Loading...
HomeMy WebLinkAboutResolutions - 2012.11.01 - 2058117, MISCELLANEOUS RESOLUTION #12276 November 1, 2012 BY: General Government Committee, Christine Long, Chairperson IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION — 2012/2013 SUBSTANCE USE DISORDER GRANT ACCEPTANCE To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Michigan Department of Community Health (MDCH) has awarded the Health Division Substance Use Disorder Grant Funds for the period of October 1, 2012 through September 30, 2013; and WHEREAS the 2011/2012 Substance Use Disorder Grant award included a total funding amount of $4,403,645 in grant revenue and expenditures for this program; and WHEREAS the 2012/2013 Substance Use Disorder Grant award reflects grant funding in the amount of $4,675,503, an increase of $271,858 (6.2%) from the previous year; and Whereas a 10% cash match is required, based on the total program budget for Substance Abuse Services, and is estimated to be $694,667 for FY 2013; and WHEREAS these funds are used to subcontract with agencies to prevent and reduce the incidence of drug and alcohol abuse and dependency; and WHEREAS these contracts are awarded through the County's competitive bidding process: and WHEREAS acceptance of this grant does not obligate the County to any future commitment; and WHEREAS the grant agreement has been submitted through the County Executive's Contract Review Process and is recommended for approval. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners accepts the 2012/2013 Substance Use Disorder Grant from the Michigan Department of Community Health in the amount of $4,675,503 with a required 10% cash match of $694,667 for a total of $5,370,170. BE IT FURTHER RESOLVED that the Chairperson of the Board of Commissioners is authorized to execute the grant agreement and to approve minor changes and grant extensions, not to exceed fifteen (15) percent variance from the original award. BE IT FURTHER RESOLVED that the future level of service, including personnel, is contingent upon the level of funding for this program. BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes its Chairperson to execute this Agreement subject to the following additional condition: That the County's approval for entering into this Agreement is specifically conditioned and premised upon the acceptance, approval and execution of the Agreement containing Addendum A, by the Michigan Department of Community Health, and that the failure of the Michigan Department of Community Health to execute the Agreement as specified shall, without any further act of the Oakland County Board of Commissioners, automatically negate and void the County's approval and/or acceptance of this agreement as provided for in this resolution. Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing resolution. GENERAL GOVERNMENT COMMITTEE GENERAL GOVERNMENT COMMITTEE Motion carried unanimously on a roll call vote with Gosselin, Hatchett and Nash absent. FY 2012/2013 SUBSTANCE USE DISO ER GRANT ACCEPTANCE FtD DEPARTMENT OF HEALTH AND HUMAN SERVICES/ HEALTH DIVISION The Substance Use Disorder Grant is funded by the Michigan Department of Community Health (MDCH) to the Office of Substance Abuse in the Health Division. The purpose of the grant is to reduce the incidence of drug and alcohol abuse and dependency, and/or to provide comprehensive treatment services to the substance abusing population. The Office of Substance Abuse is designated as the Coordinating Agency for Oakland County and also includes the • PACE Unit, .which is an Access Assessment and Referral Service. This grant acceptance from MDCH provides for substance abuse treatment services for Oakland County residents who are low income, uninsured, non-Medicaid recipients. PACE provides a central point of entry; determines financial eligibility; provides screenings, referrals and care coordination services. The Coordinating Agency assures a continuum of substance abuse prevention and treatment services, based on local needs, and federal and state requirements. The continuum of treatment services made available to uninsured clients in Oakland County include detoxification, short-term residential, long-temi residential, intensive outpatient and outpatient services. Prevention services are targeted to high-risk populations such as school dropouts, pregnant women and teens, economically disadvantaged children of substance abusers, and community coalitions. Other services include general prevention, regional HIV education, and HIV early intervention. • The Coordinating Agency subcontracts through a competitive bid process with substance abuse prevention and treatment providers to provide the above services. They serve as expert resources on substance abuse within the Health Division and in collaboration with other units of county government. The grant acceptance is for $4,675,503 and covers the period of October 1, 2012 through September • 30, 2013. GRANT P"IIEW ,S_IGIN OFF — Health nivision GRANT NAME: FY 2013 MDCH — Substance Use Disorder Grant Agreement FUNDING AGENCY: Michigan Department of Community Health DEPARTMENT CONTACT PERSON: Rachel Shymkiw / 2-2151 STATUS: Grant Acceptance DATE: October 11, 2012 Pursuant to Misc. Resolution #01320, please be advised the captioned grant materials have completed internal grant review. Below are the returned comments. The captioned grant materials and grant acceptance package (which should include the Board of Commissioners' Liaison Committee Resolution, the grant agreement/contract, Finance Committee Fis al Note, and this Sign Off email containing grant review comments) may be requested to be placed on. the appropriate Board of Commissioners' committee(s) for grant acceptance by Board resolution. DEPARTMENT REVIEW Department of Management and Budget: Approved, — Laurie Van Pelt (9/28/2012) Department of Human Resources: Approved. —Karen Jones (9/26/2012) Risk Management and Safety: Approved by Risk Management. — Andrea Plotkowski (10/02/2012) Corporation Counsel: Approved. —Bradley G. Benn (10/10/2012) COMPLIANCE The grant agreement and attachments reference an extensive number of federal and state regulations.. Please refer to the agreement for specifically cited compliance requirements for this grant. Katie Wes From: Sent: To: Cc: Subject: VanPelt, Laurie <vanpeltl@oakdov.con» Friday, September 28, 2012 9:46 AM 'West, Catherine': 'Davis, Patricia': 'Jones, Karen': 'Secontine, Julie ' 'Shymkiw, Rachel', 'Nicholas, Christina': 'McKay-Chiasson, Lisa': 'Hensel, Torre; 'Pisacreta, Antonio' RE: Grant Review: Health & Human Services/Health Division - FY 2013 MDCH Substance Use Disorder Grant - Grant Application Approved. From: West, Catherine fmailto:westca@l.oakoov.coml Sent: Monday, September 24, 2012 3:13 PM To: Davis, Patricia; Jones, Karen; Secontine, Julie ; VanPelt, Laurie Cc: Shyrnkiw, Rachel; Nicholas, Christina; McKay-Chiasson, Usa; Hensel, Tom; Pisacreta, Antonio Subject: Grant Review: Health & Human Services/Health Division - FY 2013 MDCH Substance Use Disorder Grant - Grant Application GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Karen Jones —Julie Secontine — Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE — Health & Human Services/Health Division FY 2013 MDCH — Substance Use Disorder Grant Agreement Michigan Department of Community Health Attached to this email please find the grant document(s) to be reviewed. Please provide your review stating your APPROVAL, APPROVAL WITH MODIFICATION, or DISAPPROVAL, with supporting comments, via reply (to all) of this email. Time Frame for Returned Comments: October 10, 2012 GRANT INFORMATION Date: September 24, 2012 Operating Department: Health & Human Services Department Contact: Rachel ShrnIciw Contact Phone: 248-452-2151 Document Identification Number: REV I14,W STATUS: Acceptance — Resolution Required Funding Period: October 1, 2012 through September 30, 2013 New Facility / Additional Office Space Needs: None IT Resources (New Computer Hardware / Software Needs or Purchases): None MWDBE Requirements: Yes Compliance with OMB Circular A-102 Funding Continuation/New: Continuation Application Total Project Amount: $4,675,503 10/1112012 Contract #: Grant Agreement Between herinafter referred to as the "Department" and County of Oakland 1200 N. Telegraph Road Bldg. 34 East Pontiac Ml 48341 1050 Federal I.D.#: 38-6004876, DUNS #: 136200362 hereinafter referred to as the "Contractor" for Substance Use Disorder Services-2013 Part f Period of Agreement: This agreement shall commence on October 1 :2012 and continue through September 30, 2013. This agreement is in full force and effect for the period specified. 2. Program Budget and Agreement Amount A. Agreement Amount This total amount of this agreement is $4,675,503.00. The Department under terms of this agreement wit provide funding not to exceed 04,675,503.00, The federal funding provided by the Department: is $3,793,197.66, as follows: Federal Catalog of CFDA .# Federal I Federal Grant Amountl Program Federal Agency Grant Phase !Title Domestic Name Award Assistance Number (CFDA) Title SUB ABUSE Block Grant 93.959 Substance 2B08T101-00 3,793,197.66 PREV. & TX for Prevention Abuse and 26T BLOCK & Treatment Mental Health GRANT of Substance Services Adm Abuse Total for 3,793,197.66 !Federal [Funding The grant agreement is designated as a: X subrecipient relationship or vendor relationship The grant agreement is designated as: Research and Development Project; or X Not a Research and Development Project. Equipment Purchases and Title County of Oakland, Substance Liss Disorder Services-201:3' Page: 1 of 25 Katie Wes From: Sent To: Cc: Subject: Benn, Bradley G <bennb@oakgov.com > Wednesday, October 10, 2012 2:51 PM West, Catherine' 'Shymkiw, Rachel'; Nicholas, Christina #2012-0791 FY2013 MDCH - Substance Use Disorder Grant Agreement - Grant Acceptance (OSAS) Approved. Bradley G. Benn Assistant Corporation Counsel Department of Corporation Counsel 1200 N. Telegraph Road Bldg 14 East Courthouse West Wing Extention, 3rd Floor Pontiac, MI 48341-0419 Phone: (248) 858-0558 Fax: (248) 858-1003 Email: bennboakoov.com PRIVILEGED AND CONFIDENTIAL — ATTORNEY CLIENT COMMUNICATION This e-mail is intended only for those persons to whom it is speccally addressed. It is confidential and is protected by the attorney- client privilege and work product doctrine. This privilege belongs to the County of Oakland, and individual addressees are riot authorized to waive or modify this privilege in any way. Individuals are advised that any dissemination, reproduction or unauthorized review of this information by persons other than those listed above may constitute a waiver of this privilege and is therefore prohibited. If you have received this ms_zissade in error, please notify the sender immediately. it you have any questions, please contact the Department of Corporation Counsel at (243) 858-0550. Thank you for your c..c. ioperation. 10/11/2012 Part I, Section 2, Paragraph B, is not applicable to this Agreement. Any contractor equipment purchases supported in whole or in part through this agreement must be listed in the supporting Equipment Inventory Schedule. Equipment means tangible, non-expendable, personal property having useful life of more than one (1) year and an acquisition cost of $5,000 or more per unit. Title to items having a unit acquisition cost of less than $5,000 shall vest with the Contractor upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, -to the extent that the Department's proportionate interest in such equipment supports such retention or transfer of title. C. Deviation Allowance Part I, Section 2, Paragraph C, is not applicable to this Agreement, A deviation allowance modifying an established budget category by $10,000 or 15%, whichever is greater, is permissible without prior written approval of the Department. Any modification or deviations in excess of this .provision, including any adjustment to the total amount of this agreement, must be made in writing and executed by all parties to this agreement before the modifications can be implemented. This deviation allowance does not authorize new categories, subcontracts, equipment items or positions not shown in the attached Program Budget Summary and supporting detail schedules. 3. Purpose The focus of the program is to provide for the administration and coordination of substance use disorder (SUD) services within the designated coordinating agency region, consisting of Oakland County County(ies). 4. Statement of Work The Contractor agrees to undertake, perform and complete'the services described in Attachment A, which is part of this agreement through reference. County of Oakland, Substance Use Cssorde7 Services:2013 Page: 2 of 25 10/ 1/2012 5. Financial Requirements The financial requirements shall be followed as described in Part II of this agreement and Attachments B which are part of this agreement through rcforonce. The Contractor's fiscal year allocation letter is incorporated by reference into this agreement. 6. Performance/Progress Report Requirements The progress reporting methods, as applicable, shall be followed as described in Attachment C, which is part of this agreement through reference. 7. General Provisions The Contractor agrees to comply with the General Provisions outlined in Part II, which is part of this agreement through reference. The Contractor agrees to comply with the requirements described in Attachment D: Reporting Requirements. The Contractor also agrees to comply with the requirements described in the SUD Services Policy Manual, which_ is part of this agreement through reference. County of Oakland, Substance: Use Disorder Services-2313 Page: 3 of 25 Name Title 10/11/2012 8. Administration of the Agreement The person acting for the Department in administering this agreement (hereinafter referred to a s the Contract Manager) is: Deborah J. Hollis, Director Bureau of Substance Abuse and Addiction Services (BSAAS) 320 S. Walnut Street, Lewis Cass Bldg, 5th floor Lansing, Ml 48913 (517) 335-6572 HollisD©michigan.gov Contractor's Financial Contact for the Agreement The person acting for the Contractor on the financial reporting for this agreement is: E-Mail Address Telephone No. 10. Special Conditions A. This agreement is valid upon approval by the State Administrative Board as appropriate and approval and execution by the Department. This agreement is conditionally approved subject to and contingent upon the availability of funds, C. The Department will not assume any responsibility or liability for costs incurred by the Contractor prior to the sighing of this agreement. D. The Contractor is required by PA 533 of 2004 to receive payments by electronic funds transfer. County of Oaklard. Substance Use Disorcie, Services-201; Pagel 4 of 25 1 0/1112012 11. Special Certification The individual or officer signing this agreement certifies by his or her signature that he or she is authorized to sign this agreement on behalf of the responsible governing board, official or Contractor. 12. Signature Section FOR County of Oakland Name Title For the Michigan Department of Community Health Kim Stephen 10/11/2012 Kim Stephen, Director Date Bureau of Budget and Audit County of Oakland, Substaryfe Use Disoroef ServIces-201:', Page:0 o1 25 10/11/2012 Part II General Provisions I. Responsibilities - Contractor The Contractor in accordance with the general purposes and objectives of this agreement will: A. Publication Rights 1. Where the Contractor exclusively develops books, films, or other such copyrightable materials through activities supported by this agreement, the Contractor may copyright those materials. The materials that the Contractor copyrights cannot include service recipient information or personal identification data. Contractor grants the Department a royalty-free, non- exclusive and irrevocable license to reproduce, publish and use such materials and authorizes others to reproduce and use such materials. 2. Any materials copyrighted by the Contractor or modifications bearing • acknowledgment of the Department's name must ,be approved by the Department before reproduction and use of such materials. The State of Michigan may modify the material copyrighted by the Contractor and may combine it with other copyrightable intellectual property to form a derivative work. The State of Michigan will own and hold all copyright and other intellectual property rights in any such derivative work, excluding any rights or interest granted in this agreement to the Contractor. If the Contractor ceases to conduct business for any reason, or ceases to support the copyrightable materials developed under this agreement, the State of Michigan has the right to convert its licenses into transferable licenses to the extent consistent with any applicable obligations the Contractor has to the federal government. 3. The Contractor shall give recognition to the Department in any and all publications papers and presentations arising from the program and service contract herein; the Department will do likewise. 4. The Contractor must notify the Department's (=rants and Purchasing Division 30 days before applying to register a copyright with the U.S. Copyright Office. The Contractor must submit an annual report for all copyrighted materials developed by the Contractor through activities supported by this agreement and must submit a final invention statement and certification within 90 days of the end of the agreement period. B. Fees Make reasonable efforts to collect 1st and 3rd party fees, where applicable, and report these as outlined by the Department's fiscal procedures. Any underrecoveries of otherwise available fees resulting from failure to bill for eligible services will be excluded from reimbursable expenditures. County of Oakland. Substance Use Discrcic Services-201:3 Page: 0 of 20 10/11/2012 C. Program Operation Provide the necessary administrative, professional, and technical staff for operation of the program. D. Reporting Utilize all report forms and reporting formats required by the Department at the effective date of this agreement, and provide the Department with timely review and commentary on any new report forms and reporting formats proposed for issuance thereafter. E. Record Maintenance/Retention Maintain adequate program and fiscal records and files, including source documentation to support program activities and all expenditures made under the terms of this agreement, as required. Assure that all terms of the agreement will be appropriately adhered to and that records and detailed documentation for the project or program identified in this agreement will be maintained for a period of not less than three (3) years from the date of termination, the date of submission of the final expenditure report or until litigation and audit findings have been resolved. F. Authorized Access Permit upon reasonable notification and at reasonable times, access by authorized representatives of the Department, Federal Grantor Agency, Comptroller General of the United States and State Auditor General, or any of their duly authorized representatives, to records, files and documentation related to this agreement, to the extent authorized by applicable state or federal law, rule or regulation. G. Audits This sectiononly applies to Contractors designated as subrecipients. Contractors designated as vendors are exempt from the provisions.of this section. 1. Required Audit or Notification Letter Contractors must submit to the Department either a Single Audit, Financial Statement Audit, or Audit Status Notification Letter as described below. If submitting a Single Audit or Financial Statement Audit, Contractors must also submit a Corrective Action Plan for any audit findings that impact MDCI-1- funded programs, and management letter (if issued) with a response. a. Single Audit Contractors that are a state, local government, or non-profit organization that expend $500,000 or more in federal awards during the Contractor's fiscal year must submit a Single Audit to the Department, regardless of the amount of funding received from the Department. The Single Audit must comply with the requirements of the Single Audit Act Amendments of 1996, and Office of Management and Budget (OMB) Circular A-133, "Audits of States, Local Governments, and Non-Profit Organizations," as revised. County of Oakland, Substance Use Disorder Services-2013 Page: 7 of 25 10.81112012 The Contractor must comply with all requirements in the MDCH Substance Abuse Prevention and Treatment Audit Guidelines, current edition, as issu e d by the MDCH Office of Audit. b. Financial Statement Audit Contractors exempt from the Single Audit requirements that receive $500,000 or more in total funding from the Department in State and Federal grant funding must submit to the Department a Financial Statement Audit prepared in accordance with generally accepted auditing standards (GAAS). Contractors exempt from the Singie Audit requirements that receive less than $500,000 of total Department grant funding must submit to the Department a Financial Statement Audit prepared in accordance with GAAS if the audit includes disciosures that may negatively impact IVIDCH -funded programs including, but not limited to fraud, going concern uncertainties, financial statement misstatements, and violations of contract and grant provisions. c. Audit Status Notification Letter Contractors exempt from both the Single Audit and Financial Statement Audit requirements (a. and b. above) must submit an Audit Status Notification Letter that certifies these exemptions. The template Audit Status Notification Letter and further instructions are availahle at http://wwvv.michigai-Lgov/mdch by selecting Inside Community Health — MDCH Audit. 2. Due Date and Where to Send The required audit and any other required submissions (i.e. Corrective Action Plan and management letter with a response), or audit Status Notification Letter must be submitted to the Department within nine months after the end of the Contractor's fiscal year by e-mail to the Department at MDCH -AuditReports©michigan.gov . The required materials must be assembled as one document in a PDF file compatible with Adobe Acrobat (read only). The subject line must state the agency name and fiscal year end. The Department reserves the right to request a hard copy of the audit materials if for any reason the electronic submission process is not successful. County of Oakland, SuDstanc.9 Use Disomer Serv8es-2013 Page: 8 of 20 10/11/2012 3. Penalty a. Delinquent Single Audit or Financial Statement Audit if the Contractor does not submit the required Single Audit reporting package, management letter (if issued) with a response, and Corrective Action Plan; or the Financial Statement Audit and management letter (if issued) with a response within nine months after the end of the Contractor's fiscal year and an extension has not been approved by the cognizant or oversight agency for audit, the Department may withhold from the current funding an amount equal to five percent of the audit year's grant funding (not to exceed $200,000) until the required filing is received by the Department. The Department may retain the amount withheld if the Contractor is more than 120 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit, The Department may terminate the current grant if the Contractor is more than 180 days delinquent in meeting the filing requirements and an extension has not been approved by the cognizant or oversight agency for audit, b. Delinquent Audit Status Notification Letter Failure to submit the Audit Status Notification Letter, when required, may result in withholding from the current funding an amount equal to one percent of the audit year's grant funding until the Audit Status Notification Letter is received. 4. Other Audits The Department or federal agencies may also conduct or arrange for "agreed upon procedures" or additional audits to meet their needs. H. SubrecipientNendor Monitoring The Contractor must ensure that each nfits 11..hrecipientc comply with the Single Audit Act requirements. The Contractor must issue management decisions on audit findings of their subrecipients as required by OMB Circular A- 1 TD, The Contractor must also develop a subrecipient monitoring plan that addresses "during the award monitoring" of subrecipients to provide reasonable assurance that the subrecipient administers Federal awards in compliance with laws, regulations, and the provisions of contracts, and that performance goals are achieved. The subrecipient monitoring plan should include a risk-based assessment to determine the level of oversight, and monitoring activities such as reviewing financial and performance reports, performing site visits, and maintaining regular contact with subrecipients. County of Oakland, Substance Use Disorder Services-2013 Page: 9 of 29 10/11/2012 The Contractor must establish requirements to ensure compliance for for—profit subrecipients as required by OMB Circular A-133, Section .210(e) The Contractor must ensure that transactions with vendors comply with laws, regulations, and provisions of contracts or grant agreements in compliance with r\MB Circular P,-133, Section .210M. Notification of Modifications Provide timely notification to the Department, in writing, of any action by its governing board or any other funding source that would require or result in significant modification in the provision of services, funding or compliance with operational procedures. J. Software Compliance The Contractor must ensure software compliance and compatibility with the Department's data systems for services provided under this agreement including, but not limited to: stored d ata, databases, and interfaces for the production of work products and reports. All required data under this agreement shall be provided in an accurate and timely manner without interruption, failure or errors due to the inaccuracy of the Contractor's business operations for processing date/time data. K. Human Subjects The Contractor will comply with Protection of Human Subjects Act, 45 CFR, Part 46. The Contractor agrees that prior to the initiation of the research, the Contractor will submit institutional Review Board (IRB) application material for all research involving human subjects, which is conducted in programs sponsored by the Department or in programs which receive funding from or through the State of Michigan, to the Department's IRB for review and approval, or the IRB application and approval materials for acceptance of the review of another IRB. All such research must be approved by a federally assured IRB, but the Department's IRB can only accept the review and approval of another institution's IRB under a formally-approved interdepartmental agreement. The manner of the review will be agreed upon between the Department's IRB Chairperson and the Contractor's IRB Chairperson or Executive Officer(s). H. Responsibilities - Department The Department in accordance with the general purposes and objectives of this agreement will: A. Reimbursement Provide reimbursement in accordance with the terms and conditions of this agreement based upon appropriate reports, records, and documentation maintained by the Contractor. County of Oakland, Substance Dan Disorder Services-201:S Page: 10 of 25 10/11/2012. B. Report Farms Provide any report forms and reporting formats required by the Department at the effective date of this agreement, and provide to Co ntractor any new report forms and reporting formats proposed for issuance thereafter at least ninety (90) days prior to their required Usage in order to afford the Contractor an opportunity to review and offer comment. Ill. Assurances The following assurances are hereby given to the Department: A. Compliance with Applicable Laws The Contractor will comply with applicabie federal and state iavvs, guidelines, rules and regulations in carrying out the terms of this agreement. The Contractor.. will also comply with all applicable general administrative requirements such as OMB Circulars covering cost principles, grant/agreement principles, and audits in carrying out the terms of this agreement. For purposes of this Agreement, OMB Circular A-87 is applicable to Contractors that are local government entities, and OMB Circular A-122 is applicable to Contractors that are non-profit entities. B. Anti-Lobbying Act The Contractor will comply with the Anti-Lobbying Act, 31 USC 1352 as revised by the Lobbying Disclosure Act of 1995, 2 USC 1601 et seq, and Section 503 of the Departments of Labor, Health and Human Services, and Education, and Related Agencies section of the FY 1997 Omnibus Consolidated Appropriations Act (Public Law 104-209). Further, the Contractor shall require that the language of this assurance be included in the award documents of 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, Uountyof Cialodnct, Substance Use Disorder Services-2012 Pacie.:11 of 25 10/11/2012 C. Non-Discrimination 1. 1. in the performance of any contract or purchase order resulting here,from, the Contractor agrees not to discriminate against any employee or applicant for employment or service delivery and access, with respect to their hire, tenure, terms, conditions or privileges of employment, programs and services provided or any matter directly or indirectly related to employment, because of race, color, religion, national origin, ancestry, age, sex, height, weight, marital status, physical or mental disability unrelated to the individual's ability to perform the duties of the particular job or position or to receive services. The Contractor further agrees that every subcontract entered into for the performance of any contract or purchase order resulting nerefrom will contain a provision requiring non-discrimination in employment, service delivery and access, as herein speced binding upon each subcontractor. Thlis covenant is required pursuant to the Elliot-Larsen Civil Rights Act, 1976 PA 453, as amended, MCL 37.2201 et seq., and the Persons with Disabilities Civil Rights Act, 1976 PA 220, as amended, MCL 37.1101 et seq., and any breach thereof may be regarded as a material breach of the contract or purchase order. 2. The Contractor will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: a. Title Vi of the Civil Rights Act Of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color OF national origin; b. Title IX of the Education Amendments of 1972, as amended (20 §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; e . Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; d. the Age Discrimination Act of 1975, as amended (42 U.S.C. §6101- 6107), which prohibits discrimination on the basis of ago; e. the Drug Abuse Office and Treatment Act of 1972 (FL, 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; f. the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PI, 91-616) as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 9- §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records h. any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and, the requirements of any other nondiscrimination statute(s) which may apply to the application. County of Oakland. Suostance LJ, Disorder Services-2013 PacfE/: 12 of 25 10/11/2012 3. Additionally, assurance is given to the Department that proactive efforts will be made to identify and encourage the participation of minority owned and women owned businesses, and businesses owned by persons with disabilities in contract solicitations. The Contractor shall incorporate language in all contracts awarded: (1) prohibiting discrimination against minority owned and Women owned businesses and businesses owned by persons with disabilities in subcontracting; and (2) making discrimination a material breach of contract. Debarment andSuspension Assurance is hereby given to the Department that the Contractor will comply with Federal Regulation, 2 CFR part 180 and certifies to the best of its knowledge and belief that it, its employees and its subcontractors: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or contractor; 2. Have not within a three-year period preceding this agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making faise statements, or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in section 2, and; 4. Have not within a three-year period preceding this agreement had one or more public transactions (federal, state or local) terminated for cause or default. County of Oakrund, Substance Use Disoroer Senvices-2D13 Page: 13 at 25 1011112012 E. Federal Requirement: Pro-Children Act 1. Assurance is hereby gtv'en to the Department that the Contractor will comply .v.v.ith Public 'Law 1'33-227, also kno‘vvn a.s the Pro-Children Act of 1994', 20 LlSC 6091 et seq, which requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted by and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by federal programs either directly or through state OF local governments, by federal grant, contract, loan or loan guarantee. The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such federal funds. The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities where Women, Infants, and Children (WIC) coupons are redeemed. 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 and/or the imposition of an administrative compliance order on the responsible entity. The Contractor also assures that this language will be included in any subawards which contain provisions for children's services. 2. The Contra ctor also assures, in addition to compliance with Public Law 103- 227, any service OF activity funded in whole or in part through this agreement will be delivered in a smoke-free facility or environment. Smoking shall not be permitted anywhere in the facility, or those parts of the facility under the control of the Contractor. If activities or services are delivered in facilities or areas that are not under the control of the Contractor (e.g., a mall, restaurant or private work site), the activities or services shall be smoke-free. F. Hatch Political Activity Act and Intergovernmental Personnel Act The Contractor will comply with the Hatch Political Activity Act, 5 t.ISC 1501 -1509 and 7324-7328, and the Intergovernmental Personnel Act of 1970, as amended by Title Vi of the Civil Service Reform Act, Public Law 95-454, 42 USG 4728 - 4763. Federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally-assisted programs. G. Subcontracts Assure for any subcontracted service, activity Or product: 1. That a written subcontract is executed by all affected parties prior to the initiation of any -new subcontract activity. Exceptions to this policy may be granted by the Department upon written request within 30 days of execution of the agreement. County Oahand, Substance U,o DiSOrder Services-201: Page: 1 ,1 oJ 10/11/2012 2. That any executed subcontract to this agreement shall require the subcontractor to comply with allapplicable terms and conditions of this agreement. In the event of a conflict between this agreement and the provisions of the subcontract, the provisions of this agreement shall prevail. A conflict between this agreement and a subcontract, however, shall not be deemed to exist where the subcontract: a. Contains additional non-conflicting provisions not set forth in this agreement; b. Restates provisions of this agreement to afford the Contractor the same or substantially the same rights and privileges as the Department; or c. Requires the subcontractor to perform duties and/or services in less time than that afforded the Contractor in this agreement. 3. That the subcontract does not affect the Contractor's accountability to the Department for the subcontracted activity. 4. That any billing or request for reimbursement for subcontract costs is supported by a valid subcontract and adequate source documentation on costs and services. 5. That the Contractor will submit a copy of the executed subcontract if requested by the Department. H. Procurement Assure that all purchase transactions, whether negotiated or advertised, shall be conducted openly and competitively in accordance with the principles and requirements of 0ME3 Circular A-102 as revised, implemented through applicable portions of the associated "Common Rule" as promulgated by responsible federal contractor(s), or 2 CFR, Part 215 (OMB Circular A-110) as amended, as applicable, and that records sufficient to document the significant history of all purchases are maintained for a minimum of three years after the end of the agreement period. Health Insurance Portability and Accountability Act To the extent that this act is pertinent to the services that the Contractor provides to the Department under this agreement, the Contractor assures that it is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements including the following: 1. The Contractor must not share any protected health data and information provided by the Department that falls within HIPAA requirements except as permitted or required by applicable law; or to a subcontractor as appropriate under this agreement. County of Oakland, SubstanGE Use Disnrner bees es-2/U1 Pee: 15 of 25 10/11/2012 2. The Contractor will ensure that any subcontractor will have the same obligations as the Contractor not to share any protected health data and information from the Department that fells under HIPAA requirements in the terms and conditions of the subcontract. 3. The Contractor must only use the protected health data and information for the purposes of this agreement. 4. The Contractor must have written policies and procedures addressing the use of protected health data and information that falls under the HIPAA requirements. The policies and procedures must meet all applicable federal and state requirements including the HIPAA regulations. These policies and procedures must include restricting access to the protected health data and information by the Contractor's employees. 5. The Contractor must have a policy and procedure to immediately report to the Department any suspected or confirmed unauthorized use or disclosure of protected health data and information that falls under the HIPAA requirements of which the Contractor becomes aware. The Contractor will work with the Department to mitigate the breach, and will provide assurances to the Department of corrective actions to prevent further unauthorized uses or disclosures. Failure to comply With any of these contractual requirements may result in the termination of this agreement in accordance with Part II , Section . V. Agreement Termination. 7. In accordance with HIPAA requirements, the Contractor is liable for any claim, loss or damage relating to unauthorized use or disclosure of protected health data and information by the Contractor received from the Department or any other source. 8. The Contractor will enter into a business associate agreement should the Department determine suen an agreement is required under HIPAA. IV. Financial Requirements A. Operating Advance The Department will not issue an operating advance under this agreement. B. Reimbursement Method The Department will make prepayments equal to the Contractor's prepayment schedule that has been approved by the Department and the Contractor. The prepayments will be monthly, paid up to the total Department allocation as agreed to in the approved budget. Prepayments may be adjusted quarterly based upon expenditure reports. 6. County of Oakland, Substuncn Use Disorder Services-2013 Page: 16 of 25 10/11/2012 C. Revenues and Expenditures Report Submission - Initial and Final Revenues and Expenditures Reports (RERs) shall be prepared as indicated in Attachment B, and submitted via the Electronic Grants Administration and Management System (EGrAMS). RERs shall be submitted twice per agreement year. One will be submitted with the agency's initial fiscal year EGrAMS application and one will be submitted as the final RER for the fiscal year. The final RER will be an Attachment report and due November 30 following the end of the fiscal year. The final RER must reflect total actual program expenditures, regardless of the source of funds. To access EGrAIVIS, log in at: httpriiegrams-mi.comIdch Failure to meet financial reporting responsibilities as identified in this agreement may result in withholding future payments. D. Financial Status Report Submissions Financial Status Reports (FSRs) shall be prepared and submitted electronically through MI E-Grants. FSRs must be submitted on a quarterly basis, no later than thirty (30) days after the close of each calendar quarterly. The quarterly FSRs must reflect total actual program expenditures, regardless of the source of funds. Failure to meet financial reporting responsibilities as identified in this agreement may result in withholding future payments. FSRs must reflect total actual program expenditures. Expenditures are reported only for State Agreement funds, E. Reimbursement Mechanism All contractors must sign up through the on-line vendor registration process to I eceive, all State of IViichigan p:ayments as Electronic Funds Transfers (EFT)/Direct Deposits, as mandated by PA 533 of 2004. Vendor registration information is available through the Department of Management and Budget's web site: http://michigan.gov/cpex.press County of Oakland, Substance Use Disorder Services •2013 Page: 17 of 25 10/11/2012 F. Final Obligations and Financial Status Reporting Requirements 1. Obligations Report A Obligation Report, based on annual guidelines, must be submitted by the due date using the format provided by the Department's Accounting Division. The Contractor must provide an estimate of total expenditures for the entire agreement period. The information on the report will be used to record the Department's year-end accounts payables and receivables for this agreement. 2. Final RER The final RER is due as stated in Attachment C to this agreement and must be submitted via EGrAMS as an Attachment Report. The final RER must be clearly marked "Final". Final RERs not received by the due date may result in the loss of funding requested on the Obligation Report and may result in the potential reduction in the subsequent year's agreement amount. 3. 4th Quarter FSR The 4th quarter FSRs are due sixty (60) days following the end of the fiscal year or agreement period and must be submitted electronically through MI E-Grants. G. Unobligated Funds Any unobligated balance of -funds held by the Contractor at the end of the agreement period will be returned to the Department or treated in accordance with instructions provided by the Department. V. Agreement Termination The Department may cancel this agreement without further liability or penalty to the Department for any of the following reasons: A. This agreement may be terminated by either party by giving thirty (30) days written notice to the other party stating the reasons for termination and the effective date. B. This agreement may be terminated on thirty (30) days prior written notice upon the failure of either party to carry out the terms and conditions of this agreement, provided the alleged defaulting party is given notice of the alleged breach and fails to cure the default within the thirty (30) day period. C. This agreement may be terminated immediately if the Contractor or an official of the Contractor or an owner is convicted of any activity referenced in Section III.D. of this agreement during the term of this agreement or any extension thereof. County of Oakland, Substa oco Use Disorder Services-2013 Page :18 of 25 10/11/2012 VI. Final Reporting t inon Termination Should this agreement be terminated by either party, within thirty (30) days after the termination, the Contractor shall provide the Department with all financial, performance and other reports required as a condition of this agreement. The Department will make payments to the Contractor for allowable reimbursable costs not covered by previous payments or other state or federal programs. The Contractor shall immediately refund . to the Department any funds not authorized for use and any payments or funds advanced to the Contractor in excess of allowable reimbursable expenditures. • Any dispute arising as a result of this agreement shall be resolved in the State of Michigan. VII. Severability If any provision of this agreement or any provision of any document attached to or incorporated by reference is waived or held to be invalid, such waiver or invalidity shall not affect other provisions of this agreement. VIII. Amendments Any changes to this agreement will be valid only if made in writing and accepted by all parties to this agreement. Any change proposed by the Contractor which would affect the Department funding of any project, in whole or in part in Part I. Section 2.0. of the agreement, must be submitted in writing to the Department for approval immediately upon determining the need for such change. IX. Liability A. All liability to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as direct service delivery, to be carried out by the Contractor in the performance of this agreement shall be the responsibility of the Contractor, and not the responsibility of the Department, if the liability, loss, or damage is caused by, or arises out of, the actions or failure to act on the part of the Contractor, any subcontractor, anyone directly or indirectly employed by the Contractor, provided that nothing herein shall be construed as a waiver of any governmental immunity that has been provided to the Contractor or its employees by statute or court decisions. B. All liability to third parties, loss, or damage as a result of claims, demands, costs, or judgments arising out of activities, such as the provision of policy and procedural direction, to be carried out by the Department in the performance of this agreement shall be the responsibility of the Department, and not the responsibility of the Contractor, if the liability, loss, or damage is caused by, or arises out of, the action or failure to act on the part of any Department employee or agent, provided that nothing herein shall be construed as a waiver of any governmental immunity by the State, its agencies (the Department) or employees as provided by statute or court decisions. County ot Oakland, Substance inc Disorder Seroces-2D13 Pee : 19 of 25 10/1112012 C. In the event that liability to third parties,, loss, or damage arises as a result of activities conducted jointly by the Contractor and the Department in fulfillment of their responsibilities under this agreement, such liability, loss, or damage shall be borne by the Contractor and the Department in relation to each party's responsibilities under these joint activities, provided that nothing herein shall be construed as a waiver of any governmental immunity by the Contractor, the State, its agencies (the Department) or their employees, respectively, as provided by statute Or court decisions. X. Conflict of Interest The Contractor and the Department are subject to the provisions of 1968 PA 317, as amended, MCL 15.321 et seq, MSA 4.1700(51) et seq, and 1973 PA 196, as amended, MCL 15.341 et seq, MSA 4.1700 (71) et seq. Xi. State of Michigan Agreement This is a State of Michigan Agreement and is governed by the laws of Michigan. Any dispute arising as a result of this agreement shall be resolved in the State of Michigan. XII. Confidentiality Both the Department and the Contractor shall assure that medical services to and information contained in medical records of persons served under this agreement, or other such recorded information required .to.be held confidential by federal or state law, rule or regulation, in connection with the provision of services or other activity under this agreement shall be privileged communication, shall be held confidential, and shall not be divulged without the Written consent of either the patient or a person responsible . for the patient, except as may be otherwise permitted or required by applicable state or federal law or regulation. Such information may be disclosed in summary, statistical, or other form, which does not directly or indirectly identify particular individuals. County of DalclEand, Substance Use Disorder 0ervice:;-2013 Facie: 20 of 2"..7 10/11/2012 Attachments A Att A - Statement of Work Attachment A - Statement of Work B1 Att B - Financial Reporting Requirements Attachment B -Financial Reporting Requirements B2 Att B - Revenues and Expenditures Rpt Attachment B-RCVerncoo and 'Expenditures Rpt B3 Att B - Equipment Inventory Attachment B2 Equip Inventory B4 Att B FASD Prevention Project Report - Lakeshore B5 Att B - FASO Prevention Project Report - Network 180 County of Oakland. Suostance Use Decider Services-2013 Page: 21 of 25 10/11/2012 B6 Att B - Source of Funds SOURCE OF FUNDS 1 1 Statei Activity i I Local Inkind Total Amount State Agreements 1 Community Grant 0.00i 0.00 0.00 0.00 Prevention 0.00 0.00 0.00 0.00 FASD Award 0.00 0.00 0.00 0.001 i State Disability Assistance 0.00 0.00 0.00 0.00 i 1 Gambling, State Restricted 0.00 1 0.00 0.00 0.00 1 i 1 Strategic Prevention 0.00 0.00 0.00 0.00 Enhancement Project 1 i Screening Brief Interv. & 0.00' 0.001 o.00i 0.00 Referral to Tr Total State Agreements 0.00 0.00 0.00 0.00 Totals 0.001 0.00 0.00 0.00 County of Oakland, Substance Use Disorner Services-2013 Page: 22 of a: 10/11/2012 B7 Att B - Prog ram Bud get - Summary [-PROGRAM !Substance Use Disorder Services-2U1j DATE PREPARED Hail 1/2012 !CONTRACTOR NAME BUDGET PERIOD 'County of Oakland ,From : 10/1/2012 To : 9/30/2013 r !MAILING ADDRESS (Number and Street) !BUDGET AGREEMENT !1000 NI Tcaic,rirmr0-1 R,--,..zri AMENDMENT # Bld g . 34 East ! 1W Orig inal r 'Amendment 0 CODE I ! !CITY I STATE ZIP !FEDERAL ID NUMBER li 48341- Pontiac MI I38-6004876 1050 : Activity I State Amount Local inkindI Total' DIRECT EXPENSES i State Agreements i 1 Community Grant 0.00 0.00 0.00 0.00 i 2 Prevention 0.00 0.00 0.00 0.00 3 FASD Award _ 0.00 0.00 0.00 0.00, State Disability Assistance 0.00 1 0.00! , 0.00 0.00 i Gambling , State Restricted 0.00 0.001 0.00 0.00 6 Strateg ic Prevention 0.00 0.00! 0.00 0.001 Enhancement Project , Screenin g Brief Interv. & 0.00 0.00I 0.00 0.00 Referral to Tr 1 1 Total State Agreements 0.00 0.00 0.00 0.00 i TOTAL DIRECT EXPENSES 0.00 0.001 0.00 0.00 1 TOTAL EXPENDITURES 0.00 0.00 0.00 0.00 County of Oakland, Substance Use Disorder Services-2013 Page: 23 of 2f, Locall Inkindi Total State Amounti !Activity _ 'DIRECT EXPENSES 2 0.00 0.00 0.00 0.00 Total State Agreements TOTAL DIRECT EXPENSES 0.001 0.00 O.00 l 0.00 0.00 0.00 0.00 10/11/2012 B8 Att B - Program Budget - Cost Detail State Agreements Community Grant Prevention 4 6 FASD Award State Disability Assistance Gambling, State Restricted Strategic Prevention Enhancement Project 8 !Screening Brief interv. & Referral to Tr TOTAL EXPENDITURES 0.00 County of Oakland, Substance tics asorder Services-2013 Page: 2=1 0/ 22 100 112012 C Aft C - Reporting Requirements Attachment C - Reporting Reouirements D1 Att D - Other Requirements Attachment D - Other Requirements D2 Att D - Sentinel Event Reporting Guidance Attachment D-Sentinel EventIF:epoing Cuidance anc Report Fon-T-1 D3 Att D- lob Retailer Master List Updates and instructions Attachment D-Tobac;co Retailer Master List Updates & Instructions D4 Att D injecting Drug Users 90 Percent Capacity Treatment Report Attachment D-IDU 90 Percent Capacity Treatment Rat Form-rev. 08.08 D4 Att D - injecting Drug Users 90 Capacity Treatment Instructions Attachment D-Iniecting Drug Users 90 Percent Capacity •Ireatment instructions D5 Aft D - Prevention Expenditures by Strategy Instructions Attachment ED-Prevention Expenditures by Strategy Report Instructions D5 Att D- Prevention Expenditures by Stragety Rpt Attachment D-Pre.vention Expenditures by Strategy Report 8,05 DC Att 0- Prevention Report for S,A.PT Block Grant instructions D6 Att D - Prey Rpt for SAPT Block Grant Rpt D7 Aft D - Priority Populations Waiting List Deficiencies Instructions Attachment D-Priority Pop, Waiting List Deficiencies Instructions D7 Att D - Priority Pop Waiting List Deficiencies Rpt Attachment D-Priority Pop. Waiting List Deficiencies Report 8.05 08 Att D Special Projects Rpt Earmarked Funded, for applicable agencies only Attachment ED-Special Proj Rpt Earmarked Funded eff. 10.01.07 D9 Aft D- Women's Specialty Services Instructions Attachment ED-Instructions for Womens Spec Services Report D9 Att D Womens Specialty Svcs Rpt Attachment D-Women's Specialty Services Report D10 Att D- Youth Access to Tobacco Activity Annual Rpt Attachment ED-Youth Access to Tobacco Activity Annual Report 8,05 Dll Aft D - Instructions for SUD Entity Inventory Report Attachment ED-Instructions for SUED Entity Inventory Report. Dil Att D SUD Entity Inventory Report Attachment D- SLID Entity Inventory Report D12 Att D - Charitable Choice Report Attachment D - Charitable Choice Report D13 Att D- SUD Services Policy Manual SUED Services Policy Manual County of Oakland, Substance Use Disorder Serices-2C13 Page: 25 of 25 Version: Substance Abuse Services MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 12/13 AGREEMENT ADDENDUM A 1. This addendum adds the following section to Part I and Renumbers existing 11 Special Certification to 12 and existing 12 Signature Section to 13: Part! 11. Agreement Exceptions and Limitations Notwithstanding any other term or conditbn in this Agreement including, but not limited to, any provisions related to any services as described in the Annual Action Plan, any Contractor (0 akland County) services provided pursuant to this Agreement, or any lirritations upon any Department funding obligations herein, the Parties spec ifically intend and agree that the Contractor may discontinue, without any penalty or liability whatsoever, any Contractor services or performance obligations under this Agreement when and if it becomes apparent that State or Department funds for any such services will be no longer available. Notwithstanding any other term or condition in this Agreement, the Part ies specifically understand and agree that no provision in this Agreement shall operate as a waiver, bar or limitation of any kind, on any legal claim or right the Contractor may have at any time under any Michigan constitutional provis ion or other legal basis (e.g.. any Headlee Amendment limitations) to c hallenge any State or Department program funding obligations; and, the par ties further agree that no term or condition in this Agreement is int ended and no such provision shall be argued to state or imply thatthe Contractor voluntarily assumed or undertook to provide any services as describedin the Annual Action Plan, and thereby, waived any rights the Contractor may ha:e had under any legal theory, in law or equity, without regard to whether or not the Contract or continued to perform any services herein after any State or Department funding ends. Oakland CA Addendum to FY2013 agreement.doc Page 1 of 3 ted in its entirety and Version: Substance Abuse Services 2. This addendum modifies the following sections of Part Il, General Provisions: Part II I. Responsibilities-Contractor J. Softw are Compliance. This section will be d replaced with the following language: The Michigan Department of Comm unity Health and the County of Oakland will work together to ident ify and overcome potential data incompatibility problems. Ill. Assurances A. Compliance w itl_2Applicable Law s. This first sentence of this paragraph will be stricken in its entiety and replace with the following language: The Contractor will comply with app licable Federal and State laws, and lawfully enacted administrative rul or regulations, in carrying out the terms of this agreement. I. Health Insurance Portability and Accountability Act . The provisions in this secion shall be deleted in their entirety and replaced with the following language: Contractor agrees that it will co mply with the Health Insurance Portability and Accountability Act of 1996, and the lawfully enacted and applicable Regulations promulgated there under. IX. Liability. Paragraph A. will be del eted in its entirety and replaced with the following language. A. Except as otherwise provided by law neither Party shall be obligated to the other, or indemnify the other for any third party claims, demands, costs, or judgments arising out of activities to be carried out pursuant to the obligations of either party under this Contract, nothing herein shall be construed as a waiver of any governmental immunity for either party or its agencies, or officers and employees as provided by statute or modified by court decisions. Oakland CA Addendum to FY2013 agreement.doc Page 2 of 3 Version: Substance Abuse Services 3. Special Certification: The individual or officer signing this agreementcertifies by his or her signature that he or she is authorized to sign this agreement on behalf of the responsible governing board, official or Contractor. 4. Signature Section: For the COUNTY OF OAKLAND Michael J. Cingell, Jr., Chairperson, Board of Commissioners Name and Title Signature Date For the MICHIGAN DEPARTMENT OF COMMUNiTY HEALTH Kim Stephen, Director Date Bureau of Budget and Audit Oakland CA Addendum to FY2013 agreement.goo Page 3 of 3 Version Subst2nce Abuse Services 3. Special 'C Lt,dLUt The individual or officer signing this areementcertifics by his or her signature that he OF she is authorized to sign this agreement on behalf of the responsible governing hoard, officiai or Contractor. 4. Signature Section: For the COUNTY OF OAKLAND Name and Title Signature Date For the rocHIGANi DEPARTMENT OF COMMUNITY HEALTH Kim Stephen, Director Date Bureau of Budget and Audit Oakland CA .AcicieritiLml to F{2013 agreement.doc Eaty, ot El Vendor Subrecipient Attachment A Statement of Wore: Fiscai Year 2013 Siemert of Wor<, truua'=Y2013 Statement of Work Fiscal Year 2012/Amd#2 Table of Contents Page No. General 1. General Statement of Work 1 2. Action Plan 1 3. SAPT Block Grant Requirements and Applicability to State Funds ............. 1 4. Licensure of Subcontractors 2 5. Accreditation of Subcontractors 6. SAMHSA/DHHS License 3 7. Cooperation with External Medicaid Evaluation 4 8. Monitoring of Subcontractors 4 Administrative and Financial 1. Match Rules 4 2. Reporting Fees and Collections Revenues 5 3. Management of Department-administered Funds 5 4. Sliding Fee Scala, 5 5. Inability to Pay 6 6. Subcontracts with Hospitals 6 7. Residency in CA Region 6 8. Out-of-Network and Out-of-Region Services 6 9. Reimbursement Rates for Community Grant, Medicaid and Other Services 6 Att-----A Statement c.0 Work TOE; FY2013 1:6.29.12) Attachment A (Cont.') Minimum Criteria for Reimbursing for Services to Persons with Co-Occurring Disorders 7 11. Media Campaigns 7 12. Notice of Excess or Insufficient Funds (NEIF) 7 13. Subcontractor information to be Retained at the CA a. Budgeting Information for Each Service 8 b. Documentation of How Fixed Unit Rates Were Established 8 c. Indirect Cost Documentation 8 d. Equipment Inventories 8 e. Fidelity Bonding Documentation 2 14. Reporting Requirements a. General Requirements 9 b. Legislative Reports (LRs) and Financial Reports 9 c. Mental Health and Substance Use Disorder Services Integration Status Report 10 C. Data Reporting Timeliness and Completeness Standards 10 e. Data Completeness 10 f. National Outcome Measures (NOMS) 10 g. Michigan Prevention Data System 11 15. Critical Incidents and Sentinel Events 11 16. Claims Management System 12 17. Care Management 12 18, Purchasing Drug Screens 13 19. Purchasing HIV Early Intervention Services 13 Services 1. General Services a. 12-Month Availability of Services 14 b. Persons Associated with the Corrections System 14 c. State Disability Assistance (SDA) 15 d. Persons Involved with the Michigan Department of Human Services (MDHS) 16 e. Primary Care Coordination 17 n AU'-- Statement oi Want IOC FY2013 Attachment A (Cont.') f.Cultural Competence 17 a. Charitable Choice h. Americans with Disabilities Act 19 i. Limited .English Proficiency 19 Treatment Services a. Medical Necessity Criteria for Substance Use Disorders Supports and Services 20 b. Clinical Eligibility: DSM IV—TR Diagnosis 22 c. Satisfaction Surveys 23 d. MIChild IVIIChild Covered Services 23 Eligibility 24 Per Enrolled Child Per Month 24 Data Collection and Reporting 25 Access Timeliness 26 e. Adult Benefit Waiver Withholds of State Share Amounts 26 How to Report ABVV Revenues and Expenditures 26 How to Report Expenditures for WSS- and ABVV-eligible Women 27 Use of State-administered Funds for ABW Enrollees 27 f. Intensive Outpatient Treatment-Weekly Format 28 g. Services for Pregnant Women, Primary Caregiver with Dependent Children, Primary Caregiver Attempting to Regain Custody of Their Children Federal Requirements 28 Requirements Regarding Providers 29 Financial Requirements on Initial and Final RERs 29 Financial Requirements on Quarterly FSRs 29 Treatment Episode Data Set (TEDS) and Encounter Reporting Requirements 29 h. Admission Preference ancl Interim Siervices 30 i. Access Timeliness Standards 30 j. Earmark-funded Special Projects: Reporting Requirements 31 k. Michigan Screening Brief Intervention and Referral to Treatment MI-SBIRT) 32 3. Prevention Services a. Prevention Requirements 34 Statement ot Work TOG initial F12013 6.29.12 Attachment A (Cont.') STATEMENT OF WORK Please note: Items in this Statement of 1/1/Ork have been placed into one of three categories: General; Administrative and Financial; and Services. This categorization is for conve.nience of reference only. It is not intended, and should not be interpreted, as limiting the applicability or scope of any item or items. Genera' 1. General Statement of Work The general responsibilities of the coordinating agency (CA) under this Agreement, based on P.A. 368 of 1978, as amended, are to: a. Develop comprehensive plans for substance abuse treatment and rehabilitation services and prevention services consistent with guidelines established by the Department. b. Review and comment to the Department on applications for licenses submitted by local treatment, rehabilitation, and prevention organizations. c. Provide technical assistance for local substance abuse service organizations. d. Collect and transfer data and financial information from local organizations to the Department. e. Submit an annual budget request to the Department for use of state administered funds for its city, county, or region for substance abuse treatments and rehabilitation services and prevention services in accordance with guidelines established by the Department. f. Make contracts necessary and incidental to the performance of the Agency functions. The contracts may be made with public or private agencies, organizations, associations, and individuals to provide for substance abuse treatment and rehabilitation services and prevention services. q. Annually evaluate and assess substance abuse services in the city, county, or region in accordance with guidelines established by the Department and federal goals. 2. Action Plan The CA will carry out its responsibilities under this Agreement consistent with the CA's most recent Action Plan as approved by the Department. 3. Substance Abuse Prevention and Treatment (SAPT) Block Grant Requirements and Applicability to State Funds Federal requirements deriving from Public Law 102-321, as amended by Public Law 106-310, and federal regulations in 45 CFR Part 96 are pass-through requirements. Federal Substance Abuse Prevention and Treatment (SAPT) Block Grant requirements that are applicable to states are passed on to CAs unless otherwise specified. At--i\ Statement 'of VVOlk Initial FY2013 (6.29.12) Page of 33 Attachment A (Cont.') 42 CFR Parts 54 and 54a, and 45 CFR Parts 96, 260, and 1050, pertaining to the final rules for the Charitable Choice Provisions and Regulations, are applicable to CAs as stated elsewhere in this Agreement. Sections from PL 102-321, as amended, that apply to CAs and contractors include but are not limited to: 1921(b): 1922 (a)(1)(2): 1922(b)(1)(2), 1923; 1923(a)(1) and (2), and 1923(b); 1924(a)(1)(A) and (B); 1924(c)(2)(A) and (B); 1927(a)(1) and (2), and 1927(b)(1); 1927(b)(2); 1928(b) and (c); 1929; 1931(a)(1)(A), (B), (C), (0), (E) and (F); 1932(b)(1); 1941; 1942(a); 1943(b); 1947(a)(1) and (2). Selected specific requirements applicable to CAs are as follows: a. Block Grant funds shall not be used to pay for inpatient hospital services except under condition specified in federal law. b. Funds shall not be used to make cash payments to intended recipients of services. c. Funds shall not be used to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or any other facility, or purchase major medical equipment. d. Funds shall not be used to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funding. e. Funds shall not be used to provide individuals with hypodermic needles or syringes so that such individuals may use illegal drugs. f. Funds shall not be used to enforce state laws regarding the sale of tobacco products to individuals under the age of 18. g. Funds shall not be used to pay the salary of an individual at a rate in excess of Level I of the Federal Executive Schedule, or approximately S199 ,70n. SAPT Block Grant requirements also apply to the Michigan Department of Community Health (MDCH) administered state funds, unless a written exception is obtained from iviDCH. 4. Licensure of Subcontractors The CA shall enter into agreements for substance use disorder prevention, treatment, and recovery services only with providers appropriately licensed for the service provided as required by Section 6231 of P.A. 368 of 1978, as amended. The CA must ensure that network providers residing and providing services in bordering states meet all applicable licensing and certification requirements within their state that such providers are accredited per the requirements of this Agreement, and that provider staff are credentialed per the requirements of this Agreement. Accreditation of Subcontractors AU—A Statement of \Nom r Y2013 (6.2912) Pape 2 of Attachment A (Cont.') The CA shall enter into agreements for treatment services provided through outpatient, cony intervention, Methadone, sub-acute detoxification and residential providers only with providers accredited by one of the following accrediting bodies: The Joint Commission (Thn formerly Jr.A.1-10); Commission on Accreditation of Rehabilitation Facilities (CARF); the American Osteopathic Association (AOA); Council on Accreditation of Services for Families and Children (COA); National Committee on Quality Assurance (NCOA), or Accreditation Association for Ambulatory Health Care (AAAHC). The CA must determine compliance through review of original correspondence from accreditation bodies to providers. Accreditation is not needed in order to provide access management system (AMS) services, whether these services are operated by a CA or through an agreement with a CA or for the provision of broker/generalist case management services. Accreditation is required for AMS providers that also provide treatment services and for case management providers that either also provide treatment services or provide therapeutic case management. Accreditation is not required for peer recovery and recovery support services when these are provided through a prevention license. If the CA plans to purchase case management services or peer recovery and recovery support services, and only these services, from an agency that is not accredited per this agreement, the CA may request a waiver of the accreditation requirement. 6. SAMHSA/DHHS License The federal awarding agency, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services (SAMHSA/DHHS), reserves a royalty-free, nonexclusive and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for federal government purposes: (a) The copyright in any work developed under a grant, sub-grant, or contract under a grant or sub-grant; and (b) Any rights of copyright to which a grantee, sub-grantee or a contractor purchases ownership with grant support. Cooperation with External Medicaid Evaluation The CA is expected to cooperate with Department efforts in external evaluation of Medicaid services, if the CA administers Medicaid services. The CA is expected to ensure that CA-funded providers will provide necessary data and will facilitate access to individuals' files and other records as required. Monitorino of Subcontractors The CA is required to assure that subcontractors comply with all applicable requirements contained in this agreement. To this end, the CA must adopt written policy and must implement procedures regarding monitoring of subcontractors. The monitoring policy and procedures must be consistent with AttA-- Statement of Work initial P12013 6.29.12 Page 3 of 33 Attachment A (Cont.') requirements in this agreement, with the current MDCH substance use disorder audit guidelines, and with applicable federal Office of Management and Budget (OMB) circulars. The CA must prepare a report of monitoring findings, and must make this report available to the public at least once every two years. Part II of the agreement, section I.H on Sub-recipient/Vendor Monitoring, requires that contractors conduct monitoring and risk-based assessments of sub- recipients during the period of the agreement. The CA must conduct monitoring and risk-based assessments of all subcontractors, during the period of the agreement, including subcontractors that are vendors. Administrative and Financial Match Rules Pursuant to Section 6213 of Public Act No. 368 of 1978, as amended, Michigan has promulgated match requirement rules. Rules 325.4151 through 325.4153 appear in the 1 981 Annual Administrative Code Supplement. In brief, the rule defines allowable matching fund sources and states that the allowable match must equal at least ten percent of each comprehensive CA budget (see Attachment B to the Agreement) - less direct federal and other state funds. Per PA 368, Administrative Rules, and contract, direct state/federal funds are funds that come to the CA directly from a federal agency Or another state source. Funds that flow to the CA from the Department are not in this category, such as, SDA, and, therefore, are subject to the local match requirement. Match requirements apply both to budgeted funds during the agreement period and to actual expenditures at year-end. "Fees and collections" as defined in the Rule include only those fees and collections that are associated with services paid for by the CA. If the CA is found not to be in compliance with Match requirements, or cannot provide reasonable evidence of compliance, the Department may withhold payment or recover payment in an amount equal to the amount of the Match shortfall. Reportina Fees and Collections Revenues On the initial Revenues and Expenditures Report (REP.), the CA is required to report all estimated fees and collections revenue to be received by the CA and all estimated fees and collections revenue to be received and reported by its contracted services providers (see Attachment B to this Agreement). On the final RER, the CA is required to report all actual fees and collections revenue received by the CA and all actual fees and collections revenue received and reported by its contracted services providers (see Attachment B to this Agreement). Al---A Statement of Work intal FY20 -13 1:6.29.1 2) "ape 4 of 33 Attachment A (Cont.') "Fees and collections" are as defined in the Annual Administrative Code Supplement, Rule 325.4151 and in the Match Rule section of this Attachment. 3. Management of Department -administered Funds The CA shall manage all Department-administered funds under its control in such a way as to assure reasonable balance among the separate requirements for each funds source. 4. Sliding Fee Scale The CA shall implement a sliding fee scale and attach a copy to the initial application every fiscal year, for Department approval. All treatment and prevention providers shall utilize the CA sliding fee scale. The sliding fee scale must be established according to the most recent year's Federal Poverty Guidelines. It must consist of a minimum of two distinctive fees based upon the income and family size of the individual seeking substance use disorders services. The CA must assure that all available sources of payments are identified and applied prior to the use of Department-administered funds. The CA must have written policies and implement procedures to be used by network providers in determining an individual's ability or inability to pay, when payment liability is to be waived, and in identifying all other liable third parties. The CA must also have policies and procedures for monitoring providers and for sanctioning noncompliance. Financial information needed to determine ability to pay (financial responsibility) must be reviewed annually or at a change in an individual's financial status, whichever occurs sooner. The scale must be applied to all persons (except Medicaid, MIChild, and ASIA' recipients) seeking substance use disorders services funded in whole or in part by the CA. The CA has the option to charge fees for AMS services, or not to charge. If the CA charges for AMS services, the same sliding fee scale as applied to treatment services must be used. 5. Inability to Pay Services may not be denied because of inability to pay. If a person's income falls within the CA's regional sliding fee scale, clinical need must be determined through the standard assessment and patient placement process. If a financially and clinically eligible person has third party insurance, that insurance must be utilized to its full extent. Then, if benefits are exhausted, or if the person needs a service not fully covered by that third party insurance, or if the co-pay or deductible amount is greater than the person's ability to pay, Community Grant funds may be applied. Community Grant funds may not be denied solely on the basis of a person having third party insurance, AL—A Statement of Work initial F52013 (629.12) Pape 5 ol Attachment A (Cont.') 6. Subcontracts with Hosoitals Funds made avaiiable through the Department shall not be made available to public, or private hospitals which refuse, solely on the basis of an individual's shbgtanoa. use disorder, admission or treatment for emergency medical conditions. 7. Residency in CA Region The CA may not limit access to the programs and services funded by this Agreement only to the residents of the CA's region, because the funds provided by the Department under this Agreement come From federal and statewide resources. Members of federal and state-identified priority populations must be given access to screening and to assessment and treatment services, consistent with the requirements of this Agreement, regardless of their residency. However, for non-priority populations, the CA may give its residents priority in obtaining services funded under this Agreement when the actual demand for services by residents eligible for services under this Agreement exceeds the capacity of the agencies funded under this Agreement. Out-of- Network and Out-of-Region Services The CA must have written policies and procedures for authorizing and purchasing treatment services from out-of-network and out-of-region providers for residents of the CA region who need care from such providers. Reimbursement Rates for Community Grant, Medicaid and Other Services The CA must pay the same rate when purchasing the same service from the same provider, regardless of whether the services are paid for by Community Grant funds, Medicaid funds, or other Department administered funds, including Adult Benefit Waiver (ABW) and MIChild funds. 10. Minimum Criteria for Reimbursing for Services to Persons with Co- Occurring Disorders Department funds made available to the CA through this Agreement, and which are allowable for treatment services, may be used to reimburse providers for integrated mental health and substance use disorder treatment services to persons with co-occurring substance use and mental health disorders. The CA may reimburse a Community Mental Health Services Program (CMHSP) or Pre-paid Inpatient Health Plan (PIHP) for substance use disorders treatment services for such persons who are receiving mental health treatment services through the CMHSP or PIHP. The CA may also reimburse a provider, other than a CMHSP or PIIHP, for substance use disorders treatment provided to persons with co-occurring substance use and mental health disorders. As always, when reimbursing for substance use disorders treatment, the CA must have an agreement with the CMHSP (or other provider); and the CMHSP (or other • Sta)ement of Work )nitial FO'2013 (0.29 12) Hale El of 33 Attachment A lr.nnt provider) must meet all minimum qualifications, including licensure, accreditation Lnd data repotng. 11. Media Campaigns A media campaign, very broadly, is a message or series of messages conveyed through mass media channels including print, broadcast, and electronic media. Messages regarding the availability of services in the CA region are not considered to be media campaigns. Media campaigns must be compatible with MDCH values, be coordinated with MDCH campaigns whenever feasible and costs must be proportionate to likely outcomes. The CA shall not finance any media campaign using Department-administered funding without prior written approval by the Department. 12. Notice of Excess or Insufficient Funds (NEIF) Coordinating agencies must notify the Department in writing and upload the notice to the Electronic Grants Administration and Management System (EGrAMS) by June 1 if the amount of State Agreement funding may not be used in its entirety or appears to be insufficient. The contract requires that the CA expend all allocated funds per the requirements of the SUD contract within the contract year OR notify the Department via the NEIF that spending by year-end will be less than the amount(s) allocated. This requirement applies to individual allocations, earmarks and to the total CA allocation. Of particular importance are allocations for Prevention services and Women's Specialty Services (WSS), including the earmarked allocations for the Odyssey programs. The State must closely monitor these expenditures to ensure compliance with the Maintenance of Effort requirement in the federal SAPT Block Grant. When it has been determined that a CA will not expend all of its allocated, VVSS State Agreement funds (including the earmarked allocations for the Odyssey programs), these unspent funds must be returned to the Department for reallocation to other CAs who can appropriately use these funds for VVSS programs within their CA regions within the current fiscal year. A CA's failure to expend these funds for the purposes for which they are allocated and/or its failure to notify the Department of projected expenditures at levels less than allocated may result in reduced allocations to the CA in the subsequent contract year. 13. Subcontractor Information to be Retained at the CA a. Budgeting Information for Each Service. b. Documentation of How Fixed Unit Rates Were Established: The CA shall maintain documentation regarding how each of the unit rates used in its agreements was established. The process of establishing and adopting rates must be consistent with criteria in OMB Circular A-87 or A- SLateme.nt of Work initial 171'2013 (5.29.12) Page 7 of 32 Attachment A (Cont.') 122, whichever is applicable, and with the requirements of individual fund O.J LU L..‘.7 c. Indirect Cost Documentation: The CA shall review subcontractor indirect cost documentation in accordance with OMB Circular A-87 or A-122, as applicable. d. Equipment Inventories: The CA must apply the following to all subcontractors that have budgeted equipment purchases in their contracts with the CA: Any contractor equipment purchases supported in whole or in part through this agreement must be listed in the supporting Equipment inventory Schedule. Equipment means tangible, non-expendable, personal property having useful life of more than one (1) year and an acquisition cost of $5,000 or more per unit. Title to items having a unit acquisition cost of less than $5,000 shall vest with the Contractor upon acquisition. The Department reserves the right to retain or transfer the title to all items of equipment having a unit acquisition cost of $5,000 or more, to the extent that the Department's proportionate interest in such equipment supports such retention or transfer of title. e. Fidelity Bonding Documentation: The CA shall maintain fidelity bonding documentation. 14. Reporting Requirements a. General Requirements Requirements concerning specific reports are contained elsewhere in the Agreement, including in Attachment C. The following requirements generally pertain: 1. Each report must be submitted by the specified due date. Reports successfully e-mailed or uploaded to the EGrAMS by the due date are considered timely. 2. Reports must be sent to the addressee and via the submission route (e.g., uploaded, e-mailed, etc.) specified in this Agreement. Reports that are not sent to the specified addressee are subject to being determined not timely or not received. 3. Reports must be submitted on the form and in the format specified in this Agreement (if form and format are specified). h. Legislative Reports (L_Rs) and Financial Reports If the contractor does not submit the LP., or the final RER (which includes the ABW and MIChild Year-end Balance Worksheets and Administration/ Service Coordination Report) within fifteen (15) calendar days of the due date, the Department may withhold from the current year funding an amount equal to five (5) percent of that funding (not to exceed 5100,000) AL A Si:Wel-gent of Work PY2013 INITIAL DRAFT 9.4.12.docx Page 8 of 33 Attachment A (Cont.') until the Department receives the required report. The Department may retain the amount withheld if the contractor is more than forty-five (45) calendar days delinquent in meeting the filing requirements. The contractor must assure that the financial data in these reports are consistent and reconcile between the reports; othervvise, the reports will be considered as not submitted and will be subject to financial penalty, as mentioned above. Additional financial penalties are applicable to the Notice of Excess and Insufficient Funds, The Department may choose to withhold payment when any financial report is delinquent by thirty (30) calendar days or more and may retain the amount withheld if the report is sixty (60) or more caiendar days delinquent. This does not apply to the LR and final REF<, as stated above. Financial reports are: 1. Revenues and Expenditures Report—INITIAL and FINAL; 2. Financial Status Report-1 st thru 31d quarter; 3. Financial Status Report-4th quarter; 4. Notice of Excess or Insufficient Funds; and 5. Primary Prevention Expenditures by Strategy Report. c. Mental Health and Substance Use Disorder Services integration Status Report The contractor is required to submit information regarding integration of mental health and substance use disorders services. The annual report will include either tile status of the CAs current efforts to coordinate services with the local CIVIHSPs or PIHPs or, the impact and efficiencies realized by those CAs who are currently integrated. Report form and instructions are included in Attachment D – Reporting Requirements. d. Data Reporting Timeliness and Completeness Standards MDCH monitors the timeliness of submission for all required reports. Reports that arrive after the established due date are recorded as late. If the submission arrives more than five (5) calendar days past due, a letter will be sent to the CA Director to notify the CA of the lack of compliance with the published due date. Sanctions for noncompliance (depending on the severity and frequency) may include a requirement for a corrective action plan or may include an adjustment in prepayments. For data transactions that are submitted via the Date Exchange Gateway (DEG), including admission, discharge, and encounter batches, the processing system logs the dates and times the batches were transferred (Astl--4\ Satenen Wor nit FY2013 (6.29.12) Page 9 bc g. Attachment A (Cant.') and processed. When the system is in production, monthly submissions 11 A r rs k" the r‘Ao are required. ata submissions are monitoredby I ,..Py 1. 1, staff. Data Completeness The CA is responsible for submitting 100% of required records. Initial submissions combined with error corrections and resubmissions must result in an accuracy rate of 100%. National Outcome Measures (NOMS) Complete, accurate, and timely reporting of treatment and prevention data is necessary for the Department to meet its federal reporting requirements. For the SUD Treatment NOMS, it is the CA's responsibility to ensure that the client information reported on these records accurately describes each client's status at admission first date of service (admission) and on the last day of service (discharge). Michigan Prevention Data System (MPDS) CAs are required to collect and report the state-required prevention data elements throughout the prevention provider network either through participation in the MPDS or through an upload of the state-required prevention data records to MPDS on a monthly basis. CAs must assure that all records submitted to the state system are consistent with the fV1PDS Reference Manual. (See SUD Services Policy Manual.) It is the responsibility of the CAs to ensure that the services reported to the system accurately reflects staff service provision and participant information for all CA-administered fund sources. It is the responsibility of the CAs to monitor provider completeness, timeliness and accuracy of provider data maintained in the system in a manner which will ensure a minimum of 90 percent accuracy. 15, Critical Incidents and Sentinel Events The CA must require all of its residential treatment providers to prepare and file critical incident reports and sentinel event reports that include the following components: 1. Provider determination whether critical incidents are sentinel events. 2. Following identification as a sentinel event, the provider must ensure that a root cause analysis or investigation takes place. Ati--A Statement olV)iorl; Inta FY2013 (6.29.12) Page 10 of 33 Attachment A (Cont.') Based on the outcome of the analysis or investigation, the provider must ensure that a plan of action is developed and implemented to prevent further occurrence of the sentinel event. The plan must identify who is responsible for implementing the plan, and how implementation will be monitored. Alternatively, the [provider may prepare a rationale for not pursuing a preventive plan. The CA is responsible for oversight of the above processes. Requirements for reporting data on Sentinel Events are contained in Attachment D-Reporting Requirements. These reporting requirements are narrower in scope than the responsibility to identify and follow up on critical incidents and sentinel events. A Critical Incident is any of the following that should be reviewed to determine whether it meets the criteria for a sentinel event below: 1. Death of a recipient. 2. Serious illness requiring admission to hospital. 3. Alleged cause of abuse or neglect. 4. Accident resulting in injury to recipient requiring emergency room visit or hospital admission. 5. Behavioral episode. 6. Arrest and/or conviction. 7. Medication error. A Sentinel Event is an "unexpected occurrence involving death or serious physical Or psychological injury", or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, "or risk thereof' includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome." (JCAHO, 1998) 16, Claims Management System The CA shall make timely payments to all providers for clean claims. This includes payment at 90% or higher of clean claims from network providers within 60 days of receipt, and 99% or higher of all clean claims within 90 days of receipt. A clean claim is a valid claim completed in the format and time frames specified by the CA and that can be processed without obtaining additional information from the provider. It does not include a claim from a provider who is under investigation for fraud or abuse, or a claim under review for medical necessity. A valid claim is a claim for services that the CA is responsible for under this Agreement. It includes services authorized by the CA. The CA must have a provider appeal process to promptly and fairly resolve provider-billing disputes. Staloment of Work Innial F22013 (6.29.12 Page 11 o 33 Attachment A (Cont.') 17. Care Management The CA may pay for care management as a service designed to support CA resource allocation as well as service utilization. Care management is in recognition that some clients represent such service or financial risk that closer monitoring of individual cases is warranted. Care management must be purchased and reported consistent with the instructions for the Administrative Expenditures Report in Attachment B to this agreement. 18. Purchasing Drug Screens This item does not apply to medication-assisted .services. Department-administered treatment funds can be used in pay for drug screen s , if all of the following criteria are met: (a) No other responsible payment source will pay for the screens. This includes self-pay, Medicaid, and private insurance. Documentation must be placed in the client file; (b) The screens are justified by specific medical necessity criteria as having clinical or therapeutic benefit; and Screens performed by professional laboratories can be paid for one time per admission to residential or detoxification services, if specifically justified. Other than these one-time purchases, Department funds may only be used for in house "dip stick" screens. The code(s) to use when submitting the encounter data to MDCH is as follows: H0003 is a lab test (sent out for analysis); or H80100 is for in house screens (dip stick tests). 19. Purchasing HIV Early intervention Services Department-administered Community Grant funds (blended SAPT Block Grant and General Fund) cannot be used to pay for HIV Early Intervention Services because Michigan is not a Designated State for HIV. Per 45 CFR, Part 96, Substance Abuse Prevention and Treatment Block Grant, the definition of Early Intervention Services relating to HIV means: (a) appropriate pretest counseling for HIV and AIDS; (b) testing individuals with respect to such disease, including tests to confirm the presence of the disease, tests to diagnose the extent of the deficiency in the immune system, and tests to provide information on appropriate therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from the disease; \ An--A Statement of Work Initia FY2013 (6.29.12; Page 12 al 33 Attachment A (Cont') (c) appropriate post-test counseling; and (d) providing the therapeutic measures described in Paragraph (b) of this definition. To review the full document, go to: httneill aw. justia .com/usictrititle45/45- 1.0.1 1.53.12.html Services 1. General Services a. 12-Month Availability of Services The CA shall assure that, for any subcontracted treatment or prevention service, each subcontractor maintains service availability throughout the fiscal year for persons who do not have the ability to pay. The CA is required to manage its authorizations for services and its expenditures in light of known available resources in such a manner as to avoid the need for imposing arbitrary caps on authorizations Or spending. "Arbitrary caps" are those that are not adjusted according to individualized determinations of the needs of clients. This requirement is consistent with Medical Necessity Criterion 1.4.3, which may be found elsewhere in Attachment A. b. Persons Associated with the Corrections System When the CA or its AMS services receives referrals from the Michigan Department of Corrections (MDOC), the CA shall handle such referrals as per all applicable requirements in this agreement. This would include determining financial and clinical eligibility, authorizing care as appropriate, applying admissions preferences, and oter steps. MDOC referrals may come from probation or parole agents, or from MDOC Central Office staff. In situations where persons have been referred from. MDOC and are under their supervision, state-administered funds should be used as the payment of last resort. When persons who are on parole or probation seek treatment on a voluntary basis from the CA's AMS services or from a panel provider, these self-referrals must be handled like any other self-referral to the MDCH-funded network. AMS or provider staff may seek to obtain releases to communicate with a person's probation or parole agent but in no instance may this be demanded as a condition for admission or continued stay. The CA may collaborate with MDOC, and with the Office of Community Alternatives (OCA) within MDOC, on the purchase of substance use disorders services and supports. This may include collaborative Statement of Won; Inifiai FY2013 (6.29.12; Page 13 of 33 Attachment A (Cont.') purchasing from the same providers, and for the same clients. In such situations, the CA must assure that: 1. All collaborative purchasing is supported by written agreements among the participants. 2. Rates paid to providers, whether by a single purchaser or two or more purchasers, do not exceed provider costs. 3. Rates paid to providers are documented and are developed consistent with applicable OMB Circular(s). 4. No duplication of payment occurs. c. State Disability Assistance (SDA) (Appiies Only to Agencies Who Have Allocations for this Program) MDCH continues to allocate SDA funding and to delegate management of this funding to the CA. The FY2013 SDA funding has been revised in accordance to the SDA Projected Allocation Redistribution for FY13-FY16 as approved by a MDCH/MASACA workgroup, and is identified in the CA's allocation letter. The CA is responsible for allocating these funds to qualified providers. Minimum provider qualifications are MDCH licensure as a residential treatment provider and accreditation by one of the approved accreditation bodies (identified elsewhere in this Agreement). A provider may be located within the CA's region or outside of the region. SDA funds shall not be used to pay for room and board in conjunction with sub-acute detoxification services. When a client is determined to be eligible for SDA funding, the CA must arrange for assessment and authorization for SDA room and board funding and must reimburse for SDA expenditures based on billings from providers, consistent with CA/provider agreements. In addition, the CA may authorize such services for its own residents at providers within or outside its region. The CA shall not refuse to authorize SDA funds for support of an individual's treatment solely on the basis of the individual's current or past involvement with the criminal justice system. For those individuals currently involved with MDOC and receiving services as part of MDOC programming, SDA funds shall only be used as the payment of last resort. Qualified providers may be reimbursed up to twenty-seven ($27) per day . for room and board costs for SDA -eliaibie persons during their stays in Residential treatment. To be eligible for MDCH-administered SDA funding for room and board services in a substance use disorder treatment program, a person must be determined to meet Michigan Department of Human Services (MDHS) eligibility criteria; determined by the CA or its desionee to be in need of residential treatment services; authorized by the CA for residential Stztement oi Work initial FY2013 (6.29.12) Page 1 ,1 of 33 Attachment A (Cont.') treatment when the CA expects to reimburse the provider for the treatment, at IPPQA 18 yPi-Q of age or an emancipated minor, and in residence in a residential treatment program each day that SDA payments are made. The CA may employ either of two methods for determining whether an individual meets MDHS eligibility criteria: 1. The CA may refer the individual to the local MDHS office. This method must be employed when there is a desire to qualify the individual for an incidental allowance under the SDA program. Or, 2. The CA may make its own determination of eligibility by applying the essential MDHS eligibility criteria. See this DHS link for details: http://www.mick-iidan.dcvldhs/0,1607.7-124-5453 5526— ,0Q.html For present purposes only, these criteria are: • Residency in substance use disorders residential treatment. • Michigan residency and not receiving cash assistance from another state. • U.S. citizenship or have an acceptable alien status. • Asset limit of $3,000 (cash assets only are counted). Regardless of the method used, the CA must retain documentation sufficient to justify determinations of eligibility. The CA must have a written agreement with a provider in order to provide SDA funds. d. ParQnri Involved with the Michigan Department of Human Services (MDHS) The CA must work with the MDHS office(s) in its region to facilitate access to prevention, assessment and treatment services for persons involved with MDHS, including families in the child welfare system and public assistance recipients. The CA must develop written agreements with MDHS offices that specify payment and eligibility for services, access-to- services priority, information sharing (including confidentiality considerations), and other factors as may be of local importance. e. Primary Care Coordination The CA must take all appropriate steps to assure that substance use disorder treatment services are coordinated with primary health care. in the case of CAs that are under contract with PIHPs for the Medicaid Statement of 1/Vorif. F72013 (6.29.12) Page 12 of K. Attachment A (Cont.') substance abuse program, CAs are reminded that coordination efforts must be consistent 'with these contracts. Treatment case files must include, at minimum, the primary care physician's name and address, a signed release of information for purposes of coordination, or a statement that the client: hies refused to sian a release. Care coordination agreements or joint referral agreements, by themselves, are not sufficient to show that the CA has taken all appropriate steps related to coordination of care. Client case file documentation is also necessary. Cultural Competence CA must have a written cultural competency plan implemented in practice at their agency and at all provider agencies. The plan must include: 1. The CA's identification and assessment of the cultural needs of potential and active clients based on population served. 2. The CA's identification standards for the recruitment and hiring of culturally competent staff members. 3. The CA's identification of how ongoing staff training needs in cultural competency will be assessed and met and the evidence that staff members receive training. 4. The CA's process for ensuring that panel providers comply with all applicable requirements concerning the provision of culturally competent services. 5. The CA's process for annually assessing its compliance with the CA's cultural competence plan. Charitable Choice The September 30, 2003 Federal Register (45 CFR part 96) contains federal Charitable Choice SAPT block grant regulations, which apply to both prevention and treatment providers/programs. In summary, the regulations require: 1) that the designation of religious (or faith-based) organizations as such be based on the organization's self-identification as religious (or faith based), 2) that these organizations are eligible to participate as providers—e.g. a "level playing field" with regard to participating in the CA provider panel, 3) that a program beneficiary receiving services from such an organization who objects to the religious character of a program has a right to notice, referral, and alternative services which meet standards of timeliness, capacity, accessibility and equivalency—and ensuring contact to this alternative provider, and 4) Ai--A Statement of Work Inittal FY2C13 (6.29,12) Page 12 o:::;2 9. Attachment A (Cont.') other requirements, including-exclusion of inherently religious activities and non-discrimination. The CA is required to comply with all applicable requirements of the Charitable Choice regulations. The CA rn ,,st ensure that treatment clients and prevention service recipients are notified of their right to request alternative services. Notice may be provided by the AMS or by providers that are faith-based. The CA must assign responsibility for providing the notice to the AMS, to providers, or both. Notification must he in the form of the model notice contained in the final regulations, or the CA may request written approval from MDCH of an equivalent notice. The CA must also ensure that its AMS administer the processing of requests for alternative services_ This is applicable to all face-to-face services funded in whole or part by SAPT Block Grant funds, including prevention and treatment services. The CA must submit an annual report on the number of such requests for alternative services made by the agency during the fiscal year, per Attachment C-Required Reports. The model notice contained in the federal regulations is: No provider of substance abuse services receiving Federal funds from the U.S. Substance Abuse and Mental Health Services Administration, including this organization, may discriminate against you on the basis of religion, a religious belief, a refusal to hold a religious belief, or a refusal to actively participate in a religious practice. If you object to the religious character of this organization, Federal law gives you the right to a referral to another provider of substance abuse services. The referral, and your receipt of altemafive services, must occur within a reasonable period of time after you request them. The alternative provider must be accessible to you and have the capacity to pt-evide RubRtanoe abuse services. The services provided to you by the alternative provider must be of a value not less than the value of the services you would have received from this organization, h. Americans with Disabiiities Act The CA and its contractors must comply with applicable provisions of the Americans with Disabilities Act (the ADA). Further information may be found at: Nondiscrimination on the Basis of Disability in State and Local Government Services: United States Code of Federal Regulations, Title 28, Part 35, Washington, D.C. (1991), Limited English Proficiency Att---/k Statement of Work initial 0Y2013 (6.29,12) Page 12 of 33 Ati—A Statement of Work Initia FY2013 (6.29.12) Page '7 Or 3:2> Attachment A (Cont.') The CAs must ensure a current Limited English Proficiency (LEP) policy is in place and in practice. The CA must also have documentation that all providers have implemented the required LEP policy and procedures and are in compliance with related Federal and State requirements. The LEP policies and procedures must include the following, as required by the Office of Civil Rights. 1, Procedures for identifying and assessing the language needs of the CA, individual provider and the geographic area served. Needs must be based on current local and regional census data, as well as other state and regional data. 2. Identified range of oral language assistance options appropriate to the CAs circumstances. 3. How the CA provides notice to LEP persons, in their primary language, of the right to free language assistance. 4. What staff training and program monitoring is performed related to LEP policies and procedures. 5. Provisions for written materials in language other than English where a significant number or percentage of the affected population needs services or information in a language other than English, to communicate effectively, 6. Provisions for language interpreters who are trained and competent. 7. Statements explaining timely assistance. 8. Statements explaining there will be no charge to the LEP recipient for these services. 9. Provisions regarding use of family member and/or friend as a language interpreter must not be required. Should the consumer choose to use family or friend as an interpreter, both the offering of other resources, and the consumer's choice, must be documented in writing. Availability of consumer family and friends as translator/interpreter will not waive other LEP requirements herein described. Treatment Services a, MPrfici Necessity Criteria for Substance Use Disorders Supports and Services The CA must assure that treatment service authorization and reauthorization decisions are consistent with the following Medical Attachment A (Cont.') Necessity Criteria. These criteria are substantively the same as the applicable criteria for substance use disorders Medicaid services 1.0 Medical Necessity Criteria "Medically necessary" substance abuse services are supports, services, and treatment: 1.1.1 Necessary for screening and assessing the presence of substance use disorder; and/or 1.1.2 Required to identify and evaluate a substance use disorder; and/or 1.1.3 intended to treat, ameliorate, diminish or stabilize the symptoms of a substance use disorder; and/or 1.1.4 Expected to arrest or delay the progression of a substance use disorder; and/or 1.1.5 Designed to assist the individual to attain or maintain a sufficient level of functioning in order to achieve his/her goals of community inclusion and participation, independence, recovery or productivity. 1.2 The determination of a medically necessary support, service or treatment must be: 1.2.1 Based on information provided by the individual, individual's family, and/or other individuals (e.g., friends, personal assistants/aide) who know the individual; and 1.2.2 Based on clinical information from the individual's primary care physician or clinicians with relevant qualifications who have evaluated the individual; and 1.2.3 Based on individualized treatment planning; and 1.2.4 Made by appropriately trained substance abuse professionals with sufficient clinical experience; and 1.2.5 Made within federal and state standards for timeliness; and 1.2.6 Sufficient in amount, scope and duration of the service(s) to reasonably achieve its/their purpose. 1.3 Supports, services and treatment authorized by the CA must be: 1.3.1 Delivered in accordance with federal and state standards for timeliness in a location that is accessible to the individual; and 1.3.2 Responsive to particular needs of multi-cultural populations and furnished in a culturally relevant manner; and 1.3.3 Provided in the least restrictive, most integrated setting. Residential or other segregated settings shall be used only when less restrictive levels of treatment, ,Ati-kt,, Statement of Work InitiaF FY2013 (6.29.12) Page 17 of 33 1.1 Attachment A (Cont.') service or support have been, for that beneficiary, unsuccessful or cannot be safely provided; and 1.3.4 Delivered consistent with, where they exist, available research findings, health care practice guidelines and 1.3.5 standards of practice issued by professionally , recognized organizations or government agencies. 1.4 Using criteria for medical necessity, a CA may: 1,4.1 Deny services a) that are deemed ineffective for a given condition based upon professionally and scientifically recognized arid accepted standards of care; b) that are experimental or investigational in nature; or c) for which there exists another appropriate, efficacious, less-restrictive and cost- effective service, setting or support, that otherwise satisfies the standards for medically-necessary services; and/or 1.4,2 Employ various methods to determine amount, scope and duration of services, including prior authorization for certain services, concurrent utilization reviews, centralized assessment and referral, gate-keeping arrangements, protocols, and guidelines. 1.4.3 A CA may not deny services solely based on PRESET limits of the cost, amount, scope, and duration of services; but instead determination of the need for services shall be conducted on an individualized basis. This does not preclude the establishment of quantitative benefit limits that are based on industry standards and consistent with 1.3.4 above, and that are provisional and subject to modification based on individual clinical needs and clinical progress. b. Clinical Eligibility: DSM IV-TR Diagnosis In order to be eligible for treatment services purchased in whole or part by state-administered funds under the agreement, an individual must be found to meet the criteria for one or more selected substance use disorders found in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR). These disorders are listed below. This requirement is not intended to prohibit use of these funds for family therapy. It is recognized that persons receiving family therapy do not necessarily have substance use disorders. Alcohol Dependence 305.00 Alcohol Abuse 303.00 Alcohol Intoxication 291.80 Alcohol Withdrawal 291.90 Alcohol-Related Disorder, Not Otherwise Specified Att—A Stator-nen', oi Work Inika' FY2013 (36.29.12 Paoe 19 of 33 Attachment A (Cont.') 304.40 Amphetamine Dependence 7rn •-/ LI Amphetamine Abuse 292.89 Amphetamine Intoxication 292.00 Amphetamine Withdrawal 292.90 Amphetamine-Related Disorder, Not Otherwise Specified 304.30 Cannabis Dependence 305.20 Cannabis Abuse 292.89 Cannabis Intoxication 292.90 Cannabis-Related Disorder, Not Otherwise Specified 304.20 Cocaine Dependence 305.60 Cocaine Abuse 292.89 Cocaine Intoxication 292.00 Cocaine Withdrawal 292.90 Cocaine-Related Disorder, Not Otherwise Specified 304.50 Hallucinogen Dependence 305.30 'Hallucinogen Abuse 999.89 Hallucinogen Intoxication 292.90 Hallucinogen-Related Disorder, Not Otherwise Specified 304.60 Inhalant Dependence 305.90 Inhalant Abuse 292.89 Inhalant Intoxication 292.90 Inhalant-Related Disorder, Not Otherwise Specified 304.00 Opioid Dependence 305.50 Opioid Abuse 292.89 Opioid Intoxication 292.00 Opioid Withdrawal292.90 Opioid-Related Disorder, Not Otherwise Specified 304.60 Phencyclidine Dependence 305.90 Phencyclidine Abuse 292.89 Phencyclidine Intoxication 292.90 Phencyclidine-Related Disorder, Not Otherwise Specified 304.80 Polysubstance Dependence 304.10 Sedative, Hypnotic, or Anxiolvtic Dependence 305.40 Sedative, Hypnotic, or Anxiolytic Abuse 292.89 Sedative, Hypnotic, or Anxiolytic Intoxication 299.00 Sedative, Hypnotic, or Anxiolytic Withdrawal 292.90 Sedative, Hypnotic, or Anxiolytic-Related Disorder, Not Otherwise Specified 304.90 Other (or Unknown) Substance Dependence 305.90 Other (or Unknown) Substance Abuse 292.89 Other (or Unknown) Substance Intoxication 292.00 Other (or Unknown) Substance Withdrawal c. Satisfaction Surveys The CA shall assure that all network subcontractors providing treatment conduct satisfaction surveys of persons receiving treatment at least once AM-A Statement of Work initial FY2013 (6.29.121 Page 19 of 30 Attachment A (Cont.') a year. Surveys may be conducted by individual providers or may be conducted centrally by the CA. Clients may be active clients or clients discharged up to 12 months prior to their participation in the survey. Surveys may be conducted by mail, telephone, or face-to-face. The CA must compile findings and results of client satisfaction surveys for all providers, and must make findings and results, by provider, available to the public. d. MiChild MIChild Covered Services The CA must assure use of a standardized assessment process, including the American Society of Addiction Medicine (ASAM) Patient Placement Criteria, to determine clinical eligibility for services based on medical necessity. Substance use disorder services are covered when medically necessary as determined by the CA. This benefit should be construed the same as are medical benefits in a managed care program. Inpatient (hospital- based) services are covered, but the CA is permitted to substitute less costly services outside the hospital if they meet the medical needs of the patient. In the same way, the CA may substitute services for inpatient or residential services if they meet the child's needs and they are more cost effective. Covered services are as follows: 1. Outpatient Treatment Residential Treatment inpatient Treatment Laboratory and Pharmacy These benefits apply only when a CA's employed or contracted physician writes a prescription for pharmacy items or lab. Eligibility Eligible persons are persOns of age 18 or less who are determined eligible for the MIChild program by the MDCH and enrolled by the Department's administrative vendor and live in the region covered by the CA. The CA is responsible for determining eligibility and for charging all authorized and allowable services to the MIChild program up to the CA's annual MIChild revenues. Per Enrolled Child Per Month On a monthly basis, MDCH will provide the CA with the federal share of MIChild funds as a per capita payment based upon a Per Enrolled Child Per Month (PECPM) methodology for MIChild covered services. In A11-4), Staternent of Work- Intal HY2013 (6.29.12) page 19 of 33 Statemenl of Work Initial 7".(2013 (3.29.12) Page 19 ut 33 Attachment A (Cont.') consideration for accepting the federal funding pushed to the CA, the CA •-nrIrcaa., fn rinncard •el inr4 r4r,11nrc, the 11/11rskiir4 cat Ls, ,.../\101111 OLLA1,-, CAI LA 1,4 lAl../11C.41 III 11ait 11111 ,..,11111lA federal FMAP funds (Title XXI State Children's Health Insurance Program) and carry out the associated substance use disorders program requirements . The PECPM rate and the federal fund source are updated, as needed, by the Department on an annual basis or as rates change. The PECPM funding is a per capita payment for medically necessary MIChild-covered services including outpatient, residential and inpatient services as authorized by the CA. If the MIChild capitation is not sufficient to serve the MIChild enrollees, use of state-allocated General funds is allowed. Federal SARI Block Grant funds may not be used for inpatient care. Data Collection and Reporting The CA must account separately for expenses related to MIChild enrollees. Reporting of MIChild revenues and expenditures will be through the RER as indicated in Attachment B to this Agreement and via the Financial Status Report (FSR). In the event that program costs are less than PEOPM revenues and the state match amounts, the CA may retain the balances as Local funds, In the event that program costs are greater than the federal PECPM and state match amounts, the CA may use other State Agreement funds budgeted for treatment in this Agreement The MIChild balances, as reported on the MIChild Year-end Balance Worksheet, are the Actual Revenues minus the Actual Expenditures. If reporting year-end unspent fund balances on this Worksheet, the agency must report BOTH the state match balance and the federal PECPM balance. The state match fund balance, along with the federal PECPM fund balance, cannot be expended in the same fiscal year as earned. These unexpended funds must be carried forward into the next fiscal year and reported as Local funds. The funds become Local funds only after Department acceptance of the final RER. The funds must be expended consistent with requirements in this Agreement, pertaining to State Agreement funds, to support the CA's substance use disorder programs. Enrollees who receive substance use disorder services must be entered into the Substance Use Disorder Stiatewide Client Data System following the instructions in the data reporting specifications. Attachment A (Cont.') For the required reporting of encounters for MiChild eligible clients, the CA will report these encounters via the 837 as follows: 2000B Subscriber Hierarchical Level QBP, Subscriber information SBRO4 Insured Group Name: Use "MIChild" for the group name. Access Timeliness Access timeliness requirements are the same as those applicable to Medicaid substance use disorders services, as specified in the agreement between MDCH and the PrelPs. Access must be expedited when appropriate based on the presenting characteristics of individuals. e. Adult Benefit Waiver Withholds of State Share Amounts ABVV per member per month gross payments for ABVV SUD will be paid to PIHPs, The state portion of the gross will be calculated as a projection based on an estimate of annual member months per CA. The CA's fiscal year State Agreement allocation will be reduced by this projected amount and then paid to the PIHPs by the Department. The amount of the reduction may be adjusted during the fiscal year, if warranted, based on unanticipated changes in enrollment. The amount of each CA's reduction will be determined by the Department based on: the projected annual beneficiary count per county (or city, in the case of Detroit) that is within a CA region and also within a PIHP region, multiplied by e the state share of the gross rate including use tax, multiplied by • the PIHP's geographic factor. How to Report ABW Revenues and Expenditures If the CA has ABW expenditures, if any, in the General Administration (GA) or Access Management System (AMS) categories, these expenditures should be reported in the GA and/or AMS columns on Page 3 of the RER. For ABW expenditures reported in Section C ABW (gross expenditures), state share does not have to be reflected in the Community Grant row, because the state share in included in the gross, On Page 4 of the RT---R, the Am.Al column label rPnris "ARkAi Treatment.' This is to clarify that only ABW expenditures for treatment services should be reported in this column, given that there may be /6,BW expenditures reported also for GA and AMS. AA Statement of Work Initial FY2013 (6.2212) Page 24 0[36 Attachment A (Cont.') lithe CA has expended all of its ABW funds received from its P!HP(s) during the fiscal year, the CA may choose to use its Community Grant funding to pay for treatment services for ABW beneficiaries. Those expenditures would be reported on the RFR, Page 4, Section A. APW Treatment column, Community Grant row. In order to allow for this possible action, each CA must set up a Community Grant/ABW (Treatment) budget during the completion of the initial SUDS application or subsequent amendment application. A minimum budget amount of $1 will suffice and allow EGrAMS to set up a budget associated with a line item for reporting these expenditures on quarterly FSRs and on the final fiscal year REP, (Page 4, Section A. ABVV [Treatment] column, Community Grant row). How to Report Expenditures for VVSS- and ABVV-eliqible Women When a woman is eligible for both ABW and WSS funds, the woman's expenditures must be paid for with ABVV funds. Report these expenditures on the RER, page 3, Section C. ABVV, Women's Specialty column, Rows 2 and 3—federal and state share respectively. This also applies to the Odyssey House WSS expenditures (see Page 5 of the RER). Use of State-administered Funds for ABW Enrollees ABVV funds (received from the CA's PIHPs) are first source for all services, both covered and optional, provided to ABW beneficiaries. Other funds provided through the MDCH/CA contract cannot be used for any services to ABW beneficiaries if ABVV funds are available. "Available" includes ABVV gross revenues (federal share and state share) received and not expended during the previous fiscal year. See the following paragraphs regarding CA/PIHP agreements. If the CA has NOT been delegated by one or more PIHPs the responsibility to manage the ABVV SUD program, the CA is prohibited from using any state-administered funds for covered treatment services to ABVV beneficiaries. The CA may use state-administered funds for services that are discretionary under the ABW program (examples: detoxification, residential), but ONLY if the PIHP(s) has adopted written policy that the PIHP(s) will NOT pay for these services. CAs are prohibited from using state-administered funds when other parties are financially responsible. If the CA DOES have an agreement with one or more PIHPs, the first source for billing is ABW revenue received from the PIHP(s). Any unexpended ABW Fund Balance remaining for the fiscal year should be treated according to the CA/PIHP(s)' agreement(s). A[--A Statement of \Noe,. Initial FY2013 f6.29 12j Pa qe 24 of 22 1, 9. Attachment A (Cont') Intensive Outpatient Treatment — 'Weekly Forrnat The CA may purchase Intensive outpatient treatment (10P) only if the treatment c.;onsists of reg'ularly scheduled 'a -eatment, tisually group therapy, within a structured program, for at least three days and at least nine hours per week. Services for Pregnant Women, Primary Caregiver with Dependent Children, Primary Caregiver Attempting to Regain Custody of Their Children The CA must assure that providers screen and/or assess pregnant women, primary caregivers with dependent children, and primary caregivers attempting to regain custody of their children to determine whether these individuals need and request the defined federal services that are listed below. All federally mandated services must be made available within each CA region. Federal Requirements Federal requirements are contained in 45 CFR (Part 96) section 96.124, and may be summarized as: Providers receiving funding from the state-administered funds set aside for pregnant women and women with dependent children must provide or arrange for the 5 types of services, as listed below. Use of state administered funds to purchase primary medical care and primary pediatric care must be approved, in writing, in advance, by the Department contract manager. Primary medical care for women, including referral for prenatal care if pregnant, and while the women are receiving such treatment, child care; 2. Primary pediatric care for their children, including immunizations; 3. Gender specific substance use disorders treatment and other therapeutic interventions for women, which may address issues of relationships, sexual and physical abuse, parenting, and childcare while the women are receiving these services; 4. Therapeutic interventions for children in custody of women in treatment, which may, among other things, address their developmental needs, issues of sexual and physical abuse, and neglect; and 5. Sufficient case management and transportation to ensure that women and their dependent children have access to the above mentioned services. Att-A .Statement of Work, Iniga! FY2013 (6.29.12) Page 25 of 33 Attachment A (Cont') The above five types of services may be provided through, the MDCH/CA agreement only when no other source of support is available and when no other source is financially responsible. MDCH extends the federal requirements above to primary caregivers attempting to regain custody of their children or at risk of losing custody of their children due to a substance use disorder. These individuals are a priority service population in Michigan and, therefore, the five federal requirements listed above shall be made available to them. Reguirements Re aR:_g_firjgPi_-oviders Women's Specialty Services may only be provided by providers that are designated as gender-responsive by the Department or as gender- competent by the CA and that meet standard panel eligibility requirements. The provider may be designated by the Department as Women's Specialty providers, but such designation is not required. The CA must continue to provide choice from a list of providers who offer gender-competent treatment and identify providers that provide the additional services specified in the federal requirements. Financial Reauirements on Initial and Final RERs The CA has been assigned an expenditure target for Women's Specialty Services in the CA's initial allocation letter. State general fund dollars and the state share of Medicaid and ABW dollars, as well as SAPT Block Grant dollars, can be counted toward the expenditure target. CAs must report on their RERs, in the Women's Specialty column, all allowable expenditures for Women's Specialty Services, and only allowable expenditures. Financial Requirements on Quarterly FSRs On each quarterly FSR, the CA must report all allowable Women's Specialty Services expenditures that utilize State Agreement funds. Those funds are Community Grant and/or State Disability Assistance. Treatment Episode Data Set (TEDS) and Encounter Reporting Rea uirements For TEDS reporting purposes, the Agency must code yes' for all women eligible for and receiving qualified women's specialty services. At admission, this can be coded based on eliaibility. To qualify, the women must be either pregnant, have custody of a minor child, or be seeking to regain custody of a minor child. At minimum, the provider must be certified by the agency as gender competent. AL--A Statomeni. of Wont Initial FY2013 (6.29.12) Page 23 of 33 Attachment A (Cont.') For all services that qualify based on qualifying characteristics both of the women and of the provider, the HD modifier must be u S ed (See SIUD Services Policy Manual/Section I Data Requirements: Substance Abuse Encounter Reporting HCPCS and Revenue Codes Chart). h. Admission Preference and Interim Services The Code of Federal Regulations and the Michigan Public Health Code define priority population clients. The priority populations are identified as follows and in the order of importance: 1. Pregnant injecting drug user. 2. Pregnant. 3. Injecting drug user. 4. Parent at risk of losing their child(ren) due to substance use. 5. All others. Access timeliness standards and interim services requirements for these populations are provided in the next section. Access Timeliness Standards The following chart indicates the current admission priority standards for each population along with the current interim service requirements. Suggested additional interim services are in italics: StaWment of Work initial FY2013 (6.29.12) Page 27 013::3 Attachment A (Cont.') Admission Priority Requirements Population Admission Requirement Interim Service Requirement Authority , , 1) Screened and referred Begin within 48 hours: CFR 96.121; within 24 hours 1. Counseling and education on: CFR 96,131; 2) Detoxification, a) HIV and TB Treatment Methadone or b) Risks of needle sharing Policy #04 Pregnant Residential — Offer c) Risks of transmission to Injecting i fAdmission within 24 JCALIcIl pcil II ICI b di IU 1111d1ILJ Drug User business hours d) Effects of alcohol and drug Other Levels or Care — use on the fetus Offer Admission within 48 2. Referral for pre-natal care Business hours 3. Early Intervention Clinical Svc Recommended 1) Screened and referred Begin within 48 hours CFR 96.121; : within 24 hours : 1. Counseling and education on: CFR 96.131; : 2) ni,trixification, : : a) HIV and TB . Methadone or Pregnant b) Risks of transmission to Residential —Offer Substance sexual partners and infants admission within 24 User c) Effects of alcohol and drug business hours use on the fetus Other Levels or Care — 2. Referral for pre-natal care OfferAdmission within 48 3. Early Intervention Clinical Svc Recommended ' Business hours ' Begin within 48 hours — CFR 96.121; maximum waiting time 120 CFR 96.126 days Screened and referred 1. Counseling and education on: Injecting within 24 hours; Offer a) HIV and TB Drug User Admission within 14 days b) Risks of needle sharing c) Risks of transmission to sexual partners and infants Recommended 2. Early Intervention Clinical Svc Parent at Michigan Public Screened and referred Begin within 48 business hours Risk of Health Code within 24 hours. Offer Eariy Intervention Clinical Losing Section 6232 Admission within 14 days Services Children Recommended CFR 96.131(a) — : Screened and referred , — sets the order 1 within seven calendar All Others Not Required of priority; days . Capacity to offer MDCH and CA Admission within 14 days contract j. Earmark -funded Special Projects: Reporting Requirements This reporting requirement applies to only four CAs: Statemont of Work Initial FY2013 (5.25912) Pape 25 of 32 Attachment A IC^.."- " k * Genesee County CMH, with respect to Flint Odyssey House * Macomb County CMH, with f 5p.)C;t to Sacred Heart Rehabilitation Center e network180, with respect to Hispanic Services program e Saginaw County Health Department, with respect to Saginaw Odyssey House These four CAs must submit an annual Earmark-funded Special Projects Report by January 31 following the end of the fiscal year. The report must contain the following information: 1. The name of the CA whose residents were served through the earmarked funds during the year; 2. The number of persons served by that CA, through those funds; and 3. The total amount of earmarked funds paid to the provider for those services. See Attachment 0-Other Requirements for this annual report form and form instructions. This report will be submitted via EGrAIV1S, as an 'Attachment' Report. K. Michigan Screening Brief intervention and Referral to Treatment (MI-SBIRT) Project (Applies Only to Agencies Who Have Allocations for this Program) The purpose of this project is to implement SBIRT services for individuals in primary care and/or community health settings, for substance misuse and SUD. The project is expected to: 1. Expand/enhance the continuum of care for substance misuse services and promote behavioral health and primary health integration efforts. 2. Reduce alcohol and drug consumption and their negative health impact. 3. Increase abstinence and reduce costly health care utilization. 4. Promote sustainability and improve treatment outcomes. SBIRT is designed to expand/enhance the continuum of care in primary care and a mix of other community health settings (e.g., health centers, university health centers, emergency departments, and office-based practices) and support the use of clinically appropriate services for persons at risk for, or diagnosed with, a SUD. It also seeks to identify and sustain systems and policy changes to increase access to treatment in generalist and specialist settings. The SBIRT process supports the overall goal of the MDCH to integrate behavioral health and primary care in Michigan, while promoting recovery, wellness, and a fulfilling quality of life. Atieeet Statement of Wont InitiM FY2013 (6.29:12) Page 30 of 33 Attachmient A' (Cont.') Project Requirements Projects will be developed using the strategic prevention framework and use a data driven approach to arrive at a needs analysis that will foster evidence based practices based on regional needs. Projects must also include and adhere to the areas listed below. 1. Services for Clients • Screening with designated instruments. • Brief Interventions (1 to 5 sessions) designed with client centered, non-judgmental, motivational interviewing (MI) techniques. • Brief Treatment (up to 12 sessions) including the monitoring of individuals who misuse alcohol and other drugs but are not yet dependent. • Referral to Treatment (when indicated) for those who have a SUD. Persons who qualify for a diagnosis of substance abuse or dependence and who are non-responsive to an initial brief intervention or brief treatment must he referred for specialty treatment. • Specialty Treatment Services: It is critical to ensure that appropriate services are available to treat persons for whom such services in community settings are not appropriate. These services include residential, detoxification, outpatient, opiate replacement therapy and recovery support services. 2. Data Collection r, Screening only — If, based on screening results, a client should not require any level of SUD intervention or treatment services — only intake and screening information is necessary. • Screening and Brief Intervention (BI)— If a client, based on screening .results, should or does receive brief intervention, the following must be collected and reported — intake and screening, six month-post intake and intervention completion data. • Screening and Brief Treatment (BT) or Screening and Referral to Other Types of Treatment for Substance Use Disorders (RT) — If a client's screening indicates either extended interventions or other treatment services, the following must be collected and reported — intake and screening, six month-post intake and intervention completion data, /\U—A Statement of Work FY2013 (6.29.12) P29e 31 Of 33 Attachment A (Cont.') Follow-up data will be required on 80% of the clients served in each category' of care requiring intervention/treatment (BI, BT, and RT). 3. Performance Outcome and Assessment Reporting Outcome reporting information should contain, at a minimum, the National Outcome Measures. Performance data must be reviewed to assess progress and to use the information to improve project management. The assessment should be designed to help determine if the project is achieving the intended goals, objectives and outcomes; and whether adjustments need to be made to the project. Progress reports on achievements, barriers, and efforts to overcome these barriers must be submitted at least annually. Financial status reports are also to be submitted annually. Progress reports, on the items listed above and the overall status of the projects must be submitted via EGrAMS at the following times: • 4th quarter of FY 2012— due 10-31-12 • 1 st quarter of FY 2013— due 1-31-13 • 2nd quarter of FY 2013— due 4-30-13 • 3 rd quarter of FY 2013— due 7-31-13 • 4 1h quarter of FY 2013— due 10-31-13 ▪ Final project and outcome report due no later than 4-30-14 (due to need for 6 month follow-up data on those served.) 3. Prevention Services a. Prevention Requirements Prevention funds may be used for needs assessment and related activities. All prevention services must be based on a formal local needs assF4gsrni=!nt The Department's intent is to move toward a community-based, consequence-driven model of prevention. In the meantime, based on needs assessment, prevention activities must be targeted to high-risk groups and must be directed to those at greatest risk of substance use disorders and/or most in need of services within these high-risk groups. CAs are not required to implement prevention programming for all high- risk groups. The CA may also provide targeted prevention services to the general population. The high risk subgroups include but are not limited to: children of substance abusers; pregnant women/teens; drop-outs; violent and delinquent youth; persons with mental health problems; economically disadvantaged citizens; persons who are disabled; victims of abuse; persons already using substances; and homeless and/or runaway youth. All--A Statement of Work Initial FY2013 (6.29.12) Patle 32 of 33 Attachment A (Cont.') Additionally, children exposed prenatally to ATOD are identified as a high- risk subgroup. Prevention services must be provided through strategies identified by CSAP. These strategies are: information dissemination; education; alternatives; problem identification and referral; community based processes; and environmental change. Prevention-related funding limitations the CA must adhere to are: 1) CA expenditure requirements for prevention, including Synar, as stipulated in the CA's allocation letter; 2) 90% of prevention expenditures are expected to be directed to programs which are implemented as a result of an evidence-based decision making process; 3) Alternative strategy activities, if provided must reflect evidence-based approaches and best practices such as multi-generational and adult to youth mentoring; and 4) state- administered funds used for information dissemination must be part of a multi-faceted regional prevention strategy, rather than independent, stand- alone activity, The CA must monitor and evaluate prevention programs at least annually to determine if the program outcomes, milestones and other indicators are achieved, as well as compliance with state and federal requirements. Indicators may include integrity to prevention best practice models including those related to planning prevention interventions such as risk/protective factor assessment, community assets/resource assessment, levels of community support, evaluation, etc. A written monitoring procedure, which includes requirements for corrective action plans to address issues of concern with a provider, is required, Att.--A\ Statement of Work Initial 552013 (6.29.12) Page 33 Or 33 FISCAL NOTE (MISC. #I2276) November 1, 2012 BY: FINANCE COMMITTEE, TOM MIDDLETON, CHAIRPERSON IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2012/2013 SUBSTANCE USE DISORDER GRANT ACCEPTANCE TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Chairperson, Ladies and Gentlemen: Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced resolution and finds: 1. The Michigan Department of Community Health (MDCH) has awarded the Oakland County Department of Health and Human Services/Health Division funding in the amount of $4,675,503. 9, The previous year's 2011/2012 award was $4,403,645, for a total increase of $271,858 in funding. 3. A grant match estimated at $694,667 is required based on the entire FY 2013 Substance Abuse services program budget. Specialty Substance Abuse Medicaid Services, Substance Abuse Adult Benefit Waiver, and MI Child will be accepted by separate resolution and are not subject to a required match. 4. Total funding for this program amounts to $5,370,170. 5. Funds will be used to subcontract with agencies to prevent and reduce the incidence of drug and alcohol abuse and dependency. 6. The grant period extends from October 1, 2012 through September 30, 2013, 7. The Fiscal Year 2013 Special Revenue Budget is amended as follows: HEALTH MDPH OSAS (Fund 28249) Budget Reference 2012 / GR0000000203 Revenues 1060261-134790-610313 Federal 1060261-134790-615571 State Total Revenues FY2013 Adopted $4,792,578 0 $4,792,578 FY2013 FY2013 Amended Adjustment Budget ($ 907,550) $3,885,028 790,475 790,475 $ (117,075) $4,675,503 Expenses 1060261-133405-730373 1060261-133685-730373 1060261-133950-702010 1060261-133950-722740 1060261-133950-730366 1060261-133950-730926 1060261-133960-702010 1060261-133960-702140 1060261-133960-722740 1060261-133960-730366 1060261-133960-730926 1060261-134790-702010 1060261-134790-702140 1060261-134790-722740 1060261-134790-730366 1060261-134790-730373 1060261-134790-730926 1060261-134795-702010 1060261-134795-702140 1060261-134795-722740 1060261-134795-730366 Contract Svs. $ 630,700 Contract Svs. 150,333 Salaries 99,496 Fringe Benefits 61,728 Contract Adm. 239,498 Indirect Costs 0 Salaries 86,557 Other Miscellaneous Sal. 0 Fringe Benefits 58,974 Contract Adm. 0 Indirect Costs 0 Salaries 102,076 Other Miscellaneous Sal. 0 Fringe Benefits Contract Adm. Contract Svs. Indirect Costs Salaries Other Miscellaneous Sa Fringe Benefits Contract Adm. $ (106,484) $ 524,216 (150,333) 0 ( 70,144) 29,352 ( 60,387) 1,341 (234,793) 4,705 4,124 4,124 ( 45,133) 41,424 106 106 ( 46,788) 12,186 6,057 6,057 5,835 5,835 62,414 164,490 1,050 1,050 50,520 107,034 (300,429) 37,325 1,470,076 2,884,609 1,037 23,258 4,119 122,655 630 630 723 78,209 11,804 11,804 56,514 337,754 1,414,533 22,221 118,536 0 77,486 0 FINANCE COMMITTEE Motion carried unanimously on a roll call vote. 1060261-134795-730926 1060261-134796-702010 1060261-134796-702140 1060261-134796-722740 1060261-134796-730366 1060261-134796-730926 1060261-134800-702010 1060261-134800-702140 1060261-134800-722740 1060261-134800-730366 1060261-134800-730373 1060261-134800-730926 Indirect Costs 0 Salaries 61,913 Other Miscellaneous Sal. Fringe Benefits 45,250 Contract Adm. 0 Indirect Costs 0 Salaries 411,140 Other Miscellaneous Sal. 5,355 Fringe Benefits 281,989 Contract Adm. Contract Svs. Indirect Costs 17,322 0 315 185 2,104 8,743 (184,993) ( 4,095) (104,838) (479,968) ( 7,805) 31,951 $ (117,075) 17,322 61,913 315 45,435 2,104 8,743 226,147 1,260 177,151 42,752 0 31 ,951 $4,675,503 I Old! cApi 522,720 7,805 0 $4,792,578 Resolution #12276 November 1,2012 Moved by Hoffman supported by Jackson the resolutions (with fiscal notes attached) on the amended Consent Agenda be adopted (with accompanying reports being accepted). AYES: Crawford, Dwyer, Gershenson, Gingell, Gosselin, Hatchett, Hoffman, Jackson, Long, Matis, McGillivray, Middleton, Nash, Nuccio, Potts, Quarles, Runestad, Scott, Taub, Weipert, Woodward, Zack, Bosnic, Covey. (25) NAYS: None. (0) A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent Agenda were adopted (with accompanying reports being accepted). I HEREBY :27•7710VE THIS 9ESOLUTIO CHIE LUTY COUNTY EXECUTIVE ACTING PUi'SUANT TO MCL 45.558A (7) • STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Bill Bullard Jr., Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on November 1, 2012, with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac, Michigan this 1 st day of November, 2012. eu12,2ek_,,,i 094. Bill Bullard Jr., Oakland County