The URL can be used to link to this page

Home My WebLink AboutResolutions - 2013.12.12 - 21148MISCELLANEOUS RESOLUTION #13307 December 12, 2013 BY: General Government Committee, Christine Long, Chairperson IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2013/2014 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, 2013 through September 30, 2014; and WHEREAS the 2012/2013 Substance Use Disorder Grant award included a total funding amount of $4,675,503 in grant revenue for this program; and WHEREAS the 2013/2014 Substance Use Disorder Grant award reflects grant funding in the amount of $4,655,787, a decrease of $19,716 (-0.4%) 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 $679,121 for FY 2014; and WHEREAS the source of the required cash match comes from the Convention Facility Tax revenue which requires 50% of the county distribution to be used for substance abuse treatment programs within the county (1985 PA 106, MCL 207.630); 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 2013/2014 Substance Use Disorder Grant from the Michigan Department of Community Health in the amount of $4,655,787 with a required 10% cash match of $679,121 for a total of $5,334,908. 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 Motion carried unanimously on a roll call vote. GRANT REVIEW SIGN OFF — Health Division GRANT NAME: FY 2014 MDCH — Substance Use Disorder Grant Agreement FUNDING AGENCY: Michigan Department of Community Health DEPARTMENT CONTACT PERSON: Rachel Shymkiw / 2-2151 STATUS: Grant Acceptance DATE: November 4, 2013 Pursuant to Misc. Resolution #13180, 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 Fiscal 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 (10/24/2013) Department of Human Resources: Approved. — Karen Jones (10/24/2013) Risk Management and Safety: The modifications to the agreement contained in Section 5.4 Insurance are approved by Risk . Management. — Robert Erlenbeck (10/25/2013) Corporation Counsel: I have reviewed this Grant and see no legal issues. Approved. — Bradley G. Berm (11/4/2013) 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. From: To: Cc: Subject: Date: VanPelt, Laurie "West Catherine; "Julie Secontine"; "Karen Jones"; "Pat Davis" "Shymkivr, Rachel"; Dickay-chlassonlraloakgov.com; "Nicholas, Christina"; "Pisacreta, Antonio"; "Lane. Kathy" RE: GRANT REVIEW: Health & Human Services - 2014 Substance Use Disorder Services - Grant Acceptance Thursday, October 24, 2013 11:44:22 AM Approved. From West, Catherine [mailto:westca®oakgov.com] Sent: Thursday, October 24, 2013 11:26 AM To: Julie Secontine; Karen Jones; Laurie VanPelt; Pat Davis Cc: Shymkiw, Rachel; mckay-chiassonl©oakgov.com ; Nicholas, Christina; Pisacreta, Antonio; Lane, Kathy Subject: GRANT REVIEW: Health & Human Services - 2014 Substance Use Disorder Services - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS Laurie Van Pelt — Karen Jones —Julie Secontine — Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE— Health & Human Services 2014 Substance Use Disorder Services 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: November 4, 2013 GRANT INFORMATION Date: October 24, 2013 Operating Department: Health & Human Services Department Contact: Rachel Shymkiw Contact Phone: 248-452-2151 Document Identification Number: 20140953-00 REVIEW STATUS: Acceptance — Resolution Required Funding Period: October 1, 2013 through September 30, 2014 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: $4,655,787 DEPARTMENT OF HEALTH AND HUMAN SERVICES/ HEALTH DIVISION FY 2013/2014 SUBSTANCE USE DISORDER GRANT ACCEPTANCE • 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-term 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 $4,655,787 and covers the period of October 1, 2013 through September 30, 2014. From: To: Cc: Subject: Date: Jones, Karen. "West. Catherine";'Julte3econtine"; "Laurie VanPelt"; "Pat Davis" "Shymkiw, Rachel"; mck y-chlassonloakgov,com; "Nicholas. Christina"; "Pisacreta, Antonin"; "Lane, Kathy" RE: GRANT REVIEW; Health & Human Services - 2014 Substance Use Disorder Services - Grant Acceptance Thursday, October 24, 2013 11:46:26 AM Approved. From; West, Catherine [mailto:westca@oakgov.com] Sent: Thursday, October 24, 2013 11:26 AM To: Julie Secontine; Karen Jones; Laurie VanPelt; Pat Davis Cc: Shymkiw, Rachel; mckay-chlassonl@oakgov.com ; Nicholas, Christina; Pisacreta, Antonio; Lane, Kathy Subject: GRANT REVIEW: Health & Human Services - 2014 Substance Use Disorder Services - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Karen Jones —Julie Secontine — Pat Davis RE: GRANT CONTRACT REVIEW RESPONSE—Health & Human Services 2014 Substance Use Disorder Services 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: November 4, 2013 GRANT INFORMATION Date: October 24, 2013 Operating Department: Health & Human Services Department Contact: Rachel Shymkiw Contact Phone: 248-452-2151 Document Identification Number: 20140953-00 REVIEW STATUS: Acceptance — Resolution Required Funding Period: October 1, 2013 through September 30, 2014 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: $4,655,787 From; To: Cc: Subject: Date: Erlenbecic Robeit "West. Catherine"; "Julie Secontine"; "Karen Jones"; "Laurie VanPelt"; "Pat Davis" "Shyrnkiw. Rachel"; mckay-chlassonlaoakDov.com ; 'Nicholas. Christina"; "Pisacreta, Antonio"; "Lane. Kathy" RE: GRANT REVIEW: Health 131. Human Services -2014 Substance Use Disorder Services - Grant Acceptance Friday, October 25, 2013 12:46:44 PM , The modifications to the agreement contained in Section 5.4 Insurance are approved by Risk Management. R.E. 10-25-13. From: West, Catherine [mailto:westca ©oa kg ov.corn] Sent: Thursday, October 24, 2013 11:26 AM To: Julie Secontine; Karen Jones; Laurie VanPelt; Pat Davis Cc: Shymkiw, Rachel; mckay-chiassonI©oakgov.com ; Nicholas, Christina; Pisacreta, Antonio; Lane, Kathy Subject: GRANT REVIEW: Health & Human Services - 2014 Substance Use Disorder Services - Grant Acceptance GRANT REVIEW FORM TO: REVIEW DEPARTMENTS — Laurie Van Pelt — Karen Jones —Julie Secontine — Pat DaVis RE: GRANT CONTRACT REVIEW RESPONSE — Health & Human Services 2014 Substance Use Disorder Services 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: November 4, 2013 GRANT INFORMATION Date: October 24, 2013 Operating Department: Health & Human Services Department Contact: Rachel Shymkiw Contact Phone: 248-452-2151 Document Identification Number: 20140953-00 REVIEW STATUS: Acceptance — Resolution Required Funding Period: October 1, 2013 through September 30, 2014 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 From: To: Cc: Subject: Date: Beni). Bradley G "Shyrnkiw. Rachel" Katie West' #2013-0996 FY2014 Substance Use Disorder Services Grant Agreement (MDCH) - Grant Acceptance (OSAS) Monday, November 04, 2013 10:32:23 AM I have reviewed this Grant and see no legal issues. Approved. Bradley G. Benn Assistant Corporation Counsel Department of Corporation Counsel 1200 N. Telegraph Road Bldg 14 East Courthouse West Wing Extension, 3rd Floor Pontiac, MI 48341-0419 Phone: (248) 858-0658 Fax: (248) 858-1003 Email: bennb©oakgov.com PRIVILEGED AND CONFIDENTIAL — ATTORNEY CLIENT COMMUNICATION This e-mail is intended only for those persons to whom it is specifically 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 not 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 message in error, please notify the sender immediately. If you have any questions, please contact the Department of Corporation Counsel at (248) 858-0550. Thank you for your cooperation, Contract # 20140963-00 Date: 1010912013 Contract #: 20140953-00 Grant Agreement Between Michigan Department of Community Health hereinafter 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, DUNSM 136200362 hereinafter referred to as the "Contractor" for Substance Use Disorder Services-2014 Part I 1. Period of Agreement: This agreement shall commence on October 1,2013 and continue through September 30, 2014. This agreement is in full force and effect for the period specified. 2. Program Budget and Agreement Amount A. Agreement Amount The total amount of this agreement is $4,655,787.00. The Department under terms of this agreement wil provide funding not to exceed $4,655,787.00. The federal funding provided by the Deoartment: is 3.739.187.00.as follows: - Federal Catalog of CFDA # Federal Federal Grant Amount Program Federal Agency Grant Phase Title Domestic Name Award Assistance Number (CFDA) Title SUB ABUSE Block Grant 93.959 Substance 2B08T10100 14 3,739,167.00 PREV. & TX for Prevention Abuse and 26T BLOCK GRANT & Treatment of Substance Mental Health Services Adm Abuse Total for 3,739,167.00 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. County of Oakland, Substance Use Disorder Services-2014 Page: 1 of 24 Contract # 20140953-00 Date: 10/09/2013 B. Equipment Purchases and Title Part 1, 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 A deviation allowance modifying an established budget category, budget detail by $50,000, 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. 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. 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. 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 reference. 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 also agrees to comply with the requirements described in the SUD Services Policy Manual, which is part of this agreement through reference. The Contractor agrees to comply with the FY 13/14 Addendum A which is part of this agreement through reference. County of Oakland, Substance Use Disorder Services-2014 Page: 2 of 24 Contract #20140953-00 Date: 10/09/2013 8. Administration of the Agreement The person acting for the Department in administering this agreement (hereinafter referred to as the Contract Manager) is: John Duvendeck CPA, Manager Division of Program Development, Consultation and Contracts 320 S. Walnut Street, Lewis Cass Bldg, 5th floor Lansing, Ml 48913 (517) 241-5218 DuvendeckJ@michigan.gov 9. Contractor's Financial Contact for the Agreement The person acting for the Contractor on the financial reporting for this agreement is: Thomas Hensel Financial Officer Name Title henselt@oakgov.com (248) 452 9281 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. B. 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 signing of this agreement. D. The Contractor is required by PA 533 of 2004 to receive payments by electronic funds transfer. E. The Department may revise the funding allocations contained in Ml E-Grants during the contract year without formal amendment. Such revisions in allocations shall be incorporated in a final authorization that is transmitted to the Coordinating Agency (CA) and shall be utilized for cost settlement purposes. These revisions may include reconciliation of Adult Benefit Waiver (ABW) state share withhold amounts compared to state share payments to Pre-Paid Inpatient Health Plan (PHP)s. Revisions may also include redistribution of earmarked funds, including State Disability Assistance (SDA), Prevention, and Women's Specialty Services (WSS) funds, based on relative ability among CAs to utilize the funds as required by contract. County of Oakland, Substance Use Disorder Services-2014 Page: 3 of 24 Contract #20140953-00 Date: 10/09/2013 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 the CONTRACTOR County of Oakland Michael Gingell Chairperson Name Title For the Michigan Department of Community Health Kim Stephen 10/09/2013 Kim Stephen, Director, Bureau of Budget and Purchasing Date County of Oakland, Substance Use Disorder Services-2014 Page: 4 of 24 Contract # 20140953-00 Date: 10/0912013 Part 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 r'eproduce, 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 Grants 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 Disorder Services-2014 Page: 5 of 24 Contract #20140953-00 Date: 10/09/2013 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 requi?ed. 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 section only 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 Related Audit, Financial Statement Audit, or Audit Status Notification Letter as described in this provision. Financial Related Audit is applicable to for-profit contractors that are designated as subrecipients. If submitting a Single Audit or Financial Statement Audit, Contractors must also submit a Corrective Action Plan for any audit findings that impact MDCH-funded programs, and management letter (if issued) with a response. County of Oakland, Substance Use Disorder Services-2014 Page: 6 of 24 Contract #20140953-00 Date: 10/09/2013 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. The Contractor must comply with all requirements in the MDCH Substance Abuse Prevention and Treatment Audit Guidelines, current edition, as issued by the MDCH Office of Audit. b. Financial Related Audit Contractors that are for-profit organizations that expend $500,000 or more in Federal awards during the Contractor's fiscal year must submit a financial related audit prepared in accordance with Government Auditing Standards relating to all Federal awards; or an audit that meets the requirements contained in OMB Circular A-133, if required by the Federal awarding agency. Financial Statement Audit Contractors exempt from the Single Audit and Financial Related 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 Single Audit and Financial Related 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 disclosures that may negatively impact MDCH-funded programs including, but not limited to fraud, going concern uncertainties, financial statement misstatements, and violations of contract and grant provisions. d. Audit Status Notification Letter Contractors exempt from both the Single Audit, Financial Related Audit and Financial Statement Audit requirements (a., b., and c. above) must submit an Audit Status Notification Letter that certifies these exemptions. The template Audit Status Notification Letter and further instructions are available at http://www.michigan.gov/mdch by selecting Inside Community Health — MDCH Audit. County of Oakiand, Substance Use Disorder Sorvices-2014 Page: 7 of 24 Contract #20140953-00 Date: 10/09/2013 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. 3. Penalty a. Delinquent Single Audit, Financial Related or Financial Statement Audit If the Contractor does not submit the required Single Audit Financial Related AuditT-or-Financial—Statement -Audit7-including -any management letter with a response and applicable Corrective Action Plan 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. County of Oakland, Substance Use Disorder Services-2014 Page: 8 of 24 Contract #20140953-00 Date: 10109/2013 H. Subrecipient/Vendor Monitoring The Contractor must ensure that each of its subrecipients 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- 133. 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. 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 OMB Circular A-133, Section .210(f). I. 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 data, 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. County of Oakland, Substance Use Disorder services-2014 Page: 9 of 24 Contract # 20140953-00 Date: 10/09/2013 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 (1RB) 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 1RB 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 1RB under a formally-approved interdepartmental agreement. The manner of the review will be agreed upon between the Department's 1RB Chairperson and the Contractor's ERB Chairperson or Executive Officer(s). II. 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. B. Report Forms Provide any report forms and reporting formats required by the Department at the effective date of this agreement, and provide to the Contractor 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. III. Assurances The following assurances are hereby given to the Department: A. Compliance with Applicable Laws The Contractor will comply with applicable federal and state laws, 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. County of Oakland, Substance Use Disorder Services-2014 Page: 10 of 24 Contract #20140953-00 Date: 10/09/2013 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. C. Non-Discrimination 1. In the performance of any contract or purchase order resulting herefrom, 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 herefrom will contain a provision requiring non-discrimination in employment, service delivery and access, as herein specified binding upon each subcontractor. This 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 or national origin; b. Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; c. 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 age; e. the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; County of Oakland, Substance Use Disorder Services-2914 Page: 11 of 24 Contract #20140953-00 Date: 10/09/2013 f. the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (Pl. 91-616) as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 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. 3. Additionally, assdrance 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. D. Debarment and Suspension 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 false 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 Oakland, Substance Use Disorder Services-2014 Page: 12 of 24 Contract #20140953-00 Date: 10109/2013 E. Federal Requirement: Pro-Children Act 1. Assurance is hereby given to the Department that the Contractor will comply with Public Law 103-227, also known as the Pro-Children Act of 1994, 20 USC 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 or 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 Contractor also assures, in addition to compliance with Public Law 103- 227, any service or 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 USC 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 USC 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. County of Oakland, Substance Use Disorder Services-2014 Page: 13 of 24 Contract #20140953-00 Date: 10/09/2013 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. 2. That any executed subcontract to this agreement shall require the subcontractor to comply with all applicable 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 OMB 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. County of Oakland, Substance Use Disorder Services-2014 Page: 14 of 24 Contract #20140953-00 Date: 10/09/2013 I. 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. 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 falls 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 HPAA 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. 6. 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 H1PAA 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 such an agreement is required under HIPAA. County of Oakland, Substance Use Dfsorder Services-2014 Page: 15 of 24 Contract #20140953-00 Date: 10109/2013 1V. Financial Requirements The financial requirements shall be followed as described in Part 11 of this agreement and Attachments B which are part of this agreement through reference. The Contractor's fiscal year allocation letter is incorporated by reference into this agreement. 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. 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 January 31 following the end of the fiscal year. The final RER must reflect total actual program expenditures, regardless of the source of funds. To access EGrAMS, log in at: http://egrams-mi.com/dch Failure to meet financial reporting responsibilities as identified in this agreement may result in withholding future payments. D. Financial Status Report Submission 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. County of Oakland, Substance Use Disorder Services-2014 Page: 16 of 24 Contract # 20140953-00 Date: 10/09/2013 E. Reimbursement Mechanism All contractors must sign up through the on-line vendor registration process to receive all State of Michigan payments 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/cpexpress 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 . Department-wide Payment Suspension A temporary Payment suspension is in effect on agreements during the department's year-end closing period beginning September 13th until mid- November. FSRs through the August period should be submitted by September 6th to ensure payment prior to the payment suspension period. 3- 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. 4- 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. County of Oakland, Substance Use Disorder Services-2014 Page: 17 of 24 Contract # 20140953-00 Date: 1010912013 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 of this agreement during the term of this agreement or any extension thereof. VI. Final Reporting Upon 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.C. 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. Counv a Oakland, Substance Use Disorder Serv1ces-2014 Page: 18 of 24 Contract* 20140953-00 Date: 10/0912013 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. 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, and 1973 PA 196, as amended, MCL 15.341 et seq. Xl. 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 Oakland, Substance Use Disorder Services-2014 Page: 19 of 24 Contract #20140953-00 Date: 10/09/2013 Attachments A Att A - Oakland County Addendum Attachment A - Oakland County Addendum Al Alt 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-Revenues and Expenditures Rpt B3 Aft B Equipment Inventory Attachment B2 Equip Inventory County of Oakland, Substance Use Disorder Services-2014 Page: 20 of 24 Contract #20140953-00 Date: 10109/2013 B4 Att B - Program Budget - Summary PROGRAM Substance Use Disorder Services-2014 DATE PREPARED 10/9/2013 CONTRACTOR NAME County of Oakland BUDGET PERIOD From : 1011/2013 To : 9/30/2014 ' MAILING ADDRESS (Number and Street) 1200 NI. Telegraph Road Bldg. 34 East BUDGET AGREEMENT FZ7 Original r Amendment AMENDMENT # 0 CITY Pontiac STATE MI ZIP CODE 48341- 1050 FEDERAL ID NUMBER 38-6004876 Activity State Amount Local Inkind Total DIRECT EXPENSES State Agreements 1 Community Grant 3,576,516.00 0.00 0.00 3,576,516.00 2 Prevention - - 934,459.00 0.00 0.00 934,459.00 3 FASD Award 0.00 0.00 0.00 0.00 State Disability Assistance 144,812.00 0.00 0.00 144,812.00 5 Gambling, State Restricted 0.00 0.00 0.00 0.00 6 Strategic Prevention Enhancement Project 0.00 0.00 0.00 ' 0.00 7 Screening Brief Interv. & Referral to Tr 0.00 0.00 0.00 0.00 8 Partnerships for Success II (PFS II) 0.00 0.00 0.00 0.00 Total State Agreements 4,655,787.00 0.00 0.00 4,655,787.00 TOTAL DIRECT EXPENSES 4,655,787.00 0.00 0.00 4,655,787.00 TOTAL EXPENDITURES 4,655,787.00 0.00 0.00 4,655,787.00 County of Oakland, Substance Use Disorder Services-2014 Page: 21 of 24 Contract #20140953-00 Date: 10/09/2013 B5 Aft B - Program Budget - Cost Detail lActivity State Amount Local Inkind Total DIRECT EXPENSES State Agreements I Community Grant General Adminstration 323,847.00 0.00 0.00 323,847.00 Access Management System 488,287.00 0.00 0.00 488,287.00 Treatment Services 2,564,406.00 0.00 0.00 2,564,406.00 Women's Specialty 87,399.00 0.00 0.00 87,399.00 MI Child 10,000.00 0.00 0.00 10,000.00 Outreach to Injecting Drug Users 102,577.00 0.00 0.00 102,577.00 Total for Community Grant 3,576,516.00 0.00 0.00 3,576,516.00 2 Prevention Prevention Services 815,735.00 0.00 0.00 815,735.00 General Adminstration 118,724.00 0.00 0.00 118,724.00 Total for Prevention 934,459.00 0.00 0.00 934,459.00 4 FASD Award 5 State Disability Assistance • Treatment 144,812.00 0.00 0.00 144,812.00 6 Gambling, State Restricted 7 Strategic Prevention Enhancement Project Screening Brief Interv. & Referral to Tr Partnerships for Success ll (PFS II) Total State Agreements 4,655,787.00 0.00 0.00 4,655,787.00 TOTAL DIRECT EXPENSES 4,655,787.00 0.00 0.00 4,655,787.00 TOTAL EXPENDITURES 4,655,787.00 0.00 0.00 4,655,787.00 County of Oakland, Substance Use Disorder Services-2014 Page: 22 of 24 Contract #20140953-00 Date: 10/09/2013 36 Aft B - Source of Funds SOURCE OF FUNDS Activity State Amount Local Inkind Total 1 State Agreements Community Grant 3,576,516.00 0.00 0.00 3,576,516.00 Prevention 934,459.00 0.00 0.00 934,459.00 FASD Award 0.00 0.00 0.00 0.00 State Disability Assistance 144,812.00 0.00 0.00 144,812.00 Gambling, State Restricted 0.00 0.00 0.00 0.00 Strategic Prevention Enhancement Project 0.00 0.00 0.00 0.00 Screening Brief Interv. & Referral to Tr 0.00 0.00 0.00 0.00 Partnerships for Success II (PFS II) 0.00 0.00 0.00 0.00 Total State Agreements 4,655,787.00 0.00 0.00 4,655,787.00 Totals 4,655,787.00 0.00 0.00 4,655,787.00 County of Oakland, Substance Use Disorder Services-2014 Page: 23 of 24 Contract # 20140953-00 Date: 10/09/2013 C Att C - Reporting Requirements Attachment C - Reporting Requirements E SUD Services Policy Manual SUD Services Policy Manual County of Oakland, Substance Use Disorder Services-2014 Page: 24 of 24 Version: Substance Abuse Services MICHIGAN DEPARTMENT OF COMMUNITY HEALTH FY 13114 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 I 11. Agreement Exceptions and Limitations Notwithstanding any other term or condition in this Agreement including, but not limited to, any provisions related to any services as described in the Annual Action Plan, any Contractor (Oakland County) services provided pursuant to this Agreement, or any limitations upon any Department funding obligations herein, the Parties specifically 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 Parties 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 provision or other legal basis (e,g., any Headlee Amendment limitations) to challenge any State or Department program funding obligations; and, the parties further agree that no term or condition in this Agreement is intended and no such provision shall be argued to state or imply that the Contractor voluntarily assumed or undertook to provide any services as described in the Annual Action Plan, and thereby, waived any rights the Contractor may have had under any legal theory, in law or equity, without regard to whether or not the Contractor continued to perform any services herein after any State or Department funding ends. Version: Substance Abuse Services • 2. This addendum modifies the following sections of Part II, General Provisions: Part II I. Responsibilities-Contractor J. Software Compliance. This section will be deleted in its entirety and replaced with the following language: The Michigan Department of Community Health and the County of Oakland will work together to identify and overcome potential data incompatibility problems. III. Assurances A. Compliance with Applicable Laws. This first sentence of this paragraph will be stricken in its entirety and replace with the following language: The Contractor will comply with applicable Federal and State laws, and lawfully enacted administrative rules or regulations, in carrying out the terms of this agreement. Health Insurance Portability and • Accountability Act. The provisions in this section shall be deleted in their entirety and replaced with the following language: Contractor agrees that it will comply 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 deleted 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. Version: Substance Abuse Services 3. 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. 4. Signature Section: For the COUNTY OF OAKLAND Name and Title Signature For the MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Kim Stephen, Director Bureau of Budget and Purchasing Date Date Vendor El Subrecipient Attachment A Statement of Work Fiscal Year 2014 Att--A Statement of Work Initial FY2014 (5.6.13) Statement of Work Fiscal Year 2014 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. Early CA/PIHP Integration 2 5. Licensure of Subcontractors 3 6. Accreditation of Subcontractors 3 7. SAMHSA/DHHS License 3 8. Cooperation with External Medicaid Evaluation 3 9. 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 Scale 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 of Work TOO FY2014 Initial (5.6.13) Attachment A (Cont.') 10. 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 8 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 d. 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 AttA— Statement of Work TOC FY2014 Initial (5.6.13) ii Attachment A (Cont.') e. Primary Care Coordination 17 f. Cultural Competence 17 g. Charitable Choice 18 h. Americans with Disabilities Act 19 i. Limited English Proficiency 19 2. 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 MIChild 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 ABW Revenues and Expenditures 26 How to Report Expenditures for WSS- and ABW-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 and Interim Services 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 AttA— Statement of Work FY2014 Initial (6.6.13) iii Attachment A (Cont.') STATEMENT OF WORK Please note: Items in this Statement of Work have been placed into one of three categories: General; Administrative and Financial; and Services. This categorization is for convenience of reference only, It is not intended, and should not be interpreted, as limiting the applicability or scope of any item or items. General 1. General Statement of Work The general responsibilities of the coordinating agency (CA) under this Agreement, based on P.A. 501 of 2012, 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. g. 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. 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. Att—A Statement of Work FY2014 Initial (5.6.13) Page 1 of 32 Attachment A (Cont.') 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), (D), (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 $199,700. SAPT Block Grant requirements also apply to the Michigan Department of Community Health (MDCH) administered state funds, unless a written exception is obtained from MDCH. 4. Early CA/PIHP Integration This agreement may be terminated due to early CA/P1HP integration, by giving ninety (90) days written notice to the other party. Plans for early integration must be implemented by June 1 2014. Written notice of termination must be submitted by March 1, 2014 and should include integration plans that identify concurrence of all participating parties, including all effected CAs and PIHPs. If early integration is unable to occur by June 1, 2014, CAs will integrate as of October 1, 2014, as in Section 287 (8) of P.A. 258. Should this agreement be terminated due to early CA/PIHP integration, the Contractor shall provide the Department with all financial, performance reports within sixty (60) days after termination. All other reports required as a condition of this agreement are due ninety (90) days after termination. Methods of reimbursing allowable costs and refunds made to the department remain consistent with existing contract termination requirements. AttA— Statement of Work FY2014 Initial (5.6.13) Page 2 of 31 Attachment A (Cont.') 5. 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 6234 of P.A. 501 of 2012, 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. 6. Accreditation of Subcontractors The CA shall enter into agreements for treatment services provided through outpatient, early intervention, Methadone, sub-acute detoxification and residential providers only with providers accredited by one of the following accrediting bodies: The Joint Commission (TJC formerly JCAH0); Commission on Accreditation of Rehabilitation Facilities (CARF); the American Osteopathic Association (ACM); Council on Accreditation of Services for Families and Children (COA); National Committee on Quality Assurance (NCQA), 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. 7. 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. 8. 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 Att—A Statement of Work FY2014 Initial (5.6.13) Page 3 of 32 Attachment A (Cont.) expected to ensure that CA-funded providers will provide necessary data and will facilitate access to individuals' files and other records as required. 9. Monitoring 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 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-recipientNendor 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. 10. Monitoring of Designated Women's Subcontractors In addition to the requirements referenced in number eight above, the CA is also required to monitor all Designated Women's Programs (DWP) for the following: a. Outreach activities to promote and advertise women's programming and priority population status. b. Gender-Responsive policy for treating the population. c. Education/Training of staff identified as women's specialty clinicians and supervisors. Required 12 semester hours equivalent to 64 workshop type training hours. Administrative and Financial 1. 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 1981 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 AttA— Statement of Work FY2014 Initial (5.6,13) Page 4 of 32 Attachment A (Cont.') 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. 2. Reporting Fees and Collections Revenues On the initial Revenues and Expenditures Report (RER), 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). "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 ABW 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 All—A Statement of Work FY2014 Initial (5.6.13) Page 5 of 32 Attachment A (Cont.') 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. 6. Subcontracts with Hospitals Funds made available through the Department shall not be made available to public or private hospitals which refuse, solely on the basis of an individual's substance 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. 8. 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. 9. 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 PIHP, 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 Att—A Statement of Work FY2014 initial (5.6.13) Page 6 of 32 Attachment A (Cont.') agreement with the CMHSP (or other provider); and the CMHSP (or other provider) must meet all minimum qualifications, including licensure, accreditation and data reporting. 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 kip—e-5rS-to1binsuffictent. 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, WSS 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 WSS 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 122, whichever is applicable, and with the requirements of individual fund sources. c. Indirect Cost Documentation: Aft—A Statement of Work FY2014 Initial (5,6.13) Page 7 of 32 Attachment A (Cont.') 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 - 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 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). 4. Required reports in their necessary form and format are available via EGrAMS. Upon accessing EGrAMS you will: a. Select substance abuse from the menu on the left side of the screen; b. Select SA-2014; c. Click the "show" button following "User Documents"; and d. Click the hyperlink of the report you are selecting. b. Legislative Reports (LRs) and Financial Reports lithe contractor does not submit the LR or the final RER (which includes the ABW and MIChild Year-end Balance Worksheets and Administration / Aft—A Statement of Work FY2014 Initia[ (5.6.13) Page 8 of 32 Attachment A (Cont.') 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 $100,000) 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; otherwise, 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 calendar days delinquent. This does not apply to the LR and final RER, as stated above. Financial reports are: 1. Revenues and Expenditures Report—INIT1AL and FINAL; 2. Financial Status Report-1 st thru 3rd 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 the status of the CAs current efforts to coordinate services with the local CMHSPs or PIHPs or, the impact and efficiencies realized by those CAs who are currently integrated. Report form and instructions are located under "User Documents" which may be accessed via the EGrAMS homepage. 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 and processed. When the system is in production, monthly submissions by the CAs are required. Data submissions are monitored daily by MDCH staff. AttA— Statement of Work FY2014 Initial (5.6.13) Page 9 of 32 Attachment A (Cont.') e. 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%. f. 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). g. 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 MPDS 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 cornponents: 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. 3. 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"User Documents", via EGrAMS. These reporting requirements are narrower in scope than the responsibility to identify and follow up on critical incidents and sentinel events. Att—A Statement of Work FY2014 Initial (5.6.13) Page 10 of 32 Attachment A (Cont.') 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. 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 to pay for drug screens, 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 Aft—A Statement of Work FY2014 Initial (5.6.13) Page 11 of 32 Attachment A (Cont.') (c) 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; appropriate post-test counseling; and (c) providing the therapeutic measures described in Paragraph (b) of this definition. To review the full document, go to: httr://law.justia.com/us/cfr/titIe45/45- 1.O.1.i.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 (MOOG), 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 Aft—A Statement of Work FY2014 Initial (5.6.13) Page 12 of 32 Attachment A (Cont.') appropriate, applying admissions preferences, and other 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 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) (Applies 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 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 Aft—A Statement of Work FY2014 Initial (5.6.13) Page 13 of 32 Attachment A (Cont.') 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-eligible 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 designee to be in need of residential treatment services; authorized by the CA for residential treatment when the CA expects to reimburse the provider for the treatment; at least 18 years 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: htto://vvvvw.michioan .dov/dhs/0.1607,7-124-5453 5526---,00.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. Persons Involved with the Michigan Department of Human Services (MDHS) The CA must work with the MD HS 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. Aft—A Statement of Work FY2014 Initial (5.6.13) Page 14 of 32 Attachment A (Cont.') 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 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 has refused to sign 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. f. 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. g. 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) other requirements, including-exclusion of inherently religious activities and non-discrimination Aft—A Statement of Work FY2014 Initial (5.6.13) Page 15 of 32 Attachment A (Cont.') The CA is required to comply with all applicable requirements of the Charitable Choice regulations. The CA must 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 be 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 alternative 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 provide substance 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 Disabilities 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 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 Aft—A Statement of Work FY2014 Initial (5.6.13) Page 16 of 32 Attachment A (Cont.') 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. 2. Treatment Services a. Medical 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 Necessity Criteria. These criteria are substantively the same as the applicable criteria for substance use disorders Medicaid services. Medical Necessity Criteria 1.0 "Medically necessary" substance abuse services are supports, services, and treatment: 1.0.1 Necessary for screening and assessing the presence of substance use disorder; and/or 1.0.2 Required to identify and evaluate a substance use disorder; and/or Att—A Statement of Work FY2014 Initial (5.6.13) Page 17 of 32 Attachment A (Cont.') 1.0.3 intended to treat, ameliorate, diminish or stabilize the symptoms of a substance use disorder; and/or 1.0.4 Expected to arrest or delay the progression of a substance use disorder; and/or 1.0.5 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. 1.1 The determination of a medically necessary support, service or treatment must be: 1.1.1 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 1.1.2 Based on clinical information from the individual's primary care physician or clinicians with relevant qualifications who have evaluated the individual; and 1.1.3 Based on individualized treatment planning; and 1.1.4 Made by appropriately trained substance abuse professionals with sufficient clinical experience; and 1.1.5 Made within federal and state standards for timeliness; and 1.1.6 Sufficient in amount, scope and duration of the service(s) to reasonably achieve its/their purpose. 1.2 Supports, services and treatment authorized by the CA must be: 1.2.1 Delivered in accordance with federal and state standards for timeliness in a location that is accessible to the individual; and 1.2.2 Responsive to particular needs of multi-cultural populations and furnished in a culturally relevant manner; and 1.2.3 Provided in the least restrictive, most integrated setting. Residential or other segregated settings shall be used only when less restrictive levels of treatment, service or support have been, for that beneficiary, unsuccessful or cannot be safely provided; and 1.2.4 Delivered consistent with, where they exist, available research findings, health care practice guidelines and standards of practice issued by professionally recognized organizations or government agencies. 1.3 Using criteria for medical necessity, a CA may: 1.3.1 Deny services a) that are deemed ineffective for a given condition based upon professionally and scientifically recognized and accepted standards of care; b) that are experimental or investigational in nature; or c) for which there exists another Att—A Statement of Work FY2014 Inttial (5.6.13) Page 18 of 32 Attachment A (Cont.') appropriate, efficacious, less-restrictive and cost- effective service, setting or support, that otherwise satisfies the standards for medically-necessary services; and/or 1.3.2 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. 303.90 Alcohol Dependence 305.00 Alcohol Abuse 303.00 Alcohol Intoxication 291.80 Alcohol Withdrawal 291.90 Alcohol-Related Disorder, Not Otherwise Specified 304.40 Amphetamine Dependence 305.70 Amphetamine Abuse 292.89 Amphetamine Intoxication 292.00 Amphetamine Withdrawal Aft—A Statement of Work Initial FY2014 (6.29.12) Page 20 of 29 Attachment A (Cont.') 292,90 304.30 305.20 292.89 292.90 304.20 305.60 292.89 292.00 292.90 304.50 305.30 292.89 292.90 304.60 305.90 292.89 292.90 304.00 305.50 292.89 292.00 292.90 304.60 305.90 292.89 292.90 304.80 304.10 305.40 292.89 292.00 292.90 304.90 305.90 292.89 292.00 Amphetamine-Related Disorder, Not Otherwise Specified Cannabis Dependence Cannabis Abuse Cannabis Intoxication Cannabis-Related Disorder, Not Otherwise Specified Cocaine Dependence Cocaine Abuse Cocaine Intoxication Cocaine Withdrawal Cocaine-Related Disorder, Not Otherwise Specified Hallucinogen Dependence Hallucinogen Abuse Hallucinogen Intoxication Hallucinogen-Related Disorder, Not Otherwise Specified Inhalant Dependence Inhalant Abuse Inhalant Intoxication Inhalant-Related Disorder, Not Otherwise Specified Opioid Dependence Opioid Abuse Opioid Intoxication Opioid Withdrawal Opioid-Related Disorder, Not Otherwise Specified Phencyclidine Dependence Phencyclidine Abuse Phencyclidine Intoxication Phencyclidine-Related Disorder, Not Otherwise Specified Polysubstance Dependence Sedative, Hypnotic, or Anxiolytic Dependence Sedative, Hypnotic, or Anxiolytic Abuse Sedative, Hypnotic, or Anxiolytic Intoxication Sedative, Hypnotic, or Anxiolytic Withdrawal Sedative, Hypnotic, or Anxiolytic-Related Disorder, Not Otherwise Specified Other (or Unknown) Substance Dependence Other (or Unknown) Substance Abuse Other (or Unknown) Substance Intoxication 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 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 Att-A Statement of Work FY2014 Initial (5.6.13) Page 21 of 32 Attachment A (Cont.') 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 SAPT Block Grant funds may not be used for inpatient care. Data Collection and Reportinq The CA must account separately for expenses related to MIChild enrollees. Reporting of MIChild revenues and expenditures will be throudh 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 PECPM 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 Statewide Client Data System following the instructions in the data reporting specifications. 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 SBR 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 Att—A Statement of Work FY2014 initial (5.6.13) Page 22 of 32 Attachment A (Cont.') between MDCH and the P1HPs. Access must be expedited when appropriate based on the presenting characteristics of individuals. e. Adult Benefit Waiver Withholds of State Share Amounts ABW per member per month gross payments for ABW 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: e the projected annual beneficiary count per county (or city, in the case of Detroit) that is within a CA region and also within a P1HP region, multiplied by • 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 RER, the ABW column label reads "ABW Treatment." This is to clarify that only ABW expenditures for treatment services should be reported in this column, given that there may be ABW expenditures reported also for GA and AMS. If the CA has expended all of its ABW funds received from its PIHP(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 RER, Page 4, Section A. ABW 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 RER (Page 4, Section A. ABW [Treatment] column, Community Grant row). How to Report Expenditures for WSS- and ABW-eligible Women When a woman is eligible for both ABW and WSS funds, the woman's expenditures must be paid for with ABW funds. Report these expenditures Aft—A Statement of Work FY2014 Initial (5.6.13) Page 23 01 32 Attachment A (Cont.') on the RER, page 3, Section C. ABW, 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 ABW 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 ABW funds are available. "Available" includes ABW 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 ABW SUD program, the CA is prohibited from using any state-administered funds for covered treatment services to ABW 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/PIH P(s)" agreement(s). f. Intensive Outpatient Treatment – Weekly Format The CA may purchase Intensive outpatient treatment (10P) only if the treatment consists of regularly scheduled treatment, usually group therapy, within a structured program, for at least three days and at least nine hours per week. g. 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 Att—A Statement of Work FY2014 Initial (5.6.13) Page 24 of 32 Attachment A (Cont.') pediatric care must be approved, in writing, in advance, by the Department contract manager. 1. 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. 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. Requirements Regarding Providers 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. AU—A Statement of Work FY2014 Initial (5.6.13) Page 25 of 32 Attachment A (Cont.') Financial Requirements 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 Requirements 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 eligibility.. _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. For all services that qualify based on qualifying characteristics both of the women and of the provider, the HD modifier must be used (See SUD 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: Admission Priority Requirements Aft—A Statement of Work FY2014 Initial (4.15.13) Page 26 of 32 Attachment A (Cont.') Population Admission Requirement Interim Service Requirement Authority Pregnant Injecting Drug User 1) Screened and referred within 24 hours 2) Detoxification, Methadone or Residential .-Offer Admission within 24 business hours Other Levels or Care - Offer Admission within 48 Business hours Begin within 48 hours: 1. Counseling and education on: a) HIV and TB b) Risks of needle sharing . c) Risks of transmission to sexual partners and infants d) Effects of alcohol and drug use on the fetus 2. Referral for pre-natal care 3. Early Intervention Clinical Svc CFR 96.121; CFR 96.131; Treatment Policy #04 Recommended Pregnant Substance User 1) Screened and referred within 24 hours 2) Detoxification, Methadone or Residential -Offer admission within 24 business hours Other Levels or Care - Offer Admission within 48 Business hours Begin within 48 hours 1. Counseling and education on: a) HIV and TB b) Risks of transmission to sexual partners and infants c) Effects of alcohol and drug use on the fetus CFR 96.121; CFR 96.131: 2. Referral for pre-natal care 3. Early Intervention Clinical Svc Recommended injecting Drug User Screened and referred within 24 hours; Offer Admission within 14 days Begin within 48 hours - maximum waiting time 120 days 1. Counseling and education on: a) HIV and TB b) Risks of needle sharing c) Risks of transmission to sexual partners and infants 2. Early Intervention Clinical Svc CFR 96.121; CFR 96.126 . Recommended Parent at Risk of Losing Children Screened and referred within 24 hours. Offer Admission within 14 days Begin within 48 business hours Early Intervention Clinical Services Michigan Public Health Code Section 6232 Recommended All Others Screened and referred within seven calendar , ays. Capacity to offer Admission within 14 days Required CFR 96.131(a) - sets the order of priority; MDCH and CA contract Earmark-funded Special Projects: Reporting Requirements This reporting requirement applies to only four CAs: • Genesee County CMH, with respect to Flint Odyssey House • Macomb County CMH, with respect to Sacred Heart Rehabilitation Center • networkl 80, with respect to Hispanic Services program • Saginaw County Health Department, with respect to Saginaw Odyssey House Att—A Statement of Work FY2014 Initial (5.613) Page 27 of 32 Attachment A (Cont.') 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 "User Documents" via EGrAMS for this annual report form and form instructions. This report will be submitted via EGrAMS, 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. 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 (Ml) techniques. Aft—A Statement of Work FY2014 Initial 5.613) Page 28 of 32 Attachment A (Cont.') • 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 be 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 • 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. 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: • Final project and outcome report due no later than 4-30-14 (due to need for 6 month follow-up data on those served.) Aft—A Statement of Work Fy2014 Initial (5.13) Page 30 of 32 Attachment A (Cont.') Partnership for Success II (PFS II) (Applies Only to Agencies Who Have Allocations for this Program) The purpose of this grant is to strengthen and expand the SPF five-step, data-driven process in designated counties through enhancement of community-level infrastructure. This enhanced infrastructure will address underage drinking among persons age 12-20 and prescription drug misuse and abuse among persons age 12-25. The project is expected to: 1. Build emotional health, prevent or delay the onset of, and mitigate symptoms and complications from substance abuse related to underage drinking among youth age 12-20; and 2. Build emotional healthy, prevent or delay the onset of, and mitigate symptoms and complications from substance abuse related to reducing prescription drug misuse and abuse among youth and young adults age 12-25. All participating CAs received a Request for Information (RFI) document outlining the process for assessing community needs. Information from the RFI will be used by to develop and-completa-the Strategic Prevention Framework required. Report forms and instructions for deliverables are included in "User Documents" via EGrAMS. Required annual deliverables: 1. Request for Training and Technical Assistance 2. Strategic Plan, Cost Detail Schedule, and Program Budget Summary and Justification (must be submitted together) Project Requirements CAs will contract with coalitions in the high-need counties to build and enhance the current substance abuse prevention infrastructure to meet the goals of the project. This will be achieved through the strengthening of partnerships with federally qualified health centers (FQHCs), local public health departments (LPHDs), Indian Health Services (IHS) and community college and university health and/or counseling centers (CC&UH/CC). Based on the determined needs in the community, coalitions in each county or jurisdiction will select one of two approved evidence-based programs, Communities that Care or Community Trials, to strengthen these collaborative partnerships. As part of building this capacity, the expectation is that the coalition or a prevention provider will develop mechanisms to implement screening, brief intervention, and problem identification and referral at a primary health clinic. The FQHC, LPHD, IHS, or CC&UH/CC will then assist coalitions in identifying and referring appropriate individuals and families to participate in one of two evidence- based programs: Strengthening Families or Active Parenting for Teens: Families in Action. CAs will work with coalitions in the target counties/jurisdictions to assess data and capacity needs in order to implement the PFS II and achieve the goals of the project, including the need for training and technical assistance. One of the first steps in this process is to distribute a Request for Information (RFD. The RFI will be used for the CAs to identify, vet, and Att—A Statement of Work FY2014 Initial (5.6.13) Page 31 of 32 Attachment A (Cont.') select a coalition with the capacity to most effectively achieve the goals outlined in the PFS II grant. Role of the CA The CAs will be responsible for: 1. Organizing and convening the CEW and CSPPC partners and stakeholders for the purpose of implementing the PFS II project in the target county/jurisdiction. 2. Fostering community-wide and community-based collaborative among stakeholders and partners committed to addressing the priority problems. 3. Administrative activities and project management of PFS II funds including: a. Contracting and funding local training and technical assistance recommended by the CEVVs and CSPPCs. b. Selecting and contracting with coalition/provider to implement the project in the target county/jurisdiction. c. Monitoring CEW,-CSPPC, and provider progress. d. Preparing and submitting required financial and programmatic reports on PFS II program activity per contract requirements. 4. CAs will be required to convene a CEW that will conduct a county- level needs assessment utilizing local data derived from the SEOW. 5. Assisting the PFS II Evaluator in providing data services and technical assistance to programs reporting capacity, process, and outcome data. 6. CAs will work in collaboration with CSPPCS to develop a community- level and culturally competent Strategic Plan to implement the PFS II project. 7. CAs must submit a Request for Training and Technical Assistance form to BSAAS, with documented input of the CSPPC, CEW, and other stakeholders as appropriate. 8. CAs must submit a PFS II Strategic Plan to BSAAS with documents input of the CSPPC 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 assessment. 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 All—A Statement of Work FY2014 Initial (5.6.13) Page 31 of 32 Attachment A (Cont.') 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 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-th- 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. Aft—A Statement of Work FY2014 Initial (5.6:13) Page 32 of 32 Attachment B MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES ADMINISTRATION Financial Reporting Requirements Aft--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Attachment B.1 Financial Reporting Requirements Fiscal Year 2014 Table of Contents Page No. 1. REPORTING REVENUES AND EXPENDITURES 1 2. ADMINISTRATIVE BUDGETS AND EXPENDITURES Certificate of Cost Allocation Plan form 3 3. STATE AGREEMENT FUNDING CHANGE 4 A. Allocation Revision Request 4 B. Budge Revisions 4 4. REVENUES AND EXPENDITURES REPORT (RER): Initial and Final 5 A. Initial RER 5 B. Final RER 5 5. QUARTERLY FINANCIAL STATUS REPORT—SUBMISSION FLEXIBILITY 6 )). Deviation Allowance 6 6. NOTICE OF EXCESS OR INSUFFICIENT FUNDS (NEIF)—DUE JUNE 1 6 7. REVENUES 7 8. INITIAL OR FINAL ANNUAL BUDGET PLAN 7 9. REPORTING FEES AND COLLECTIONS 7 10. LOCAL MATCH—HOW TO BUDGET FEES/COLLECTIONS AND LOCAL FUNDS 8 > Match Computation Worksheet 8 11. MICHILD AND ABW SAVINGS 9 12. POSTING MEDICAID REVENUES THAT ARE TRANSFERS FROM A PIHP 9 Att—B1 Financial Reporting Reg TOG FY2014 Initial (7.15.13) Attachment B.1 Page No. 13. ADULT BENEFITS WAIVER 9 A. Withholds of State Share Amounts 9 B. How to Report ABW Revenues and Expenditures 9 C. How to Report Expenditures for WSS- and ABW-eligible Women 10 D. Use of State-administered Funds for ABW Enrollees 10 14. MICHILD 11 15. EARMARKED FUNDS 11 16. WOMEN'S SPECIALTY SERVICES—REQUIRED TARGET 12 17. PREVENTION ALLOCATION 13 18. SUDS TREATMENT ADMINISTRATION MINI REPORT 13 19. HOW TO REPORT GENERAL ADMINISTRATION 13 20. HOW TO REPORT ACCESS MANAGEMENT SYSTEM (AMS) 14 21. HOW TO COMPLETE THE MDCH ADMINISTRATION AND SERVICE COORDINATION REPORT 14 22. DISTRIBUTION 15 23. RETENTION 15 FINAL YEAR-END REPORTING 1. FINAL REVENUES AND EXPENDITURES REPORT 16 2. MAINTENANCE OF EFFORT (MOE) REPORT 16 2. RECONCILIATION OF FINAL REPORTS 18 3. DEFINITIONS 19 EQUIPMENT 1. EQUIPMENT INVENTORY SCHEDULE 20 Att-131 Financial Reporting Req TOC FY2014 Initial (5.6.12) ii SUDS Contract Agreement Attachment B.1 (cont.) Michigan Department of Community Health Financial Reporting Requirements Fiscal Year (FY) 2014 The reporting of revenues and expenditures will be accomplished via two avenues. For revenues and expenditures: an initial and a final Revenues and Expenditures Report (RER). For expenditures only: quarterly and final Financial Status Reports (FSRs). The MDCH must allocate and manage state-administered funds in a way that assures compliance with all federal and state requirements, including SAPT Block Grant expenditure requirements. Each CA will receive its initial FY allocation letter via EGrAMS. The letter will be available on-line after the initial FY Substance Use Disorder Services (SUDS) Agreement has been published in EGrAMS. Initial SUDS allocations are in compliance with all federal and state requirements at the beginning of the fiscal year. REPORTING REVENUES AND EXPENDITURES Revenues and Expenditures Report The main purposes and applications of the RER include the following: • Display revenue sources and expected amounts, and how these are budgeted at the start of a fiscal year; • Enable management and monitoring of federal and state spending requirements; and • Enable reconciliation of prepayments and expenditures on an annual basis. 2. ADMINISTRATIVE BUDGETS AND EXPENDITURES CA budgets and expenditures for Administration must be reasonable, prudent, and commensurate with meeting the requirements of this Agreement, consistent with 2 CFR Part 225 (previously OMB Circular A-87) or 2 CFR Part 230 (previously OMB Circular A-122), as applicable. The CA's Access Management System (AMS) is considered an administrative operation, and cannot be a direct service operation. To assure accurate classification of AMS expenditures and in the interest of reporting consistency, AMS expenditures must be reported separately on the initial and final RER, on Page 3, in the indicated column. All of the CA's administrative costs must be entered in the General Administration or the AMS column on page 3 of the RER. This includes costs for all CA personnel (Prevention Coordinators, Treatment Coordinators, etc.), information and data systems, financial audits, and other administrative costs. Aft--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 1 of 20 SUDS Contract Agreement Attachment BA (cont.) If the Administration budget contains a central cost allocation amount or rate, this allocation must have been developed consistent with 2 CFR Part 225 (OMB Circular A-87, Attachment C). Payments are subject to recovery, based on audit findings. When there is a central cost allocation, the CA must also submit via EGrAMS, on CA letterhead, a Certificate of Cost Allocation Plan whenever a central cost allocation is introduced or is revised, or every two years, whichever is sooner. This Certificate of Cost Allocation Plan form is available electronically (in WORD) from the MDCH contract manager or use the format shown below: Aft--B. Financial Reporting Requirements F12014 Initial (7.15.13) Page 2 01 20 SUDS Contract Agreement Attachment 5.1 (cont.) (Printed On CA Letterhead) Certificate of Cost Allocation Plan This is to certify that I have reviewed the Cost Allocation Plan and to the best of my knowledge and belief: (1) All costs included in this proposal to establish cost allocations or billings for October 1, 2013 through September 30, 2014 are allowable in accordance with the requirements of 2 CFR Part 225, "Cost Principles for State, Local, and Indian Tribal Governments", and the Federal award(s) to which they apply. Unallowable costs have been adjusted for in allocating costs as indicated in the Cost Allocation Plan, 2 CFR Part 225 can be found at the following link: http://www.whitehbuse.govisites/default/files/omb/assets/ombffedreg/2005/083105 a87.odf (2) All costs included in this proposal are properly allocable to Federal awards on the basis of a beneficial or causal relationship between the expenses incurred and the awards to which they are allocated -in -accordance-with-applicable requirements. Further, the same costs that have been treated as indirect costs have not been claimed as direct costs. Similar types of costs have been accounted for consistently. I declare that the foregoing is true and correct. CA Name: Signature: Name of Official: Title: Date of Execution: This Certificate of Cost Allocation Plan should be used for certification of the CA's Cost Allocation Plan. This form must be signed by the Executive Director or Finance Director of the CA. Aft--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 3 of 20 SUDS Contract Agreement Attachment B.1 (cont.) 3. AMENDMENTS A. State Agreementnulin Change When there is an increase, decrease, or transfer of funds in the CA's State Agreement allocation, an amendment must be processed via EGrAMS. Amendment requests must be submitted by the CAs contract manager in accordance to the following submission table. Amendments requests received following the final amendment submission date will not be processed. FY201 Amendment Submission Schedule Document Due Date - Effective Date Amendment #1 October 7,2013 November 4, 2013 Amendment #2 December 9, 2013 January 13, 2014 Amendment #3 February 10, 2014 March 10,2014 Amendment #4 April 7,2014 May 12, 2014 - Final Amendment June 20, 2014 August 4, 2014 B. Allocation Revision Request An Allocation Revision Request (ARR) is a request to transfer State Agreement funds between allocation categories, during the amendment application process. An ARR may only be used to move funds between Community Grant and Prevention and must not exceed the total State Agreement amount. To request an ARR, the CA must contact its Contract Manager, via email, with the rationale supporting its ARR. Once the ARR has been approved, the Contract Manager will then initiate the amendment process in EGrAMS. The MDCH will be receptive to approving ARRs, when 1) the CA can demonstrate that all applicable planning and agreement requirements can be achieved, perhaps through the use of other available resources, for all affected program and budget areas and 2) the MDCH can maintain compliance with federal and state requirements. With regard to redirection of Treatment funds, the CA must be able to demonstrate that treatment needs within the catchment area are fully met and that there is adequate capacity to meet drug court and offender re-entry initiatives as well. The associated rationale for ARRs that reduce Prevention allocations will be closely monitored by the CA's Contract Manager. The SAPT Block Grant requires states to spend at least 20 percent of these federal funds on Prevention activities. Aft--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 4 of 20 SUDS Contract Agreement Attachment BA (cont.) C. Budget Revisions A Budget Revision involves moving State Agreement funds between budgets within each allocation category. As an example-- Community Grant: General. Administration,_AMS, Treatment, Women's Specialty, and MIChild. A Budget Revision must not exceed the total allocation category or State Agreement amount. A Budget Revision can only be accomplished via an amendment. ALL AMENDMENTS MUST BE INITIATED BY MDCH STAFF ONLY. CAs CANNOT INITIATE AMENDMENTS IN EGrAMS. ANY PREPAYMENT MODIFICATION RESULTING FROM ALLOCATION OR BUDGET REVISIONS WILL BE REFLECTED IN THE MONTH FOLLOWING THE AMENDMENT EFFECTIVE DATE. 4. REVENUES AND EXPENDITURES REPORT (RER): Initial and Final The fiscal year initial and final RER will be used to provide a standardized format for reporting the financial status of individual programs. Reporting of revenues and expenditures must be consistent with Generally Accepted Accounting Principles (GAAP). All amounts entered on the RERs must be whole dollars. A. Initial RER The fiscal year initial RER is submitted with the initial, fiscal year SUDS Agreement application in EGrAMS. No State Agreement allocation changes will be allowed during this initial SUDS Agreement processing phase. In reviewing the fiscal year initial RER, the CA's Contract Manager will assess Local Match compliance, using the initial and final Match Computation tables completed by the CA as demonstrated in Attachment B.1; and included in the RER workbook. The Match Computation table is included in If at least 10% match is not achieved, the initial SUDS Agreement application will be rejected in EGrAMS. Once the match criteria is met, the initial SUDS Agreement application and initial RER will need to be revised and resubmitted for approval via EGrAMS. B. Final RER The fiscal year, final RER is submitted as an 'Attachment' report in EGrAMS. The due date is listed in Attachment C-Required Reports. Aft--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 5 of 20 SUDS Contract Agreement Attachment B.1 (cont.) Budgets on the final RER must be the same as those presented on the final fiscal year amendment. All actual expenditures and revenues (including Medicaid, Adult Benefits Waiver [ABM, MI Child, Local, Fees and Collections, and Other Contracts and Sources) for the particular program must be reported on the final RER. On the final RER, Community Grant expenditures for AMS, Treatment, Women's Specialty Services (WSS), Adult Benefits Waiver (Treatment) and MIChild are fungible, once required targets and match requirements are met. The CA is granted limited discretion in moving State Agreement expenditures between allocated categories without prior approval by MDCH. Under this discretion, $50,000 is the annual, maximum net change. In reviewing the fiscal year final RER, the CA's Contract Manager will assess Local Match compliance, using the Match Computation table demonstrated in Attachment B.1; and included in the RER workbook. If at least 10% match is not achieved, the fiscal year final RER will be rejected in EGrAMS, requiring revision and resubmission into EGrAMS. 5. QUARTERLY FINANCIAL STATUS REPORT--SUBMISSION FLEXIBILITY The Financial Status Report (FSR) is used to provide a standardized format for reporting the financial status of individual programs. All expenditures and revenue for the State Agreement are reported on the FSR. The FSR must be submitted to the Michigan Department of Community Health, Bureau of Finance through MI E-Grants, no later than the last day of the month following the end of each fiscal quarter. The fourth quarter FSR must be marked as final and is due sixty (60) days after the end of the Agreement. Deviation Allowance Within the State Agreement, there are several allocation categories; i.e., Community Grant, Prevention, SDA and FASD. When completing an FSR in EGrAMS, the system will allow a CA to post expenditures above the budgeted amount for that allocation category. The maximum allowance is $50,000, per allocation category. CAs have this reporting flexibility WITHIN each of the allocation categories but not BETWEEN each of the allocation categories. As an example, if a CA wants to report $25,000 more in Treatment expenditures than the Treatment budget, EGrAMS will accept this. That Att--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 6 of 20 SUDS Contract Agreement Attachment B.1 (cont.) would leave $25,000 available for a CA to use within the Community Grant allocation category. EGrAMS will not allow a CA to exceed the total State Agreement amount. If the expenditures will be greater than the $50,000 Deviation Allowance, the CA will need to contact its Contract Manager and request an amendment to revise the budget(s). 6. NOTICE OF EXCESS OR INSUFFICIENT FUNDS (NEIF)—DUE JUNE 1 Coordinating agencies must notify the Department in writing and upload the notice to 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, WSS 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 WSS 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. 7. REVENUES For State Agreement allocation categories, Revenues are as listed in the CA's initial allocation letter and subsequent amendments in EGrAMS. Each CA will receive its initial FY allocation letter via EGrAMS. The letter will be available on- line after the initial FY SUDS Agreement has been published in EGrAMS. For most other allocation categories, Revenues are estimates. In some cases, the CA may not be planning to expend all fiscal year Revenues. On the final RER for the fiscal year, actual revenues and expenditures must be reported. It is understood that, for non-State Agreement allocation categories, total actual expenditures may be less than total Revenues. Att--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 7 of 20 SUDS Contract Agreement Attachment B.1 (cont.) 8. INITIAL OR FINAL ANNUAL BUDGET PLAN There are links and formulas within the RER form which will automatically populate the _Local Match Computation table and all of the Composite Page, except for the Revenues Column (B). On the final RER for the fiscal year, 1) Actual revenues and expenditures must be reported; and 2) Budgets must be the same as those presented in the final fiscal year amendment. It is understood that, for non-State Agreement sources, total actual expenditures may be less than total planned budgets. 9. REPORTING FEES AND COLLECTIONS The MDCH/CA Agreement requires agencies to report actual fees and collections associated with services that the CA purchases. Expected revenues from fees and collections must be reported on the initial fiscal year RER. The final fiscal year RER must report actual revenues. If there is no expectation of revenue from fees and collections by the due date of the Initial RER, a footnote explaining the rational is required. The same is applicable if no revenues from fees and collections are collected by the due date of the Final RER. Some agencies reimburse providers net of co-pay amounts, whether or not the co-pays are actually collected by providers. Please do not report uncollected co- pay revenues. Report only the revenues actually earned. Food stamp revenue, in conjunction with residency, should be reported in Fees and Collections—Section F on the initial and final RERs. 10. LOCAL MATCH—HOW TO BUDGET FEES/COLLECTIONS AND LOCAL FUNDS Amounts for Local Match are reported in the initial and final RERs. Please be sure that the amounts entered meet Local Match criteria. The Substance Use Disorders Agreement (Attachment A) clarifies which fees and collections may count toward Local Match. The following Local Match Computation table is included in the RER workbook for initial and final completion. Formulas calculating each revenue category are embedded to assist in computing CA Local Match percentage: Att--B. Financial Reporting Requirements FY2014 Initial (7.15,13) Page 8 of 20 SUDS Contract Agreement Attachment B.1 (cont.) Match Computation — Must Be At Least 10% a. GRAND TOTAL (RER Composite) b. LESS: Section B, Medicaid subtotal Section C. ABW Gross subtotal Section D. MIChild subtotal Section G. Other Contracts & Sources (incl. direct Federal) $ c. TOTAL (Subtotal of b.) d. FUNDS SUBJECT TO MATCH (a. minus c.) e. MATCH FUNDS: Section E. Local Subtotal Section F. Fees & Collections Subtotal s_ f. TOTAL MATCH FUNDS (Subtotal of e.) g.. MATCH PERCENTAGE (f/d * 100 = 00.00%) 11. MICHILD AND ABW SAVINGS MIChild savings become Local funds in the fiscal year following the year in which the savings were earned. Savings should be entered in Section E. Local, Row 3- Other Local in the initial and final RER of the fiscal year following the year in which the savings were earned. The MIChild savings must be expended consistent with requirements in this Agreement, pertaining to State Agreement funds, to support the CA's substance use disorders program. The ABW savings should be treated according to the CA/Prepaid Inpatient Health Plan(s)' (PIHP) agreement(s). 12. POSTING MEDICAID REVENUES THAT ARE TRANSFERS FROM A PIHP Some CAs receive increased Medicaid revenues in the form of transfers from a PIHP, usually late in the fiscal year. Assuming these are current year PEPM funds, these revenues and associated expenditures should be entered on the final RER-Composite Page/Revenues Column (B). Att--B. Financial Reporting Requirements FY2014 Initial (7A5.13) Page 9 of 20 SUDS Contract Agreement Attachment B.1 (cont.) 13. ADULT BENEFITS WAIVER A. Withholds of State Share Amounts ABW per member per month gross payments for ABW 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 • the state share of the gross rate including use tax, multiplied by • the PIHP's geographic factor. B. 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 is included in the gross. On Page 4 of the RER, the ABW column label reads "ABW Treatment." This is to clarify that only ABW expenditures for treatment services should be reported in this column, given that there may be ABW expenditures reported also for GA and AMS. If the CA has expended all of its ABW funds (Gross) received from its PIHP(s) during the fiscal year, the CA may choose to use its Community Grant funds to purchase treatment services for ABW beneficiaries. Those expenditures would be reported on the RER, Page 4, Section A. ABW 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 RER (Page 4, Section A. ABW [Treatment] column, Community Grant row). Aft—B. Financial Reporting Requirements FY2014 Initial (T15.13) Page 10 of 20 SUDS Contract Agreement Attachment B.1 (cont.) When Community Grant funds are used to purchase treatment services for ABW beneficiaries, an explanation supporting this action must be provided on the ABW Year-End Balances report on page 8 of the RER. Due to new regional entity designation, existing PIHPs geographic regions may overlap more than one region. Therefore, reporting of ABW revenues and expenditures must be reported in two separate time periods: October 1 – December 31: Allocation of ABW funding from current PIHP January 1 – September 3: Allocation of ABW funding from new regional entity. C. How to Report Expenditures for 1NSS- and ABW-eligible Women When a woman is eligible for both ABW and WSS funds, the woman's expenditures must be paid for with ABW funds. Report these expenditures on the RER, page 3, Section C. ABW, 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). Report ABW funding used in support of WSS as WSS expenditures and not ABW. D. Use of State-administered Funds for ABW Enrollees ABW 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 ABW funds are available. "Available" includes ABW gross revenues (federal share and state share) received and not expended during the previous fiscal year. See the following paragraphs regarding CA/P1HP agreements. If the CA has NOT been delegated by one or more P1HPs the responsibility to manage the ABW SUD program, the CA is prohibited from using any state- administered funds for covered treatment services to ABW 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). All--B. Financial Reporting Requirements FY2014 initial (7.15.13) Page 11 o1 20 SUDS Contract Agreement Attachment B.1 (cont.) Any unexpended ABW Fund Balance remaining for the fiscal year should be treated according to the CA/PIHP(s)' agreement(s). 14. MIChild 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 consideration for accepting the federal funding pushed to the CA, the CA agrees to redirect existing State General fund dollars to match the MIChild federal FMAP funds (Title X)(I State Children's Health Insurance Program) and carry out the associated substance use disorder 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 M1Child capitation is not sufficient to serve the M1Child enrollees, use of state- allocated General Funds is allowed. Federal SAPT Block Grant funds may not be used for inpatient care. 15. EARMARKED FUNDS Special, earmarked funds will be identified in the CA's initial fiscal year allocation letter and subsequent amendments, as shown in EGrAMS. Earmarked funds may include Odyssey House, Hispanic Services Program, Sacred Heart, or other identified programs. The CA must budget separately these special earmarked . funds in the initial fiscal year SUDS Agreement application, the initial RER, subsequent amendments, and the final RER. When it has been determined that a CA Will not expend all special, earmarked State Agreement funds (including the earmarked allocations for the Odyssey programs), these unspent funds must be returned to the Department. If those unspent funds are Odyssey House (WSS) funds, the Department will reallocate the funds to other CAs who can appropriately use these funds for WSS programs within their CA regions within the current fiscal year. 16. WOMEN'S SPECIALTY SERVICES—REQUIRED TARGET Each CA's Women's Specialty Services (WSS) funds are combined with the Community Grant allocation. For the purpose of assuring statewide compliance with the SAPT Block Grant minimum expenditure requirement for Women's Specialty Services, each CA is given a minimum expenditure target for these services, as stated in its initial fiscal year allocation letter in EGrAMS. All program/services objectives related to Women's Specialty Services remain in place. The expenditure target can be reached through expenditures of a combination of SAPT Block Grant and state funds (Community Grant), State Disability Assistance, Medicaid state share, and ABW state share for specialty treatment services for eligible individuals. Eligible individuals are pregnant women, primary Aft—B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 12 of 20 SUDS Contract Agreement Attachment B.1 (cont.) caregivers with dependent children, or primary caregivers attempting to regain custody of their children. Use of federal and state funds must be consistent with applicable SUDS Agreement requirements. MDCH extends the five federal requirements 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 shall be made available to them. Attainment of the expenditure target and program/services objectives is a contract performance requirement. The target can be amended by mutual agreement. MDCH will not approve budget revisions or amendments that appear to create risk of failing to meet the Women's Specialty Services Maintenance of Effort. If an CA reports Medicaid and ABW funds for WSS on the initial and final RERs, the CA must post both Medicaid and ABW federal and state shares for WSS- not just the Medicaid and ABW state shares. The federal and state Medicaid and ABW Federal Medical Assistance Percentages (FMAP) percentages for each fiscal year will be updated, as needed, by MDCH on an annual basis or as rates change. As a check, when adding both Medicaid and ABW federal and state shares for WSS (budgets or expenditures), the total amount multiplied by the current-year state or federal Medicaid and ABW FMAP percent must be the amount posted in the CA's RER budget and final RER expenditures. EXAMPLE: FUND SOURCE BUDGET FINAL EXPENDITURES B. Medicaid 1. Current Year PEPM (Federal & State) 2. Federal share only for WSS $87,107 $69,383 3. State share only for WSS $44,594 $35,520 4. Reinvestment Savings B. Subtotal $131,701 $104,903 $131,701 x .3386 = $44,594 (state share for WSS budget) $104,903 x .3386 = $35,520 (state share for WSS expenditures) 17. PREVENTION ALLOCATION The Prevention allocation is 100% federal SAPT Block Grant. There are no separate allocations for Tobacco Vendor Education or Non-Synar Tobacco Aft--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 13 of 20 SUDS Contract Agreement Attachment B.1 (cont.) Retailers Inspections. CAs are expected to use their Prevention allocations to meet tobacco-related performance objectives and to accomplish other Prevention plans developed through the Annual Plan Guidelines. 18. SUDS TREATMENT ADMINISTRATION MINI REPORT (Bottom of Page 3) On the bottom of Page 3 is a mini report labeled "SUD Treatment Administration." This report contains links/formulas which automatically populate all three cells. The information provided here is needed by the Department in order to complete the annual SAPT Block Grant application. 19. HOW TO REPORT GENERAL ADMINISTRATION On Page 3, in Column C, enter expenditures charged to CA General Administration for each of the applicable funding sources (Column A). "Administration" includes the seven administrative functions listed and defined in the document entitled, "Establishing Administrative Costs Within and Across the CA System" (Attachment B.3). General Administration does not include AMS. (See below.) The Administrative Rules for the Substance Use Disorders Service Program prohibit CAs from providing services. Any activity or function that is carried out within the CA or that is allocated to the CA is considered an administrative activity or function, and expenditures must be reported as such. For example, all CA personnel expenditures for employees and contractors are administrative expenditures, including expenditures for Prevention Coordinators, Treatment Coordinators, and others. If a CA purchases administrative functions from a vendor or subrecipient, these contractual expenditures must be reported as CA administration. This would include audit services, data reporting functions, building maintenance, and so forth. Refer to the document entitled, "Establishing Administrative Costs Within and Across the CA System" (Attachment B.3). The administrative costs of service providers, whether vendors or subrecipients, are not counted as CA administrative costs. 20. HOW TO REPORT ACCESS MANAGEMENT SYSTEM (AMS) On Page 3, in Column E, enter expenditures charged to AMS functions for each applicable fund source (Column A). AMS functions are as described in Treatment Policy #07 — Access Management System, which may be found in the SUD Services Policy Manual. All AMS functions are administrative. The AMS column (category) can be considered a subcategory of Administration, for RER purposes. AMS budget and expenditures must be reported in AMS/Column E, whether the functions are carried out within the CA, by another entity, by a contractor, or by a combination of these. Aft--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 14 of 20 SUDS Contract Agreement Attachment B.1 (cont.) If a CA purchases AMS functions through a contractor, and if the contractor also provides direct services under the contract, expenditures associated with AMS functions are to be reported in AMS/Column E on the RER. Expenditures associated with services are to be reported in the appropriate services category column(s). 21. HOW TO COMPLETE THE MDCH ADMINISTRATION AND SERVICE COORDINATION REPORT This report has a sub-category of Administration called "Service Coordination." This captures the work and funds that CAs apply to activities that are administrative, but that may engender more direct benefit to the community. Service Coordination does not involve the delivery of direct services. Service Coordination may include activities conducted by CA employees or by contractors, but only includes activities that otherwise would be categorized as administration. Examples of Service Coordination: • collaborative planning with community stakeholders; • work with community coalitions; • development of new services and supports (such as recovery services); • developing media campaigns; • sustaining and expanding promising practices and methods; and • providing consultation and technical assistance regarding services. 22. DISTRIBUTION The initial RER (submitted with initial FY EGrAMS application) and final RER (submitted as an attachment in EGrAMS) should be prepared and distributed as follows; One Copy - An electronic or printed copy of each RER should be retained by CA. One Copy - Submitted electronically via EGrAMS at http://eqrams-mi.corn/dch. Submission of the RERs shall be in accordance with the instructions in Attachment C-Required Reports. 23. RETENTION All RERs should be retained for a period complying with the retention policies established in the SUDS Agreement. Att--B. Financial Reporting Requirements FY2014 Initial (7.15.13) Page 15 of 20 SUDS Contract Agreement Attachment B.1 (cont.) MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Final Year-end Reporting 1. FINAL REVENUES AND EXPENDITURES REPORT (RER) The final RER is due by January 31 following the end of the fiscal year. The form must be marked "FINAL" on the Face Page. The final RER will be used for final cost settlement purposes. Budgets on the final RER must be the same as those presented on the final amendment for the year. Final, year-end expenditures can be more than the corresponding budget, within the $50,000Discretionary Revision Allowance. On the final RER, Community Grant expenditures for AMS, Treatment (IP, OP, Case Management, Early Intervention, Recovery Support, Methadone, Detox, and Residential as listed on the Adm_AMS_Tx_Prev_WSS tab of the RER workbook), Women's Specialty Services (WSS), Adult Benefits Waiver (Treatment) and MIChild are fungible, once required targets and match requirements are met. The minimum Community Grant balance reported on the composite page must be equivalent to the MIChild carry-forward balance as reported on page 9 of the RER. The 'CA is granted limited discretion in moving State Agreement funds between allocated categories without prior approval by MDCH. Under this discretion, $50,000 is the annual, maximum net change. 2. MAINTENANCE OF EFFORT MOE) REPORT The MOE report is due by March 31 following the end of the fiscal year. Only state General Fund expenditures must be reported. MOE-related expenditures include: • The state Medicaid share of any reserves/savings/redirection to substance abuse services from the Medicaid benefit or other substance abuse prevention / treatment services (if prior-year savings were directed towards substance abuse services for the current fiscal year, the department must be notified of the source to ensure funds were not "counted" in previous years); • The state Medicaid share of any current fiscal year expenditures for substance abuse treatment that supplemented the substance abuse Medicaid benefit; and • Mental Health (MH) General Fund expenditures for integrated treatment/persons with co-occurring disorders. Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 16 of 20 SUDS Contract Agreement Attachment B.1 (cont.) With regard to expenditures for persons with co-occurring disorders, MH General Fund expenditures for clinical services addressing substance use disorders can be counted, including the state share of Medicaid. Generally, integrated clinical treatment is acceptable. It is also permissible to use a cost allocation method to determine the expenditures for services to persons with dual diagnoses that are specific to substance use disorders. All reported expenditures must withstand audit and meet standards for cost distribution, etc. Further information on the MOE criteria is given below, followed by detail on what expenditures will be counted. To meet the technical requirements for MOE inclusion: • Expenditures associated with the activity must be included in the CA's, CMH`s or PIHP's financial reporting documents (unless noted otherwise in the following); • The activity must be consistent with that described in the CA's • Action Plan; . • The activity must be a part of the CA's overall substance abuse treatment and prevention programming. HIV, EIP, and other communicable disease-related expenditures can be counted as well, if consistent with Block Grant requirements; and • The CA's, CMH's or PIHP's expenditures must be of General Fund dollars administered by or flowing through MDCH. To meet the accounting requirements for MOE inclusion, the expenditures must: • Be directly or indirectly authorized through a contract, grant award, Memo of Understanding (MOU), or other recognized instrument; • Be reported on Financial Status Reports (FSRs), financial reports, or other recognized method for documentation; • Be calculated consistent with Generally Accepted Accounting Principles; and Meet audit requirements. Once you have identified allowable MOE expenditures that meet the criteria outlined above, complete the MOE Activities and Expenditures form (found in EGrAMS under "User Documents"). For each type of expenditure, please provide the following: • Description of the activity/expenditure; • The title and contract number for reference, if associated with another contract with MDCH; • Expenditures for the previous FY; • Expenditures for the current FY; 9 Projected expenditures for the next FY 2014; Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 17 of 20 SUDS Contract Agreement Attachment B.1 (cont.) • "Location" of the expenditure information in the final FSR or expenditure report, as applicable; • Identification of the fund source; • Description of the cost allocation process to determine the expenditure amount, as applicable (central cost allocation amount or rate, for specified allocation must be developed consistent with 2 CFR Part 225 (OMB Circular A-87); and • Other information, comments, or attachments that explain the expenditure/activity. 3. RECONCILIATION OF FINAL REPORTS Financial information must be consistent and reconcile between the following final year-end reports: a. Legislative Report; b. Primary Prevention Expenditures by Strategy Report; c. Revenues and Expenditures Report (Final), including: 1. ABW Year-end Balance Worksheet; 2. MIChild Year-end Balance Worksheet; and 3. Administration and Service Coordination Expenditures Report. The CA is required to liquidate all accounts payable and encumbrances by December 31 (see definitions below). Exceptions may be granted for one-time obligations that cannot be liquidated within this time period. However, should this be the case, an additional fifteen (15) days may be provided if a written request for an extension, with the reason why additional time is needed, is submitted by the due date of the final RER. Please submit such requests to the CA's contract manager. Failure to meet these final reporting deadlines may result in the State's inability to reimburse the full amount of the State's share of the gross expenditures. ln addition to submitting initial and final RERs, other financial information will be requested to assist MOCK in properly closing the State's fiscal year (September 30). This information will help ensure sufficient funds have been reserved by the State to make reimbursement for the Agreement in the State's upcoming fiscal year. The additional financial information required will include an estimate of open commitments and obligations incurred as of September 30, but not yet paid. The MDCH/Accounting Division will provide detailed instructions for reporting additional financial information by mid-August of each year. Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 16 of 20 SUDS Contract Agreement Attachment B.1 (cont.) 4. DEFINITIONS Accounts Payable - Obligations for goods or services received, which have not been paid for as of the end of the agreement period. Encumbrances - Commitments at the end of the agreement period related to unperformed (executor) contracts for goods and services. Note: If an agreement does not end on September 30, it is still necessary to estimate accounts payable as of September 30. All inquiries regarding financial reporting issues should be directed to the Expenditure Operations Section of the MDCH/Accounting Division. References: Michigan Department of Management and Budget )=. Guide to State Government (1210.27) )=. Year-End Closing Guide Federal OMB Circular A-102 (Revised & DHHS Common Rule). Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 19 of 20 Quantity Item Name Item Specification Tag Number Purchased Amount Total $ 0 Attachment B.2 MICHIGAN DEPARTMENT OF COMMUNITY HEALTH GRANTS AND PURCHASING DIVISION EQUIPMENT INVENTORY SCHEDULE Please list equipment items that were purchased during the grant agreement period as specified in the grant agreement budget's cost detail schedule - Attachment B.2. Provide as much information about each piece as possible, including quantity, item name, item specifications: make, model, etc. Equipment is defined to be an article of non-expendable tangible personal property having a useful life of more than one (1) year and an acquisition cost of $5,000 or more per unit. Please complete and forward to this form to the MDCH contract manager with the fi nal progress report. Contractor Name: Contract #: Date: Contractor's Signature: Date: Att—B.1 Financial Reporting Requirements FY2014 initial (7.15.13) Page 20 of 20 Attachment B MICHIGAN DEPARTMENT OF COMMUNITY HEALTH BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES ADMINISTRATION Establishing Administrative Costs Within and Across the Coordinating Agency (CA) System December 2010 Att—B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Attachment 83 Establishing Administrative Costs Fiscal Year 2014 Table of Contents Page No. 1. Introduction and Overview. 1 2. Reporting Premise and Principles 3. Reporting and Models of CA-Provider Relationship 2 4. Administrative Functions 2 A. General Management 2 B. Financial Management 3 C. Information Systems Management 3 a Provider Network Management 5 E. Utilization Management 6 F. Customer Services 7 G. Quality Management 8 Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Attachment B.3 (cont.) 1. Introduction and Overview Requirements for reporting coordinating agency (CA) administrative costs are revised based on the findings and recommendations of a 2010 work group consisting of CA and State staff. Revisions focused most heavily on several . considerations: Reporting must be made consistent with federal and state requirements and with updated interpretations of requirements (such as the clarification that SAPT Block Grant cap on spending for administration being applicable only to the state agency). Consistency of cost reporting should be improved, with CAs including and excluding the same cost items. For example, all CAs should include Prevention Coordinator costs as administration. Improved consistency of reporting will lead to increased fairness and accountability with respect to administrative costs and comparing costs. CAs are prohibited by Administrative Rule (R 325.14213) from providing direct services. So, by implication, CAs costs are all administrative. However, CAs as a group devote considerable resources to developing, creating, and coordinating regional services. They also work at increasing regional support, both material and moral, for Substance Use • Disorders (SUD) services and for persons with SUDs and for reducing the costs of SUDs to the communities. While these are nominally administrative costs, CA will have the opportunity to report them as a sub-category of administration called Service Coordination. I. Reporting Premise and Principles The following premises and principles guide CA efforts to identify administration costs: • CA administrative cost reporting is required to be consistent with A-87 principles recognizing that there are various methods by which A-87 compliance may be achieved. • All organizations have administrative functions (and costs) irrespective of their status as a CA or direct service provider. These functions include: General Management, Financial Management, Information Systems, Provider Network Management, Utilization Management, Customer Services, and Quality Management. The methods by which administrative costs are allocated vary by organization. Att--B.1 Financial Reporting Requirements FY2014Initia1 (7.15.13) Page 1 of 10 SUDS Contract Agreement Attachment B.3 (cont.) • Differences in administrative costs are expected in that the CA organizational status varies; Michigan Department of Community Health (MDCH) reporting formats are intended to capture and account for these differences. • Some CAs are also Community Mental Health Services Program/Prepaid Inpatient Health Plans (CMHSPs/PIHPs) and as such have some costs that are unique to this status. As such, the intent of administrative reporting requirements is to: • Provide greater transparency of administrative costs using definitions that are common to health care organizations. • Provide comparable administrative cost information by fund sources other than Medicaid specialty services. Ill. Reporting And Models Of CA-Provider Relationship It is important to remember that if the activity is reportable as a service (i.e., there is an appropriate procedure code, as defined and included in the "Substance Abuse Encounter Reporting: HCPCS and Revenue Codes" document revised August 2011 from the SUD Services Policy Manual); then the cost for that activity is not an administrative cost IV. Administrative Functions The following seven (7) core functions have been identified as administration. The costs of these functions must be reported by CA, regardless of who carries them out. The terminology used below may not correspond with that used in individual CA; further, some CAs may consider components or sub-components identified within these categories to belong under a different category/function. If activity can be reported as an encounter, then the cost is excluded from administration costs — this is particularly relevant for access activities. It is also assumed that overhead expenses; such as, rent, travel, supplies, insurance, etc. are allocated in accordance with A-87. That is to say where such costs can be attributed to a direct service activity, it is included as overhead with that activity (i.e., as a cost attached to the service encounter). The administration costs would include its share of such expenses. A. GENERAL MANAGEMENT General Management consists of functions which do not fit elsewhere Many of these are executive or leadership functions, including: Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 2 of 10 SUDS Contract Agreement Attachment BZ (cont.) • The Chief Executive Officer (CEO) of the CA; • The Chief Operating Officer (C00), or equivalent staff position reporting to the CEO; • The CA Director; • The Medical Director; and • Human Resources office staff. Other General Management activities and costs include: • Activities to organize an affiliation governance structure and management structure; • Administrative support to executive office; • Legal support; • CA Board of Directors' costs; • Memberships and dues; and • Management and technical consultants provided general assistance to the Managed Care Entity. If the consultant's activities are directed at one of the other administrative functions, the cost should be included with that function. B. FINANCIAL MANAGEMENT Financial Management consists of: 1) the professes for managing revenues and expenditures in order to provide accountability to management and funders; 2) maximizing financial resources; and 3) maintain fiscal integrity. Financial Management is also a key function of an effective CA as a service provider. Critical components of financial management include: • Budgeting, General Accounting (Accounts Receivable, Accounts Payable, etc.), and financial reporting; • Revenue analysis; • Expense monitoring and management; • Service unit and consumer-centered cost analyses and rate-setting; • Risk analysis, risk modeling, and underwriting; • Insurance and re-insurance, management of risk pools; • Purchasing, administrative contracts, and inventory management; • Supervision of audit and financial consulting relationships; • Claims adjudication and payment; and • Audits. C. INFORMATION SYSTEMS MANAGEMENT Information Systems (IS) include processes designed to support management, administrative and clinical decisions with the provision of data and information and to support the accountability and information requirements of funders, regulatory bodies, consumers and communities. Att--B.1 Financial Reporting Requirements FY2014initial (7.15.13) Page 3 of 10 SUDS Contract Agreement Attachment B.3 (cont.) Components include hardware, software, specific applications and their integration, network configuration and connectivity. Telecommunications equipment, software, and management are often included. Information Technology (IT) refers to the hardware and connectivity - including individual workstations, laptops, servers, routers, and management of IS networks. Managing security requirements for access to the network is also included in IT, information systems also include the development and running of electronic health records Information systems within the CA system usually fall into two (2) categories: General Management and Service Support and Coordination. General Management: Information System General Management functions are those which support all other administrative functions. Service Support and Coordination: Information System Management functions support the direct provision of services and supports, including electronic health records (development and operating). Information System costs and cost allocations are handled in a variety of ways across the CAs. As such, there may not a consistent way to ascribe costs within General Management vs. Service Support and Coordination. The following are examples of CA General Management - IS activities/costs: • hardware, software and other devices for collection, storage, retrieval and reporting to the state which include demographic, service encounter, and performance indicators; • capacity to collect, verify, store and analyze fund source eligibility information; • the system for authorizing services to provider agencies; • the system of enrolling both network organizations and professionals into the software for credentialing and claims payment purposes; • the system for managing and processing claims for services across the provider network; • the system for processing payment to service providers; • systems to collect, analyze and act on data regarding the quality of services; • confidentiality and security sub-systems intended to protect integrity of data; • collecting information necessary to demonstrate compliance with the contract or with performance standards; and • MDCH reporting requirements, including the costs of reporting demographic, encounter, cost and performance indicators to MDCH by Att--B.1 Financial Reporting Requirements FY2014Initial (7.15.13)) Page 4 of 10 SUDS Contract Agreement Attachment B.3 (cont.) the CA. Administrative costs in performing reporting requirements may also include the costs associated with data validation and correction. D. PROVIDER NETWORK MANAGEMENT Provider Network Management encompasses activities directed at ensuring that qualified providers in sufficient number and variety are available to permit meaningful consumer choice and that the provider network is in compliance with regulatory requirements and the performance expectations of the CA. Providers include both organizations and individual professional practitioners providing clinical services or paraprofessionals providing supports to consumers. Although most providers are part of the provider panel, Provider Network Management activities may include off-panel provider management as well. All organizations and practitioners providing specialty supports and services to consumers are considered part of the network. Provider Network Management consists of the following components: • Network Development - This is the process of identifying consumer services and supports needs and procuring sufficient providers to meet those needs. Activities include: 1) needs assessment; 2) analysis of current network capacity to meet projected need and development of a "gap assessment" which identifies procurement needs; 3) procurement of providers; and 4) development of agreements with alternative payors or related agencies with a goal of coordinating care, such as with Department of Human Services (DHS), Michigan Rehabilitation Services (MRS), nursing homes, and schools. Contract Management - Activities include: 1) development of provider contract language; 2) negotiation of contracts; 3) monitoring providers for compliance with all aspects of the contract (NOTE — audits of providers' performance included under Quality Management); 4) conducting reviews for evidence of abuse and/or fraud; 5) sanctioning providers through Plans of Compliance or other means; 6) training network providers concerning performance expectations; and 7) managing contracts for consumer services with non—panel providers. Network Policy Development - This includes development of standards for participation in the provider panel. Operating and performance expectations are also included through this policy development function. • Credentialing, Privileging And Primary Source Verification - These functions may be part of Provider Network Management although frequently carried out by staff participating in Quality Management Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13)) Page 5 of 10 SUDS Contract Agreement Attachment 8.3 (cont.) (QM) or Utilization Management functions. These functions are carried out at both service delivery and administrative levels. The CA must, at least, verify the credentialing done at the service delivery level (direct run and contracted practitioners, contracted provider staff). E. UTILIZATION MANAGEMENT Utilization Management (UM) is a set of administrative functions that pertain to the assurance of appropriate clinical service delivery. Through the application of written policies and procedures, UM is designed to ensure: 1) that only eligible beneficiaries receive plan benefits; 2) that all eligible beneficiaries receive all medically necessary plan benefits required to meet their needs; and 3) that beneficiaries are linked to other services when necessary. Utilization Management consists of the following components: • Access And ,Eligibility Determination - This functional component includes both screening for clinical eligibility and financial eligibility determination Activities include: 1) development of access and eligibility policy and procedures; 2) initial contact with potential consumers (when not reported as an encounter); 3) initial screening (when not reported as an encounter); 4) collection of consumer-specific information; 5) verification of funding sources including determination of public funding status and first and third part liability; and 6) service referral, setting up first appointment if determined eligible. Utilization Management Protocols - This component is the development and monitoring of clinical and authorization protocols to be used for determining level of care (LOC) and service selection process. This includes protocols for: 1) determination of Medical Necessity, 2) LOC assessments; 3) service intensity or selection criteria; 4) Continuing Stay review; and 5) services requiring specialist review, best practice guidelines. • Authorization - This component is the process of linking LOG and service selection processes to payment processes. • Utilization Review - It should be noted that there may be overlap between UM and Utilization Review (UR). This component provides review/monitoring of individual consumer records, specific provider practices and system trends. Review of activities of the provider network is included. It may include: 1) review and monitoring to determine appropriate application of guidelines and criteria (LOC, service selection, authorization, best practice); 2) consumer outcomes; Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 6 of 10 SUDS Contract Agreement Attachment B.3 (cont.) 3) over-utilization or under -utilization; 4) review of outliers; 5) development of procedures for system-level data review; 6) policy and procedures regarding use of review documents; and 7) documentation and monitoring of UM/UR activities. F. CUSTOMER SERVICES The Customer Services function encompasses activities directed at the entire population of the CA's service area, including all services and supports to consumers. Some CAs have centralized these functions. Virtually all service providers provide customer services functions, as a part of the service delivery process, which should not be included in the cost of administrative functions. It should be noted that some CAs have begun using certified peers to provide customer services. As such, when providing that activity, the peer costs should be included as an administrative cost. Customer Services consist of the following components: Information Services - This component includes activities directed to the general population of the service area as well as to consumers of treatment and support services. This component includes: D general orientation to CA services (community meetings, informational brochures); D- consumer handbook; > operation of a telephone line and web site(s) in order to provide information about benefit plans and to respond to general inquiries; and D outreach activities to identify and establish communication with under-served groups. • Consumer Empowerment And Participation In CA Planning And Monitoring Activities - This component includes: D development of policy and implementation of activities designed to engage consumers, and other stakeholders, including members of the general public, in decision-oriented activities throughout the organization, including its provider network; and > training and orientation of stakeholders, especially consumers, to participate actively in advisory groups, task forces, working committees and other management related groups. • Customer Complaint, Grievance And Appeals Processes - Both formal and informal grievance and appeal mechanisms are Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 7 of 10 SUDS Contract Agreement Attachment B.3 (cont.). coordinated as part of the Customer Services function. This component includes: D Investigation and management of informal issues and grievances (Customer Services); D investigation and management of all formal grievances, appeals, and complaints, including local dispute resolution (Due Process, Recipient Rights); D Administrative Fair Hearings conducted by MDCH; and D formal tracking and coordination of Complaint Management processes, across the entire network. Community Benefit - This component consists of activities directed at the population of the entire service .area, or sub-groups of that population, rather than at identified individuals. It includes: D community collaborative activities. It focuses on activities designed to promote wellness and Healthy Communities as well as coordinated human services delivery systems of care; D provision of specialized educational and informational services to at-risk groups; D community emergency and group trauma services; D partnership arrangements with community organizations to provide a specialty health service perspective on issues of concern to the general population or sub-groups served by the organization; ). outreach activities and screening of the general population, or identified sub-groups, for health conditions such as depression, eating disorders, etc.; D cross training of, and specialized consultation with, school, jail, police, fire, church and other service personnel; D participation in community planning bodies, including the Human Services Coordinating Council, Indian Health Centers and other groups; D Jail Diversion; and D System of Care initiatives. G. QUALITY MANAGEMENT The Quality Management (QM) function encompasses activities directed at ensuring that 1) standards for staff, program and management performance exist; 2) compliance with them is assessed and 3) ongoing improvements are introduced, monitored and assessed with respect to their outcomes. Virtually all service provider organizations have QM programs. Some components of these QM activities are mandated for providers (such as Att--B.1 Financial Reporting Requirements FY2014 Initial (7.15.13) Page 8 of 10 SUDS Contract Agreement Attachment B.3 (cont.) regulatory management or corporate compliance, and accreditation). Unless specifically delegated by the CA or operated in the CA interests, these activities of provider organizations should not be identified as administrative functions or included in the costs. Some of the components identified below may reside in some CAs in UM. Quality Management consists of the following components: Standard Setting - This component includes review, analysis and recommendations concerning standards and measurement methodologies in the following areas essential to a continuous, quality improvement orientation: D- choice of accrediting body; D- best practice guidelines; D- assessment tools; and D- performance expectations for both clinical and management programs • Conducting Performance Assessments - This component includes both routine, periodic performance assessment and specially designed evaluation activities. Performance assessments and evaluations, as used here, are generally analyses of data submitted as part of regular management information requirements or as part of a special study. The results of both periodic and special performance assessments are provided to the CA's leadership team on a regular basis as part of the management decision-making process. Results of selected periodic assessments are made available to consumers and the community. Regulatory Management/Corporate Compliance - This component includes review of performance and clinical source documents and summary data conducted, or overseen, by CA staff for compliance with regulations of outside bodies, including the State of Michigan, Center for Medicare and Medicaid Services (CMS) and other federal regulatory bodies. Activities include: D. developing a compliance plan that focuses on regulations dealing with healthcare fraud and abuse; D maintaining current inventory of regulations; D conducting prevention activities; D providing direction to contractors regarding their responsibilities; D taking action when non-compliance issues are revealed; and D establishing a compliance-friendly environment, • Managing Outside Agency Review Processes - This component includes ensuring that source material is complete and available for reviews by outside bodies, including: Att--B.1Financial Reporting Requirements FY2014 Initial (7.15.13) Page 9 of 10 SUDS Contract Agreement Attachment B.3 (cont.) )=- Accrediting bodies; • MDCH certification reviews and financial audits; • External Quality Review (EQR); )=- licensing bodies; and • non-MDCH payer audits and reviews: CMS, Auditor General, Office of Inspector General (01G), etc. • Research — This component consists of research activities, including management of a research committee. Quality Process Facilitation - This component consists of activities aimed at continuous improvement of the processes by which agency and contractor business is conducted. It includes facilitation of activities related to management processes and technical assistance/facilitation of activities in contract agencies. Provider Education And Training And Quality Management Oversight - This component includes activities related to ensuring that contractors have and carry out their own quality management plan, as well as ensuring that a Quality Improvement Culture is developed and maintained within all clinical and management arenas. Att—B. Financial Reporting Requirements FY2014 Initial (7A5.13) Page 10 of 10 Attachment C MICHIGAN DEPARTMENT OF COMMUNITY HEALTH Required Reports Table Fiscal Year 2014 Att—C Required Reports Table FY2014 Initial (7.15.13) SUDS Contract Agreement Attachment C (cont.) Required Reports — Fiscal Year (FY) 2014 All reports listed here, unless otherwise noted, must be submitted via the Electronic Grants Administration and Management System (EGrAMS). There are three (3) types of reports: Statistical, Expenditure, and Attachment. Statistical and Expenditure Reports will be completed on-line. Attachment Reports will be uploaded to EGrAMS. The following table lists reports that the Contractor is required to submit to the Department under this Agreement. The table also indicates the time period covered by each report, the due date of each report, where to submit each report within the Department, and the source of instructions and specifications for completing each report. The contents of the table supersede any other communication of reporting requirements. Contractors are responsible for submitting all reports on time and per reporting instructions. Reports transmitted on or before the due date are considered timely. Reports that require an original signature should be mailed to the appropriate addressee(s) as listed at the end of Attachment C, with the transmission date determined by postmark or commercial carrier receipt. Required Reports Due Date Following Early Integration I If the FY14 SUDS CA contract agreement is terminated due to early integration,slue dates in the following chart are not applicable. All financial reports will be due sixty (60) days following termination. All other reports will be due ninety (90) days following termination. AU—C Required Reports Table FY2014 Initial (7.15.13) Page 1 of 4 SUDS Contract Agreement Attachment C (cont.) Required Reports — Fiscal Year (FY) 2014 Document Title/Data Submissions Time Period Covered Due Date Where to. Submit Instructions Audit Report FY 2014 9 mths after Close of fiscal year Office of Audit (See last page of Attachment C) Contract Part II Charitable Choice Report FY 2014 August 16, 2014 EGrAMS- Att. Report User Documents in EGrAMS Communicable Disease (CD) Provider Information Plan (Plan must be submitted only if CA funds CD services.) FY 2014 Same due date as CA's Annual Plan With 1 year implementation plan User Documents in EGrAMS Communicable Disease Provider Information Report (Report must be submitted only if CA funds CD services.) FY 2014 60 days following end of FY Email to: mcich- User Documents in EGrAMS bsaas@michiean.00v Encounter Reporting via H1PAA 837 Standard Transactions Mthly, as svos are provided. Mthly (minimum 12 submissions per year) Via DEG to MDCH /MIS Operations (See last page of Attachment C) SUD Services Policy Manual Financial Status Report — 1 st thru 3rd Quarters Qrtr — Oct-Dec; Jan.31, April 30, and July 31 (Last day of the mth, following the end of the qtr) EGrAMS — Expenditure Report User Documents in EGrAMS Financial Status Report — 41" Quarter/Final FY 2014 Nov. 30, 2014 EGrAMS — Expenditure Report User Documents in EGrAMS Injecting Drug Users 90% Capacity Treatment Report Qrtr- Oct-Dec; Jan.31, April 30, July 31, and Oct, 31 (Last day of the rnth., following the end of the qrtr) EGrAMS — Att. Report User Documents in EGrAMS Legislative Report/Section 408 FY 2014 Jan.31, 2015 EGrAMS — Att. Report Instructions are issued by 12/ 10 annually. Att--C Required Reports Table FY2014 Initial (7.15.13) Page 2 of 4 SUDS Contract Agreement Attachment C (cont.) Required Reports — Fiscal Year (FY) 2014 Document Title/Data Submissions Time Period Covered Due Date • Where to Submit Instructions & Specifications Mental Health and Substance Use Disorder Services Integration Status Report FY 2014 • Jan.31, 2015 EGrAMS- Att. Report User Document in EGrAMS Michigan Prevention Data System (MPDS) Mthly Last day of the mth. following the mth. In which the data was uploaded vvww.sudpds.com SUD Services Policy Manual ' Maintenance of Effort (MOE) Report Annual March 31, 2015 EGrAMS- Aft. Report User Documents in EGrAMS Notice of Excess or Insufficient Funds FY 2014 June 1, 2014 EGrAMS — Att. Report User Documents in EGrAMS Preliminary Closeout Report (REREXP-Obligation) FY 2014 Sept. 2014 Determined by OMB, in Aug.t, at year-end closing. EGrAMS — Expenditure Report • User Document i n EGrAMS Primary Prevention Expenditures by Strategy Report FY 2014 Jan.31, 2014 EGrAMS —. Aft. Report User Documents EGrAMS Priority Populations Waiting List Deficiencies Report Mthly End of the mth. following the mth in which the exception occurred (must submit even if no data to report) EGrAMS — . Statistical Report User Documents in EGrAMS Revenues and Expenditures Report (RER) including ABW, MIChild, & Admin/Service Coord. Worksheets— Initial FY 2014 Submit with the initial FY contract app. via EGrAMS. EGrAMS — Att. Report User Documents in EGrAMS Revenues and Expenditures Report (RER) including ABW, MIChild, & Admin/Service Coord. Worksheets— Final FY 2014 Jan.31, 2015 EGrAMS — Aft. Report User Documents in EGrAMS SBIRT Data Collection and Reporting Qrtr- Oct-Dec Apr. 30, 2014& Oct. 31, 2014 EGrAMS- Aft. Report User Documents in EGrAMS Sentinel Events Data Report (residential treatment only) Qrtr- Oct - Dec Apr. 30, 2014& Oct 31, 2014 (mth end after 2nd & 4th qrtrs) EGrAMS — Att. Report User Document in EGrAMS Att—C Required Reports Table FY2014 Initial (7.15.13) Page 3 of 4 SUDS Contract Agreement Attachment C (cont.) Required Reports — Fiscal Year (FY) 2014 Document Title/Data Submissions. Time Period Covered . _ Due Date_._ Where to — Submit -;1 Instructions & Specifications Special Projects, Earmark-funded: Flint Odyssey House Hispanic Services Sacred Heart Rehab Center Saginaw Odyssey House (Applies Only To Agencies VVho Have Earmarked Allocations For These Programs) FY 2014 Jan.31, 2015 EGrAMS – Att. Report I User Documents in EGrAMS Tobacco/Formal Synar – Youth Access to Tobacco (YTA) Compliance Checks Report February 1-28, 2014 , March 15, 2014 EGrAMS – Att. Report Instructions e-mailed in June 2014 Tobacco Retailer Master List Updates Annual Nov. 30, 2014 EGrAMS – Att. Report User Documents in EGrAMS Treatment Episode Data Set (TEDS) Mthly Last day of each nnth. Via DEG to MDCH /MIS Operations (See last page of Aft C) SUD Services Policy Manual I Women's Specialty Services Report FY 2014 Nov. 30, 2014 EGrAMS – Att. Report User Documents in EGrAMS Youth Access to Tobacco Activity Annual Report FY 2014 Oct. 31, 2014 EGrAMS – Aft. Report User Documents in EGrAMS To submit via DEG to MDCH/MIS Operations-- Client Admission and Discharge Client records must be sent electronically to: Michigan Department of Community Health Michigan Department of Technology, Management & Budget Data Exchange Gateway (DEG) For admissions: put c:14823 4823@dchbull For discharges: put c:14824 4824@dchbull To send to the Office of Audit-- Required audit materials or the Audit Status Notification Letter must be submitted by e-mail to MDCH at MDCH-AuditReports@michioan.00v. 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. MDCH reserves the right to request a hard copy of the audit materials if for any reason the electronic submission process is not successful. Aft--C Required Reports Table FY2014 Initial (7.15.13) Page 4 of 4 Attachment D REPORTING REQUIREMENTS Charitable Choice Report—February 2011 Communicable Disease (CDFProvider Information Plan/Report—January 2012 (Applies Only to Agencies That Chose to Continue to Fund CD Services.) fnjecting Drug Users 90% Capacity 4reatment Report/Instructions—August 2008 Mental Health and pubstance Use Disorder ervices fntegration ptatus Report/Instructions—April 2012 Primary prevention Expenditures by ptrategy Report/Instructions—August 2005; Revised February 2012 Priority Populations Waiting List Deficiencies Report/Instructions—August 2005; Revised January 1I 2006; devised April 2010 6entinel ( vent Reporting Guidance—Revised August 2007 ppecial Projects Report: Earmarked,Funded—( ffective 2 ctober 1, 2007; Revised dune 2009 (Applies Only To Agencies Who Have Allocations For BSAAS-identified, Statewide Programs) pubstance Use Disorder pervices Entity Inventory Report/Instructions—August 2010; Revised February 2012 'Ioloacco Retailer Master List Updates/fnstructions—( ffective 2 ctober 1, 2007; Revised August 2011 : omen's 6 pecialty 6ervices Report/lnstructions—Revised August 2009; February 2012 Youth Access to obacco Activity Annual Report—August 2005; Revised June 2009 Att—D Reporting Requirements Initial FY2014 (10.11.13F FISCAL NOTE (MISC . #13307) December 12, 2013 BY: FINANCE COMMITTEE, TOM MIDDLETON, CHAIRPERSON IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - 2013/2014 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 $4,655,787. 2. The previous year's 2012/2013 award was $4,675,503, for a total decrease of $19,716 in funding. 3. A grant match estimated at $679,121 is required based on the entire FY 2014 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 $5,334,908. 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, 2013 through September 30, 2014. 7. The Fiscal Year 2014 Special Revenue Budget is amended as follows: Expenses 1060261-133405-730373 1060261-133950-702010 1060261-133950-722740 1060261-133950-730366 1060261-133950-730926 1060261-133960-702010 1060261-133960-722740 1060261-133960-730366 1060261-133960-730926 1060261-134790-702010 1060261-134790-722740 1060261-134790-730366 1060261-134790-730373 1060261-134790-730926 1060261-134795-702010 1060261-134795-722740 1060261-134795-730366 1060261-134795-730926 1060261-134796-702010 Contract Svs. Salaries Fringe Benefits Contract Adm. Indirect Costs Salaries Fringe Benefits Contract Adm. Indirect Costs Salaries Fringe Benefits Contract Adm. Contract Sys. Indirect Costs Salaries Fringe Benefits Contract Adm. Indirect Costs Salaries FY2014 Adopted $3,885,028 790,475 $4,675,503 $ 521,511 29,939 1,368 4,705 4,206 42,259 12,186 6,057 5,951 170,731 91,465 37,325 2,886,237 23,988 125,109 77,311 12,804 17,578 63,151 FY2014 Adjustment ($ 145,861) 126,145 $ (19,716) $ 68,638 0 21 ( 2,950) 282 ( 772) ( 1,052) 383 0 0 ( 1,267) ( 79,617) 1,605 ( 6,716) ( 270) ( 400) 169 0 FY2014 Amended Budget $3,739,167 916,620 $4,655,787 $ 590,149 29,939 1,389 1,755 4,488 42,252 11,414 5,005 6,334 170,731 91,465 36,058 2,806,620 25,593 118,393 77,041 12,404 17,747 63,151 HEALTH MDPH OSAS (Fund 28249) Budget Reference 2013 / GR0000000203 Revenues 1060261-134790-610313 Federal 1060261-134790-615571 State Total Revenues FINANCE COMMITTEE VOTE: Motion carried unanimously on a roll call vote with Scott and Matis absent. 1060261-134796-722740 Fringe Benefits 1060261-134796-730366 Contract Adm, 1060261-134796-730926 Indirect Costs 1060261-134800-702010 Salaries 1060261-134800-722740 Fringe Benefits 1060261-134800-730366 Contract Adm. 1060261-134800-730926 Indirect Costs Total Expenses 44,906 2,104 8,873 233,619 176,545 42,752 32,823 $4,675,503 0 904) 593 0 0 352 2,196. $ (19,716) 44,906 1,200 9,466 233,619 176,545 43,104 35,019 $4,655,787 Resolution #13307 December 12, 2013 Moved by Spisz supported by McGillivray the resolutions (with fiscal notes attached) on the amended Consent Agenda be adopted (with accompanying reports being accepted). AYES: Dwyer, Gershenson, Hatchett, Hoffman, Jackson, Long, Matis, McGillivray, Middleton, Quarles, Runestad, Scott, Spisz, Taub, Weipert, Zack, Bosnic, Crawford. (18) 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). 4-1—//.6/ I HEREBY APPROVE THIS RESOLUTION CHIEF DEPUTY COUNTY EXEOUTIVE ACTING PURSUANT TO isliCL 45.559A (7) STATE OF MiCHIGAN) COUNTY OF OAKLAND) I, Lisa Brown, 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 December 12, 2013, 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 12th day of December 2013. Lisa Brown, Oakland County