a Medicaid enrollee. Additionally, the FIT Team Provider shall assist families who may be eligible for Medicaid to complete the program's application process and assist with the required eligibility documentation, pursuant to Chapter 65E-14,014(2), F.A.C. The FIT Team remains responsible for immediate access to services for admitted individuals, regardless of payer. XII. Reporting and Performance Measures A. Access Database: The FIT Team Provider shall enter all client data in the Access database, export the data on a monthly basis and submit the report to the ME by the 131h day of each month following service delivery. B. Service Targets: Annual Target: 1) The FIT Team at Guidance/Care Center shall serve 17 families per year. Monthly Target: 1) The FIT Team at Guidance/Care Center shall maintain a minimum of 5 families in treatment, In the event the FIT Team Provider fails to achieve the minimum performance measures, the Managing Entity may apply appropriate financial consequences. C. Programmatic Performance Measures and Methodologies The FIT Team Provider shall meet the following performance measures and: 1. Upon successful treatment completion, 95 percent of eligible parent s)/guard!an(s) served will be living in a stable housing environment: Revised Exhibit AI Page 10 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 llrhiug Mind scadil 1,11,nuida t.`m lV ulilug"Is "Sl mxlln l"hilidda Ca.Ihovuauu•nd ffeatffi N_e wii7�u k'h1e, 7,1�./2,0121 a. Stable housing is defined as: Independent Living (Alone, with Relatives, with Non-Relatives), Dependent Living (with Relatives,with Non-Relatives), Foster Care/Home (including Extended Foster Care for ages 18-21, or Supportive Housing. b. The numerator is the sum of the number of eligible parents)/guardian(s)discharged as Completed Treatment during the reporting period who are living in a stable housing environment. c. The denominator is the sum of the total number of eligible parents)/guardian(s)discharged as Completed Treatment during the reporting period. d. The percentage of eligible parent(s)/guard ian(s)living in a stable housing environment at treatment completion should be equal to or greater than 95 percent. 2. Upon successful treatment completion, 95 percent of eligible parents)/guardian(s) served will have stable employment: a. Stable employment is defined as: Active military, overseas; Active military, USA; Full Time; Unpaid Family Worker(A family member who works at least 15 hours or more a week without pay in a family-operated enterprise. If an individual refuses to work because that are making money through illegal activities,the client must be coded as Unemployed); Part Time; Retired; Homemaker(Manages household for family members); Student; or Disabled. b. The numerator is the sum of the number of eligible parent(s)/guardian(s)discharged as Completed Treatment during the reporting period who have stable employment. c. The denominator is the sum of the total number of eligible parent(s)/guardian(s)discharged as Completed Treatment during the reporting period. d. The percentage of eligible parent(s)/guardian(s)with stable employment at treatment completion should be equal to or greater than 95 percent. 3. Upon successful treatment completion, 90 percent of eligible parents)/guardian(s)served will improve their level of functioning,as measured by the Daily Living Activities(DLA-20):Alcohol-Drug Functional Assessment. 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 eligible parent(s)/guardian(s) discharged as Completed Treatment during the reporting period with an overall functioning score that is higher than the initial recorded score. c. The denominator is the sum of the number of eligible parents)/guardian(s) discharged as Completed Treatment with more than one DLA-20 score during the reporting period. d. The percentage of eligible parents)/guardian(s)who improve their level of functioning at treatment completion should be equal to or greater than 90 percent. Revised Exhibit AI Page 11 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 ul'luu im Wg 'lumum7 Sonflil 14"Ila,mmida 1.mfl racdng s "^i'olflIh Floirkfa gm Il ovilmuiralll Nta hh N-cl lii Vey 111 e, 7,1l/2,0121 4. Upon successful treatment completion, 90 percent of eligible parent(s)/guardian(s)served will improve their Caregiver Protective Capacities as rated by the FIT Team Provider. a. Measure of improvement is based on improvements to the Caregiver Protective Capacities ratings. b. The numerator is the sum of the number of eligible parent(s)/guardian(s) discharged as Completed Treatment during the reporting period with Caregiver Protective Capacities that are higher than the initial recorded rating. c. The denominator is the sum of the number of eligible parent s)/guard!an(s) discharged as Completed Treatment with more than one Caregiver Protective Capacities rating during the reporting period. D. 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 FIT Team Provider shall use the reporting template provided in Appendix 1 of this Exhibit Al. XIII.Additional Resources 1. Florida's Center for Child Welfare Hosts online references and training videos that can be useful to members of the FIT team. Caregiver Protective Capacities http://centervideo.forest.usf.edu/video/summitl 7/focusandchange/Caregiver%20 Protect ive%2 OCapaci ty%20Reference.pdf FSFN Traininas FSFN 101 (08/18/2016): http://centervideo.forest.usf.edu/fsfn/fsfn101/start.htmI FSFN Basic Functionality for Child Welfare Partners (07/19/2017): htti)://centervideo.forest.usf.edu/video/center/fsfnfunction/start.html Additional FSFN el-earning Modules: http://centerforchildwelfare.fmhi.usf.edu/fsfnwebtrain.shtml Plans of Safe Care http://centervideo.forest.usf.edu/video/center/safecare/start.htmI Revised Exhibit AI Page 12 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 llrhiug Mind scadil 1,11,nuida(`m lV ulilug"Is "Sl)Ixlln l"hilidda Ca,Ihovuauu•nd ffeatffi N_e wii7�u k'h1e, 7,1�./2,0121 http://centerforchildwelfare.fmhi,usf.edu/kb/subabuse/plan ofsafecaresustanceaffectedinfants. pdf Integrating Behavioral Health and The Child Welfare Practice Model: Finding a Common Language: http://centervideo,forest.usf.edu/familiesfirst20l7conf/integratingbh/start.html 2. National Center on Substance Abuse and Child Welfare(NCSACW) Tutorial for Substance Use Disorder Treatment Professionals https://ncsacw.samhsa.gov/tutorials/tutorialDesc.aspx?id=26 Module One: Primer on CW and Dependency Court Systems for Substance Use Disorder Treatment Professionals. Module Two: Engaging Child Welfare-Involved Families in Treatment Module Three: Effective Treatment for Child Welfare-Involved Families Module Four: Special Considerations for Children Whose Parents Have Substance Use Disorders Module Five: Collaborative Strategies to Effectively Serve Child Welfare Families Affected by Substance Use Disorders 3. Florida Certification Board Register and click Available Courses: Motivational Interviewing for Behavioral Health Professionals New Perspectives on Recovery Creating a Culture of Engagement in Behavioral Health Services Welcoming Services and Service Coordination for Women with Substance Use and Co-occurring Disorders Revised Exhibit AI Page 13 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 Hjr11'Wg Mind Sonflil Folida Cmflin'IcHng s 1"hilidda Behoviolind ffeahh N-clwlii k'Ine, 7/11/2 112 1 APPENDIX 1 Child Welfare Programs Active Cases Weekly Report REPORTING PERIOD: Family Intensive Treatment Team (FITT) Revised Exhibit AT Page 14 of 14 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Con rat:„fing aS Soiii.d:lla If:ll a ucl a li:3e1°uaavioi fll II e allilla Network, Uric.) 711/2022 Revised 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, 2022, 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 FY22-23 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 — CAT Return on Investment Report 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 81h of the month following services. o Appendix 2 and Appendix 3 — Quarterly submission to the Managing Entity 101h of the month following the end of each state Fiscal Year Quarter. 0 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; 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; Revised Exhibit AJ Page 1 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uaavioi fll II e allilla Network, Uric.) 711/2022 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 for the CAT Team 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; 5. Decrease substance use and abuse; 6. Decrease psychiatric hospitalizations; 7. Transition into age appropriate services; and Revised Exhibit AJ Page 2 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida (Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uavioi fli II e allllla Network, Ilu ic.) 7111/2022 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. Network Providers may serve families who exceed the financial eligibility while applying a sliding fee scale in accordance with 394.674 F.S. and Ch. 65E-14.018, F.A.C., if no other option for treatment at this level is available (i.e. rural areas). 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, or certified peer specialists, 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 Entity.CAT members work collaboratively to deliver the majority of behavioral health services,coordinate Revised Exhibit AJ Page 3 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida (Confl-aat:„Hing aS Soiii,d:ll'a If:ll a ucl a li:3e1°uaavioi fll II e allilla (Network, Uric.) /2022 t 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://www.starstrainingacademy,com/tip-model-institute/ 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. http://www.pathwaysrtc.pdx.edu/about 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. https://nwi.pdx,edu/wraparound-basics 4. Florida Wraparound model and toolkits available for providers and Managing Entities http://www.socflorida,com/wraparound.shtml 5. Strengthening Family Support for Young People: Tip sheet for strengthening family support. https://www,pathwaysrtc.pdx.edu/pdf/projPTTC-FamilySupportTiPSheet.pdf Revised Exhibit AJ Page 4 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilhii1iiSMiiil.g IIWirid Soi.itlh If:Ioii iida (Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uaavioi fll II eaallilla Network, Uric.) 711/2022 6. Positive Youth Development (PYD), Resilience and Recovery: Actively focuses on building strengthens and enhancing healthy development. https://www.pathwaysrtc,pdx.edu/pdf/pbCmtyBasedApproaches09-201 1,pdf 7. Section 394.491, F.S. —Guiding principles for the child and adolescent mental health treatment and support system. htti)://www.leg.state,f1.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&U RL=0300-0399/0394/Sections/0394,491.html 8. 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, juvenilejustice,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. https://www.youthmovenational.org/mission-and-vision V. Serving Young Adults The CAT program serves young adults up to the age of twenty-one(21), which includes young adults ages eighteen (18) up to twenty (20) who 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 be shared. In 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. VII. Screening and Assessment Within 45 days of an individual's admission to services,the Network Service Provider must complete the North Carolina Family Assessment Scale for General Services and Reunification° (NCFAS-G+R) as the Revised Exhibit AJ Page 5 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 i.lhii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-at:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 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 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. Guidelines for Adolescent Depression in Primary Care(thereachinstitute.org and and A.T-MAY Cover Page (thereachinstitute.orc 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,integration.samhsa.gov/clinical-practice/screening-tq ools • SAMHSA Co-occurring Center for Excellence—Integrated Screening and Assessment Integrated Treatment for Co-Occurring Disorders Evidence-Based Practices (EBP) KIT I SAMHSA Publications and Digital Products • 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. htti)://adai,uw.edu/pubs/infobriefs/ADAI-IB-2011-01.pdf Revised Exhibit AJ Page 6 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida (Con raacflare a�a Soiii,tt:ll'a If:ll a ucl a Ii:3e1°uavioi fli II e allllla Network, Ilu ic.) C1 I1/2022 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, httips://www.casey.org/casey-life-skills/ 5. Youth Efficacy/Empowerment Scale and Youth Participation in Planning Scale-Portland Research and Training Center(Pathways RTC): https://www.pathwaysrtc,pdx.edu/pdf/DbCmtyBasedApproaches09- 2011.pdfpdx.edu/pdf/pbCmtyBasedApproaches09-2011.pdf 6. 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/proj-3-amp See,http://www.aacap.org/aacap/Policy Statements/2009/Family and Youth Participation in Clinical Decision Making.aspx Revised Exhibit AJ Page 7 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll ru ucl a li:3e1°uaavioi fll II e allilla Network, Uric.) 711/2022 2. Family and Youth Participation in Clinical Decision Making. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/aacap/Policy_Statements/2009/Family_and_Youth_Participation_in_Cli nical_Decision_Makin .asaspxx 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 monitor the Wraparound plan to ensure effectiveness and to revise as needed to ensure the plan best matches the individual's and family's self-identified needs. https://nwi.pdx.edu/NWI-book/Chapters/SECTION-4.pdf 4. Florida Wraparound model and toolkits available for providers and Managing Entities http://www.socflorida.com/wrai)around.shtml IX. Plan of Care 1. Initial Plan of Care Within 30 days of an individual's admission to services,the Network Service Provider must complete an Initial Plan of Care to guide the provision of services by the CAT team. 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; • Specify the CAT services and supports to be provided by CAT Team 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 of Care 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 individual's assets and resources; • Be individualized and developmentally appropriate to age and functioning level; Revised Exhibit AJ Page 8 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 Ph iiirvii SM ii ii.g IIWi irid So i.itlh Ii: oiii iida Confl-aat:„Hing aS Soiii,tt:ll'a If:ll a ucl a Ii:3e1°uaav oii fli II e allilla INetwork, Uric.) 711/2022 • Address needs in various life domains, as appropriate; • 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 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/amh/wraparound/docs/wraparound-approach-soc.pdf 2. Florida Wraparound model and toolkits available for providers and Managing Entities http://www.socflorida.com/wraparound.shtml 3. Achieve My Plan (AMP): Youth participation in planning — provides tools, tip sheets for professionals and youth https://www.pathwaysrtc,pdx.edu/p3c-achieve-myplan 4. 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/pdf/PbJCFS-Walker-AMP-Enhancement-for-Wraparound-05-2017.pdf 5. Community-based Approaches for Supporting Positive Development in Youth and Young Adults: RTC Pathways Community-Based Approaches for Supporting Positive Development in Youth and Young Adults with Serious Mental Health Conditions(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.2 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 2Chapter 394.491,F.S.-Guiding principles for the child and adolescent mental health treatment and support system. http://www.1eg.state.fl.us/statutes/index.cfm?App mode=Display Statute&Search String=&URL=0300-0399/0394/Sections/0394.491.html Revised Exhibit AJ Page 9 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 I Ill ISM1l•llg 'u"IIIrid oil,A h I„II I da (;Gonfl actuing&�Soiii,it:ll'I cla li['I II°°uav ouall II ea lli Network, Uric'.) 71I1/2022 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 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.edu/pathways-transition-training-collaborative 2. 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/pdf/pro'-5-AMP-what-is-peer- sugport.pdf 'Transition Youth with Serious Mental Illness:http://www.aPa.org/about/gr/issues/cyf/transition-youth.pdf Revised Exhibit AJ Page 10 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilhii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida (Confl-aat:„Hing aS Soiii.d:lla If:ll ru ucl a li:3e1°uaav of fll II eaallilla Network, Uric.) 711/2022 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. 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.), Revised Exhibit AJ Page 11 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida (Confl-aat:„Hing aS Soii.d:lla If:ll a ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 7111/2022 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 Individuals receiving services must attend an average of 80%percent of school days, according to the following methodology: a. 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. b. The numerator is the sum of the total number of school days attended for all individuals. c. 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. Revised Exhibit AJ Page 12 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilhii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida (Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uavioi fll II eaallilla Network, Uric.) /2022 • 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. e. There needs to be two scores(admission and discharge scores)for the performance measure to be included. 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. • "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, 70% 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. Revised Exhibit AJ Page 13 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilhii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll ru ucl a Ii:3e1°uaav of fli II eaallilla Network, Uric.) /2022 t d. There needs to be two scores(admission and discharge scores)for the performance measure to be included. Note: If an admission WAS assessment has been completed on a child and parent/caregiver and the child moves to a different home with a different caregiver, a WAS 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 parent/caregiver. • If a child changes placements multiple times, the provider and ME should discuss how to report on the WAS 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 14 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 (Conflma+°t ung aS Soi,.Wh cla Ii:3e1°uavioi ill Il ea flili Network, Ilric.) 71 i/2022 APPENDIX 1 ..,............... CAT PROGRAM PERSONS SERVED AND PERFORMANCE MEASURE REPORT"" . �_.-......_......._. ...................._......._..." Provider Name Contract Number � _ _.Reportin Period _� _� . .� ... .__. Reporting om To _.- � Reporting Requirement Target This Period This Quarter to Year to Date Date RABLE Number of Persons Served Section D-2 1St Month=10 Min _ per 2nd Month=20 month 3rd Month=25 Thereafter=35 MINIMUM PERFORMANCE MEASURES—Section XV t E C E E c E c 2 E z o a z o a z o a School Attendance 800/' CFARS or"FA'R'SLf Functioning, _�.., 80%::::::::: Improvedq based upon Living in a Community Setting 90% Improved Family Functioning, based on Child 70% Well being Domain, N C F A S G+R Notes: 1. Performance measures for CFARSIFARS 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 _.-......_ ......_ ......_ ......_......._......._......._.. ...._......._......._-. ......_ ......_......._......._......._..... 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. _.�""""""��"" pleaseAuthorized Name print)an """"""��""""""��"." d Title ( Signature Date Revised Exhibit AJ Page 15 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 hiliVing Wind fwoutfllh Ii of kla! (Coi olu afting as a uatll°u Ii:Ilu)u ucla li:tehaVoi .all Il amallllll a Il lietraaoii , Ili ic.) 7/ /2022 APPENDIX 2 ..._........._......... Provider Name ................................... QUARTERLY SUPPLEMENTAL DATA REPORT CAT PROGRAM Contract # Reporting.......... From To Period Individuals Diverted from Otat of Home Placement � At ...... .n.,..,.,.. ...... ...Aadmission, ., ..._, .............. ....... admissionumber of participants at risk of out of home placement due to: Total Discharge Options number of Residential a nu ants not This Total Child mental Juvenile participants Year to Date Welfare health justice at risk of out of Quarter involvement treatment commitment home placement Numberof charges removed from the home due to child welfare involvement .. Number of discharges , ... charges � � � � ......................................................... � � admitted to a residential mental health treatment center � .�..� .� Number of discharges committed to juvenile justice placement Number of dis ,e n e . . charges liv i ng in the community �..Totals.... .... .... � � � � � � .... .... Use the space discussion detailsaffectin the services and p p Y 9 Y pp (Optional) �e, ,......... . ......... . ............ o,e.,. „ ,,,.,, ., .. .., 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 P the re ortin period age e 9 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 herebyattest the information provided herein is accurate,reflects e with the terms and conditions of ects services provided in a p accordance 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 16 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 (Conflmaat:„Hing aS oi,d:lla Ii Ilaau ucl a Ii:3e1°uaav of fli II eaallllla Network, Ilu ic.) 7111/20 t t 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 psychologist/psychiatrist for placement in residential mental health treatment center? • Has a recommendation from a Qualified Evaluator for 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 17 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 Ph ii1ii SM ii il.g IIWi irid So i.itllh Ii:I oii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a kl a Ii:3e1°uaaaa of fli II eaallilla Network, Uric.) /2022 APPENDIX 3 CAT Return on Investment Quarterly Report Network Service Provider: Managing Entity: South Florida Behavioral Health Network,Inc. Cumulative Fiscal Quarterly R01 Report: Number or Clients - Actual Cosfs Per Da , Total Costs Per Quarter Clients Served in CAT Clients Discharged from CAT Clients Discharged from CAT who Remain in Community The'Ctients'&Scharged from CAT were diverted from: Cost Per pay, Annuatized Cost Avoided Diverted from Child Welfare $170 Diverted from Juvenile Justice $223 Diverted from Psychiatric $483.78 Residential(SIPP) Total Cost Avoidance ROI Differential(Tutat Cdst,AvoidanCe minus 6tat Costs—for the(quarter) Return on Investment Differential (p v ded'by Total Casts for the auarter) Attestation 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 18 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 I Iii iSM I•IIg 'u"IIII'id oil,Ith I„II IIda (Gonfl act ing&S Soiii.ifli'I cla li['I II°°uav of ai II ea flIi Network, Uric'.) C1 /2022 Appendix 3 Guidance Instructions for Calculating the RO1 Report 1) Days in Quarter: Provide total number of days for the reporting quarter 2)To calculate the"Actual Cost Per Day": Total Cost for the Quarter divided by Clients Served then divided by Days in Quarter 3)Total Cost for the Quarter: Should be 1187,500.00" PLEASE NOTE: $187,500.00 should be the standard cost per quarter of a$750,000.00 annual budget 4) Diverted from Child Welfare Cost Avoided: Number diverted from Child Welfare x Cost Per Day($170)x 365 5) Diverted from Juvenile Justice Cost Avoided: Number diverted from Juvenile Justice x Cost Per Day($223)x 180 6) Diverted from Psychiatric Residential (SIPP)Cost Avoided: Number diverted from Psychiatric Residential (SIPP)x Cost Per Day($487.42)for 01 &Q2/$478.04 for 03&Q4)x 180 7)Total Cost Avoidance: Add up Cost Avoided totals for Child Welfare,Juvenile Justice and Psychiatric Residential (SIPP) 8) RO1 Differential: Total Cost Avoidance amount minus Total Cost for the Quarter 9) Return on Investment: RO1 Differential amount divided by Total Cost for the Quarter PLEASE NOTE THE FOLLOWING REMINDERS: 1) Providers must input"zeros" instead of simply leaving the field blank. 2) Providers must include cents. 3) For numbers that extend out beyond 2 spots after the decimal place, if the third number to the right of the decimal place is a 5,round the second number to the right of the decimal place up. For example,1.125 would be rounded to 1.13. Screenshot of the CAT ROI formula calculation: Revised Exhibit AJ Page 19 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 PhiliVing IIWii.d i.utllh i�]oilda (Confl-acHing a�SSoii.dh cla i:3el'iavioi fli i ealfli'i Network, ric.) 711/2022 A C .............................................................................I....................0...................................................................................0 .................... W'i'&'5'F'orcrula rumple AdwICONNy TOW(051 fo, 4 Chw6%Seved m CAT 47 -(MIFAIJC2 ISIVA 5 Cl IS Min CAT ........................................................... ............................... ................................................................................................. ............... ............................... ............................................................. 6 OvIn Dahuaed firm CAT who Camara in Commul# 1� ...................................................................................... ................... ............... ............... ............... ............... 7 1 ---------------------------------------------------------------------------------------------------------------------------------- a Owls khafged fw CAT who renamed m thpmmmmdm mre'� (Oitpeloq (05thowed B. --------------------------------------------------------------------------L------------------------------------------n----------------------------------- 's±n tr—m------------------------------ M 48WOO)IM ..................................... ........rl IT Dvwed from Pj;;T; pp �l ON 14 -- ------------- ------------------------------ --------------- 13 detAtotal W AV011hil ---------------------- ---------------------------------------- - ----------------------------— Rol Oiffefellwl jloal(o0AvoWmp.ml LusTOalCWf%Ow — 14 QlAafte) :1 1.bW --................................................................................................................................... Adam onlovestmeM aRol Nffewgij bided 4 flee TOW Cast dw ffif II te:Bawd on Memm data/n'k mesamefll at timp of admmi'm V1 CAT Revised Exhibit AJ Page 20 of 20 Guidance/Care Center,Inc. Contract No.ME225-12-27 I Ii riSM1l•llg WI'id oil,Ath I„II IIda (Cc)IIItil act uing °rS soiii,uf:ll'I d Il eallilli Network, Uric'.) 71II/2022 EXHIBIT AN For FY 2022-2023 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 Managers)/SOAR Processors) 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, 2022, or the latest revision thereof. The Case Manager(s)/SOAR Processors) 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://soarworks.prainc.com/content/soar-on I ine-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 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilhii1iiSMiiil.g IIWiirid Soi.utlh If:Ioii iida (Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uaav of fli II eaallilla Network, Uric.) 71II/ 0 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://soartrack.prainc.com/login,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://soarworks.samhsa.gov/course/ssissdi-outreach-access-and-recovery-soar-online-training. 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 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..i hi lVlng 'td 1111'•id South I„IIoI Idd,'.4 (Contrat:„t ing&S Soiil,if:llI If:ll a ucl II:' Il u:r rilr a ill II ear ills Network, Uric'.) 7111/022 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 1,2022),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 1,2022 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://soarworks.prainc.com/course/soar-child-curriculum b. The annual SOAR application target will be measured by a combination of adult and children's cases.The Network Provider agrees to an annual target of 1 children's applications. C. 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 Exhibit AN Page 3 of 4 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 (;Conflma+:°Hing aS oiii,if:lll If:Il a u11a Ii:3e hav of fll Il eallilli II lie woirk, Uric.) 7/II/ 022 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 1,2022), 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 1,2022 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 RESPONSIBILITIES 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.m\/flfamilies.com/service-programs/samh/managing-entities/index.shtml Note: To access the form click on FY22-23 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 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Thriving Mind South Florida Contracting as South Florida Behavioral Health Network,Inc, 07/01/2022 Revised Appendix I to Exhibit AN SOAR Applicant Eligibility Criteria Form First Name: Last Name: Date of Birth (DOB): Last 4 SS#(if available):_XXX-XX- The individual is a (circle one): Adult/Child Screening Agency: Date of Screening: Name of Screener: Position: Date of Admission with Provider: PLEASE MARK ON THE SHEET BELOW ANY OF THE ITEMS THAT APPLY—staff response to each eligibility criteria below should be based on response provided by individual served and review of collateral information (i.e. Medical Records, family input,etc.)This form is designed to be utilized by agency staff(not necessarily trained in SOAR)for the purposes of making a referral to a SOAR Trained Processor. The form may be utilized as a tool by, but not limited to, the following Departments: Intake, Case Management, Physicians, etc. Key Eligibility Criteria: The following 5 characteristics represent key eligibility criteria for SSA disability benefits. Individuals being screened for SOAR who have all 5 elements should be referred to a trained SOAR Processor for further determination of eligibility, ❑ 1 a. Immigration status= U.S. Citizen (U.S. Born or Naturalized, check# 1 and move on the#2) ❑ 1 b. For applicants born outside of the United States further review may be needed by a SOAR Trained staff. Specific immigration laws allow SSI benefits for persons born in Cuba and Haiti which differ from other countries. o Individuals with work history in the United States may be eligible for SSDI despite Immigration Status. Children with immigration barriers may also apply if their parents have a qualifying work history. Work History: No ❑ Yes ❑ (if yes,check#1 and also respond to questions on#1) o Reported Immigration status(if known): Legal Permanent Resident, Parole, Unknown Other: o Place of Birth (Country): o Date of Entry in the USA: Date of arrival prior to or after August 22,1996 may further impact SSI eligibility for Cuban/Haitian born. All Cuban born individuals who arrived prior to August 22,1996 should check#1. o Port of Entry in the USA: o Alien number(if available): o Method of entry in the USA (circle one): Sponsored*, Visa, Asylum, GTMO, Mariel, Parole, Other *If the person is sponsored,they need to become a citizen before applying for benefits. Do not check#1 if the individual is sponsored and not a US Citizen. Revised Appendix 1 of Exhibit AN Page 1 of 3 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Thriving Mind South Florida Contracting as South Florida Behavioral Health Network,Inc, 07/01/2022 ❑ 2. Diagnosis and Earned Income: Applicant has a serious mental illness or exhibits symptoms and/or has serious physical illnesses which causes marked and severe limitations and affect his/her ability to work at a substantial gainful level (SGA) as established by Social Security. Dollar amount changes annually based on the Cost of Living Adjustment (COLA) and can be found on the SSA website. o Diagnosis: o Monthly income amount earned by employment (contributing to FICA only): $ o For children: Parent's monthly earned income$ *Parent's resources are also counted by SSA(stocks,other properties, life insurance, burial funds, etc) ❑ 3. Duration:The illness(es)or condition(s) have lasted or are expected to last for at least 12 months(or result in death) o Date of onset of symptoms: ❑ 4. Frequency of decompensation: Individual is currently or has periods with worsening of symptoms of mental illness that prevents sustainable employment. Episodes may or may not result in hospitalization or incarceration. Mark all that apply, if�jny items below are indicated check#4: o Psychotic Symptoms (positive or negative) o Depressive Symptoms (decreased energy, lack of motivation, suicide attempts) o Manic Symptoms(racing thoughts, disorganized thoughts) o Anxious feelings(paranoia, nervousness) o Cognitive deficits(brain injury, problems with concentration, memory, etc.) o History of trauma (history of abuse, posttraumatic stress disorder, etc.) o Number hospitalizations (mental health): Last 6 months Lifetime: o Number incarcerations: Last 6 months Lifetime: o Other: ❑ 5. Functional Areas(adults): For applicants with mental illness, he/she has marked restrictions in at least 2 of these functional areas, or extreme limitations in one area. Mark all that apply, check#5 as indicated: o Understand, remember, or apply information (memory,following instructions,solving problems, etc.) o Interact with others (getting along with others, anger, avoidance,etc.) o Concentrate, persist, or maintain pace (task completion,focusing on details, distractibility) o Adapt or manage oneself(hygiene, responding to change, setting realistic goals, etc.) Functional Areas(children):The child struggles to do things on a daily basis that other children their age who do not have impairments typically do in the following six domains of functioning: o Acquiring and using information (learning and using new information) o Attending/completing tasks(focusing and maintaining attention/keeping pace in carrying out tasks) o Interacting and relating with others(initiating and sustaining emotional connections with others) o Moving about and manipulating objects(considering the development of fine and gross motor skills) o Caring for themselves (personal care, including both physical and emotional health, coping with stress) o Health and physical well-being (cumulative physical efforts of physical or mental impairments) Date of internal referral to SOAR Processor: Name and email address of SOAR Processor: Revised Appendix 1 of Exhibit AN Page 2 of 3 I nserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Thriving Mind South Florida Contracting as South Florida Behavioral Health Network,Inc. 07/01/2022 **DO NOT COMPLETE THE TASKS BELOW UNLESS YOU ARE PROVIDING THE ELIGIBILITY REVIEWS TO SFBHN Quarterly SFBHN/DCF Eligibility Review Requirements 1. Within fifteen days after the quarter,each provider's SOAR trained processor will complete a total of ten individual file/record reviews to see if the individuals were screened for SOAR using the SFBHN tool "Identifying SOAR Applicants dated October 2018." Five of these will be from different programs within the provider and five of these will be for indigent individuals identified by the SFBHN Housing Coordinator as receiving transitional vouchers (TRV) during the same quarter. *A copy of this form needs to be sent to SFBHN for each file/record review for a total of ten (10) individuals each quarter. *The SOAR Processor needs to complete the information below if a SOAR application was completed and submitted to the SSA. Date: of completed SOAR application submitted to SOAR Liaison: located at Social Security Administration (SSA) office. Date data was entered into the SOAR Online Application Tracking (OAT) system: 2. In addition to the above requirement,the provider's internal SOAR Processor will provide a SOAR in-service training to the outpatient and residential program intake staff, housing program intake staff,and case management psychiatric unit staff. SFBHN and DCF recommend that the psychiatrists also attend this training. A sign-in sheet of the attendees is required to be submitted to SFBHN for each training. Revised Appendix 1 of Exhibit AN Page 3 of 3 I nserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii,d:ll'a If:ll a ucl a Ii:3e1°uavioi fll II e allilla Network, Uric.) 7111/2022 Revised Exhibit AO Peer Services Peer Support Specialists (as defined in s. 397.311(30), F.S.) and Recovery Management practices (as described in Exhibit BH, Recovery Management Practices ) have become an integral part of recovery services. , 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 their 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, while working alongside the treatment team if applicable. 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]. The requirements in this exhibit applies to all Network Providers providing peer support services funded by this contract. NETWORK PROVIDER RESPONSIBILITIES 1. Employee Orientation for Peers: The Network Provider must provide standardized training on Recovery Management best practices in employee orientation and refresher trainings,as required by Exhibit BH, Recovery Management Practices. 2. Assessment Tools: Peers must use the Recovery Capital Scale available at https://facesandvoicesofrecovery.org/resource/recovery-capital-scale/ in the recovery planning process. The ME may require the Network Provider to report aggregate scores derived from the collection of Recovery Capital Scale tool. This information may be used to determine baseline data for the development of future performance measures. 3, Attain Client Consent: Initiate peer support services after voluntary consent when there is reason to believe such services will help the individuals served recovery, build resilience, or assist the individual to live successfully in their community with greater purpose. 4. Educate Peer Staff Regarding Community Resources: Peer Specialist can greatly assist individuals if the specialist isfamiliarwith appropriate community resources that can advance the individual's recovery. Peers should be well integrated into the community to assist individuals served with the development of natural supports, community activities and employment. 5, Peer Specialist Education,Trainings,Seminars,and Committees: Peer Specialists must be allowed time for attending trainings and seminars that advance the practice of peer support and further Revised Exhibit AO Page 1 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-IlriirviiSMiiil.g IIWiirid Soi.itlh Ii: oiii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uavioii fll II e allilla (Network, Uric.) /2022 their professional development. They should also be allowed and encouraged to join committee meetings where their lived experience can be valued. 6, Document Peer Services Provided: Peer services must be documented in each client's clinical file, for example, development of wellness plans, WRAP Plans, the goals of the individual served, progress notes, linkages, etc. These plans should be updated regularly in consultation with the client to review progress and evidenced by proper documentation in the client file. 7. 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. 8, Weekly Supervision: Weekly supervision meetings are required so case issues are addressed quickly,and also to make sure that the peer specialists are receiving supportive oversight for their own well-being. 9. Recovery Oriented: The peer must provide Recovery-Oriented care recognizing that each person must be the agent of and the central participant in their own recovery journey. All services and supports need to be organized to support the developmental stages of this process.Services should instill hope, be person-and family-centered,offer choice,elicit,and honor each person's potential for growth, build on a person's and family's strengths and interests, and attend to the overall quality of life, including health and wellness. These values can be the foundation for all services regardless of the service type. 10. Reporting Requirements: No later than the 10th of each month, the Network Provider must submit to the Managing Entity, the following monthly reports: A. Monthly Peer Support Employment Report -This report must be signed by the Peer Supervisor,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. Position Title(s) and Program Name for current vacancies d. Duration of current Peer Specialist vacancies, e. Name of the Peer Specialist f. Certification Status g. Role/Title h. Status (full-time vs. part-time) i. Program Name Revised Exhibit AO Page 2 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uaavioi fll II e allilla Network, Uric.) 711/2022 j. Number of persons served by each Peer Specialist, k. Maximum recommended caseload for the Peer, and I. Hours of Peer Supervision B. Monthly Peer Support Services Report — This report should be completed by the Peer Specialist and signed by the Peer Supervisor. a. Peer-to-Peer Contact b. Groups c. Treatment Team Staffing's d. Outside Agency Staffing's e. Trainings f. Outreach g, Trainings taken C. The Network Provider shall submit any ad-hoc reports requested by the ME. D. The reports must be submitted by the dates and to the individuals specified in Exhibit C, Required Reports. 11. ROSC Champion: By 08/02/2021, the Network Provider must submit the name and contact information of at least two IntegratedROSC Champions who will attend trainings and meetings. The information must be submitted to the individuals and by the dates listed in Exhibit C,Required Reports. One of the identified Champions should be a Peer Specialist who is providing peer services, if at all possible. 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. a. Responsibilities of champion: i. Attendance at scheduled ROSC meetings including ROSC Steering Committee Workgroup meetings and peer or peer supervisor meetings conducted by the ME to continue the development and implementation of a recovery-oriented system of care. ii. Participation in all ROSC related activities to ensure staff and agency become knowledgeable of a Recovery-Oriented System of Care, iii. Participation in all Peer related activities to ensure staff and agency become knowledgeable of the role/supervision of peer supports. 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. Revised Exhibit AO Page 3 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 ulI11Vlf"g Mllli""pd Soilil,Ith I]oil III.a Cc)IIItil act ing a�S SOIIII ll"1 d ea lli Network, Uric'.) 71 II/2022 I. MANAGING ENTITY RESPONSIBILITIES 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, Revised Exhibit AO Page 4 of 4 Guidance/Care Center,Inc. Contract No.ME225-12-27 I Iii iSM1l•llg 'u"IIII'id oil,A h I„II IIda (;Conti ac;fong as Soii,iflh Ii: 011 uda Ii:i I''iav oirali II Ne.: flh Il i.1 woi1<,, Uric::, C1 /2022 0 REVISED 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 individuals which are managed by a designated case manager. Case management services consist of activities that identify the person'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. Service Plan is the part of the clinical record which outlines a comprehensive strategy for improving a person'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 person served 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 individual 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 an individual's living situation which includes a determination strengths and weaknesses, needs and resources, and the strengths and weaknesses of the individual's support system.The case manager shall be responsible for Revised Exhibit AP Page 1 of b Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilhii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida (Conti ac:„fing as Soii,iflh Ii: of uda Ii:3e1,iava ors:i II Ne.: flh Il etwoi1<, Ilriu+:, C1 /2022 the overall completion of the assessment, but shall work with the individual and consult with relevant professionals where specific expertise is needed. 2. The case management assessment shall consider information from the following sources: a. Individual'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 person served 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 individual is involved and an evaluation of the impact these services have on the individual's s life. 3. The case management assessment shall consider the following: a. The presenting problem; b. individual's current and potential strengths and areas of improvement C. The family's current and potential strengths d. Individual's relationship with family members and significant others; e. The impact of the currently provided services on the individual's life; f. Individual'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 orjob-seeking skills; i. Need for housing,food, clothing, and transportation; j. Need for mental health, alcohol and substance use 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 individual ; 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 individual for case management services. Revised Exhibit AP Page 2 of b Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilhii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida (Conti ac:„fing as Soii,iflh Ii: of uda Ii:3e1,iavior� ill II Ne.: flh Il ettvoi1<,, Ilriu+:, /2022 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 Person served. 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 individual changes residence, enters or is discharged from a state treatment facility or at other times when the individual'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 person served, 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 person served, 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 individual served.All service plans shall be included in the 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, 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. Revised Exhibit AP Page 3 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 l-Ilhii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida (Conti ac:„tuna as Soiiflh Ii: of uda Ii:3e1,iavior�:i II Ne.: flh Il etwoi1<, Ilriu+:, C1 /2022 b. Each objective shall state the name of the individual or agency responsible for the action to be achieved. b. Individual serviced shall be provided a copy of the Service Plan, and this shall be documented in the record. With the approval of the person served, 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 person served, 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 person served 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 person served,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 person served, 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 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 person served and shall intercede on their behalf of to assure that service and resource needs are met. 2. The case manager shall identify service and resource gaps and barriers which limit an individual'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. Revised Exhibit AP Page 4 of b Guidance/Care Center,Inc. Contract No.ME225-12-27 Ph ii1ii SM ii il.g IIWi irid So i.itlh Ii:I oii iida )Conti ac:„fing as Soii,iflh Ii: of uda Ii:3e1,iaaior� ill II Ne.: flh Il etwoi1<, Ilriu+:,) C1 /2022 (3) Case managers may utilize incidental funding to provide for unmet resource needs for individuals served when other resources are not available or in combination with other resources. (4) For individuals residing in the community, the case manager shall make a home visit or field visit within the individual'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 individual 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 person served 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 individual either by telephone or face-to-face meeting within twenty-four hours. If initial contact attempts are unsuccessful, the case manager shall make additional efforts by telephone, face-to-face meetings, or correspondence. Upon contacting the individual, the case manager shall explore the reasons for the absence or the missed appointment and shall work with the individual 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 individual 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 Revised Exhibit AP Page 5 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-INurvuSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida �: utu ec:„tuu t a aii.uVll°°� If:lluu uwt li: c 11°uvii u ill II Ne�:flflh li tw'uu ll:, Ilu°u+°:. C1 IIt22 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) Caseload. The mental health case manager's caseload shall not exceed 40 individuals 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. C. State Mental Health Treatment Facility Admission and Discharge Processes 1. Community Mental Health Centers are responsible for meeting the requirements described in the DCF Guidance 7, State Mental Health Treatment Facility Admission and Discharge Processes, incorporated herein by reference. 2, In addition, Community Mental Health Center's will meet the requirements of the State Mental Health Treatment Facility Plan for Re-Integration of Discharge Ready Individuals, incorporated herein by reference, and available upon request to the ME. Revised Exhibit AP Page 6 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 I Ii riSM1l•llg 'u"IIII'id oil,A h I„II IIda (;Gonfl act ing&S Soiirrt:ll'I cla li['I II°°uavioirai II r;allillr Network, Uric'.) 711/2022 REVISED EXHIBIT AV TRANSITIONAL VOUCHER PROGRAM DISCUSSION: The purpose of this document is to provide guidance for the implementation and management of the Transitional Voucher project. This project provides care coordination and vouchers to purchase treatment and support services for adults transitioning from Florida Assertive Community Treatment(FACT)teams,acute crisis services,and institutional settings to independent community living; and individuals experiencing homelessness, at risk for homelessness, or receiving care coordination services.Vouchers may also be utilized to assist eligible individuals maintain their current level of care by achieving residential stability. I. GOALS 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.The project aims to: • Prevent recurrent hospitalization and incarceration, • Provide safe, affordable, and stable housing opportunities, • Maximize use of FACT resources and community supports, • Increase participant choice and self-determination in their treatment and support service selection; and • Improve community involvement and overall quality of life for program participants. Transitional Vouchers provide a participant with a monthly budget to be spent on allowable services pursuant to Rule 65E-14.021, F.A.C.This service is intended to support Care Coordination efforts outlined in Guidance 4—Care Coordination. To access the Department's FY 22-23 Guidance Document 4, click on the link below: rat.t,p�,;,��www„rrt�flFr1r11ilies.coim�service ��rotgrarrs/sar�lhlmarlaginr� �.ntil:ies/index.shtml Note: Click on FY22-23 ME Templates and click on Guidance Document 4, Care Coordination "Voucher" refers to any electronic or paper record documenting a Network Service Provider's agreement to pay a third party for allowable services provided to an eligible program participant. This project offers time-limited financial assistance to support consumer-driven services based on the person's needs assessment and care plan objectives. The use of vouchers requires shared decision making in planning and service determinations, emphasizing self- management. Care Coordinators provide options and choices such that the care plan reflects the individual's values and preferences. This project has two funding and implementation components. The first component targets FACT participants and individuals discharging from a state mental health treatment facility (SMHTF) back to Revised Exhibit AV Page 1 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 I Ii riSM i•IIg 'u"III rid oil,A h I„II I da Qu:;onflat:„t ing&�Soiii,if:ll'I cla li['II iav oiiai II eallilli 11'Je worlk, Uric'.) 7111/2022 their regions; the second targets additional individuals in need of specialized community integration supports. II. FACT AND SMHTF TARGETS This component satisfies the terms of a settlement agreement entered into by the Department and Disability Rights Florida and amended on July 27, 2018.' The settlement agreement requires the Department to develop a project designed to more fully utilize existing FACT resources and create additional opportunities for community integration of individuals being discharged from SMHTFs.This component is intended to transition approximately 96 FACT participants each fiscal year to less intensive community-based services and supports, allowing persons referred from SMHTFs to fill the vacated slots, if appropriate, Other allowable options for individuals discharging from SMHTFs using Transitional Voucher funds are to adult family care homes with community-based services and directly into permanent supported housing with community-based services, Managing Entities and Network Service Providers shall select FACT participants determined to be clinically and functionally ready for lower levels of care ready to transition out of FACT services. Considerations for transition readiness include, at a minimum,the individual's choice,their ability to self-manage, and the availability of a natural support system.Transition is gradual, individualized and actively involves the participant and the next provider to ensure effective coordination and engagement. Each Network Service Provider FACT team shall accept individuals referred for discharge from SMHTFs to replace individuals selected to receive Transitional Voucher services. III. COMMUNITY INTEGRATION TARGETS Research indicates that a combination of long-term housing,treatment,and recovery support services leads to improved residential stability and reductions in substance use and psychiatric symptoms', The Transitional Voucher project is intended to assist eligible individuals obtain and maintain accessible, affordable housing with supportive recovery services. Each Managing Entity shall approve individuals who meet Transitional Voucher eligibility requirements. Persons eligible for services under this component must be currently receiving Department-funded SAMH services pursuant to Chapters 394 and 397, F.S., and must meet one the following alternative characteristics: A. Experiencing homelessness, meaning an individual who lacks housing, including: 1. An individual whose primary overnight residence is a temporary accommodation provided by a supervised public or private facility, or 2. An individual who resides in transitional housing, or 3. An individual at risk for homelessness; for example: an individual whose only housing option is shelter due to lack of affordable housing opportunities. T.W.,P.M.and Disability Rights Florida v.Michael Carroll,Department of Children and Families(Case No.4:13-CV-457 RFUCAS)Settlement Agreement,Amended July 27,2018 z Substance Abuse and Mental Health Services Administration,Leading Change:A Plan for SAMHSA's Roles and Actions 2011-2014.HHS Publication No.(SMA)11-4629.Rockville,MD:Substance Abuse and Mental Health Services Administration,2011. Revised Exhibit AV Page 2 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll ru ucl a li:3e1°uaav of fll II e allilla Network, Uric.) 711/2022 4. Vouchers may also be utilized to assist eligible individuals maintain their current level of care by achieving residential stability. Or B. Receiving Care Coordination services pursuant to Guidance 4. Or C. Participating in FACT teams and ready to transition to a lower level of care. Or D. Discharging from SMHTFs to adult family care homes or directly into permanent supported housing with community-based services. IV. 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:housinc L�>sfbhr7,or . All supports and 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 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. Revised Exhibit AV Page 3 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..I..I 11i 11SM I•IIg 'III I'id Sb..F'i,ith i,IIoI dU;'.4 (Confl-aat:„Hing&S Soii.d:lla If:ll a ucl a Ii:3e1°uaavioi fli II eaallilla Network, Uric'.) 711/2022 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. V. 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. Each month requires a new voucher request and ME approval, 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.: 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. Revised Exhibit AV Page 4 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uavioi fll II e allilla (Network, Uric.) /2022 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. VI. 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. C. Establish accurate record keeping that reflects specific services offered to and provided for each participant. D. Approve Transitional Voucher invoices and expenditures for services provided by non-Network Service Providers. E. The Care Coordinator or Case Manager must maintain in the individuals' file a record of all individual expenses charged against the funds. F. 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. G. All Transitional Vouchers must be coded with the appropriate modifier: a) For Substance Abuse use modifier: DS b) For Mental Health use modifier: DM H. All invoices and supporting documentation must be submitted to the ME by the 8t"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 Revised Exhibit AV Page 5 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida (Confl-at:„Hing a�S Soii.d:ll If:Ilrru ucla Ii:3e1°uavioi fll Il ear ills Network, Uric.) 711/2022 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. VII. 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 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 Network Provider shall adhere to the requirements identified in the Department's Transitional Voucher Guidance Document 29,dated 7/1/2022,or the latest revision thereof. To access the Department's FY 22-23 Guidance Document 29, click on the link below: h:tt.ps://w�nr�nr.m f1farnilitxs.carTt/servicepr.egrams/sarrlh/managinr� entitieslindex.shtml Note: Click on FY22-23 ME Templates and click on Guidance Document 29, Transitional Voucher Revised Exhibit AV Page 6 of 6 Guidance/Care Center,Inc. Contract No.ME225-12-27 oathaw . .0 Wo 04004 xx o' 0,0 T H P 1 V 1 N G M I N O SOUTH FLORIDA !a, nc'+rfvvcrk c:;r1°c;xc;c�K:rCic>rrr:'I r't`rr rtt`I hua, lCr' a n(J sL-ibstance c_ise prc')viders. 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 ARplies: ❑ 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.ME225-12-27 oathaw . .0 Wo 040xx o' , T H P 1 V 1 N G M I N O SOUTH FLORIDA !a, nc'+rfvvc�rk c:;r1°c;xc;c�K:rCic>rrr:'�I r't`rr r�tt`I hua,�lCr'� a n(J sL-ibstance c_ise prc')viders. 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.ME225-12-27 M 4,i-. rm0 also. 0.�" *6: o .0 *00. THRIVING MIND SOUTH FLORIDA A netwofV<afexneptlmil mental health and substance-:use,pi'mide.rs, 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.ME225-12-27 M 4,i-. rm0 also. 0.�" *6: o re . *00. THRIVING MINCE SOUTH FLORIDA A netwofV<afexneptlmil mental health and substance-:use,p i'mide.rs, The assistance requested is for (please check one): ❑Housing Assistance ❑Childcare ❑Clothing El Transportation (Bus passes, bicycles, airfares) ❑Educational Services ❑Vocational Services ❑Medical Care (Medication, doctor visits) ❑Housing Subsidies(Utility bills,furniture, toiletries) ❑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 MSTRV Not approved by: Date: Reason not approved: Signature: Title: Appendix 2 of Exhibit AV Page 2 of 2 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida Confl-et:„Hing aS Soiii,d:ll'a If:ll ru ucl a Ii:3e1°uaavioi fll II e allilla Network, Uric.) 711/2022 Revised Exhibit AY Mobile Response Team (MRT)for Monroe County Purpose: To ensure the implementation and administration of Mobile Response Team(MRT)services and adherence to the service delivery and reporting requirements herein and in the DCF Guidance Document 34, Mobile Response Team, dated July 1, 2022. Best practice considerations and resources are provided to support continuous improvement of the MRT program; however,these are not contractually required. A. Authority The Marjory Stoneman Douglas High School Public Safety Act, Ch. 2018-3, Laws of Florida, created a statewide network of MRTs. The Florida Legislature appropriated recurring funds to ensure reasonable access to MRT services in all Florida counties. In 2020, House Bill 945 amended s. 394.495, F.S.,to include MRTs in the child and adolescent array of services and outlined programmatic requirements included herein. B. Program Goals The goals of MRTs are to lessen trauma;conduct an independent assessment to determine if the individual may be safely diverted from emergency departments; prevent unnecessary psychiatric hospitalization; or divert from juvenile justice or criminal justice settings. MRTs are intended to provide on-demand crisis intervention services in any setting in which a behavioral health crisis occurs, including, but not limited to, homes, schools, the community, and emergency departments. Mobile response services must be available 24 hours a day, 7 days a week. Services are provided by a team of licensed professionals, master's level professionals, and paraprofessionals trained in crisis intervention skills. In addition to helping resolve the crisis, MRTs work with individuals and families to identify resources, provide linkages, and develop strategies for effectively dealing with potential future crises. Intervention is warranted when a crisis interferes with the ability to function and places the individual at risk of self-harm, harm to others, or disruption of services or living environment. The individual may present with an overt change in functioning or have difficulty coping with traumatic life events. Mobile Response Teams may coordinate in-person services with law enforcement to provide additional safety, when appropriate and necessary. Supporting the "no wrong door" model, MRTs provide warm hand-offs and referrals to other services in the community to meet the ongoing needs of the individual and will follow-up to determine that the appropriate linkage is made, When the situation warrants, MRTs will assist with the individual being received by a designated receiving facility or a licensed substance abuse provider for further evaluation. Peer support services can be an effective way to connect individuals and families experiencing behavioral health crises with resources, ensure they engage in services,and assist them navigate the system. It is not required that the MRT have an individual team member who is either credentialed as a Certified Recovery Peer Specialist or working toward credentialing, however it is encouraged, MRTs must be designed to address a wide variety of interventions, including: • Based on a clinical assessment, determine the need for further examination at a Designated Receiving Facility or licensed substance use provider; • Assess the individual for risk of suicidal and homicidal thoughts or behaviors; Revised Exhibit AY Page 1 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..i hi IVIng 'u"II I'•id S 'u4h I„II I Idd,'.4 is ontrac:„Hing a S Soiii,d:II' If:ll a uda li:' Il u.0 rliu: a rll Il eallilli Network, Ilric.) 71 i/2 2 • Assess the individual for mood disturbances such as depression, anxiety, delusional thoughts, or hallucinations that may contribute to and exacerbate the crisis; and, • Identify family or peer conflicts and other disruptive behaviors that are or may contribute to escalating the crisis. C. Eligibility MRTs provide immediate, onsite behavioral health crisis services at minimum to individuals who are 25 and younger who: 1. Have an emotional disturbance; or 2. Are experiencing a mental health or emotional crisis; or 3. Are experiencing escalating emotional or behavioral health reactions and symptoms that impact their ability to function typically within the family, living situation, or community environment; or, 4. Are served by the child welfare system and are experiencing or at high risk of placement instability. D. Managing Entity Responsibilities The Managing Entity shall: 1. Ensure statewide access to MRT services 24 hours a day, 7 days a week. 2. Collaborate with local law enforcement agencies and public schools, colleges and universities in the planning, development, evaluation, and selection processes for Network Service Provider subcontracts for MRTs; 3. Post contact information for all MRTs on the start page of the Managing Entity's public website; 4. Collaborate with local and county governments to ensure the process to access MRT services is addressed in county transportation plans and Behavioral Health Receiving System plans; 5. Monitor MRT Network Service Provider data quality, response process, customer satisfaction, community collaboration, and warm hand-offs to community service providers; 6. Notify the Department of changes to MRT providers, including the number of teams per provider or updates to MRT contact information; 7. Submit Reporting Template 28 Mobile Response Team Monthly Report to the Department no later than the 18th of the month following services; and 8. Include requirements in subcontracts with Network Service Providers providing MRT services to: a. Adhere to the criteria in Sections C, E, F and G herein. b. Participate in all MRT program conference calls, meetings, or other oversight events scheduled by the Department. c. Make Mobile Response Team services available 24 hours per day, 7 days a week statewide, d. Establish response protocols with local law enforcement agencies, local community-based care lead agencies, child protective investigators, the Department of Juvenile Justice, and local schools, including public K-12 schools, colleges, and universities. e. Have access to a licensed mental health professional. f. Have access to a board-certified or board-eligible psychiatrist or psychiatric nurse practitioner. Revised Exhibit AY Page 2 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..I..I II Iry VII•llg W rid Soluth I"]oI Idd,'.4 (;Confl-at:„ding&S,Soiii,d:ll' If:ll a k1a li['I II°°uav oirali II eallilli Network, Uric'.) 7111/2022 g. Provide an array of crisis response services to eligible persons and their families, designed to address individual and family needs, including screening, standardized assessments, crisis de- escalation, safety planning, and linkage to community services as necessary to address the immediate crisis event and ongoing behavioral health needs. Screenings and assessments shall be completed for the presence of an emotional disturbance, serious emotional disturbance, substance use, or mental illness including depression and risk for suicide. h. Adhere to standards for informed consent and confidentiality compliance, pursuant to but not limited to 394.459(3), F.S., 394.4784, F.S., 394.495, F.S. and relevant state laws and federal regulations. i. Establish formal Memorandum of Understanding or agreements with the local school districts) that identify roles and responsibilities of schools and MRT when responding to schools to provide services. This agreement must include requirements for obtaining parental consent when the MRT responds to children 13 or younger or with unlicensed mental health professionals. J• k. Establish formal and informal partnerships with key entities providing behavioral health services and supports to eligible persons and their families to facilitate warm hand-offs for continuity of care. I. Coordinate with the Community-Based Care (CBC) Lead Agency in the Network Provider's area to provide MRT services to children served by the child welfare system who are experiencing a behavioral health crisis. E. MRT Network Provider Responsibilities The Network Provider must adhere to the following: 1. Adhere to the criteria in Sections C, E, F and G herein. 2. Participate in all MRT program conference calls, meetings, or other oversight events scheduled by the Department. 3. Make Mobile Response Team services available 24 hours per day, 7 days a week statewide. 4. Establish response protocols with local law enforcement agencies, local community-based care lead agencies, child protective investigators, the Department of Juvenile Justice, and local schools, including public K-12 schools, colleges, and universities. 5. Have access to a licensed mental health professional on staff. 6. Have a Certified Recovery Peer Specialist, or someone who is working toward credentialing, on staff. 7. Have access to a board-certified or board-eligible psychiatrist or psychiatric nurse practitioner. 8. Provide an array of crisis response services to eligible persons and their families,designed to address individual and family needs, including screening, standardized assessments, crisis de-escalation, safety planning, and linkage to community services as necessary to address the immediate crisis event and ongoing behavioral health needs. Screenings and assessments shall be completed for the presence of an emotional disturbance, serious emotional disturbance, substance use, or mental illness including depression and risk for suicide. 9. The Mobile Response Teams telephone number must be displayed the number to their MRT on the start page of its public-facing website. Revised Exhibit AY Page 3 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..I..I IIIrvIVIng W rid Soluth I"]oI Idd,'.4 (;Confl-at:„Hing&S,Soiii,d:ll' If:ll a ucla li['I II°°uav of ai II ea flili Network, Uric'.) C1 II/022 10. Ensure that the local 2-1-1 provider(s),Jewish Community Services, has information on the MRT and how to refer individuals in need. 11. Triage new requests to determine the level of severity and prioritize new requests that meet the clinical threshold for an in-person response. 12. Ensure there is a process in place for informed consent and confidentiality compliance measures. 13. Provide in-person response to calls meeting the clinical threshold within 60 minutes after prioritization. In-person responses may be provided face-to-face or via telehealth. If requested,face- to-face responses must be provided. Respond in the location where the crisis is occurring when requested and determined safe. 14. Establish formal Memorandum of Understanding or agreements with the local school district(s), and charter schools or alternative schools that identify roles and responsibilities of schools and MRT when responding to schools to provide services. This agreement must include the following elements: 1) List school district(s), for the purpose of this contract the school district is Monroe County Public Schools. 2) If the Network Provider enters into agreements with charter schools and alternative schools, list the name of school(s). 3) Process for obtaining parental consent when the MRT responds to children 13 or younger or with unlicensed mental health professionals. 4) Process that addresses a timely and effective response to Monroe County Public Schools who are initiating a Baker Act with a student. 5) If the Network Provider enters into agreements with charter schools and/or alternative schools, a process that addresses timely and effective response to the charter school and alternative schools who are initiating a Baker Act with a student.a list the name of school(s). 15. 16. Establish formal and informal partnerships with key entities providing behavioral health services and supports to eligible persons and their families to facilitate warm hand-offs for continuity of care. 17. Provide behavioral health crisis-oriented services that are responsive to the needs of the child, adolescent, or young adult and his or her family. 18. Utilize evidence-based practices to deescalate and respond to behavioral health challenges and to reduce the potential for future crises. When evidence-based practices are not available, the MRT shall use approaches based on clinical judgement and within the scope of their practice. 19. Provide a warm handoff to referred services and brief care coordination by facilitating the transition to ongoing services for up to 72 hours, Warm handoff means that the MRT provider actively connects the individual to another service provider. 20. Coordinate with the Care-Based Care (CBC) to provide information about the MRT services to foster parents and to provide services to children served by the Child Welfare system who are experiencing a behavioral health crisis, 21. Report to the Managing Entity on the performance outputs in Section G. and the number of individuals who did not require an involuntary examination that were actively linked to the appropriate level of care with a community provider for ongoing behavioral health services. Revised Exhibit AY Page 4 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..I..Nrlving '±911 i"ld South I"]oIIdd,'.4 (;Confl-at:„Ming&S,Soiiii.dl' If:ll uucla li['I II°°uaviloirali II eallilli Network, Uric'.) 7111/2022 F. MRT Service Components: The Network Provider's Mobile response services encompass an array of crisis interventions including: 1. Evaluation and assessment, 2. Development of safety or crisis plans, 3. Providing or facilitating stabilization services, 4. Supportive crisis counseling, 5. Education, 6. Development of coping skills, 7. Linkage to appropriate resources,and 8. Connecting individuals who need more intensive mental health and substance use services to the needed level of care. 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 assessments, follow- up consultation, and initial triage to determine if an in-person response is needed to individuals via video-teleconferencing systems, phones,and remote monitoring. MRT staff who are not actively responding to calls,either face-to-face or through telehealth must not have other duties and responsibilities within the Network Provider. An MRT's ability to successfully divert inpatient admissions depends on service availability.Staff who are not actively responding or providing follow-up services should be conducting outreach to community partners,key stakeholders,and the general public to educate the public on the availability of and how to access services. G. Performance Outputs The Network Provider shall meet the following targets for MRT services: 1. Average response time within 60 minutes. 2. A minimum of seven (7) formal outreach activities conducted annually. This may include activities such as presenting at School Board meetings, community health fairs, and community partner meetings. Targets for outreach activities may include detoxification programs, emergency departments, schools and colleges, community behavioral health providers, law enforcement and other first responders, child protective investigators, dependency case managers, parents, family and youth run organizations, Department of Juvenile Justice, group homes, foster care organizations, 2-1-1 and other social service type call centers, as well as community leaders such as county commissions and city government. 3. At a minimum, the MRT shall serve 180 unduplicated persons through June 30'. "Served" means the MRT has responded to an acute care crisis and engaged with the individual and, if applicable, their family and caregivers. Revised Exhibit AY Page 5 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..i hi IVIng 'u"II I'•id S 'u4h I„II I Idd,'.4 Confl-ac:„Hing a S Soiii,d:II' If:ll a uda li:' Il u.0 rliu: a rll Il ea flili Network, Uric:.) 71 i/2 2 H. Service Data Service Data: Service Data must be submitted monthly by the 4th 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 14.0, or the latest revised edition thereof. I. Reporting Requirements 1. Monthly MRT Tracker: The Network Provider must submit MRT Monthly Tracker using template provided by the ME by the 10th 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. Monthly Vacant Position(s) Report: The Network Provider must submit MRT Monthly Vacant Position Report using template provided by the ME by the 101h of every month for the previous month of service. The Network Provider will submit the monthly tracker to the individuals listed in Exhibit C, Required Reports. 3. Outreach Activities Log: -The Network Provider must submit a quarterly log of formal outreach activities(such as trainings,education and networking)as described in Section G„2.,Performance Outputs above.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. 4. MRT Policies and Procedures: By October 1, 2022, the Network Provider must submit its MRT policies and procedures . At a minimum, the policies and procedures must address the following elements: a) Staffing; b) Service Array, including transition of services; c) Triage process; d) Response times; e) Informed Consent; f) Confidentiality; g) Information Sharing; h) Use of innovative technology (telehealth); i) Identification and referral process for children, adolescents, or young adults, including those who are high utilizers (defined in Exhibit AC, Care Coordination) and their families to the Care Coordination Team located at Community Health of South Florida ; j) Identification and referral process for adults, including referrals for high utilizers (defined in Exhibit AC, Care Coordination) to care coordination services; k) Outreach efforts plan. Revised Exhibit AY Page 6 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 L Iii1iVng Wrid Sol.fih I:IIGII"ilda (Cc)IIIfl at:„fong� S soii,uf:ll'I Ii: 011 id Il eallilli Network,worlk, Uric'.) 711/0 J2 5. Memorandum of Understanding or Agreements: 1) By October 1,2022,the Network Provider must submit a formal agreement or formalized plan with the Monroe County Public Schools that identify roles and responsibilities of schools and MRT when responding to schools to provide services. This agreement must include requirements for obtaining parental consent when the MRT responds to children 13 or younger or with unlicensed mental health professionals. 2) By December 31,2022, the Network Provider must establish response protocols with the following stakeholders: a) Monroe County Sheriff's Office; b) Key West Police Departments; c) Department of Juvenile Justice d) Southern Region Community-Based Care Lead Agency that addresses situations where youth are served by the child welfare system and are experiencing or are at high risk of placement instability. e) Colleges and Universities 6. 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. J. 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 and/or Department staff at regularly scheduled or specially called meetings, calls, trainings,or other oversight events when scheduled by the ME and/or the Department. K. Best Practice Considerations and Guiding Principles: The System of Care values and principles are the foundation of MRTs. The core values include: • Strength-based — move the focus from the deficits of the individual and family to focusing on their strengths and resources related to the goal of recovery. This includes viewing the individual and family as resourceful and resilient. • Family-driven and youth-guided—recognize that families have the primary decision-making role in the care of their children. The individual's and family's preferences should guide care. • Community based with an optimal service array—provide services in the least restrictive setting possible, ideally in the community. Individuals should be able to obtain any behavioral health service they need in their home community. Peer support is an important component of services. Revised Exhibit AY Page 7 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..I..hrIVIng 'u"II I'•id S 'u4h I„II I Idd,'.4 (Contrac:„Hing&S Soiii,d:II' If:ll ru uda li:'r 11 u.urrliu: a rll Il eallilli Network, Ilric.) 7/i/202 • Trauma sensitive—respond to the impact of trauma, emphasizing physical, psychological, and emotional safety for both service providers and individuals; and create opportunities for individuals to rebuild a sense of control and empowerment. • Culturally and linguistically competent—be respectful of, and responsive to, the health, beliefs, practices, and cultural and linguistic needs of diverse individuals. "Culture" is a term that goes beyond race and ethnicity to include characteristics such as age, gender, sexual orientation, disability, religion, income level, education, geographical location. Cultural competence applies to organizations as well as individuals. Cultural Competence is a set of behaviors, attitudes, and policies that come together in a system to work effectively in multicultural situations. Linguistic competence is the ability to communicate effectively in a way that can be easily understood by diverse audiences. • Coordinated — provide care coordination for individuals with serious behavioral health conditions with an emphasis on individualized services across providers and systems. At the system level, leverage resources by analyzing funding gaps, assessing the use of existing resources from all funding streams,and identifying strategies to close the funding gaps, including the options of blending and braiding of funding sources. • Outcome-focused — ensure that programmatic outcome data is accessible to mangers, stakeholders, and decision makers, and that the data is meaningful and useful to those individuals. Collect feedback from each individual and family regarding the service delivery to improve outcomes of care that inform, individualize, and improve provider service delivery. Research suggests that best practice is to provide continued crisis intervention and care coordination services as indicated for up to 72 hours. In addition to helping resolve the crisis, teams work with the individual and their families to identify and develop strategies for effectively dealing with potential future crises. MRTs facilitate "warm handoffs" to community services, and other supports. Facilitating a warm handoff means actively connecting an individual to another service provider. This process goes beyond simply providing a referral name, phone number, and appointment time. Particularly for individuals in crisis, it has been shown that a referral alone is not adequate. Warm handoffs are a transfer of care between two providers in the presence of the individual and their family. This can involve an introduction to the new service provider during a short meeting with the crisis counselor. It is important to explain the process the individual should follow, what to expect during their first appointment, and allow them to ask questions. For additional information and resources to implement or improve the use of warm handoffs, the Agency for Healthcare Research & Quality provide resources for clinicians, staff, and a Quick Start Guide'. ' https://www.ahrg.gov/professionals/quality_patient-safety/patient-family_ engagement/pfeprimarycare/interventions/warmhandoff.html. Revised Exhibit AY Page 8 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 Confl-at:„Hllrg&S,Soiiii.dl' If:ll uucVµ[� II II°°uavioirai II eallilli Network, Uric'.) 711/2022 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 access to further evaluation at 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. In 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) published the National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit, This toolkit identifies minimum expectations and best practices for mobile crisis teams that are funded with Block Grant Crisis Set-Aside funding. SAMHSA identifies the mobile response teams to respond in two person teams for safety reasons. The minimum expectations are: 1. Include a licensed and/or credentialed clinician capable to assessing the needs of individuals; 2. Respond where the person is and not restrict services to select locations within the region or particular days/times; and 3. Connect individuals to facility-based care as needed through warm hand-offs and coordinating transportation. The best practices include: 1. Incorporate peers within the mobile crisis team; 2. Respond without law enforcement accompaniment unless special circumstances warrant inclusion in order to support true justice system diversion; 3. Implement real-time GPS technology in partnership with the region's crisis call center hub to support efficient connection to needed resources and tracking of engagement; and 4. Schedule outpatient follow-up appointments in a manner synonymous with a warm hand-off in order to support connection to ongoing care. The toolkit is available at: https://www.samhsa,gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care- 02242020.pdf. Below are some exemplary models of MRTs developed in other states. State of New Jersey The Mobile Response and Stabilization Services (MRSS) System delivers mobile response services to children/youth/young adults experiencing escalating emotional and/or behavioral reactions and symptoms that impact the youth's ability to function typically(at baseline)within their family, living situation,school and/or community environments. Mobile response services are available 24 hours per day, 7 days a week, year-round, are delivered by MRSS staff and include both initial (within 1 hour) face-to-face intervention wherever the youth's need presents, and follow-up interventions, services and coordination for up to 72 hours subsequent to the initial intervention. If at the end of Revised Exhibit AY Page 9 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..i hi IVIng 'u"II I'•id S 'u4h I„II I Idd,'.4 (Contimac:„Hing&S Soii,d:II' If:ll a uda li:' Il u.0 rliu: a ill Il eallilli Network, Ilric.) 71 i/202 initial mobile response services, a youth continues to exhibit patterns of behavioral and emotional needs that require continued intervention and coordination to maintain typical functioning and prevent continued crisis reaction,a child/youth may be transitioned to Mobile Response Stabilization Management Services that can continue to serve the individual for up to eight weeks. More information may be found at: https://www.n'.qov/dcf/families/csc/mobile/. State of Massachusetts In Massachusetts, Mobile Crisis Intervention (MCI) is provided to youth (under the age of 21) by all emergency service program (ESP) providers. MCI provides a short-term service that is a mobile, on- site, face-to-face therapeutic response to a youth experiencing a behavioral health crisis for the purpose of identifying, assessing, treating and stabilizing the situation and reducing immediate risk of danger to the youth or others consistent with the youth's risk management/safety plan, where one exists. This service is provided 24 hours a day, 7 days a week and includes: A crisis assessment; engagement in a crisis planning process that may result in the development/update of one or more crisis planning tools(e.g.,Safety Plan;Advance Communication to Treatment Providers;Supplements to Advance Communication and Safety Plan, Companion Guide for Providers on the Crisis Planning Tools for Families) that contain information relevant to and chosen by the youth and family; up to 7 days of crisis intervention and stabilization services including on-site face-to-face therapeutic response, psychiatric consultation and urgent psychopharmacology intervention, as needed; and referrals and linkages to all medically necessary behavioral health services and supports, including access to appropriate services along the behavioral health continuum of care. More information may be found at: https://www.mass.gov/files/documents/2016/07/oi/ps-mobile-crisis- intervention.pdf. Milwaukee County,Wisconsin Milwaukee County in Wisconsin has a nationally respected and effective crisis response model for children in their region. The program is called the Mobile Urgent Treatment Team (MUTT) and its primary focus is to keep children at home with families and out of hospitals. MUTT provides MRSS services for children and adolescents (up to age 18) and addresses a family's immediate concerns about their child by phone or by responding to them in the community or in their home. Services are available 24 hours a day, seven days a week. Once called, the MUTT team immediately travels to the location where a crisis may be occurring. The team assesses the situation, including the potential for danger that the child poses to himself or others. Based on the assessment, the team weighs intervention options, including keeping the child home (with adequate support services), temporary placement in a crisis group home or other emergency setting, or hospitalization in a psychiatric facility. The team can provide short-term case management services as necessary and frequently acts as a liaison between the family and available community services. For more information, please visit: https://county.milwaukee.gov/EN/DHHS/BHD/Childrens-Services. King County,Washington Revised Exhibit AY Page 10 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 ..I..I II rIVIng W I'•id S 'luth I„II I Idd,'.4 is ontrac:„Hing a S Soiii,d:II' If:ll a uda li:' Il u.0 rliu: a rll Il eallilli Network, Ilric.) t/i/tit2 The Children's Crisis Outreach Response System (CCORS) in King County,Washington provides crisis outreach and stabilization services 24 hours a day, 7 days a week to all residents of King County regardless of income. Specific services include mobile crisis outreach, which consists of specially trained teams available to respond in the child or youth's natural environment to de-escalate the situation. The team conducts mental health and suicide risk assessments and works with the family to implement ongoing services and supports to prevent future crises. CCORS also provides non- emergency outreach appointments, available within 24-48 hours for families who are not in immediate crisis but require timely support and linkages to services. Crisis stabilization services in the form of in-home support are available for up to 8 weeks following the initial acute crisis. Intensive crisis stabilization services (90-day in-home support) and crisis stabilization beds are also available to specialty populations. More information may be found at: htti)s://www.kingcounty.gov/depts/community-human-services/mental-health-substance- abuse/services/Youth/CrisisOutreach.aspx. Maine Behavioral Health Care Crisis Team After police respond to a call involving ajuvenile, the officer completes a police juvenile reporting form and sends it to the Maine Behavioral Healthcare crisis team. A clinician then calls the family to arrange an assessment, provide resources and services and provide later follow-up to ensure the family has engaged in referred services. The reporting form captures critical information for tracking and accountability. In addition, parents of juveniles in crisis use the form as a tool to convey concerns and record problem behavior to mental health professionals. With parental consent, they use the information to inform the school system and help prepare an appropriate response to the child's needs. The result is a program that recognizesjuveniles at risk at the earliest possible stage,captures relevant and useful information, secures an appropriate referral network and tracks results for mutual accountability. The results of the program were decisive-86 percent of the families reported that only one response was needed to receive the appropriate resources. More information may be found at: https://maineheaIth.org/services/behavioral-mental-health/mental-health-crisis-services. Central Ohio Brings together crisis intervention specialists, therapists, case managers and other staff members who pair up to visit teens and young adults in schools,jails, hospital emergency rooms and other places to connect them with mental health services. Initially contacted though the community crisis hotline, the flow with a 2-1-1 call that is triaged and sent to a helpline. Appropriate calls are sent to the behavioral health provider crisis staff who again triages and respond in-person with a secondary staff person,who may be a therapist or case manager. L. Additional Resources There are many resources available online related to mental health services. This is not meant to be an all-inclusive list, but rather a starting point for additional resources. Revised Exhibit AY Page 11 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 (;Confl-at:„Hing&S,Soiiii.d l' If:ll a ucla li['I II°°uav of� ll II ea lli Network, Uric'.) 71 II/022 The Substance Abuse and Mental Health Services Administration (SAMSHA) has a resource tool on screening for behavioral health risk in school, available at: https://www.samhsa.gov/sites/default/files/ready_set_go_review_mh_screeni ng_in_schools_508. pdf The U.S. government has sponsored a Stop Bullying campaign with tips and information at: https://www.stopbullying.gov/ Zero Suicide is a commitment to suicide prevention in health and behavioral health care systems and is also a specific set of strategies and tools; a toolkit is available at: http://zerosuicide.edc.org/tool kit Department-sponsored webinars on mobile response services, provided at no cost to the provider by the Florida Certification Board, are accessible by creating a free account with the Florida Certification Board at: https://flcertificationboard.org/education-training/continuing-education/ and searching for the title of the webinars below: • Introduction to Mobile Response Teams (2019) • Mobile Response Teams: Strengths-Based Crisis Planning (2019) • Mobile Response Teams: Crisis Assessment and Intervention (2019) • Building Partnerships with Local Resources for Crisis Response(2019) Revised Exhibit AY Page 12 of 12 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWirid Soi.itlh Ii:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uaav of fll II e allilla Network, Uric.) 711/,20,22 Exhibit BE For FY 2022-2023 Tele- Behavioral Health Services For Services Provided to Children& Families Engaged in the Monroe County School System—OCA MHTLH A. PURPOSE The purpose of this funded project is to expand an integrated telecommunications technology platform used by the Network Provider for behavioral health services provided to children, adolescents and families engaged in the Monroe County Public School system. B. HISTORY/BACKGROUND OF FUNDING: In 2020,the Florida Legislature passed HB945, amending s. 394, F.S., requiring the implementation of a coordinated system of care which integrates services provided through providers funded by the state's child-serving systems and facilitating access by children and adolescents,as resources permit, to needed behavioral health treatment and services at any point of entry regardless of the time of year, intensity, or complexity of the need, and other systems with which such children and adolescents are involved,as well as treatment and services available through other systems for which they would qualify. C. ALLOWABLE COSTS/SERVICE ARRAY All covered services described in chapter. 65E-14.021, F.A.C„ are allowable when delivered by telehealth platforms to otherwise eligible students and their families. Any technology and system implementation supports needed to address identified needs for behavioral telehealth services to students and their families engaged with the school system.This may include the purchase of equipment,software, licenses, training, hosting and maintenance, and technical support services needed for the selected telehealth platform. Any combination of behavioral telehealth services of technology and system implementation supports. D. FUNDING: The available funding for this project for Monroe County is $111,112.00. Refer to Exhibit G, Covered Services Funding by OCA and Exhibit H, Funding. Exhibit BE Page 1 of 4 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilhi1i uu°g IItt1111rid Soi,itlh Ii lloi 11da (Confl-aat:„ding aS oii.d:ll'a li llaau ucl a Ii:3e1°uaav of fll II eaallilla Network, Ulric.) 71II/ 0,22 E. CLIENT ELIGIBILITY CRITERIA: 1. Children, adolescents and their families engaged in the Monroe County Public School system, 2. 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: � :.i . /i9tY ..�� ,S�a� °o � u / i�AiiVJiiiEs/IIIr�d .CIpA Ia�Q3d :::::iDIIS iia Statute&Uil�ii..:::::0 300...0399/fD394./dD394.Iha LIlxall ....................................................................................................................... F. REFERRALS: Referral Sources—Monroe County Public Schools and the Managing Entity. G. STAFFING PATTERN: The Network Provider has sixteen (16) counselors and therapists who are co-located in each public school and four charter schools at least one day per week. H. DESCRIPTION OF SERVICES Telehealth is the delivery of an evaluation, assessment,consultation, treatment planning, or other allowable service via non-public facing live videoconference between a licensed clinician and an individual. 1. The Network Provider has a long-standing partnership with Monroe County School District including being part of the district school mental health plan for the past 3 years. GCC is the contracted provider in the Keys for behavioral health services (which includes the use telehealth services) in and for the school system. This funding allows for expansion of behavioral health services to school aged children with various accommodations available to implement various types of behavioral health care. 2. The Network Provider uses various evidenced based practices including Apple A Day, Project Success, Wraparound, Cognitive behavioral therapy, and Sesame Street in Communities 3, Use of technology: The platform used for telehealth is Blue Jeans which is a free application that is HIPPA compliant that allows for face to face services from/to anywhere from any computer or smart phone. 4. The Network Provider outpatient offices are open Monday through Friday from 8 am to 5 pm excluding holidays. However, children's services are community based and offered with flexibility to meet the needs of the clients and families serviced. In addition, 24-hour crisis line is available to triage emergencies. Exhibit BE Page 2 of 4 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 i-Ilrii1iiSMiiil.g IIWiirid Soi.itlh If:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a li:3e1°uaav of fll II e allilla (Network, Uric.) 711/,20,22 I. LICENSES: For licensable services to be provided with these 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. J. PRIVACY AND SECURITY/TELEHEALTH PLATFORM: 1. 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. 2. 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. 3. Telehealth Platform: The Network Provider must use a tele-behavioral health software platform that is HIPAA compliant and provides secure, encrypted, audio-video conferencing to communicate with consumers. The Managing Entity approved tele-behavioral health software platform for this project is Blue Jeans which is HIPAA compliant—staff can also use texting is also an option from work issued cell phones provided that that client has signed consent. K. DATA REPORTING AND COLLECTION REQUIREMENTS: 1, Service Data: Service Data must be submitted monthly by the 4th of every month following the month of service into the ME's designated data system and must comply with the requirements of the FASAMS DCF Pamphlet 155-2, 2. Monthly Tracker:The Network Provider must submit Referral Monthly Tracker using the template provided by the ME by the 10th of every month for data from the previous month to the ME's Contract Manager. Exhibit BE Page 3 of 4 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 I-Ilrii1iiSMiiil.g IIWiirid Soi.itlh Ii:Ioii iida Confl-aat:„Hing aS Soiii.d:lla If:ll a ucl a Ii:3e1°uavioi fli II e allilla Network, Uric.) 711/,20,22 3. Return on Investment—At the discretion of the ME,the Network Provider may be required to submit quarterly return on investment reports. 4. Any adhoc reports requested by the ME. L. NUMBERS TO BE SERVED: Proposed number of clients/families to be served with this funding: 25 Refer to Exhibit D,Substance Abuse& Mental Health Required Performance Outcomes& Outputs,for a listing or all required performance measures applicable to this project. M. MEETINGS/TRAININGS: 1. The Network Provider will ensure that its staff is properly trained on the utilization of the telehealth platform, 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 BE Page 4 of 4 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Thriving Mind South Florida (Contracting as South Florida Behavioral Health Network, Inc.) 7/1/2022 Revised Exhibit BH Recovery Management Practices 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 participate in all implementation activities and Technical Assistance provided by DCF and the ME. The purpose of this document is to provide direction and recommendations for implementation of Recovery Management practices in Network Service Providers in accordance with the guidelines is this document and in the Department's Guidance Document 35, Recovery Management Practices, dated July 1, 2022, or the latest revision thereof, herein incorporated by reference. These practices are accomplished using Florida's Recovery-Oriented System of Care (ROSC) Framework. This document provides best practice standards to transform delivery of care to one that focuses on sustainable wellness and recovery. I. DEFINITIONS A. Peer Specialist:As defined in s. 397.31](30), F.S. B. Recovery: As defined in s. 397.311(37), F.S. Through key stakeholder engagement, SAMHSA developed the following working definition of recovery,' Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives,and strive to reach their full potential. This definition describes recovery as a process, not an end state. Complete symptom remission is neither a prerequisite of recovery nor a necessary process outcome. Recovery can have many pathways including professional clinical treatment and use of medications;family,school,and faith-based supports;peer support and other approaches. Four major dimensions support a life in recovery: 1. Health: Learning to overcome, manage, or more successfully live with symptoms; and making health choices that support one's physical and emotional wellbeing. 2. Home: A safe,stable place to live. 3. Purpose: Meaningful daily activities such as,work,school,volunteer activities,or creative endeavors;an increased ability to lead a self-directed life;and meaningful engagement in society. 4. Community: Relationships and social networks providing support,friendship,love,and hope. C. Recovery Management(RM):A philosophical framework for organizing treatment services to provide pre- recovery identification and engagement, recovery initiation and stabilization, long-term recovery maintenance, and quality-of-life enhancement for individuals and families affected by behavioral health disorders.z D. Recovery-Oriented: Recovery-Oriented care recognizes that each person must be the agent of and the central participant in their own recovery journey. All services and supports need to be organized to support the developmental stages of this process. Services should instill hope, be person and family-centered,offer choice,elicit and honor each person's potential for growth, build on a person's and family's strengths and interests, and attend to the overall quality of life, 1(Re nry.2010) 2 White,W.(2008).Recovery management and recovery-oriented systems of care.Chicago:Great Lakes Addiction Technology Transfer Center,Northeast Addiction Technology Transfer Center and Philadelphia Department of Behavioral Health and Mental Retardation Services. Revised Exhibit BH Page 1 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 including health and wellness.These values can be the foundation for all services regardless of the service type. E. Recovery-Oriented system of care (ROSQ A value-driven framework to guide transformation of a behavioral health system of care. The framework structures behavioral health systems to involve a network of clinical, nonclinical services, and supports that sustain long-term, community-based recovery. Formal and informal service networks are developed and mobilized to sustain long-term recovery for individuals and families impacted by behavioral health disorders. ROSC reflects variations in each community's vision, institutions, resources,and priorities.The"system"is not a treatment agency but a macro-level organization of a community, a state,or a nation. F. Recovery Capital: Recovery capital is the breadth and depth of internal and external resources that can be drawn upon to initiate and sustain recovery. G. Recovery Support: As defined in s 397.311(40), F.S. H. Support Services: As defined in s. 394.67(16)(c), F.S. II. ROSC TRANSFORMATION OVERVIEW Based on the Department's Florida Substance Abuse and Mental Health Plan Triennial State and Regional Master Plan', Florida's behavioral health, recovery-oriented transformation includes: A. Action-Oriented Priority Areas to Foster: 1. Collaborative Service Relationship indicated by a mutual service relationship between the provider and the service recipient that shift from a hierarchy model to the shared decision-making process and best practices that support the service recipients. 2. Cross-system Partnerships indicated by strategically leveraging resources and working across sectors to achieve common goals. 3. Community Integration indicated by assertively connecting service recipients to natural community- based resources to promote development of interest,skills, and supportive relationships. 4. Community Health and Wellness indicated by a focus on prevention,early intervention,wellness and increased recovery capital through targeted community education, strategic partnership development, and improved connections between system and local communities. 5. Peer-based Recovery Support indicated by increasing access to peer-based recovery support services. B. Goals of a Recovery-Oriented System of Care 1. Promote good quality of life community health and wellness for all. 2. Prevent the development of behavioral health conditions. 3. Intervene earlier in the progression of illnesses. 4. Reduce the harm caused by substance use disorders and mental health conditions on individuals, families, and communities. 5. Provide the resources to assist people with behavioral health conditions to achieve and sustain their wellness and build meaningful lives for themselves in their communities. 3 Florida Substance Abuse and Mental Health Plan,Triennial State and Regional Master Plan,Fiscal Years 2019-2022,Department of Children and Families, Office of Substance Abuse and Mental Health,May 30,2019 Revised Exhibit BH Page 2 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 C. Best Practice Standards as defined in Table 1. D. Performance Arenas for Quality Improvement Monitoring. The practices below are aligned with the Department's Recovery Oriented Quality Improvement Monitoring process and protocols produced by Florida Certification Board. 1. Meeting Basic Needs indicated by assessment, planning and delivery of all services to first address basic needs. 2. Comprehensive Services indicated by treatment and recovery supports that provide for a variety of treatment and recovery support modalities. 3. Medication Assisted Treatment where applicable indicated by the provision of information on psychotropic medication and medication-assisted treatment(MAT). 4. Strength Based Approach indicated by treatment delivery and planning that are fundamentally oriented toward individual's strengths rather than deficits. 5. Customization and Choice indicated by the planning and delivery of all services and supports are designed to address the unique circumstances, history, needs, expressed preferences, and capabilities of individuals receiving services. 6. Opportunity to Engage in Self-Determination indicated by the level of involvement of the individual determining treatment approaches and other recovery-oriented services. 7. Network Supports and Community Engagement indicated by active efforts in the planning and delivery of services to involve environmental supports in the individual's treatment and overall recovery that promotes community integration. 8. Recovery Focus indicated by providing services that are centered on helping individuals to achieve recovery goals and ensuring ongoing and seamless connections with services and supports. E. Potential Practice Changes as described in Table 1. Revised Exhibit BH Page 3 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 c c a> a c CZ p >.o a> p CD a o a> a c@ o Q w o> a@ m E c 0 c c v E in x O c> a>> > 2 0 E E -2 U _ � n _ c _. o ._ Y o> w O E c I Eo o> c c) E m o aa�> m o m o N U C .E- -O Q (> N c0 (n�O O C °) U r T CU C C N L O n E O) .>'-� @ @@ N N oU t @ N "@ O �:! 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RS L N 2.2 E = R o >. E N m � o' v7 � OOG -N a) ro E N _0 o N E D-N m 0 a) - m o n c a3 a) y a o u E c U as ._ E o a'i @ a3 m e g.c m o n c c Q -o as a) c o E- C� a m c 0 �n �� 70 � E > o L � � R � 0 E R n m� -E E c . aci c E c N 0 .O °' co a) .� o p 0 � pG u CO po .o °) E� :c ca 0a y c E .4 0 o p �'� a)-a �' o 0) M y o - T d a >,.y- 3 am p c m w c is a) a a uo 6 m cOa - a) .N 0 a) a) uo E a) C7 cc E o > n o m E > c E c . > 0 3 c c n c t 3 E c > Q C EO 'C 'O a f6 N N pU '��--.L Y N—� a n d =O O iE VOi Y �- W U o E as --o U U N.� a) o w U Q.N Q a U a) <n III. IMPLEMENTATION A. MANANGING ENTITY RESPONSIBILITIES Each Managing Entity shall demonstrate progress toward implementation of a ROSC framework within its service areas.The Managing Entity shall: 1. Incorporate specific Best Practice Standards and Potential Practice Changes in Table 1 into Network Service Provider subcontracts and monitor compliance with the Performance Arenas for Quality Improvement Monitoring aligned with the specific standards and changes selected. 2. Incorporate concepts designed to bolster the role of peer support and ROSC concepts with community stakeholders incorporating the elements of the Florida Peer Services Handbook 2016, available at: https://www.myflfamilies.com/service-programs/samh/publications/ 3. Support programmatic changes to include prevention and early intervention. 4. Promote adoption of sustainable recovery-oriented practices, 5. Analyze and assess current Managing Entity administrative,fiscal,policy, monitoring,and evaluation functions to align with recovery-oriented concepts using the Best Practices Standards in Table 1. 6. Identify opportunities to promote the expansion of peer-based recovery support services and recovery communities,enhance the role of peers in the workforce, and support development of peer-run organizations in their network in collaboration with the Department's local Recovery Oriented Quality Improvement Specialist. 7. Require subcontracted Network Service Providers providing direct services to use,at minimum,the following tools to assess recovery-oriented activities: a. Annually the Provider Self-Assessment/Planning Tool process for Implementing Recovery- Oriented Services(SAPT)and shall include technical assistance as needed for improvements among three primary domains,Administration,Treatment, and Community Integration available at: SAPT b. The Recovery Self-Assessment-R(RSA) RSA Provider Staff and RSA Family where applicable,available at: https://medicine.vale.edu/pssychiatry/prch/tools/rec_selfassessment,and 8. Require subcontracted Network Service Providers who employ peers with direct recovery-support service roles to: a. Use the Reaching for their Dreams Using Recovery Capital as a foundation to inform the individualized recovery planning process by developing goals among applicable domines available at Recovery Oriented System of Care I Florida Department of Children and Families(myflfamilies.com) b. Receive standardized supervision of peer-based support services training for peer supervisors Providers- Recovery Oriented System of Care I Florida Department of Children and Families(myflfamilies.com) 9. Monitor Network Service Providers utilization of the Self-Assessment/Planning Tool (SAPT)and document areas of improvements from the SAPT and the Recovery-Oriented Quality Improvement process available at: Recovery Oriented System of Care I Florida Department of Children and Families(myflfamilies.com) 10. Require direct Network Services Providers to receive standardized training on Recovery Revised Exhibit BH Page 7 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 Management best practices in employee orientation and refresher training,developed by the Florida Certification Board, 11. Include the Department's local Recovery-Oriented Quality Improvement Specialist(ROQIS) in Managing Entity Quality Improvement monitoring, using the Recovery Oriented Quality Improvement Monitoring Blueprint, developed by the Florida Certification Board to: 1) Conduct Recovery-Oriented Quality Improvement monitoring of Network Service Providers, 2) Provide follow-up training and technical assistance on enhancing recovery management approaches and practices to Network Service Providers and provide technical assistance in collaboration with the Department to any Network Service Providers with a cumulative average score of less than 4.0 across all recovery domains, and 3) Provide training and technical assistance to expand peer-based recovery services in Network Service Providers and Recovery Community Organizations, 12. Include findings from the recovery-oriented QI Monitoring Blueprint Tool in Network Service Provider monitoring or standalone reports and shall include all elements of the site visit,facility tour, policy and procedure review, person served interviews,surveys,clinical chart scoring outcomes,staff interviews,and where applicable,review of peer specialist staff job description(s). Reports shall be submitted to the Network Service Provider within 30 days of the site visit. IV. RESOURCES Managing Entities and Network Service Providers are encouraged to research the following recovery-oriented promising practices as examples of effective implementation: Recovery Support Bridger's/Navigators-Certified Recovery Peer Specialists(CRPS)are utilized to assist individuals successfully transition back into the community following discharge from a SMHTF, CSU or Detox.The CRPS engages the individual while still inpatient and provides support and information on discharge options.They participate in discharge planning and assist the person in identifying community-based service and support needs and build self-directed recovery tools, such as a Wellness Recovery Action Plan (WRAP).The CRPS then supports the individual as they transition to the community. More information on WRAP may be accessed at: http://mentalhealthrecovery.com/ Care Transition Programs®-This intervention utilizes a Transition Coach to preferably meet an individual in the acute care setting to engage them and their family(as appropriate) and sets up in-home follow up visits and phone calls designated to increase self-management skills, personal goal attainment, and provide continuity across the transition.4 More information on the Care Transition Programs may be accessed at: hitp:Hcaretransitions.org/ Behavioral Health Homes-The SAMHSA—HRSA Center for Integrated Health Solutions has proposed a set of core clinical features of a behavioral health-based health home that serves people with mental health and substance use disorders,with the belief that application of these features will help organizations succeed as health homes. This resource may be accessed at: http://www.integration,samhsa.gov/clinical- practice/CIHS Health Homes Core Cl inical_Features.pdf Reducing Avoidable Readmissions Effectively-The RARE Campaign in Minnesota was established to improve the quality of care for persons transitioning across care systems and to reduce avoidable readmissions by 20%. Five areas were identified as a focus of these efforts: a See,http://caretransitions.orgiabout-the-care-transitions-intervention/,site accessed October 14,2015. Revised Exhibit BH Page 8 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 • Patient/Family Engagement and Activation, • Medication Management, • Comprehensive Transition Planning, • Care Transition Support, and • Transition Communication For more detail,the RARE Campaign published recommendations on actions to address the above areas of focus which can be accessed at: http://www.rarereadmissions.org/documents/Recommended_Actions_Mental_Health,pdf Telehealth-Technology presents another promising practice in coordinating care,specifically related to access. For example,the Department of Veterans Affairs piloted a care coordination/home telehealth initiative that continually monitored veterans with chronic health conditions.Vital signs and other disease management data was transmitted to clinicians remotely located.The pilot reported reductions in hospital admissions and length of stay.' Wraparound-Wraparound is an intensive, individualized care planning and management process for individuals with complex needs, most typically children,youth,and their families.The Wraparound approach provides a structured, holistic and highly individualized team planning process which includes meeting the needs of the entire family.The philosophy of care begins with the principal of"voice and choice",which stipulates the child and family perspective and drives the planning.The values further stipulate that care be community-based and culturally and linguistically competent. The staff to family ratio typically does not exceed one Wraparound facilitator to ten families. More information on Wraparound may be accessed at: http://nwi.pdx.edu/. Related Articles: • Philadelphia Behavioral Health Services Transformation Practice Guidelines for Recovery and Resilience Oriented Treatment. • Philadelphia Dept. of Behavioral Health and Intellectual Disabilities Services and Achara Consulting Inc. (2017). Peer Support Toolkit. Philadelphia, PA: DBHIDS. • Davidson, L.; Tondora, J.; Ridgway, P.; & Rowe, M. (2012). Inventory of transformation characteristics for recovery-oriented systems of care. New Haven,CT:Yale University Program for Recovery and Community Health. • Winarski, J., Dow., M, Hendry, P., & Robinson, P. (2018). Self-Assessment/Planning Tool for Implementing Recovery-Oriented Services (SAPT)Adapted for Florida's Recovery Oriented System of Care Initiative(ROSC). Tampa, FL: Louis de la Parte Florida Mental Health Institute, University of South Florida. • Recovery concept finds common ground in mental health and addiction, Co-occurrences Newsletter of the Minnesota Co-Occurring State Incentive Grant Project. • Recovery in Mental Health &Addiction, Davidson and White, Recovery to Practice Issue No. 14 • Kelly,J. &White,W. (Late 2010)Addiction recovery management:Theory,science and practice, New York: Springer Science. • Monographs published by Great Lakes ATTC, available at http://Www.williamwhitepapers.com/: o Recovery Management o Peer-based Addiction Recovery Support: History,Theory, Practice, and Scientific Evaluation IOM(Institute of Medicine).2010.The healthcare Imperative:Lowering Costs and Improving Outcomes:Workshop Series Summary.Washington,DC:The National Academies Press Revised Exhibit BH Page 9 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 o Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices o Practice Guidelines for Resilience and Recovery Oriented Treatment, Philadelphia Department of Behavioral Health and Intellectual Disability Services Relevant Websites: http://www.williamwhitepaapers,com/ http://www.acharaconsulting.com/ http://www.acharaconsulting.com/peer-support-toolkit/ https://www.samhsa.gov/brss-tacs https://Inaps.memberclicks.net/assets/docs/RTP%20Next%20Steps%20Manual.pdf https://store.samhsa.gov/sites/default/files/d7/priv/pepl 2-recdef.pdf Revised Exhibit BH Page 10 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 THRIVING MIND SDUTH NLURIOA" ATTACHMEVENT VI For Fiscal Year 2022-2023 SCOPE OF WORK NAME OF PROVIDER: Guidance Care Center NAME OF PREVENTION PROGRAM: Power of Prevention AMOUNT OF CONTRACT AWARD: $199,063.00 "Regular" Prevention TYPE OF FUNDING: Prevention Block Partnership SOR Grant Services Grant PPG X COST ALLOCATED TO: (check both Children's Substance Abuse Adult Substance Abuse if approved for both covered services) 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 prevention program, POP (Power of Prevention) consists of(8) Evidence- Based Practices: (1) Facilitated at Schools or Community Sites: Integrated services: (1)An Apple A Day© (Elementary K-4), (2) Catch My Breath (Middle & High School), (3) Teen Intervene (Middle & High School). (2) Virtual Online Self-Guided Courses- Partnered with Monroe County Coalition (MCC), integrating strategies: (4) AlcoholEdu, (5) Prescription Drug Safety, (6) Nicotine 101, (7) Marijuana Wise, and (8) Alcohol Wise. 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. Attachment VI Scope of Work Page 1 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 IOM Specific Category primary Number of Activity/Program - (Universal prevention Unduplicate include whether Indirect, programs, d Brief Description practices in the strategy is an Universal Participants EBP Direct, each of the six (if duplicated Selective, prevention note) Indicated) strategies CSAP An Apple A Day© Classroom education Selective Education 400 Youth Elementary EBP teaching inner strength protective & risk factors and resilience to resist ATOD Catch My Breath Classroom education Selective Education 100 Youth High & Middle addressing challenges of School EBP adolescence, risk of ATOD, relationships & refusal skills Teen Intervene One-on-One early Indicated Education 10 Youth High & Middle intervention for youth deemed School EBP high risk for or reporting alcohol/drug use referred by school counselor, coach, or as self-referred Problem ID: An Support to youth and families Selective Problem #will be Apple A Day© who need additional services Identification tracked EBP, Catch My and Referral Breath EBP &Teen Intervene EBP Virtual EBP's Online interactive education Selective Education 200 Youth Courses: Alcohol courses ATOD pre/post Edu, Prescription completion Drug Safety, Nicotine 101, Marijuana Wise, Alcohol Wise Community Face to Face anti-ATOD Universal Information 600 Youth & Activities, Events messages through school- Direct Dissemination Adults (including any based assemblies, fairs), workshops, health fairs, Drives, and community events or Workshops meetings for youth Summer: An Apple School and summer camp Selective Alternative 25 Youth A Day© EBP & participants will participate in Catch My Breath alternative activities ATOD to EBP reinforce skills as well as risks & protective factors Community Community Norms, Prosocial Universal Information 75 Adults Capacity Building — Activities, Opportunities for Direct Dissemination Adults Prosocial Involvement Attachment VI Scope of Work Page 2 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 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. Also serving County Libraries &Child Day Care Centers, Health Fairs, Family Relief Programs, and Food Banks 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. Educational priorities in accordance with the Monroe County CCAP are Youth Alcohol Use/Abuse, Youth Drug Use/Abuse. 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 Education - Favorable Attitudes Towards ATOD, Peer Norms, 1, 2, 3 AlcoholEdu, Prescription Drug Peer Perceptions, Perceptions of Harm, Increased Safety, Nicotine 101, Marijuana Knowledge and Awareness, Boundaries, Family Wise, Alcohol Wise, An Apple A Management&Adult Role Models. Day, Catch My Breath, &Teen Intervene Community Activities, Events, 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, Catch My Breath Linkage to Community Resources, Family & Teen Intervene Management. Community Capacity Building — Community Norms, Pro-social Activities, 3 Adults Opportunities for Pro-social Involvement Other Program/Strategy and Related Risk/Protective Factors Targeted Coalition Target Population CCAP Goal Addressed Attachment VI Scope of Work Page 3 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Community Activities, Events, Community Norms, Pro-social Activities, MCC— 1, 2, Drives, and Workshops & Opportunities for Pro-social Involvement 3 Community Capacity Building Section III. SITE LOCATIONS AND INFORMATION* Site Name Target Participants Zip Check all that apply) Note whether school or Street Address City Code Child/ community Youth Parents Others Community Partner County Wide Monroe ALL X X Sites Covering 110 Miles Count Key Largo Middle 104801 Overseas Key Largo 33037 X School Hwy Key Largo Library 101485 Overseas Key Largo 33037 X Highway Plantation Key Middle 100 Lake Rd Tavernier 33070 X School Coral Shores High 89901 Old Hwy Tavernier 33070 X School Ocean Studies 92295 Overseas Tavernier 33070 X Charter School Hwy Treasure Village 86731 Overseas Islamorada 33036 X Montessori School Hwy Marathon Library 3490 Overseas Hwy Marathon 33050 X Grace Jones Daycare 230 41 st Street Marathon 33050 x Center Summer Program Hammock House 1060 Western Ho Marathon 33050 X Summer Camp Lane Marathon Park & Rec 33rd Street Marathon 33050 X Center Summer Program Stanley Switlik Middle 3400 Overseas Marathon 33050 X School Hwy Marathon Middle/High 350 Sombrero Rd Marathon 33050 X School Key West Library 700 Fleming St, Key West 33040 X Sugarloaf School 255 Crane Blvd Sugarloaf 33042 X Gerald Adams 855 W College Rd Key West 33040 X Elementary School Attachment VI Scope of Work Page 4 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Poinciana Elementary 1407 Kennedy Dr Key West 33040 X School Sigsbee Charter School 939 Felton Rd Key West 33040 X Horace O'Bryant School 1105 Leon Street Key West 33040 X Boys & Girls Club 2100 Flagler Ave Key West 33040 X May Sands Montessori 1400 United Street Key West 33040 X School Key West High School 2100 Flagler Ave Key West 33050 X TOTAL NUMBER TO BE SERVED 1,420 *Changes in sites/locations of services must adhere to contractual requirement procedures. Section IV. MAJOR REFERRAL SOURCES List the major referral sources for the servicesprovided: Monroe County Schools—Teachers, Principals and School Counselors Department of Juvenile Justice Self-Referral Parent, Guardian, or Family Member 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 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/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 Timeline 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 Attachment VI Scope of Work Page 5 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 Include all Thriving Mind 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 Type a of EBP % to Meet this Obsery Activities/Service Name and Description 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: Education—An Apple A Day 200 (8-10) 100%will 2 on site Activity Description: EBP Anti-ATOD youth sessio receive or virtual Curriculum ns services visits • Recruit sites/locations K—4t" and • Create Memorandums of grade 85% of Understanding/Affiliation program agreements for each site. completers • Meet with staff for curriculum will show scheduling of educational sessions in decreased the site. favorable • Curriculum preparation- print learning attitudes, materials, prepare PowerPoint and presentations. increased • Youth registration- create participant perceptions data record sheet at initiation of first of harm, session. and • Complete registration, pre/posttest, increased satisfaction prosocial • Enter all outcome data in the BSRI skills. 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 1x weekly (or 2x—3x depending on site/cohort schedule Attachment VI Scope of Work Page 6 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 summer. Meaningful Improvement Satisfaction:90% of program completers demonstrate satisfaction with program services Activity Title: Education- Catch My Breath 100 (4-5) 100%will 2 on Activity Description: E B P Anti-ATOD Curriculum youth Sessions receive site or • Recruit sites/locations services virtual • t"-12 Create Memorandums of Understanding 5th and visits /Affiliation agreements for each site. grade 85/o of • Meet with staff for curriculum scheduling of program educational sessions in the site. completers will show • Curriculum preparation- print learning decreased materials, prepare PowerPoint presentations. favorable • Youth registration- create participant data attitudes, record sheet at initiation of first session. and • Complete registration, pre/posttest, satisfaction increased • Enter all outcome data in the BSRI D.O.E.S perceptions system. of harm, • Update participant information in database. and • Conduct weekly curriculum sessions. increased • Update weekly attendance. prosocial skills • 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:4-5 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: Education - Teen Intervene 10 (3-5) 100% will Activity Description: EBP Anti-ATOD youth Sessions receive Curriculum services • Recruit sites/locations 6th-12th and • Create Memorandums of grade 85% of Understanding/Affiliation program agreements for each site. • Meet with staff for curriculum completer scheduling of educational sessions in swill the site. show decreased Attachment VI Scope of Work Page 7 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 • Curriculum preparation- print learning favorable materials, prepare PowerPoint attitudes, presentations. and • Youth registration- create participant increased data record sheet at initiation of first perception session. s of harm, • Complete registration, pre/posttest, and satisfaction Enter all outcome data in the BSRI increased • D.O.E.S system. prosocial skills. • 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 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: Education -Virtual Online Courses: 100 As 100%will AlcoholEdu, Prescription Drug Safety, Nicotine youth needed receive 101, Marijuana Wise, &Alcohol Wise services Activity Description:Online interactive 6th-12th and ATOD education courses partnered with grade 85% of Monroe County Coalition. . program • Recruit sites/locations completers • Get Parent approval will show • Meet with staff for curriculum scheduling of decreased educational sessions in the site. favorable • Youth registration- create participant data attitudes, record sheet at initiation of first session. and • Complete registration, pre/posttest, satisfaction increased • Enter all outcome data in the BSRI D.O.E.S perceptions system. of harm, • Update participant information in database. and increased • Enter participant or event data in PBPS data prosocial collection system. skills. • Provide follow up information as needed. Frequency: Education as needed to complete course. Intensity: 1 or 3 hours depending on course Duration: As needed to complete the course Attachment VI Scope of Work Page 8 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 Meaningful Improvement Satisfaction: 90% of program completers demonstrate satisfaction with program services Activity Title: Capacity Building/ATOD 75 As 100% of Presentations adults needed individuals Activity Description ATOD prevention receive materials presentations to adults in both school All ages and/or and non-traditional settings. As well as information for site personnel, other community key stakeholders including parents, teachers, and coaches. Frequency: One-time presentation Intensity:As Needed Duration: Year-Round scheduled with school faculty/administration and community partners. Activity Title: Community Activities, Fairs, 600 As 100% of Drives, and Workshops /ATOD youth & needed individuals Activity Description: Face to Face anti- adult receive ATOD messages and providing materials materials through school based anti- All ages and/or ATOD assemblies, workshops, health information fairs, community events or meetings for youth. Freauency: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 need additional prevention services are identified via problem ID and referral strategies and are referred into Teen Intervene program. This will be noted in BSRI data tracking 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 coordinates with The Florida Keys Children's Shelter who provide services in Monroe County. They provide the EBP All Stars. We have meetings regarding the schools we are in, so we are not duplicating services. Attachment VI Scope of Work Page 9 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 partners with MCC on (5) EBP's AlcoholEdu, Prescription Drug Safety, Nicotine 101, Marijuana Wise, and Alcohol Wise. GCC and the MCC partnered in implementing these (5) 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 1. Site Locations and Site Schedule The sites for services will be identified in the Scope of Work and will serve as the official sites for service provision. final site schedule, on the Site Schedule form, with dates, times, and location of services shall. Sites must be approved by Thriving Mind / 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 the Thriving Mind/SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity (ME) in writing and submitted to the Contract Manager for review and approval by the Prevention Director or her/his designee. The Contract Manager will reply with approval. Two (2) site schedule changes may be made in the contract year. The site schedules shall be submitted on the Thriving Mind South Florida/SFBHN Prevention Site Schedule format as requested by the Prevention Department staff or other Thriving Mind staff. 2. Memorandum of Understanding (MOU) Between Prevention Direct Service Providers and Community Coalitions To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition in the geographic area where services are provided 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. All MOUs shall be current and up to date, outlining the terms of the agreement. The provider and the coalition 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). In addition, existing MOUs should be submitted within thirty (30) calendar days of renewal dates when renegotiated. Both the community coalition and the provider will be responsible to meet the terms of the MOU, particularly in the data sharing and tracking of community trends to inform programming. This will include the appropriate agreement(s)with Miami-Dade County Public Schools and their sites. 3. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work and the Thriving Mind contract. 4. Meetings Attachment V1 Scope of Work Page 10 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, Behavioral Science Research Institute (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 BSRI, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, data planning meetings with CPGSI/Performance Based Prevention System (PBPS), data meetings with BSRI and other evaluation entities, and other meetings as noticed by Thriving Mind South Florida/SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 5. 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 Thriving Mind/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 Thriving Mind/SFBHN staff, including the Prevention Director and Prevention Department staff, and may be requested verbally or in writing. There may be times when other collaborative partners request information and Thriving Mind/SFBHN will support these requests. 6. Training All staff of provider organizations funded by this contract, whether full-time, part-time, contractual, or consultant, and/or who report units in the Performance Based Prevention System (not those paid by cost reimbursement nor that are vendors), is required to attend identified trained, among those are Evidence Based Practice training, Florida Certification Board approved training for those seeking certification, and PBPS training. All providers shall attend scheduled and/or recommended training as required by the ME, and the ME and the evaluation team, for technical assistance and / or training, at regularly scheduled or specially called meetings when notified by the ME. Time spent in training activities, for up to twenty (20) hours, are considered Administrative Time. These twenty (20) hours are built into the negotiated unit rate in each of the prevention services listed in Exhibit G, Covered Service Funding by OCA. For additional hours spent in training, the Network Providers shall submit the data in PBPS as support time. 7. 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. In addition, Providers are required to adhere to all measures in the DCF Guidance Documents attached to this contract. 8. 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; Attachment VI Scope of Work Page 11 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 ■ Review the data submitted with designated Thriving Mind/SFBHN Prevention Department staff monthly, or decline data review, 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 Thriving Mind/SFBHN Prevention Department; ■ Submit an email to the Thriving Mind / SFBHN Prevention Department designated staff and the designated Thriving Mind / 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. 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. Attachment VI Scope of Work Page 12 of 12 Inserted 6/30/2022 Guidance/Care Center,Inc. Contract No.ME225-12-27 THRIVING MIND SDUTH NLURIOA" Attachment VII SCOPE OF WORK State Opioid Response SOR NAME OF PROVIDER: Guidance/Care Center NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: $28,241 MSSP4 (SOR Y4) $84,722 MSSP5 SOR Y5 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 9th graders, and individual counseling to those in need of additional supportive counseling. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20-year old 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 Attachment VII Scope of Work—State Opioid Response(SOR) Page 1 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 IOM Specific Category primary Number of ctivity/Program - (Universal prevention Unduplicate include whether Indirect, programs, d Brief Description practices in the strategy is an Universal 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 arouas 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 ID 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 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 Planpriorities: Youth Attachment VII Scope of Work—State Opioid Response(SOR) Page 2 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 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 Attachment VII Scope of Work—State Opioid Response(SOR) Page 3 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 Positive peer influence, Healthy behaviors Increased knowledge/awareness 7' Grade Prevention Education Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Self-regulation 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 Attachment VII Scope of Work—State Opioid Response(SOR) Page 4 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 Section III. SITE LOCATIONS AND INFORMATION* Site Name Target Participants Zip Check all that apply) Note whether school or Street Address City Code Child/ community Youth Parents Others 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 servicesprovided: 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 Attachment VII Scope of Work—State Opioid Response(SOR) Page 5 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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. 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 Type a of EBP % to Meet this Obsery Activities/Service Name and Description 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 o Activity Description:. 7t" 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 Attachment VII Scope of Work—State Opioid Response(SOR) Page 6 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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. 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 visits session 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 41" 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 Attachment VII Scope of Work—State Opioid Response(SOR) Page 7 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 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 1. Site Locations and Site Schedule The sites for services will be identified in the Scope of Work and will serve as the official sites for service provision. final site schedule, on the Site Schedule form, with dates, times, and location of services shall. Sites must be approved by Thriving Mind / 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 the Thriving Mind/SFBHN funding. Any change shall be justified in writing and submitted to the Managing Entity (ME) in writing and submitted to the Contract Manager for review and approval by the Prevention Director or her/his designee. The Contract Manager will reply with approval. Two (2) site schedule changes may be made in the contract year. The site schedules shall be submitted on the Thriving Mind South Florida/SFBHN Prevention Site Schedule format as requested by the Prevention Department staff or other Thriving Mind staff. 2. Memorandum of Understanding (MOU) Between Prevention Direct Service Providers and Community Coalitions To address local community substance abuse prevention needs and wellness promotion strategies, prevention providers and the community coalition in the geographic area where services are provided 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. All MOUs shall be current and up to date, outlining the terms of the agreement. The provider and the coalition 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). In addition, existing MOUs should be submitted within thirty (30) calendar days of renewal dates when renegotiated. Both the community coalition and the provider will be responsible to meet the terms of the MOU, particularly in the data sharing and tracking of community trends to inform programming. This will include the appropriate agreement (s)with Miami-Dade County Public Schools and their sites. 3. Participant Satisfaction Survey All providers shall collect and submit participant satisfaction surveys as noted in the Scope of Work and the Thriving Mind contract. 4. Meetings All providers shall attend scheduled Prevention meetings as required by the ME and the evaluation team, Behavioral Science Research Institute (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 BSRI, individual provider quarterly meetings with BSRI and/or SFBHN, Evidence Based Practice workgroup meetings to comply with the Block Grant requirements, data planning meetings with CPGSI/Performance Based Prevention System (PBPS), data meetings with BSRI Attachment VII Scope of Work—State Opioid Response(SOR) Page 8 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 and other evaluation entities, and other meetings as noticed by Thriving Mind South Florida/SFBHN. The contract notes the other meetings where representatives of the provider organization are required to attend. 5. 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 Thriving Mind/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 Thriving Mind/SFBHN staff, including the Prevention Director and Prevention Department staff, and may be requested verbally or in writing. There may be times when other collaborative partners request information and Thriving Mind/SFBHN will support these requests. 6. Training All staff of provider organizations funded by this contract, whether full-time, part-time, contractual, or consultant, and/or who report units in the Performance Based Prevention System (not those paid by cost reimbursement nor that are vendors), is required to attend identified trained, among those are Evidence Based Practice training, Florida Certification Board approved training for those seeking certification, and PBPS training. All providers shall attend scheduled and/or recommended training as required by the ME, and the ME and the evaluation team, for technical assistance and / or training, at regularly scheduled or specially called meetings when notified by the ME. Time spent in training activities, for up to twenty (20) hours, are considered Administrative Time. These twenty (20) hours are built into the negotiated unit rate in each of the prevention services listed in Exhibit G, Covered Service Funding by OCA. For additional hours spent in training, the Network Providers shall submit the data in PBPS as support time. 7. 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. In addition, Providers are required to adhere to all measures in the DCF Guidance Documents attached to this contract. 8. 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 designated Thriving Mind/SFBHN Prevention Department staff monthly, or decline data review, 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 Thriving Mind/SFBHN Prevention Department; Attachment VII Scope of Work—State Opioid Response(SOR) Page 9 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 ■ Submit an email to the Thriving Mind / SFBHN Prevention Department designated staff and the designated Thriving Mind / 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. 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. Attachment VII Scope of Work—State Opioid Response(SOR) Page 10 of 10 Guidance/Care Center,Inc. Contract No.ME225-12-27 ATTACHMENT D (continued) Contractual Agreements P-03 - Guidance/Care Center and South Florida Behavioral Health Network, Inc. Guidance Care Center-SAMH Contract FY22 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 Z State Funds 0 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.thr.ivir7. mig nd.orrg. 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 1,2021.It shall end at midnight,local time in Miami-Dade County,Florida on June 30,2024, 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.dunleavyCwestcare.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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 $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 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 individual served 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. (ii) Noncompliance involving the provision of service not having a direct effect on individual served 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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, the ME 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 for transition 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 prohib it 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 NETWORK PROVIDER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119,F.S.,TO THE NETWORK PROVIDER'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,CONTACT THE ME's CUSTODIAN OF PUBLIC RECORDS AT 786-507-7458 OR BY EMAIL AT JIIZOII)IIZII_G_UII CCaaSIFI[31l-IN..OIRG, OR BY MAIL AT SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK D/B/A THRIVING MIND SOUTH FLORIDA, 7205 NW 19 STREET SUITE 200, MIAMI, FLORIDA 33126 OR CONTACT THE DEPARTMENT'S CUSTODIAN OF PUBLIC RECORDS AT 850-487-1111,OR BY EMAIL AT DCFCustodian@MYFLFAMILI ES.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 individual served 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 individuals served,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 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Standard Contract Page 5 of 16 Guidance/Care Center,Inc. Contract No. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 sec.), section 508 of the Federal Water Pollution Control Act,as amended(33 U.S.C.§1251 et sec.),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 other than 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 individual served 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 individual served 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 th is 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. 20. Individual served Risk Prevention Standard Contract Page 6 of 16 Guidance/Care Center,Inc. Contract No. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- a. If services to individuals served are to be provided under this Contract,the Network Provider and any subcontractors shall,in accordance with the individual served 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 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. 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.mvflfamilies.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: htt.ps://www.mYFlfamilies.t:omiseriice .�rams./individlva.L.wi.1h.::clisabiliay/orauiders/ and sign the Attestation of Understanding. Direct service employees Standard Contract Page 7 of 16 Guidance/Care Center,Inc. Contract No. P-03 4; .wain moo. THRIVING MIND PSOU1 19 FI..()HIDA- 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 individuals served, 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 individuals served 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 individuals served 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 M E 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. 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 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,_[_hrivingrrr.ind...org. 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 Provider further agrees that neither the ME nor the Departme nt 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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, individuals served,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 individuals served 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 a ny 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 secti on 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 individual served 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 individual served or other confidential information.The Information Security Officer will ensure that any access to the ME or Department information systems or any individual served 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 individual served 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 individual served 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. P-03 4; .wain moo. THRIVING MIND PSOU1 19 FI..()HIDA- 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 individual served 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 individual served or other confidential information. Individual served 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 individual served 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 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. Standard Contract Page 13 of 16 Guidance/Care Center,Inc. Contract No. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..oHIDA- 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, individual served 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 49.c.shall be followed. In the event of a dispute regarding individual served 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/orthe ME's full 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. P-03 4; .wain moo. THRIVING MIND PSOUI 19 FI..()HIDA- 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 or, c. electronic signatures,whether digital or encrypted,have the same force and effect as manual signatures. 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 hla : A w,I rivin. re7ind.orr ,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,II•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 BY SIGNING THIS CONTRACT, THE PARTIES AGREE THAT THEY HAVE READ AND AGREE TO THE ENTIRE CONTRACT, AS DESCRIBED IN SECTION 55.ABOVE. Signature Page Follows Standard Contract Page 15 of 16 Guidance/Care Center,Inc. Contract No. P-03 . pro.. "4J4" , THRIVING MIND SiO0"11-9 F1.ORIDA" 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 GLjidanre/fare Center,Inc., SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK,INC. a fL 501c3 not fpr-"'profit,o�rp& tion SIGNED t ;.0 SIGNED BY: BY: NAME: Frank C.Rabbito NAME: John W.Newcomer,M.D. TITLE:Chief operations Officer TITLE:President and CEO DATE: 8/3/2021 DATE: Federal Tax ID#(or SSN)59-1458324 Network Provider Fiscal Year Ending Date 6/30 Resolution WCGCC 2019-10 Standard Contract Page 16 of 16 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwauauflh Fllauill k1 a Pnelluraviou at Jfelflflh 7"e'lvi ll h Inc.) 07/fUal./"tll12,�. 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) "Comprehensive Community Action Plan (CCAP" A document that describes and depicts goals and objectives related to the state consumption priorities and the proposed programs and strategies. It also describes and depicts intermediate changes to risk and protective factors and process-based objectives. Applications must include at least one objective that Attachment I HCO2(f) Page 1 of 46 Guidance/Care Center,Inc. Contract No. P-03 (Conilraefling as^,wollflh FllauiilWa PW11rnvi#a at Heu flh'1i,"Im uirl" 'Inc.) 07/11,111./2d11211. addresses sustainability and at least one objective that addresses capacity building. Goals and objectives are subject to modification during the negotiation process. (8) "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. (9) "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. (10)"Co-occurring Disorder" is any combination of mental health and substance use in any individual,whether or not they have been already diagnosed. (11)"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. (12)"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. (13)"Cost Analysis" is the review of the proposed cost elements to determine if they are necessary, allowable, appropriate and reasonable. (14)"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. (15) "Department" means the State of Florida Department of Children and Families. (16) "Electronic Health Record (EHR)" is defined in s. 408.051(2)(a), F.S. (17) "Evaluation Plan" A document that explains and describes program assessment, improvement, and strategic management. The assessment portion should address the process for verification and documentation as well as how program activities and their effects will be quantified. Additionally, areas that can be improved or enhanced need to be identified to address areas of weakness. The final piece of strategic management will Attachment I HCO2(fl Page 2 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil t,llolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauii llama Pnelluraviou at ttu.,uu flh 71"e'lvi ll h Inc.) 07/U:II./"tll12,�. provide information to help make decisions about how resources should be applied in the future to better serve its mission or goals. (18)"Evidenced-Based Practices (EBP) are programs, practices or strategies that are supported by research. EBP's are programs that have demonstrated effectiveness with established general izabiIity (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.m\/flfamilies.com/service-programs/samh/managing-entities/index.shtml Note: Click on FY21-22 ME Templates and click on Guidance Document 1, Evidence Based Guidelines (19) "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 (20) "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. (21) "Harmful Consequences" Negative effects caused by drug use, such as diseases, fatalities, academic failures, and criminal behavior. (22) "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. (23) "Indicated Prevention" As defined in rule 65E-14,021(4)(v)1., F,A.0 (24) "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). (25) "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 Attachment I HCO2(fl Page 3 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh FllauiiWnu Pnelluraviou at Jfeuu0flln 7"e'lvi ll h Inc.) 07/dual./"tll12,�. (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. (26) "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. (27)"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. (28) "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. (29) "Mental Health Services" is defined pursuant to Chapter 394,67(15) F.S. (30)"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, (31) "Needs Assessment Logic Model (NALM)" A visual depiction of the relationships between risk and protective factors, drug consumption, and harmful consequences. A logic model visually demonstrates the causal mechanisms and interconnections between variables using arrows to show the direction of influence. (32)"Network Provider" is an entity that contracts with the ME and receives funding to provide services to individuals ; in this contract the Network Provider is synonymous with provider or subcontractor. (33)"Outcome for Individual Service Recipient" is a measure of the quantified result, impact, or benefit of services on the individual service recipient. (34) "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. (35) "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. (36)"Prevention" refers to the proactive approach to preclude, forestall, or impede the development of substance abuse or mental health related problems.These strategies focus Attachment I HCO2(fl Page 4 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauii llama Pnelluraviou at ttu.,uu flh 71"e'lvi ll h Inc.) 07/dual./"tll12,�. 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.myflfamilies.com/service-programs/samh/managing-entities/index.shtml Note: Click on FY21-22 ME Templates and click on Guidance Document 10, Prevention Services (37) "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. (38)"Prime Contract" is the contract between the Department of Children and Families and the ME. (39) "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. (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) "Protective Factors" Conditions or variables that reduce the likelihood of drug use. (42)"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. (43) "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. Attachment I HCO2(fl Page 5 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwauauflh FllauiiWnu Pnelluraviou at ttu.,uu flh 71"e'lvi ll h Inc.) 07/dual./"tll12,�. (44) "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. (45) "Risk Factors"Conditions or variables that increase the likelihood of drug use. (46) Request for Application # 11L2GN1" is the Department's most recent Prevention Partnership Grant Request for Application for Fiscal Years2021-2024. (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 does not possess sufficient documentation. (49)"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. (50) "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. (51) "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. (52) "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, Attachment I HCO2(f) Page 6 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (Conilraefling as^,wollflh Fllauill kj a PW11rnvi#a at Heu flh'1i,"Im uirl" 'Inc.) 07/11,111./2d112111. 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. (53) "Target Population"The PPG Target Population is students up to 20 years of age. Parents, teachers and other school staff, coaches, social workers, case managers, and other prevention stakeholders may also be the target of proposed activities because of their ability to influence students up to 20 years of age. Activities that target the behavior of these stakeholders for change can be considered process measures. Approved performance measures, on the other hand, must measure improvements in the attitudes and behaviors of students up to 20 years of age. (54) "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. (55) "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 #11L2GN1, 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 Attachment I HCO2(fl Page 7 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (;Conilu•a ailing.umH^,wollflh Fllauill k1 a PW11rnvi#u at Heu flh 'Inc.) 07/11,111./2d11211. 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 #11 L2GN1, 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/Participantsto be Served, and in accordance with the tasks outlined in Section 13.1.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 Objectives The objectives of the PPG program are to: (1) Develop effective substance abuse prevention and early intervention strategies for Target Populations at risk for the state priorities for consumption reduction. (2) Conduct prevention activities serving students who are not involved in substance use, 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 Attachment I HCO2(fl Page 8 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (;Conilu•aailing.umH^,wollflhFllauiilWaPW111nvi#natHeu flh 'Inc.) 07/11,111./2d112111. Assessment Logic Model (NALM)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 need's 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 multiple services are provided and change as seamlessly as possible when warranted; (g) Cultural and linguistic competence Attachment I HCO2(fl Page 9 of 46 Guidance/Care Center,Inc. Contract No. P-03 fluu ilvhu g Mind scadil Florkla (C'onilra ailing.umH^.iwauauflh Fllauill kt a Pnelluraviou at 14tu„uu0fllu 7"e'lvi ll h Inc.) 07/fi1i1l./2fill2 (h) Gender responsive, (i) Sexual orientation, and Q) Recovery-oriented and recovery-supported 3. Consumers to be Served See Exhibit A, Ind ividuals/Partici pants 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 Attachment IV, 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 bejustified 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 must assure the delivery of services is based on Evidence-Based Practices implemented with fidelity and in accordance with the Department's Guidance 1, Evidenced- Based Guidelines, herein incorporated by reference, and the approved Program Description(s). (4) The Network Provider shall serve the number of persons indicated Attachment IV, Scope of Work,within the covered services listed in Exhibit G,Covered Service Funding by OCA. (5) The Network Provider shall ensure the fidelity of each EBP the agency is utilizing. (6) 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 8/02/2021, 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. Attachment I HCO2(f) Page 10 of 46 Guidance/Care Center,Inc. Contract No. P-03 fhrllvhu g Mind scadil Flolld'a (C'onilravfling as^.ioll lhFllauiiWmaPnelluraviou atHeuu0flh'i,"( ioaVt Inc.) 07/d11l./2dll2:II. (7) 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, (8) By 08/02/2021, 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. (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 08/02/2021,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 The relationships should be cooperative and reciprocal; that is, the partnership adds value to Attachment I HCO2(f) Page 11 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (;Conilu•aailing.umH^,wauauflhFllauiilWaPW111nvi#natlleAflln 'Inc.) 07/11,111./1d11211. 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 08/02/2021, 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. (g) Fraud, waste, abuse and other potential wrongdoing auditing, monitoring, and remediation procedures. Attachment I HCO2(fl Page 12 of 46 Guidance/Care Center,Inc. Contract No. P-03 rhr ilv hu g Mind 5;cuadl 14"Ila,urkla (;Conilu•a ailing.umH^,wauauflh Fllauill k1 a PW11rnvi#a at lleAflln 'Inc.) 07/11,111./1d112111. (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 10/01/2021,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 orjustification when not returning. (15) 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 Attachment I HCO2(fl Page 13 of 46 Guidance/Care Center,Inc. Contract No. P-03 llr ilvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwauauflh FllauiiWnu Pnelluraviou at Jfelflflh 7"e'lvi ii h Inc.) 07/fi1i1l./2fill2 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—Network Providers must comply with all of the provisions for the initiatives outlined below: (a) Recovery Oriented System of Care The Managing Entity has adopted the recovery-oriented system of care(ROSC)concept as the core philosophy for the design and delivery of substance use disorder (SUD) Attachment I HCO2(f) Page 14 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwauauflh FllauiiWnu Pnelluraviou at Jfeuu0flln 7"e'lvi llh Inc.) 07/fial./"tll12,�. prevention, treatment, and recovery services, and integration with primary care, The ROSC is being used as a roadmap on how to align SUD services and community-level partners.The Network Provider will be aware and understand ROSC and its role in basic prevention concepts as they relate to: • Strategic Prevention Framework • Proactive approach to preclude,forestall or impede the development of SUD or related problems • Addressing risk and protective factors • Underage and adult problem drinking • Prescription and over-the-counter drug abuse • Marijuana use and risk factors 1) As part of the ROSC initiative,The Network Provider must also: i. Identify one (1) ROSC Champion who will attend trainings and meetings. The name of the ROSC Champion 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. ii. Attend scheduled ROSC meetings, trainings and activities to ensure staff and agency become knowledgeable of ROSC. (b) Integration of Behavioral Health Services and Primary Health Care 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 principles within ROSC,The integration will be ensured through linkage from 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. (c) 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 Attachment I HCO2(f) Page 15 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwauauflh Fllauill kj a Pnelluraviou at ttu„uu flh 71"e'lvi ll h Inc.) 07/fial./"tll12,�. identify those affected by trauma and a system of care that meets their needs. Network Providers will be implementing the Trauma Informed Care(TIC) principles within ROSC. Progress on TIC should continue to be reported in the CQI semi-annual update, and should include, at minimum, required trauma trainings for all staff upon hire, and annually thereafter, (d) 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: 1) 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; 2) 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. (e) Integration of Behavioral Health and the Child Welfare System 1) The Network Provider will ensure that behavioral health services are available to individuals 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. Attachment I HCO2(f) Page 16 of 46 Guidance/Care Center,Inc. Contract No. P-03 llr ilvhu g Mind d cadil Flolld'a (tC'onifu•muu;flin7.umH^.iwauauflh Fllauill kj a Pnelluraviou at l4tu.,uu flh 71de4viu ll h Inc.) 07/d11l./2dll2 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. 2) 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 one (1) CWI Champion who will attend trainings and meetings. The names of the CWI Champion 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 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. (t) Mandatory Accreditation The Network Provider shall take appropriate steps to maintain its accreditation or become fully accredited by June 30, 2022, 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. Attachment I HCO2(f) Page 17 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil t'lloild'a (tC'onifu•a ailing.umH^.iwauauflh Fllauill k1 a Pnelluraviou at Jfeuu0flln 7"e'lvi ii h Inc.) 07/dual./"tll12,�. 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. The Network Provider must participate in all implementation activities and Technical Assistance provided by DCF and the ME. Time spent in training activities are considered Administrative Time and is time built into the negotiated unit rate for each of the services listed in Exhibit G, Covered Service Funding by OCA. The Network Provider cannot bill separately in PBPS for any training activities. (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) ROSC Activities: • Participation in trainings and activities relating to ROSC. • Any coordination with ROSC strategies/programming within the Scope of Work (Attachment IV). (b) Integration of Behavioral Health Services and Primary Care, including evidence of the implementation of integrated care, including warm hand-offs and the process to track and report referrals of individuals from behavioral health to primary care and from primary care to behavioral health services. (c) Trauma Informed Care. • Participation in trainings and activities relating to Trauma Informed Care. • Trauma trainings for all staff upon hire,and annually thereafter. (d) Cultural and Linguistic Competence initiative. • Participation in trainings and activities relating to CLC. • Any coordination with CLC strategies/programming within the Scope of Work (Attachment IV). (e) Participation in trainings and activities relating to the Integration of Behavioral Health and Child Welfare Systems; Attachment I HCO2(f) Page 18 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (Conilraefling as^,wauauflh FllauiilWa PW11rnvi#a at Heu flh'1i,"Im uirl" 'Inc.) 07/11,111./1d112111. (18) Prevention Services Quarterly Reports (Fidelity to Evidence-Based Practices) — Program Status Report as Required by RFA#11 L2GN1. The Network Provider shall submit quarterly reports by the dates specified in Exhibit C, Required Reports, on the implementation and progress of the following activities: (a) Evidence- based practice(s) fidelity report based on the results of the fidelity checks conducted and the identification of the strategies for program improvements. The format of the report shall be as agreed upon between the ME, the ME's Evaluation of Prevention Services Provider and the Network Provider. (19) 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. (20) 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 individuals) 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/index.shtml Note: Click on FY21-22 ME Templates and click on Reporting Template 9 — Local Match Calculation Form (21) 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 Attachment I HCO2(fl Page 19 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (;Conilu•a ailing.umH^,wollflh Fllauill kj a PW11rnvi#u at Heu flh 'tine") 07/11,111./2d11211. 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. (22) 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. (23) 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. (24) 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. (25) 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. (26) 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. (27) 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. 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. Attachment I HCO2(fl Page 20 of 46 Guidance/Care Center,Inc. Contract No. P-03 (;Conilu•a ailing.umH^,wauauflh Fllauill k1 a PW11rnvi#u at HeuuOflln 'Inc.) 07/11,111./1d112111. (28) 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. (29) 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. (30) Individual Served 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. (31) Department-Sponsored Surveys The Network Provider must participate in any Department-sponsored satisfaction surveys. (32) 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 Attachment I HCO2(fl Page 21 of 46 Guidance/Care Center,Inc. Contract No. P-03 jJ11q ma iIg %,Jtjuu]Sj,qjItjj tllau�°tiukr (Co as So of lln Fllauii lWa Belliaviou at I feaHIIlu 'S(Al�auu Vt 'tine.) 07/flal./112,:II. 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., (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 Attachment I HCO2(fl Page 22 of 46 Guidance/Care Center,Inc. Contract No. P-03 flldvh�g Mind scadl Forkla (ComilraedogumSomflh0mdd«Po11n,i#ratBemob Inc.) O7/Ul/203l the performance required under this Contract, subject to the provisions relating to Assignments and Subcontracts in the Standard Contract and referenced therein. Written requests bythe 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 fn||om/inQ definitions for vendors, subcontractors and/or independent contractors who are contracted by the Network Provider to do work contemplated under this contract: Cu\ Vendor: A person or company offering something for sale. (b) Subcontractor: A business to business relationship; contracting business orperson outside of one's own company to du work as part of larger project. A1 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 |nU|v|Uua| 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]35kA(5) prohibit States from expending Substance Abuse Prevention and Treatment Block Grant (SAPTB[) 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 fnr'prnOtnnt|t|rs' procurement contracts may bnentered 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). [PH5 Act. oo, 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 moot the requirements of 45 CFR s.164.504( )' Standard: Business Associate Contracts. the Privacy Attachment 1HCO2Vl Page 23vf46 sumanco/camconwr'Inc. Contract No. P'on llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauii llama Pnelluraviou at ttu„uu flh 71"e'lvi ll h Inc.) 07/dual./"tll12,�. 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: (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,orwhich 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 Attachment I HCO2(fl Page 24 of 46 Guidance/Care Center,Inc. Contract No. P-03 fli ua iu g N'Tuuuu]sonflil Fllou ida (Collif a mua:if,iiuuo as So uflh Fllauill kt a Beliaviou at f ft"utf llu 7�(A m�ii h 'Ine") 0 7/111 111./2tl 2111. (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 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 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. Attachment I HCO2(fl Page 25 of 46 Guidance/Care Center,Inc. Contract No. P-03 Th i iu g N'Tuuuu]sonflil Fllou ida p�;:.lulu mua:if,iiuuo as So of lln Fllauill kt a Belluuu.viou at f➢[a atfllu 7�(A m�ii h 'Inn.) 0 7/111 111./2tl 2111. 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 IV,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. (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. Attachment I HCO2(fl Page 26 of 46 Guidance/Care Center,Inc. Contract No. P-03 J'➢uumViIg r�umuu� q,qjItu tllau�°tiukr (Co as So of lln Fllauii lWa nelliaviou at I feaHIIlu 'S(Al�auu Vt 'tine.) 07/(II11./2fl2111. (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 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 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 I Director of Prevention Services and any other ME staff, attesting that the data submitted has been reviewed and approved. Refer to Attachment IV,Scope of Work for instructions. (f) In accordancewith the provisionsof 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 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, 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 IV, Scope of Work. Attachment I HCO2(fl Page 27 of 46 Guidance/Care Center,Inc. Contract No. P-03 1_L i1,W 'lumuud sonflil Flolld'a q,ConilrMaur'flingTM.umH^.iwollflh Fllauii llama Pnelluraviou at Heu flh Inc.) 07/dual./2d11211I. (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 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. 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.m\/flfamilies.com/service-programs/samh/fasams/index.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. Attachment I HCO2(fl Page 28 of 46 Guidance/Care Center,Inc. Contract No. P-03 1-111 ua iu g N'Tuuuu]sonflil Fllou ida p�;:.lulu mua:if,iiuuo as So of lln Fllauill kt a Belluuu.viou at f➢[a atfllu 7�(A m�ii h 'Inn.) 0 7/111 111./2tl 2111. (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 Attachment IV, Scope of Work (2) In the event of a dispute as to the ME's determination regarding eligibility and/or placement into the appropriate level of care of an individual,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 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 Attachment I HCO2(fl Page 29 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrllvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauill kj a Pnelluraviou at l4tu.,uu flh 71de4viu ll h Inc.) 07/d11l./2dll2 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 by the 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 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 accessibilityand 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. Attachment I HCO2(fl Page 30 of 46 Guidance/Care Center,Inc. Contract No. P-03 fli ua iu g N'Tuuuu]sonflil FIIou ida (Collifu mua:if,iiuuo as So uflh Fllauill kt a Belluuu.viou at fft" tflh 7�(A m�ii h 'Inn") 0 7/111 111./2tl 2111. (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 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. Attachment I HCO2(f) Page 31 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrllvhu g Mind scadil Flolld'a (C'onilravfling as^.ioll lhFllauiiWmaPnelluraviou atHeuu0flh'i,"( ioaVt Inc.) 07/d11l./2dll2:II. (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 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 Attachment I HCO2(fl Page 32 of 46 Guidance/Care Center,Inc. Contract No. P-03 ul'luu 1u'W 'lumuul son lu Flu,ulld'a q'C'onifu•muu;flingTM.umH^.iwollflh Flluuu Wa PneIluavi uu at Hu.°u0f lli 7leA vi uii h 'tine") 07/011/""0211l. 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 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 determinations) and to set the Attachment I HCO2(fl Page 33 of 46 Guidance/Care Center,Inc. Contract No. P-03 1_111 ! oIln„ N"Thuut sonflil 14"Ila,urkla QCollifuwmucif,iiuuo as���o uflln Fllauill kt a nnelluuu.vlou at f➢[a atflh 7111�o�m� ii h 'tine.) 07/d7ial./11�1',:II. 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 each fiscal year of this contract, unless otherwise noticed by the ME. 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. 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. Attachment I HCO2(fl Page 34 of 46 Guidance/Care Center,Inc. Contract No. P-03 Tbrh,h g blind Son li 14"IloHda (Conh-avfling.umHSauldhFlluillkjuPwIIttavi#nultluauulflln Inc.) 07/d7i:11./2tlll2,l. 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://guidancecarecenter.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. (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 Attachment I HCO2(fl Page 35 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauill kj a Pnelluraviou at ttu.,uu flh 71"e'lvi ll h Inc.) 07/dual./"tll12,�. 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 an individual, 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: Individual's Served initials, incident report tracking number from IRAS (if applicable), incident report category, date and time of incident,and follow-up action taken. b. All designated public and private Baker Act receiving facilities, all State Mental Health Treatment Facilities,and all licensed Addictions Receiving Facilities that provide for the evaluation,diagnosis, care, treatment, training, or hospitalization of persons who appear to have a mental illness or have been diagnosed as having a mental illness must report seclusion and restraint event data in accordance with the DCF Pamphlet 155-2, Version 12.03, Chapter 14, or the latest revision thereof. This chapter is posted on the DCF website at https://myflfamilles.com/service- programs/samh/samhis/pamphlet-155-2-v12.shtml 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 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 Attachment I HCO2(fl Page 36 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil t,llolld'a (tC'onifu•muu;fling.umH^.iwollflhFllauiiWnuPnelluraviouutJfeuu0flln7"e'lvi llh Inc.) 07/fial./"tll12,�. 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. 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. Attachment I HCO2(fl Page 37 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh FllauiiWnu Pnelluraviou at Jfelflflh 7"etviu ll h Inc.) 07/dual./"tll12,�. (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. 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. 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. Attachment I HCO2(fl Page 38 of 46 Guidance/Care Center,Inc. Contract No. P-03 fhrllvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauill k1 a Pnelluraviou at Jfelflflh 7de4viu ll h Inc.) 07/d11l./2dll2 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 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. Attachment I HCO2(fl Page 39 of 46 Guidance/Care Center,Inc. Contract No. P-03 llr ilvhu g Mirld scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh FllauiiWnu Pnelluraviou at l4tu„uu flh 71de4viu ll h Inc.) 07/d11l./2dll2 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 individuals. 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 individuals. 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/portal/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.ph.NAT.500.htm (2) The National Plan and Provider Enumeration System (NPPES) located at: https://ngpes.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 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 Attachment I HCO2(fl Page 40 of 46 Guidance/Care Center,Inc. Contract No. P-03 HJ 11,W7 'lumud sonflil FIolld'a q,C'unilrmuu;flin7TM.umH^.iwollflh Fllauii lWa PneIluavi uu at Hu,°u0f lli 7"eA viols h 'tine.) 07/U:IL/""0211I. 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 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 Attachment I HCO2(f) Page 41 of 46 Guidance/Care Center,Inc. Contract No. P-03 Huu 11,W 'lumud Sonflil Flolld'a q,C'unilrmuu;flingTM.umH^.iwollflh Fllauii lkta PneIluavi uu at Hu,°u0f lli 7"eA viols h 'tine.) 07/011/""0211I. 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 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 VI and certificate number; acquisition date, original acquisition cost, funding source, information needed to calculate the federal and/or state share of its cost. Attachment I HCO2(fl Page 42 of 46 Guidance/Care Center,Inc. Contract No. P-03 Huu 11,W 'lumud sonflil Flolld'a q,C'unilrmuu;flingTM.umH^.iwollflh Fllauii lkta PneIluavi uu at Hu,°u0f lli 7"eA viols h 'tine.) 07/ 11/""0211I. (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. (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. Attachment I HCO2(fl Page 43 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrllvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh FllauiiWnu Pnelluraviou at l4tu.,uu flh 71de4viu ii h Inc.) 07/d11l./2dll2 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.myfIorida.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 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 Attachment I HCO2(fl Page 44 of 46 Guidance/Care Center,Inc. Contract No. P-03 llrlvhu g Mind scadil Flolld'a (tC'onifu•a ailing.umH^.iwollflh Fllauii llama Pnelluraviou at ttu.,uu flh 71"e'lvi ll h Inc.) 07/fUal./"tll12,�. 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 itsjudgment. 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. 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. Attachment I HCO2(fl Page 45 of 46 Guidance/Care Center,Inc. Contract No. P-03 fll ilv hu g Mind 5;cuadl 14"Ila,urkla (;Conilu•aailing.umH^,wauauflhFllauiilWaPW111nvi#natHeuuOflln 'tine") 07/11,111./2d112111. 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 Attachment I HCO2(fl Page 46 of 46 Guidance/Care Center,Inc. Contract No. P-03 I III IV'I I ig '?d 11 ri d So i,ith I•• oii da (';l:ontrac,fling :, oiiiWi''i Ii:]ou ui1a li:3ei°,iavioii fli II NeMllh II Iiettwork, Ilinc.) 1/°1/202°II 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 i] 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. INDIVIDUAL SERVED/PARTICIPANT ELIGIBILITY 1. The Network Provider agrees that all individuals 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: httip://www.leg.state.fl.us/STATUTES/index.cfm?Apg_mode=Disiplay_Statute&URL=0300- 0399/0394/0394.html 2. Behavioral Health services must be provided to individuals 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 0), below. Individuals in categories (a) and (b) are specifically identified as individuals 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. P-03 i-Ilrii1iiSMiiing IIWiirid Soi.itlh If:Ioii iida (Contract ng w:,Soi,di'i Ii:llou ucla li:3e1°uavioi fli II Near ilitih Network, Iluiiic.) 1/°1/202°II 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 individuals 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 I, 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. P-03 i-Ilrii1iivuu°g Ilttluirid Soil.itllh Ii:Ioii iida (Contract ng w:,Soi,d:li'i Ii:llou ucp,a li:3e1°uavo of fli II Near ilitih (Network, Iluiiic.) 1/°1/202°II providing the services to eligible individuals until the dispute is resolved. The dispute resolution process is described in Paragraph 49, 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 individuals 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-03 (;Conflmat:„fing aaS Soi.if:lla If:Il ru ucla Ii:3ei°iiavio fll Il eallilla II IIaMtwa°urk, Uric.) 71 i/202 II EXHIBIT B METHOD OF PAYMENT 1. PAYMENT CLAUSES 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 $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. b. Case Rate:This contract purchases(N/A)services and is reimbursed by the ME using a Case Rate in accordance with subsection 65E-14.02](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 under OCA. c. Capitation Rate: This contract purchases (N/A) 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 (N/A), subject to the availability of funds.The Capitation Rate is listed in Exhibit G,Covered Services Funding by OCA under OCA. 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 $450,000.00 ($150,000.00 per fiscal year of this contract) 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 appropriate 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 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. P-03 (;Conflmat:„Hing aaS Soi.if:lla If:Il a ucla Ii:3ei°iiavio fll Il eallilla II lie wa°irk, Uric.) 71I/202 II 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$112,500.00 ($37,500.00 per fiscal year of this contract) 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 2of7 Guidance/Care Center,Inc. Contract No. P-03 I hi1iVrig 'III IdSoi,ith I,• of IdU,'.4 (;Conflmat:„fingaaSSoi.if:lla If:Il uucla Ii:3ei°iiavio fll Il eallilla INietwork, Uric.) 7/I/202II 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 3of7 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„HingaaSSoi.if:lla If:Il uucla Ii:3ei°iiavio fll Il eallilla II lie wa°irk, Uric.) 71i/20 II individual who has depleted other fund sources. b. Department funds may not reimburse services provided to: i. 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 a. 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. b. Requirements for all Medicaid-enrolled Network Service Providers, prior to invoicing the Managing Entity for any services provided to any Medicaid-enrolled recipients, the Network Exhibit B Page 4of7 Guidance/Care Center,Inc. Contract No. P-03 ..I..II,• IrvIVIng 'u"II I'•id So i,�.ith I„IIoI IdU,'.4 (u:;ontimacHng v S,Soiii.if:llI If:Il ru ucla Ii:3e1°uavioi fll Il ear ills Network, Uric.) 71 i/202 II Provider must maintain documentation for each individual served in a format that is easily accessible and retrievable for monitoring or auditing purposes by the ME or Department that it has: i. Submitted a prior authorization request for any Medicaid-covered services provided. ii. Appealed any denied prior authorizations. iii. Provided assistance to appeal a denial of eligibility or coverage. iv. Verified the provided service is not a covered service under Florida Medicaid, as defined In Chapter 59G-4, F.A.C.,or is not available through the individual's MMA Plan. V. In cases where the individuals Medicaid-covered service limit has been exhausted for mental health services, an appropriately licensed mental health professional has issued a written clinical determination that the individual continues to need the specific mental health treatment service provided. vi. In cases where the individual's Medicaid-covered service limit has been exhausted for substance use disorder treatment services a qualified professional as defined in Section 397.311, F.S., has issued a written clinical determination that the individual continues to need the specific service provided. 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 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, 2020—September 30, 2023, 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: htt.s://www.rn flfarr7ilis.corrtlservicF� ro rarrrslaccesslctocslTANF Paatt. rTf 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 Exhibit B Page 5of7 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„HingaaSSoi.iflllI If:Il uucla Ii:3ell°iiavio fll Il eallilla II Ile wa`irk, Uric.) 71V202II 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. 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-1 4.021(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 Exhibit B Page 6of7 Guidance/Care Center,Inc. Contract No. P-03 I hi1iVrig 'III IdSoi,ith I,• of IdU,'.4 (;Confl-at:„HingaaSSoi.if:lla If:Il ruucla Ii:3eri°iiavio fll Il eallilla INietwork, Uric.) 71 V20 II 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, Temporary Assistance for Needy Families (TANF) Funding Guidance, 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: hl.t h[rn 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 website is found in the link below: r].tt.ps://www.rnyfloridacl'o.com/i:}ivision/AA/Merrios/dc faul t..ht.rr7 16. 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 7of7 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-at:„Hing aaS Soiii.if:lla If:ll a ucla Ii:3di°iiaario fll II ed l lla IINetwork, Uric.) 7/1/"a021 Exhibit C Require Reports Required R��orfs Dfi Ll t� t1fCc�pies P ...,,,,,, Res once 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 2021-2022 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 21 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarario fll Il earllilla II Network, Uric.) 7/1/2021 Exhibit C Require 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://fs16.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) Exhibit C Page 2of21 Guidance/Care Center,Inc. Contract No. P-03 (';Conflmat:„Hing aaS Soiii.ifliI If:ll a ucla Ii:3di°iiaario fli II ed llla IINetwork, Uric.) 7/1/"a021 Exhibit C Require 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 Court Ordered If the court ordered service is 1 (Electronic ME Adult System of Care Involuntary not available,submit copy of Submission via E-mail) Director Commitment, court order within one(1) Placements,Services, working day of receiving from Treatment the court if the service is not available Inventory Report ME Contract Manager 8/2/2021 1 (Electronic Submission via E-mail) Exhibit C Page 3of21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiasario ill Il eallilla II Network, Uric.) 7/1/"021 Exhibit C Require Reports Attestation of 8/2/2021 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 Civil Rights 8/2/2021 1 (Electronic ME Contract Manager Compliance Checklist Submission via E-mail) (CF0946) Civil Rights 8/2/2021 1 (Electronic ME Contract Manager Certificate(CF707) Submission via E-mail) Client Trust Fund 8/2/2021 1 (Electronic ME Contract Manager Letter Submission via E-mail) Quality 8/2/2021 1 (Electronic 1. ME Contract Manager Assurance/Quality Submission via E-mail) Improvement Plan 2. ME Continuous Quality Improvement Manager Signed Florida 8/2/2021 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 Peer/ROSC 8/2/2021 1 (Electronic ME contract manager Champions, per Submission via E-mail) Exhibit AO. Peer Services Manager Attestation signed by 10/1/2021 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 Exhibit C Page 4of21 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-at:„HingaaSSoiii.il:lla If:ll uucla Ii:3di°iiaario fll II eallilla II Network, Uric.) 7/1/2021 Exhibit C Require Reports amendments made to this Contract. NVRA Voter July 6,2021 1 (Electronic 1. ME Voter Registration Registration Agencies (Period:04/01/21 -06/30/21) Submission via E-mail) Activities Coordinator Quarterly Activities October 5,2021 Report Form (DS- (Period:07/01/21 -09/30/21) 2. ME Contract Manager DE131;effective January 5,2022 01/2012 or latest (Period: 10/01/21 - 12/31/21) revision thereof, if April 5,2022 applicable (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) Quarterly Financial October 29,2021 1 (Electronic 1. ME VP of Finance Statements(Balance (Period:07/01/21 -09/30/21) Submission via E-mail) Sheet and Statement January 31,2022 2. ME Contract Manager of Activity) (Period: 10/01/21 - 12131121) April 29,2022 (Period:01/01122-03/31/22) July 29, 2022 (Period:04/01/22-06/30/22) Attestation indicating October 29,2021 1 (Electronic ME Contract Manager the filing of Form 941 (Period:07/01/21 -09/30/21) Submission via E-mail) and payment of any January 31,2022 taxes due to the IRS (Period: 10/01/21 - 12/31/21) have been paid. April 29,2022 (Period:01/01/22-03/31/22) July 29,2022 (Period:04/01/22-06/30/22) January 31,2022 1 (Electronic 1. ME Contract Manager Continuous Quality (Period:07/01/21 - 12/31/21) Submission via E-mail) Improvement July 29, 2022 2. ME Continuous Quality Updates (Period:01/01/22-06/30/22) Improvement Manager Ye 'f=Enid Flnanci l R port fo"N uffark pr i r der'`s:, f eju riri '�4iadit `f er`t#f hirfent l( 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 2.VP of Finance less than$750,000 in (federal)or 45(state) of the Federal Awards or in recipient's receipt of the audit State Awards during report,whichever occurs first, the fiscal year 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 5of21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„HingaaSSoi.i):Ila If:Il uucla Ii:3di°iiaario fll Il eallilla IINetwork, Uric.) 7/1/2021 Exhibit C Require 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 (federal)or 45(state) 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 2.VP of Finance Actual Expenses& (federal)or 45(state) of the Revenues Schedule 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 2.VP of Finance Department of days(federal)or 45(state) of Children and Families the recipient's receipt of the form,available at the audit report,whichever following website: occurs first, directly to each of the following unless https://www.myflfa otherwise required by Florida milies.com/service- Statutes The schedule shall be programs/samh/man based on revenues and aging-entities/2020- expenditures recorded during contract-docs.shtml 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 2.VP of Finance days(federal)or 45(state) of the recipient's receipt of the audit report,whichever occurs first, directly to each of the following unless otherwise required by Florida Exhibit C Page 6of21 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-art:„Hing aaS Soi.i):Ila If:Il a ucla Ii:3di°iiavio fll Il earllilla IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports 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 2.VP of Finance Statement of Activity days(federal)or 45(state) 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. Y��r�E>'�d Firf�rici�l ft�p4rts fc�r'Nettu�rk;I�r� idr a Re�uirlig'Audits I�eP"�1tfa� hrfiri I� Correspondence Due 180 days after the end of 1 (Electronic 1. ME Contract Manag er ger from the Auditor the Network Provider's fiscal Submission via E-mail) showing proof of year or within 30 days 2.VP of Finance submission of the (federal)or 45(state)of the Audit Report and recipient's receipt of the audit Management Letter report,whichever occurs first, to the Network directly to each of the Provider. following unless otherwise 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 2.VP of Finance issued by the Auditor days(federal)or 45(state)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. Exhibit C Page 7 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„Hing aaS Soi.i):Ila If:Il a ucla Ii:3di°iiavio fll Il eallilla IINetwork, Uric.) 7/1/2021 Exhibit C Require 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 2.VP of Finance schedules per (federal)or 45(state)of the Attachment II 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 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(federal)or 45(state)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 2.VP of Finance (federal)or 45(state)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, 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 2.VP of Finance Department of (federal)or 45(state)of the Children and Families recipient's receipt of the audit form,available at the report,whichever occurs first, following website: directly to each of the following unless otherwise Managing Entities- required by Florida Statutes Florida Department The schedule shall be based of Children and on revenues and expenditures Exhibit C Page 8of21 Guidance/Care Center,Inc. Contract No. P-03 (';Confl-art:„Hing aaS Soiii.if:lla If:ll a ucla Ii:3di°iiarario fll II eall l lla II Network, Uric.) 7/1/"021 Exhibit C Require Reports Families recorded during the state's m flfamilies.com 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 2.VP of Finance Actual Expenses& (federal)or 45(state)of the Revenues Schedule 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 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 2.VP of Finance (federal)or 45(state)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, r eports"R giu�r d"fc f'Childretili.f ht (H"It 'Pr uid Fs,;as Ir abf+ s Crisis Per Exhibit S- Monthly Census One 1 Encrypted 1. ME Contract Manager Children' ( ) yp g 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 Re cfrts""Re aired fc r 6 aufctra("`HeA h'NetWork°(0Net)Bra ider, Alternative Services Within 15 calendar days after One Encrypted 1. ME Contract Manager Y YP ger 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 Exhibit C Page 9of21 Guidance/Care Center,Inc. Contract No. P-03 I hiliVing Wind Soi,ith i"] i udU,'a (';Confl-arc ours)aaS oiii.r):Ila If:ll a ucla Ii:3di°iiaario rll II ed llla IINetwork, Ilu ic.) 7/1/2021 Exhibit C Require Reports Statement of September 111 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 Rdiw'r't `Regi urea fir Prfja t"faf"1sltne„in l ransrtirrrr f`rarrc Hctrif± lnt�(PATFI„Providr ,, PATH Monthlyb Monthly, y 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) PATH Annual Data No later than November 17th 1 (Electronic https://www.pathi)dx,org// Report into the PATH Submission via E-mail) Data Exchange(PDX) data system R frcfft/�,k`64 (ddf//Adiflt /h` Healtfi Fir iiid66;a ;applrc Assisted LivingProvider to Maintain the 1 Electronic Re u ( q estor Facility with a Report on file and submit Submission via E-mail) Limited Mental upon Request by ME staff Encrypted and Health License Client Password Protected Quarterly Report, per October 5,2021 Exhibit L (Period:07/01/21 -09/30/21) January 5,2022 (Period: 10101/21 - 12/31/21) April 5,2022 (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) IRcirt Required fcfr Fldrda Axerti "C�arttrtturtitt Trtfnri't`F#CT Prdde'r 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 IV.H., Reports in service Exhibit AF 2. ME Director of the Adult System of Care Exhibit C Page 10 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„Hing aS Soi.ifliI If:Il a ucla Ii:3di°iiaario fli Il ed flila IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports FACT Report Monthly by the 7th of each 1 (Electronic 1. ME Contract Manager (Template 29)per month following the month of Submission via E-mail) Section IV.H, Reports service 2. ME Director of the Adult in Exhibit AF System of Care Link to Template 29: Guidance 29 Transitional Vouchers.pdf (mvflfamilies.com) FACT Enhancement October 5,2021 1 (Electronic Reconciliation Report (Period:07/01/21 -09/30/21) Submission via E-mail) 1. ME Contract Manager per Section IV.H., January 5,2022 Reports in Exhibit AF (Period: 10/01/21 - 12/31/21) 2. ME Director of the Adult April 5,2022 System of Care (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) Outcomes Measures October 5,2021 1 (Electronic per Section W.I., in (Period:07/01/21 -09/30/21) Submission via E-mail) 1. ME Contract Manager Exhibit AF January 5,2022 (Period: 10/01/21 - 12/31/21) 2. ME Director of the Adult April 5,2022 System of Care (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) I pc;rt""kequir6d for" Jai ii Dade."F4664","Atterti, (u (MI`yFA )I ris,idea ,",,,,,,, Daily Census Report Daily, by 10 00 am 1„ ,(Eleectrctr onic 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 Rp:iirt f2aulred 1111111111111111 forrensFc rvias Prduicr "" Monthly Report"for By 1Oth of each month 1 Mental Health Admin istrator I ndividuals on Office Conditional Release, if applicable Exhibit C Pagel 1 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiaario fll Il eallilla II Network, Uric.) 7/1/2021 Exhibit C Required Reports kp, rt Ad 1red 6f Ft ren tclUlultid sciplin r 7e tri Pr6vid i 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- orograms/samh/man aging-entities/2021- 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 Court Reports preceding months'services Submission via E-mail) Forensic Team at Community , Health of South Florida, Inc. Report Requifed Pcif'Ci�Lnluoidf�brivefl­ EnrollAc rl f s ment/Member October 5,2021 1,(Electronic ME Contract Manage r ship Report (Period:07/01/21 -09/30/21) Submission via E-mail) January 5,2022 (Period: 10/01/21 - 12/31/21) April 5,2022 (Period:01/01/22-03/31/22) July 5,2022 (Period:04/01/22-06/30/22) f ports a giatr6 far ubifi c�b//Abd rvice l fi a def Report for HIV Early January 5,2022 1 (Electronic ME Contract Manager Intervention (Period:07/01/21 - 12/31/21) Submission via E-mail) Services,SAPT Block July 5,2022 Grant Set Aside (Period: 01/01/22-06-30-22) 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 Exhibit C Page 12 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarvio fll Il eallilla IINetwork, Uric.) 7/1/"021 Exhibit C Require Reports 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 I rt� equlr d fcxr tatd0,p,'I id R6 066 b[Stretl nary, rant Provlddrs Monthly SOR Data Due monthly, by the 15th of 1 (Electronic ME Contract Manager Collection Report every month following the Submission via E-mail) Exhibit BD month of service Encrypted and Password Protected R6*t!i�Re1UW4 fcsr° '11` tan e Abus P(f6v- orf' ervkk Phov dei MonthlyData Prevention service data shall Electronically PBPS,or other data y 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 In the BSRI database system ME's contracted day after the month of service or any other format evaluation entity- requested by BSRI BSRI Monthly Service Monthly,by the eighth (8th) 1 ME Sr.Accountant(Fiscal Invoice calendar day after the month Department) of service Invoice Review Submitted with the monthly 1 ME Sr.Accountant(Fiscal Supporting invoice Department) Documentation- from PBPS in ajpeg format Exhibit C Page 13 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Confl-vt:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarvio fli Il gad flila IINetwork, Uric.) 7/1/2021 Exhibit C Require 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 8/31/2021 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 f�,�pvrf�rl���irrei�f"ci"r l�'reverit)c�rr"�artri�rs�ilp; rarif�'r� rcf�r�'` Monthly E-Mail Monthly,b the calendar 1 Electronic 1. ME Director or Prevention Y t" ( 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 Prevention Services As Required by the Evaluation 1 (Electronic In the BSRI database system Quarterly Reports Entity(BSRI) Submission via E-mail) or any other format (Fidelity to Evidence- requested by BSRI Based Practices)— Exhibit C Page 14 of 21 Guidance/Care Center,Inc. Contract No. P-03 I hiliVing Wind Soi,ith i"] i IdU,'JI (;u:onfrart:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiarario fli Il gad flila IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Program Status Report as Required by RFA#11 L2GN1. 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 8/31/2021 1 (Electronic 1. ME Contract Manager Schedule Submission via E-mail) 2. ME Director of Prevention Services ko t R a uird'd f ur"E ralu ti,rftri"t)ty,ftar Preventi Monthly Service Monthly by 20t�calendar day 1 (Electronic 1. ME Contract Manag er 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 29,2021 1 (Electronic 1. ME Contract Manager, Expenditure Report (Period:07/01/21 -09/30/21) Submission via E-mail) January 31,2022 2. ME VP of Finance, and (Period: 10/01/21 - 12/31/21) April 29,2022 3. ME Director of Prevention (Period:01/01/22-03/31/22) Services July 29,2022 (Period:04/01/22-06/30/22) f part;.I e tuli e for,rrtuid6r lie eivir7 p66Mr. Quarterly Updates on October 12,2021 1 (Electronic 1. ME Contract Manager Return on (Period:07/01/21 -09/30/21) Submission via E-mail) Investment Report- January 10,2022 Per Exhibit AM (Period: 10/01/21 - 12/31/21) April 11,2022 (Period:01/01122-03/31/22) July 11, 2022 (Period:04/01/22-06/30/22) Reps rt R quf fc r the:NAAgat6 Jr6'4r4' Prc v der Quarterly Services October 29,2021 1 (Electronic ME Contract Manager Report (Period:07/01/21 -09/30/21) Submission via E-mail) January 31,2022 (Period: 10/01/21 - 12/31/21) April 29,2022 (Period:01/01/22-03/31/22) July 29,2022 (Period:04/01/22-06/30/22) Exhibit C Page 15 of 21 Guidance/Care Center,Inc. Contract No. P-03 I hiliVing Wind Soi,ith i"] i IdU,'JI (';Confl-art:„Hing aaS Soiii.if:lla If:ll a ucla Ii:3di°iiarario fll II earllilla IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Navigate Program October 29,2021 1 (Electronic ME Contract Manager Quarterly (Period:07/01/21 -09/30/21) Submission via E-mail) Expenditure Report January 31,2022 (Period: 10/01/21 - 12/31/21) April 29,2022 (Period:01/01/22-03/31/22) July 29,2022 (Period:04/01/22-06/30/22) Ra�pbrt&R6qulfcd far the„2 1-1 Hit lfne,,,,, MonthlyOutreach Due monthly, b the 30th of .......1.,( . y Electronic 1. ME Contract Manager Log every month following the Submission via E-mail) 2. Children's System of month of service Care Manager 3. VP of Contracts& Procurement Information and Due monthly, by the 30th of 1 (Electronic ME Contract Manager Referral Monthly every month following the Submission via E-mail) Report month of service Exhibit P-1, Information and Referral Monthly Report. Follow-Up Pilot As negotiated 1 (Electronic 1. ME Contract Manager Project Report Submission via E-mail) 2.Children's System of Care Manager 3.VP of Contracts& Procurement Re 6rts Required fear they.'F6f6 ik I�(artt l He fth' ertiic Pr o r rrm 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 or as requested by any Report ME Staff Weekly Statewide Weekly by 12:00 Noon every 1 (Electronic Director of Adult System of Census Report Thursday Submission via E-mail) Care or as requested by any ME Staff 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 or as requested by any ME Staff 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 or as requested by any visit ME Staff Exhibit C Page 16 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„iron aaS Soi.ii:lla If:Il a ucla Ii:3di°iiaario fll Il eallilla II Network, Uric.) 7/1/2021 Exhibit C Require Reports Staffing Report Weekly by 10:00 A.M.for the 1 (Electronic Director of Adult System of previous work week Submission via E-mail) Care or as requested by any ME Staff R port :Required fi r the,/Cttimmunity' on Tre4frrient`Tdam SAT 1 eafi�„prograrrr 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 Data Monthly shall be submitted Electronically KIS, FASAMS,or other data Required by DCF electronically to the ME no system designated by the ME FASAMS PAM 155-2 later than the 4th of each or the Department month following the month of service Appendix 1 -Persons By the 811 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 12,2021 1 (Electronic 1.Children System of Care Quarterly (Period:07/01/21 -09/30/21) Submission via E-mail) Manager Supplemental Data January 10,2022 Report (Period: 10/01/21 - 12/31/21) 2.Contract Manager April 11,2022 (Period:01/01/22-03/31/22) July 11,2022 (Period:04/01/22-06/30/22) Appendix 3-CAT Monthly,by the eighth (8th) 1 1. ME Sr.Accountant(Fiscal Team Monthly calendar day after the month Department) Invoice 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 Rip"6'r"t{Required for th%Mo ile,Rep+ rie,T6ams ....... Mobile Response Monthly b the 10 following 1 Electronic 1. ME Contract Manager Team Report the month of service Submission via E-mail) 2. ME VP of Behavioral -Encrypted, password Health Services protected 3. ME Data Analysts MRT Policies and October 1,2021 1 (Electronic 1. ME Contract Manager Procedures Submission via E-mail) 2. ME VP of Behavioral Health Services 3. ME Data Analysts Exhibit C Page 17 of 21 Guidance/Care Center,Inc. Contract No. P-03 I hiliVing Wind Soi,ith i"] i IdU,'JI (;Confl-art:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiaario fli Il ed flila IINetwork, Uric.) 7/1/2021 Exhibit C Require Reports Memorandum of October 1,2021 1 (Electronic 1. ME Contract Manager Understanding/ Submission via E-mail) 2. ME VP of Behavioral Agreement with the Health Services Local School District 3. ME Data Analysts Response protocols December 31,2021 1 (Electronic 1. ME Contract Manager with the following Submission via E-mail) 2. ME VP of Behavioral stakeholders: Health Services 3. ME Data Analysts • Local Police Departments • Department of Juvenile Justice • Southern Region Community-Based Care Lead Agency • Colleges and Universities Outreach Activities October 15,2021 1 (Electronic 1. ME Contract Manager Log (Period:07/01/21 -09/30/21) Submission via E-mail) 2. ME VP of Behavioral January 14,2022 Health Services (Period: 10/01/21 - 12/31/21) April 15,2022 (Period:01/01/22-03/31/22) July 15,2022 (Period:04/01/22-06/30/22) Re��if•tat'Required ft�r'E�mily fnta�hiu�T��,�fm �it 1`c�ft'rt(SIT)�erUlce Fr6Vlelers,,,, WeeklyChild Each Monday by close of 1 Electronic Child Integration- ( g tion 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) Access Database By the 13th day of the month 1 (Electronic 1. Contract Manager Report following the month of Submission via E-mail) 2.Child Welfare Integration services Coordinator Exhibit C Page 18 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„Hing aaS Soi.if:lla If:Il a ucla Ii:3di°iiavio ill Il eallilla IINetwork, Uric.) 7/1/2021 Exhibit C Required Reports R 'pch#s R jutra fir#Ic'6,,H1tn " d In"RtS�rer ; �d fiFet; , E12A ,,,f r6ulders WeeklyChild Each Monday by close of 1 (Electronic g- nic 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 10th 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 Recfr'tsRequire fi frhr�c( (% :If roll �secial#y;Frc 'fafri Proid "r"„" 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 18th day of the month 1 (Electronic Child Welfare Integration Welfare Monthly following the month of Submission via E-mail) Coordinator Tracker services 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 Repirqulred fdi Child 1Nelffe:lr�tertirt upi t Terri '( NIST) Monthly Family Monthly by the 5th for the 1 (Electronic MEChild 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 „ Report ,Requihed f©r'Na tale Pk Prbv an, Nf�th is„�ni1„ f,�1elr„A,ffiterl, fTlllle { C/�s„11�1Uf1dIU10$ ?,,,,,,,,,� Women's Special By the 81h 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 Exhibit C Page 19 of 21 Guidance/Care Center,Inc. Contract No. P-03 (';Confl-arc Dire as a oiii.il:lla If:ll a ucla Ii:3di°iiarario fll II ed l lla II Network, Ilu ic.) 7/1/"021 Exhibit C Required Reports u cittecl'Et1t �c a ht . 6rt, ',+wry Proms+-h nd cf ltabtit Supported October 12,2021 One(1) Password, ME Peer Services Manager Employment (Period:07/01/21 -09/30/21) protected and January 10,2022 encrypted Electronic (Period: 10/01/21 - 12/31/21) Submission April 11,2022 (Period:01/01/22-03/31/22) July 11,2022 (Period:04/01/22-06/30/22) eSort ; a6ir ed 1 br I t) rk J! 11rs st Feentncfctt uplerY>tta aaarity IOme/ i � dcunty Certificate of onlineWithin ten (10) business days 1 (Electronic SOAR Local Lead SOAR course of completion Submission via E-mail) completion Records review per October 15,2021 One(1) Password, SOAR Local Lead Exhibit AN,Section (Period:07/01/21 -09/30/21) protected and 11,c. Individual January 14,2022 encrypted Electronic Records Review and (Period: 10/01/21 - 12/31/21) Submission in Exhibit AN,Section April 15,2022 13.b.,Children's (Period:01/01/22-03/31/22) SOAR July 15,2022 (Period:04/01/22-06/30/22) t riST talxil i tion llnlfs ;I e id[Visrn,Iates C to Grill ctr r5 CSU Recidivism Rate October 15,2021 1 (Electronic VP of IT and Data Analytics Data Collection (Period:07/01/21 -09/30/21) Submission via E-mail) (Attachment I, January 14,2022 Section D.Special (Period: 10/01/21 - 12/31/21) Provisions) April 15,2022 (Period:01/01/22-03/31/22) July 15, 2022 (Period:04/01/22-06/30/22) Pear up�c��t=e'r�rre�,,,, Peer Support By the 101"day of the month One(1) Password, ME Peer Services Manager Employment Report following the month of protected and (Monthly, per Exhibit services encrypted Electronic AO) Submission Exhibit C Page 20 of 21 Guidance/Care Center,Inc. Contract No. P-03 (;Conflmat:„HingaaSSoiii.ifliI If:ll uucla Ii:3ei°iiavio fli II eMllla II Ii wa`irk, Uric.) 7/1/2021 Exhibit C Require Reports Peer Support By the 10t"day of the month One(1) Password, ME Peer Services Manager Services Report following the month of protected and (Monthly, per Exhibit services encrypted Electronic AO) Submission Per n Aftecatef �ces Outpatient Report By the 15th day of the month One(1) Password, Adult System of Care " (Monthly) following the month of protected and Department services encrypted Electronic Submission Department of October 15,2021 One(1) Password, Adult System of Care Corrections Referrals (Period:07/01/21 -09/30/21) protected and Department for Baker Act January 14,2022 encrypted Electronic Services(Quarterly) (Period: 10/01/21 - 12/31/21) Submission April 15,2022 (Period:01/01122-03/31/22) July 15,2022 (Period:04/01/22-06/30/22) CaunfraI Reeiung'racilrf y N Performance By the 301"days of the month 1 (Electronic 1. ME Contract Manager Measures following the month of Submission via E-mail) 2. ME Data Analyst services 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 21 of 21 Guidance/Care Center,Inc. Contract No. P-03 11 11-11VIng Und Sou,ulflh II Ila rldau (C"o ih--! flinq as South II I1 ida 113011h,viiou;all II Ile alltlh II\xAwoirk,I1111c.) 7/1/ 02"'1 EXHIBIT D Substance Abuse & Mental Health Required Performance Outcomes&Outputs Network Provider Name: Guidance/Care Center,Inc. Contract#: P-04 Date: 7/1/2021 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 21-22 Guidance Document 24,click on the link below: https://www.myflfamilies.com/service-programs/samh/managing-entities/index.shtml. Note: Click on FY21-22 ME Templates and click on Guidance Document 24—Performance Measurement Manual Adults Community Mental Health a.MH003-Average annual days worked for pay for adults with severe 40 38 and persistent mental illness b. MH703- Percent of adults with serious mental illness who are 24% 22.8% competitively employed c. MH742 - Percent of adults with severe and persistent mental 90% 85.5% illnesses who live in stable housing environment d. MH743 - Percent of adults in forensic involvement who live in 67% 63.7% stable housing environment e. MH744-Percent of adults in mental health crisis who live in stable 86% 81.7% housing environment Adult Substance Abuse a. SAA73 - Percentage change in clients who are employed from 10% 9.5% admission to discharge b. SA754- Percent change in the number of adults arrested 30 days 15% 14.3% prior to admission versus 30 days prior to discharge c. SA755 - Percent of adults who successfully complete substance 51% 48.5% abuse treatment services d. SA756-Percent of adults with substance abuse who live in a stable 94% 89.3% housing environment at the time of discharge Children's Mental Health a. MH012 - Percent of school days seriously emotionally disturbed 86% 81.7% (SED)children attended b. MH377- Percent of children with emotional disturbances(ED)who 60.8% improve their level of functioning 64% c.MH378 - Percent of children with serious emotional disturbances 65% 61.8% (SED)who improve their level of functioning d. MH778- Percent of children with emotional disturbance (ED)who 95% 90.3% live in a stable housing environment e. MH779 - Percent of children with serious emotional disturbance 93% 88.4% (SED)who live in a stable housing environment f.MH780 - Percent of children at risk of emotional disturbance (ED) 96% 91.2% who live in a stable housing environment Children's Substance Abuse a. SA725 - Percent of children who successfully complete substance 48% 45.6% abuse treatment services b.SA751 - Percent change in the number of children arrested 30 days 20% 19.0% Exhibit D Guidance/Care Center,Inc. Page 1 of 3 Contract No. P-03 11 rrlivui g Mlurid Sou,ulflh II Ila rldau (C"o ih--! flinq as South II I1 ida lit0lli,!vlioralll II Ile alltlh II\Mwoirk,Il11c) 7/I F 0211 prior to admission versus 30 days prior to discharge c. SA752 - Percent of children with substance abuse who live in a 93% 88.4% stable housing environment at the time of discharge Table 1—Network Minimum Year to Date Service Provider Annual Target Acceptable Performance This Performance Performance Performance Period Measures Network Provider Compliance: Network Providers shall achieve a minimum of 95% of the annual target levels in Table 1.The measures shall be demonstrated on an annual basis but will be monitored by the ME monthly. For each measure where the Year-to-Date performance falls below the Minimum Acceptable Performance, the Network Provider will submit a brief narrative, at the request of the ME, describing each of the following elements: 1. Any specific challenges,obstacles,or other operational considerations which are identified as significant factors underlying the unsatisfactory level of performance. 2. Any extenuating circumstances beyond the Network Provider's scope which are identified as significant factors underlying the unsatisfactory level of performance. 3. Efforts the Network Provider has undertaken to support improved performance during this reporting period. 4. Efforts the Network Provider will undertake in the future to support improved performance during subsequent reporting periods. 5. Any region-wide guidance,capacity,training,or other logistical supports needed to support improved performance during subsequent reporting periods. Exhibit D Guidance/Care Center,Inc. Page 2 of 3 Contract No. P-03 11 rrlitring lu11111d Sou.ulilh II Ilauw lda (I°ouiuuracriiinq as South II Ilorida litk)lli,!rrlloirall II Ile')h11h II x^/w,:irk,II°1u') 7/1/202 Table 2 Network Service Provider Output Measures—Persons Served For Fiscal Years FY21-22, FY22-23, FY23-24 Service Category FY Target Residential Care N/A Outpatient Care N/A Crisis Care N/A x State Hospital Discharges N/A Peer Support Services N/A Residential Care N/A c Outpatient Care N/A U Crisis Care N/A Residential Care N/A a Outpatient Care N/A a� U Detoxification N/A Women's Specific Services N/A V) +- Injecting Drug Users N/A a Peer Support Services Residential Care N/A cc c Outpatient Care N/A N N C) Detoxification N/A N � � Q Prevention **Refer to Attachment IV,Scope of Work for the numbers served.** 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 3 of 3 Contract No. P-03 iii11 Ong IMv I'Id `;fw li c:i'ldt "1.0111 FJd,'i II Ui dt,>St11.11 1101 I,i.l � '1x.vloI' l I u'7l 111 Nr.;9;:1+oI,<' 11I I;.) 7,/11 011:" 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: F2-1 Federal Authority F2-1.1 Block Grants Regarding Mental Health and Substance Abuse F2-1.1.1 Block Grants for Community Mental Health Services 42 U,S,C. ss. 300x, et seq. F2-1.1.2 Block Grants for Prevention and Treatment of Substance Abuse 42 U.S.C. ss. 300x-21 et seq. 45 CFR Part 96, Subpart L F2-1.2 Department of Health And Human Services,General Administration, Block Grants 45 CFR Part, 96 F2-1.3 Charitable Choice Regulations Applicable to Substance Abuse Block Grant and PATH Grant 42 CFR Part 54 F2-1.4 Confidentiality Of Substance Use Disorder Patient Records 42 CFR Part 2 F2-1.5 Security and Privacy 45 CFR Part 164 F2-1.6 Supplemental Security Income for the Aged, Blind and Disabled 20 CFR Part 416 F2-1.7 Temporary Assistance to Needy Families(TANF) 42 U.S.C. ss. 601 - 619 45 CFR, Part 260 F2-1.8 Projects for Assistance in Transition from Homelessness(PATH) 42 U.S.C, ss, 290cc-21 —290cc-35 F2-1.9 Equal Opportunity for Individuals with Disabilities(Americans with Disabilities Act of 1990) 42 U.S.C. ss. 12101 - 12213 F2-1.10 Prevention of Trafficking(Trafficking Victims Protection Act of 2000) 22 U.S.C. s. 7104 2 CFR Part 175 F2-1.11 Governmentwide Requirements for Drug-Free Workplace(Financial Assistance) 2 CFR Part 182 2 CFR Part 382 Exhibit F Page 1 of 4 Guidance/Care Center,Inc. Contract No. P-03 (;Conti actu ig as,Sccrutll°l li oii id li[:!eil,iiavtoi all II Nea flh II II^:^t: oii llk, Uric:.) 711120 t II 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. P-03 (;Conti rcc°:tou ig w;Sccrutll°l li oii id li[:!eil,iiavtoi vll II Nev flh II II^:^t: oii llk, Uric:,)' 71112 2 II 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 F241 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. P-03 (';Conti rcc°:tou ig w;Sccrutll°l li oii id li[:!eiI,iiavtoi all II Nd.Mlllh II II^:^t: oii llk, Uric:,) 71 i/."1 1.II CFOP 155-47 Processing Referrals From The Department Of Corrections CFOP 215-6 Incident Reporting and Analysis System (IRAS) F242 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. 65I-42, F.A,C. Travel Expenses Ch. 69I-5, F.A.0 State Financial Assistance CFO's Memorandum No. 01 Contract and Grant Reviews and Related Payment Processing Requirements CFO's Memorandum No. 02 Reference Guide for State Expenditures Comptroller's Memorandum No. 04 Guidance on all Contractual Service Agreements Pursuant to Section 215.971, Florida Statutes CFO's Memorandum No. 20 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 F243 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. P-03 N O N M a � o Z O U G � x C O z U x i r x , x m z Ci O 4 , z 0 z vi p ^. 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A^GA A^a Y o F F-�v v �rn� o � > . ±w W� w w ;Z V V v v 0 Ra ¢o��o �S�F`zz��ooa�zw�w��,�,�F_=aQ..=m�r�U600�zawaw¢¢� � ¢mwxm"w� - .� , -r .i ,f I;,vr .. 7 �, July 1 2021-June 30,2022 EXHIBIT H-FUNDING DETAIL July 2021 Provider.Guid.—ICare Center,Inc.PPG Contract4:P-03 Amendment ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT ...., ... .., ....... Re'I taL Services MH001 � Residential Szrvices MH001 � - Non Residential Services MH009 $ - Non-Re lerand Services MH009 $ - Crisis and Baker Act Services MH018 Crrsrs and Baker Act Ser-ces MH018 � - Commuity,Forensic Program MH072 $ - Special Appropriation-ICFH MHOBN $FACT Team MH073 Purchased Residential Treatment(PRTS) MH071 $ - In<hgeat Drug Program MH076 $ - Community Action Treatment(CAT)Team MHCAT $ - ProvisoAllocation-Citrus MHO94 $ _ _ Mobile Crisis Team MHMCT _$ _ PATH Grant MHOPG $ CSOC Grant Year 2 CSOC2 $ TAN Services MHOTB S Specialty Programs SPLTY $ Lady Intervention-Psychotic Disorders MHO26 $ Telehealth Behavioral Health Services MHTLH Forensic Hospital Multidisciplinary Teanr MHOFH $ - MH Serbicee MHBG SUPI MHCOM $ - ForProftSuh-Recipein[-Key WestLIMA MHSFP $ Early Intervention Services MHBG SUP MH26S $ Supported Employment Services MHEMP $ Care Coordhnation MHBG SUPI MHCM2 $ Miami-Dade County Homeless Trust MH010 $ Core Crisis Set Aside MHBG SUPL MHCCS MH Services MHBG SUPI MHCOM $ - Suicide Prevention MHBG SUP MHSPV $ - MDC-Cennzl Receiving Facility MDCRF $ _ Cues Act-Care Coordination MHCAS _$ _ Care Coordination MHOCN $ _ _ Care Coordination MHOCN $ Carve Forward MHOFF $ - Carry Forward MHOFF $ - Early Inten—tion Services MHBG SUPI MH261; $ Cares Act-(CAT)Team MHCA2 $ Coe Coordination MHBG SUPI MHCM2 $ Specialty Pmgarns SPLTY $ ,,,,,,, Core Crisis Set Aside MHBG SUPI MHCCS $ Emergency COVID 19(imit Supplemental MHCOS $ Forensic Transitional Beds MHFMH $ Teleheakh Behavioral Health SeoTices MHTLH $ Suicide Prevemum MHBG SUP I MHSPV Expaudiu,211 Call MH211 $ Residential cr Filiry Cnnrd MHBG SUPI MHRES Emergency COVID-Supptcnncatat MHSC5 $ Short Term Residential Treatment(SRT) MHCR2 $ Cares Act-FACT Team MHCAF $ Cares Act-Care Coordmanon MHCAS Cares Act-ISR Expansion MHCA8 $ Emergency COVID-19(nant MHCO\ $ TOTAL ADL:LT MENTAL HEALTH= $ TOTAL CHILDREN MENTAL HEALTH= $ ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Service s MS003 $ _ _ Rsidential Services MS003 _$ _ Non Residzntnal Szrvices M5011 $ Nun Residential Services MS011 $ Detoa Services MS021 $ Det-Services MS021 $ HIV Services MS023 � HIV Services MS023 $ - Prevemion Services MS025 $ - Prevention Services MS025 $ - Warner's Services MS027 $ Prevention Partnership Gant MSOPP $ ISO O00 Pregnant Women Project MS081 $ - TANF Services MSOTB $ FIT Team MS091 $ Proviso Allocation-Here's Help MS903 PANE Services MSOTB $ - Here's Help Opicid Training MS921 $ - Proviso Allocation-New Hope CORPS MS908 $ _ _ In tional Family Therapy-EBA M11911 _$ _ Cuz Coordination Judgement t MS923 $ _ _ SOR Prevention Year2 MSSP2 _$ _ Opioid Response Disc Ree Comm Or.—Yew 3 MSRC3 $ SOR Prevention Year MSSP3 $ Here's Help Opioid Training MS921 $ SA Primary Prevention SAPT SUPI MS25S $ commuuity Based Services MSCBS $ Specialty Programs SPLTY $ SA Rimary Prevention SAPT SUP I MS25S $ NES.SEN Care Coord SAPTSUPI MSCS2 $ MDC-Central Receiving Facility MDCRF $ Suicide Prevention SAPT SUPI MSSPV $ Care Coordination MSOCN $ - Care Coordination MSOCN $ - Carry Forward MSOCF $ Carry Forward MSOCF $ SOR-MAT Year 2 AtSSM2 - SA Services SAPT SUPI MSCOM $ - Optoid Response Disc,Gruen GPRA Year 3 MSSG3 $ Prevention Partnership Prog S 4PT SUPI MSPPS $ SOR-VIAT Year MSSM3 $ -......... NE5/5EN Care Cnnrd SAPT SUPI MSCS2 $ Speciatty Programs SPLTY $ Oprnid Response Di-Rec Comm Ora-Year 2 MSRC2 $ Suicide P—ention SAPT SUP I MSSPV $ Opioid Respnnse Disc Gant GPRAYe,r4 MSSG4 SA Services SAPT SUPI MSCOM $ Cares Act-C re Coordination MICAS $ TOTAL ADULT SUBSTANCE ABUSE $ - TOTAL CHILDREN SUBSTANCE ABUSE= $ 150,000 FUNDS NOT REQUIRING MATCH: Drug Abuse xusea $ 37,500 TOTAL ALL PROGRAMS= $ 150,000 Prevention $ UNCOMPENSATED UNITS= $ - Demstitr n alizanon Project $ TOTAL= S 150,000 CMH Pragrazn $ SOR Grant $ TOTAL FUNDS REQUIRING MATCH= $ 112.500 TOTAL FUNDS NOT REQUIRING MATCH $ 37,500 LOCAL MATCH REQUIRED= S 37.500 NOTES $150,000 is added to CSA-MSPPP per year as per RFA 11 L2GN1 award for the period FY 2021=_'4. Guidance/Care Center,Inc. Contract No. P-03 Exhu tH Page 1 of 1 July 1 2022-June 30,2023 EXHIBIT H-FUNDING DETAIL July 2021 Provider.Guid.—ICare Center,Inc.PPG Contract4:P-03 Amendment ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT ...., ... .., ....... Re'I taL Services MH001 � Residential Szrvices MH001 � - Non Residential Services MH009 $ - Non-Re lerand Services MH009 $ - Crisis and Baker Act Services MH018 Crrsrs and Baker Act Ser-ces MH018 � - Commwity,Forensic Program MH072 $ - Special Appropriation-ICFH MHOBN $FACT Team MH073 Purchased Residential Treatment(PRTS) MH071 $ - In<hgeat Drug Program MH076 $ - Community Action Treatment(CAT)Team MHCAT $ - ProvisoAllocation-Citrus MHO94 $ _ _ Mobile Crisis Team MHMCT _$ _ PATH Grant MHOPG $ CSOC Grant Year 2 CSOC2 $ TAN Services MHOTB S Specialty Programs SPLTY $ Lady Intervention-Psychotic Disorders MHO26 $ Telehealth Behavioral Health Services MHTLH Forensic Hospital Multidisciplinary Teanr MHOFH $ - MH Serbicee MHBG SUPI MHCOM $ - ForProftSuh-Recipein[-Key WestLIMA MHSFP $ Early Intervention Services MHBG SUP MH26S $ Supported Employment Services MHEMP $ Care Coordhnation MHBG SUPI MHCM2 $ Miami-Dade County Homeless Trust MH010 $ Core Crisis Set Aside MHBG SUPL MHCCS MH Services MHBG SUPI MHCOM $ - Suicide Prevention MHBG SUP MHSPV $ - MDC-Cennzl Receiving Facility MDCRF $ _ Cues Act-Care Coordination MHCAS _$ _ Care Coordination MHOCN $ _ _ Care Coordination MHOCN $ Carve Forward MHOFF $ - Carry Forward MHOFF $ - Early Inten—tion Services MHBG SUPI MH261; $ Cares Act-(CAT)Team MHCA2 $ Coe Coordination MHBG SUPI MHCM2 $ Specialty Pmgarns SPLTY $ ,,,,,,, Core Crisis Set Aside MHBG SUPI MHCCS $ Emergency COVID 19(imit Supplemental MHCOS $ Forensic Transitional Beds MHFMH $ Teleheakh Behavioral Health SeoTices MHTLH $ Suicide Prevemum MHBG SUP I MHSPV Expaudlug 211 Call MH211 $ Residential cr Filiry Cnnrd MHBG SUPI MHRES Emergency COVID-Supptcnncatat MHSC5 $ Short Term Residential Treatment(SRT) MHCR2 $ Cares Act-FACT Team MHCAF $ Cares Act-Care Coordmanon MHCAS Cares Act-ISR Expansion MHCA8 $ Emergency COVID-19(nant MHCO\ $ TOTAL ADL:LT MENTAL HEALTH= $ TOTAL CHILDREN MENTAL HEALTH= $ ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Service s MS003 $ _ _ Rsidential Services MS003 _$ _ Non Residzntnal Szrvices M5011 $ Nun Residential Services MS011 $ Detoa Services MS021 $ Det-Services MS021 $ HIV Services MS023 � HIV Services MS023 $ - Prevemion Services MS025 $ - Prevention Services MS025 $ - Warner's Services MS027 $ Prevention Partnership Gant MSOPP $ ISO O00 Pregnant Women Project MS081 $ - TANF Services MSOTB $ FIT Team MS091 $ Proviso Allocation-Here's Help MS903 PANE Services MSOTB $ - Here's Help Opicid Training MS921 $ - Proviso Allocation-New Hope CORPS MS908 $ _ _ In tional Family Therapy-EBA M11911 _$ _ Cuz Coordination Judgement t MS923 $ _ _ SOR Prevention Year2 MSSP2 _$ _ Opioid Response Disc Ree Comm Or.—Yew 3 MSRC3 $ SOR Prevention Year MSSP3 $ Here's Help Opioid Training MS921 $ SA Primary Prevention SAPT SUPI MS25S $ commuuity Based Services MSCBS $ Specialty Programs SPLTY $ SA Rimary Prevention SAPT SUP I MS25S $ NES.SEN Care Coord SAPTSUPI MSCS2 $ MDC-Central Receiving Facility MDCRF $ Suicide Prevention SAPT SUPI MSSPV $ Care Coordination MSOCN $ - Care Coordination MSOCN $ - Carry Forward MSOCF $ Carry Forward MSOCF $ SOR-MAT Year 2 AtSSM2 - SA Services SAPT SUPI MSCOM $ - Optoid Response Disc,Grunt-GPRA Year 3 MSSG3 $ Prevention Partnership Prog S 4PT SUPI MSPPS $ SOR-VIAT Year MSSM3 $ -......... NE5/5EN Care Cnnrd SAPT SUPI MSCS2 $ Speciatty Programs SPLTY $ Oprnid Response Di-Rec Comm Ora-Year 2 MSRC2 $ Suicide P—ention SAPT SUP I MSSPV $ Opioid Respnnse Disc Gant GPRAYe,r4 MSSG4 SA Services SAPT SUPI MSCOM $ Cares Act-C re Coordination MICAS $ TOTAL ADULT SUBSTANCE ABUSE $ - TOTAL CHILDREN SUBSTANCE ABUSE= $ 150,000 FUNDS NOT REQUIRING MATCH: Drug Abuse xusea $ 37,500 TOTAL ALL PROGRAMS= $ 150,000 Prevention $ UNCOMPENSATED UNITS= $ - Demstitr n alizanon Project $ TOTAL= S 150,000 CMH Pragrazn $ SOR Grant $ TOTAL FUNDS REQUIRING MATCH= $ 112.500 TOTAL FUNDS NOT REQUIRING MATCH $ 37,500 LOCALMATCHREQUIRED= S 37.500 NOTES $150,000 is added to CSA-MSPPP per year as per RFA 11 L2GN1 award for the period FY 2021=_'4. Guidance/Care Center,Inc. Contract No. P-03 Exhu tH Page 1 of 1 July 1,2023-June 30,2024 EXHIBIT H-FUNDING DETAIL July 2021 Provider.Guid.—ICare Center,Ice.PPG Contract4:P-03 Amendment ADULT MENTAL HEALTH CHILDREN MENTAL HEALTH OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT ...., ... .., ....... Re'I taL Services MH001 � Residential Services MH001 � - Non Residential Services MH009 $ - Non-Re lerand Services MH009 $ - Crisis and Baker Act Services MH018 Crisis and Baker Act Ser-ces MH018 � - Commw ity Forensic Program MH072 $ - Special Appropriation-ICFH MHOBN $FACT Team MH073 Purchased Residential Treatment(PRTS) MH071 $ - In<hgeat Drug Program MH076 $ - Commwity Action Treatnrenrt(CAT)Team MHCAT $ - ProvisoAllocation-Citrus MHO94 $ _ _ Mobile Crisis Team MHMCT _$ _ PATH Grant MHOPG $ CSOC Grant Year 2 CSOC2 $ TAN Services MHOTB S Specialty Programs SPLTY $ Lady Intervention-Psychotic Disorders MHO26 $ Telehealth Behavioral Health Services MHTLH Forensic Hospital Multidisciplinary Teanr MHOFH $ - MH Serbicee MHBG SUPI MHCOM $ - ForProftSuh-Recipeiw-Key WestLIMA MHSFP $ Early Intervention Services MHBG SUP MH26S $ Supported Employment Services MHEMP $ Care Coordhnation MHBG SUPI MHCM2 $ Miami-Dade County Homeless Tmst MH010 $ Core Crisis Set Aside MHBG SUPL MHCCS MH Services MHBG SUPI MHCOM $ - Suicide Prevention MHBG SUP MHSPV $ - MDC-Cennzl Receiving Facility MDCRF $ _ Cues Act-Care Coordination MHCAS _$ _ Care Coordination MHOCN $ _ _ Care Coordination MHOCN $ Carve Forward MHOFF $ - Carry Forward MHOFF $ - Early Inten—tion Services MHBG SUPI MH261; $ Cares Act-(CAT)Team MHCA2 $ Coe Coordination MHBG SUPI MHCM2 $ Specialty Progarns SPLTY $ ,,,,,,, Core Crisis Set Aside MHBG SUPI MHCCS $ Emergency COVID 19(imit Supplemental MHCOS $ Forensic Transitional Beds MHFMH $ Teleheakh Behavioral Health SeoTices MHTLH $ Suicide Prevention MHBG SUP I MHSPV Expaudiu,211 Call MH211 $ Residential cr Fili y Cnnrd MHBG SUP I MHRES Emergency COVID-Supplcmcntat MHSC5 $ Short Term Residential Treatment(SRT) MHCR2 $ Cares Act-FACT Team MHCAF $ Cares Act-Care Coordmatron MHCAS Cares Act-ISR Expansion MHCA8 $ Emergency COVID-19(nant MHCO\ $ TOTAL ADL:LT MENTAL HEALTH= $ TOTAL CHILDREN MENTAL HEALTH= $ ADULT SUBSTANCE ABUSE CHILDREN SUBSTANCE ABUSE OCA DESCRIPTION NEW OCA AMOUNT OCA DESCRIPTION NEW OCA AMOUNT Residential Service s MS003 $ _ _ Rsidential Services MS003 _$ _ Non Residzntnal Szrvices M5011 $ Nun Residential Services MS011 $ Detoa Services MS021 $ Det-Services MS021 $ HIV Services MS023 � HIV Services MS023 $ - Prevemion Services MS025 $ - Prevention Services MS025 $ - WomensServices MS027 $ Prevention Partnership Gant MSOPP $ ISO O00 Pregnant Women Project MS081 $ - TANF Services MSOTB $ FIT Team MS091 $ Proviso Allocation-Here's Help MS903 PANE Services MSOTB $ - Here's Help Opicid Training MS921 $ - Proviso Allocation-New Hope CORPS MS908 $ _ _ Functional Family Therapy-EBA M11911 _$ _ Cuz Coordination Judgement t MS923 $ _ _ SOR Prevention Year2 MSSP2 _$ _ Opioid Response Disc Ree Comm Or.—Yew 3 MSRC3 $ SOR Prevention Year MSSP3 $ Here's Help Opiord Training MS921 $ SA Primary Prevention SAPT SUPI MS25S $ commuuity Based Services MSCBS $ Specialty Programs SPLTY $ SA Pimary Prevention SAPT SUP I MS25S $ NES.SEN Care Coord SAPTSUPI MSCS2 $ MDC-Central Receiving Facility MDCRF $ Suicide Prevention SAPT SUPI MSSPV $ Care Coordination MSOCN $ - Care Coordination MSOCN $ - Carry Forward MSOCF $ Carry Forward MSOCF $ SOR-MAT Year 2 AtSSM2 - SA Services SAPT SUPI MSCOM $ - Optoid Response Disc,Gruen GPRA Year 3 MSSG3 $ Prevention Partnership Prog SAPT SUPI MSPPS $ SOR-VIAT Year MSSM3 $ -......... NE5/5EN Care Cnnrd SAPT SUPI MSCS2 $ Speciatty Programs SPLTY $ Opund Response Di-Rec Comm Ora-Year 2 MSRC2 $ Suicide P—ention SAPT SUP I MSSPV $ Opioid Response Disc Gant GPRAYe,r4 MSSG4 SA Services SAPT SUPI MSCOM $ Cares Act-C re Coordination MICAS $ TOTAL ADULT SUBSTANCE ABUSE $ - TOTAL CHILDREN SUBSTANCE ABUSE= $ 150,000 FUNDS NOT REQUIRING MATCH: Drug Abuse xusea $ 37,500 TOTAL ALL PROGRAMS= $ 150,000 Prevention $ UNCOMPENSATED UNITS= $ - Demstitr n alizanon Project $ TOTAL= S 150,000 CMH Pragrazn $ SOR Grant $ TOTAL FUNDS REQUIRING MATCH= $ 112.500 TOTAL FUNDS NOT REQUIRING MATCH $ 37,500 LOCALMATCHREQUIRED= S 37.500 NOTES $150,000 is added to CSA-MSPPP per year as per RFA 11 L2GN1 award for the period FY 2021=_'4. Guidance/Care Center,Inc. Contract No. P-03 Exhu tH Page 1 of 1 N G N T 7 ti co O a 0 z O G U M M U i.y „m Jj A C O rr•� oG W x H F z x v z F Q a z a U � o F z to a rn z z � C4 L: A zn f Efi EF,EF, N?.0 V;fA Yi C013 EF,S4 64 b4 y5 E,A&9 6S 69 Ef3 6S V3 69 V3 Vj Ji Vj fA Yi 4fa 69 6O b9 65 F n W A 69 EF 69 V3 69 N3 U ✓ v 7t w w V v V I--I ti 'd O' W °' J > > p ❑ > > > C7 u •V v d-o U v 'J" w U c o E o = ❑ v o .� n —° a s a .� .� a a, a', � o a-o o -o -o-p y � :b �- ✓. :� G �. ° � O e o d W a o 0 0 U v c = O o o •� o > P i .o C Cq a o c o o c c � C . m 2S o t y e e a a Z aO c F H > aj '" r` !� -� �:. 'O Q' °o 0 0 7 QUUU - � � UOUP: � CC P: coI I � F 41<1< 41 1 r4. N. V� U UCJxCG P• P. 4 P-�� Q � � � O� U M � G1 O rl 7 Vl h a' M O 7 �C. l� 09 O� O 7 in V r W O .. N M 7 Vl b n N .-i N N N N N N N N M M M M M M 't 7 7 7 7 7 7 In Vl V: Vl Vi V N Ll N U N cu Cl N N �.7 co O N C 7 N O N T 7 N G N T 7 ti co O a 0 z O G U M M U i.y „m Jj A C O rr•� oG W x H F z x v z F Q a z a U � o F z to a rn z z � C4 L: A zn f Efi EF,EF, N?.0 V;fA Yi C013 EF,S4 64 b4 y5 E,A&9 6S 69 Ef3 6S V3 69 V3 Vj Ji Vj fA Yi 4fa 69 6O b9 65 F n W A 69 EF 69 V3 69 N3 U ✓ v 7t w w V v V I--I ti 'd O' W °' J > > p ❑ > > > C7 u •V v d-o U v 'J" w U c o E o = ❑ v o .� n —° a s a .� .� a a, a', � o a-o o -o -o-p y � :b �- ✓. :� G �. ° � O e o d W a o 0 0 U v c = O o o •� o > P i .o C Cq a o c o o c c � C . m 2S o t y e e a a Z aO c F H > aj '" r` !� -� �:. 'O Q' °o 0 0 7 QUUU - � � UOUP: � CC P: coI I � F 41<1< 41 1 r4. N. V� U UCJxCG P• P. 4 P-�� Q � � � O� U M Qj O� O 7 in .-i N N N N N N N N M M M M In M 't 7 7 7 7 7 7 In VJ Vl V: Vl Vi N G1 U 0 M U N cu ClN N .7 co O N C 7 N N O N T 7 N G N T 7 ti co O a 0 z O G U M M U i.y „m Jj A C O rr•� oG W x H F z x v z F Q a z a U � o F z to a rn z z � C4 L: A zn f Efi EF,EF, N?.0 V;fA Yi C013 EF,S4 64 b4 y5 E,A&9 6S 69 Ef3 6S V3 69 V3 Vj Ji Vj fA Yi 4fa 69 6O b9 65 F n W A 69 EF 69 V3 69 N3 U ✓ v 7t w w V v V I--I ti 'd O' W °' J > > p ❑ > > > C7 u •V v d-o U v 'J" w U c o E o = ❑ v o .� n —° a s a .� .� a a, a', � o a-o o -o -o-p y � :b �- ✓. :� G �. ° � O e o d W a o 0 0 U v c = O o o •� o > P i .o C Cq a o c o o c c � C . m 2S o t y e e a a Z aO c F H > aj c} " 'O °o 0 00 , 7 U I v QUUU - � � UOUP: � CC P: coI I rN.� F 41<1< 41 C4 r4 V� U U CJxCG P• P. 4 r` !� -� M O N M 7 N .-� N � Ll N cu O N N �.7 co O N C 7 M N O N T 7 Hirn inl Mind "rol9llli i"IoI I,I n g,1sS i ! II 11�zn rhl C,tIIViOT,`l :IIVCKI W l'11;,IrIc 7"I/i02,'I. ATTACHMENT II Financial and Audit Compliance The administration of resources awarded by the Department of Children & Families, through the Managing Entity,to the Network 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. 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 CIF 1120,Effective March 10,2021,(CF-1120-2021) Attachment II Page 1 of 3 Guidance/Care Center,Inc. Contract No. P-03 i on ravI�n ra^, Sot h Il 11� id Il�ctI vNor� LI:IItc,IIll wor1,;,I r 1 7 /202.'I. 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) B. Department of Children & Families (1 electronic copy and management letter, if issued) Office of the Inspector General CIF 1120,Effective March 10,2021,(CF-1120-2021) Attachment II Page 2 of 3 Guidance/Care Center,Inc. Contract No. P-03 Hirn inl Mind "rol9llli i"IoI I,I n g,1sS i ! II 11�zn rhl C,tIIViOT,`l :IIVCKI W l'11;,IrIc 7"I/i02,'I. Single Audit Unit The Centre, Suite 400-1 2415 Monroe Street Tallahassee, Florida 32303 Email address: HQW.IG.Single.AuditC 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: https://harvester.census.gov/facweb/ and other Federal agencies and pass-through entities in accordance with 2 CFR §200.512. D. Copies of reporting packages required by Part 11 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 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, CIF 1120,Effective March 10,2021,(CF-1120-2021) Attachment II Page 3 of 3 Guidance/Care Center,Inc. Contract No. P-03 I h.'t8 I','111d`� 1111d� .,oC,;dp��h1 I Il'oC Id i 1 ;t'wd.rt9r .d 111 u� s. Sou�.h FIorir9a Be hh:O+.dr.Il l cakItl lulvoO, Ill`ii':'1 0;7`0 ;.t;�,° I 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 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 a L�-_ nnnu rt sch failure.rruitL1110. 0w0 f u Frank C. Rabbito, COO Signature'' a Date FOR Maureen Dunleavy, Vice President P-04 Name of Authorized Individual Application or Contract Number Guidance/Care Center, Inc. Name of Organization 1205 4th Street, Key West, FL 33040 Address of Organization CF 1123, PDF 03/96 Attachment III Page 1 of 1 THRIVING MIND SOUTH FLORIDA' Prevention Partnership Grant SCOPE OF WORK Attachment IV NAME OF PROVIDER: Guidance/Care Center Inc. NAME OF PREVENTION PROGRAM: Project SUCCESS AMOUNT OF CONTRACT AWARD: $450,000.00 ($150,000.00 per fiscal year of this contract) "Regular" Prevention TYPE OF FUNDING: Prevention Block Partnership SOR Grant Services Grant PPG X COST ALLOCATED TO: (check both Children's Substance Abuse Adult Substance Abuse if approved for both covered services) 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 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. CCAP Goals: Goal 1: Reduce DUI crashes countywide amongst 18-20 year old youth 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. Contract No. P-03 IOM Specific Category primary Number of Activity/Program - (Universal Prevention Unduplicate include whether Indirect, programs, d Brief Description practices in the strategy is an Universal Participants EBP Direct, each of the six prevention (if duplicated Selective, note) Indicated) strategies CSAP School wide 9 months out of the school Universal Information and 2,600 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 450 Prevention consists of 4 topics taught in Education Series 4 to 8 sessions to all 9th graders enrolled in the district Screening A prevention strategy in Selective Problem 825 which all students who are Identification enrolled in the school are and Referral screened for prevention and other needs Student Assistance A prevention strategy in Selective Problem 750 which students who are Identification identified as needing other and Referral services are provided that service by Project SUCCESS staff or referred elsewhere for the needed service. Individual A prevention strategy in Indicated Education 30 Prevention which a student can receive 3 sessions to 5 sessions of individual support Champions for Champions of Change Selective Education 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 500 includes presentations on Direct Attachment IV PPG Scope of Work Page 2 of 10 Guidance/Care Center,Inc. Contract No. P-03 ATOD prevention and other relevant topics in both school and non- traditional settings Social Media Consists of online posts by Universal Information and 350 Campaign the KWHS Prevention Indirect Dissemination Specialist on Instagram and school newsletter 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 the 91n grade PES, Student Assistance, 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 and approved. 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 ATOD Perceptions of 1 & 2 harm Prosocial opportunities/activities Positive peer influence, Healthy behaviors Increased knowledge/awareness Attachment IV PPG Scope of Work Page 3 of 10 Guidance/Care Center,Inc. Contract No. P-03 9" Grade Prevention Education Favorable attitudes towards ATOD Perceptions of 1 & 2 Series 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 ATOD Perceptions of 1 & 2 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 Favorable attitudes towards ATOD Perceptions of 1 & 2 harm Self-regulation Prosocial opportunities/activities Positive peer influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Favorable attitudes towards ATOD Perceptions of harm Self-regulation Champions for Change Prosocial opportunities/activities Positive peer 1 & 2 influence Skill/competency Healthy behaviors Increased knowledge/awareness Self-Esteem Positive family communications Community values Capacity Building Favorable attitudes towards ATOD Perceptions of 1 & 2 harm Increased knowledge/awareness Community values Skill/competency Social Media Campaign Favorable attitudes towards ATOD 1 & 2 Perceptions of harm Program/Strategy and Related Risk/Protective Factors Targeted Prevention Target Population System of Care/CCAP Other Goal Addressed Community Activities, Events, Community Norms, Pro-social Activities, MCC-1 Drives, and Workshops & Opportunities for Pro-social Involvement Community Capacity Building Attachment IV PPG Scope of Work Page 4 of 10 Guidance/Care Center,Inc. Contract No. P-03 Section III. SITE LOCATIONS AND INFORMATION* Site Name Target Participants Zip Check all that apply) Note whether school or Street Address City Code Child/ communit Youth Parents Others Key West High School 2100 Flagler Key West 33040 X Avenue Coral Shores High 89901 Old Tavernier 33070 X School Highway Marathon Middle and 350 Sombrero Marathon 33050 X High School Beach Road 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 servicesprovided: Parents, school personnel, self-referrals, 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. GCC will use results from previous years' FYSAS as the baseline and utilize more results during the course of this project to define meaningful improvement, and gauge GCC participant outcomes as they relate to the overall goals of the CCAP. Attachment IV PPG Scope of Work Page 5 of 10 Guidance/Care Center,Inc. Contract No. P-03 • Adhere to the Fidelity requirements of each program. Any problem areas in the classrooms or during other prevention activities, 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 the Prevention Coordinator and/or 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 Include all Thriving Mind 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. Numbe r and Program Activity— EBP Tope EBP % to Meet this Activities/Service Name and Description Outcome Observati (Include frequency, intensity, & duration of Partici Recomme and on Visits sessions, as well as the number of cycles/cohorts pants - nded Meaningful by Evalua expected to be offered and tentative Annual Sessions Improvement tion schedule/timing) Goal or Hours Pre-Post Numbe r served Activity Title: 91" Grade Education Series 450 4 to 8 85%of As Activity Description: A prevention sessions completers scheduled strategy which consists of 4 topics taught will show by BSRI in 4 to 8 sessions to all 9th graders improvement enrolled in the district in their post Frequency: Daily or over a 4 to 8-week period test scores Intensity:4 to 8 sessions Duration: 50-minute class periods Meaningful Improvement Satisfaction:90% of program completers demonstrate satisfaction with program services Activity Title: Recruitment/Screening 825 NA 85% of all NA Activity Description: All students referred or referrals presenting for services will receive an initial will screening of risk and protective factors complete Frequency: one time screenings Intensity one session Duration: 50 minutes Attachment IV PPG Scope of Work Page 6 of 10 Guidance/Care Center,Inc. Contract No. P-03 Meaningful Improvement Satisfaction:90% of program completers demonstrate satisfaction with program services Activity Title: Indicated Prevention 30 3 to 5 85% of NA Activity Description:3 to 5 sessions of Session` completers individual support will show Frequency:2 times per month improveme Intensity: 3 to 5 sessions nt in their Duration: 50 minutes o post test Meaningful Improvement Satisfaction: 90/o of program completers demonstrate satisfaction with scores program services Activity Title: Champions for Change 30 NA 85% of NA Activity Description: Participants will completers be pre and post tested with an outcome will show instrument approved by BSRI and improveme SFBHN. nt in their Frequency. Twice Intensity: Once at the beginning of participation post test and once at the end scores Duration: 30 minutes Activity Title: Social Media Campaign Activity Description: A strategy consisting of 9 posts to Instagram in conjunction with school wide 350 NA 100% NA activities, which promote prevention themes Frequency: Once per month during the 9 months of the school year Intensity. 9 posts Meaningful Improvement Satisfaction: NA 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, and is providing Virtual Online Self-Guided Courses - Partnered with Monroe County Coalition (MCC): Alcohol Edu, Prescription Drug Safety, Nicotine 101, Marijuana Wise, and Alcohol Wise. 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. Attachment IV PPG Scope of Work Page 7 of 10 Guidance/Care Center,Inc. Contract No. P-03 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 communicate to ensure there is not duplication or overlap. 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 VIII. 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. 3. Memorandum of Understandinq (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. Attachment IV PPG Scope of Work Page 8 of 10 Guidance/Care Center,Inc. Contract No. P-03 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 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; Attachment IV PPG Scope of Work Page 9 of 10 Guidance/Care Center,Inc. Contract No. P-03 ■ 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. 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. Attachment IV PPG Scope of Work Page 10 of 10 Guidance/Care Center,Inc. Contract No. P-03 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: 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 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 Guidance Care Center-SAMH Contract FY22 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: 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 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 Guidance Care Center-SAMH Contract FY22 ATTACHMENT G DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: (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. (Signature) Date: 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 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 Guidance Care Center-SAMH Contract FY22 ATTACHMENT H FY2020 Annual Performance Report (For year October 1, 2022—September 30,2023) Agency Name Point of Contact POC 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 FY2023 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. IMUMM OMEN=,wzw=�i 2. What were the measurable outcomes(including numbers)accomplished in FY2023? 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 FY2023; and/or 200%; and/or another standard used by your organization? 4. Were all the awarded funds used in FY2023? If not, please explain. 5. What is the number of FTEs working on the program(s)funded by the award in FY2023? Guidance Care Center-SAMH Contract FY22 6. Were the awarded funds used as match in FY2023? If so, please list matching sources. 7. What area of Monroe County did you serve in FY2023? 8. How many total FTEs in your organization? 9. Volunteers: hours of program service were contributed by volunteers in FY2023. 10. What was the CEO/Executive Director(or highest paid title)compensation in FY2023? (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 FY2023 IRS Form 990. If your FY2023 IRS Form 990 is not yet prepared, please provide an estimate for the following questions. 12. What were your organization's total expenses in FY2023? 13. What was your organization's total revenue in FY2023? 14. What was the organization's total in grants and contracts for FY2023? 15. What was the organization's total donations and in-kind (fundraising) in FY2023? 16. What percentage of your expenses are program service expenses' versus management and general expenseS2 in FY2023 as reported on your IRS Form 990? Fatal the Annual p nce Report ttm the Coordinator for Monroe County 1Program service expenses are defined as expenses needed to run your programs. 'Management 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 FY22